\n<\/p>\n
Editor’s Note: This article is a reprint. It was originally published June 30, 2024.<\/em><\/strong><\/p>\n
<\/p>\n I interviewed Dr. Ahvie Herskowitz, former clinical professor of medicine at the University of California, San Francisco, and founder of Anatara Medicine, a multidisciplinary integrative center in San Francisco.1<\/span><\/sup> Herskowitz, an internist, has a deep foundational knowledge and science background that\u2019s ideal for treating complicated health care cases.<\/p>\n
<\/p>\n We may be collaborating on a project in the future, but in the meantime at his center, they\u2019re using advanced techniques to help people restore their health, including strategies for longevity and treatments for very ill patients, including those with autoimmunity, gut problems, cancer, and more.<\/p>\n
<\/p>\n
<\/p>\n Herskowitz treats illness by looking at the foundational causes of disease. We discussed that a leading cause of death is, in my view, endotoxemia resulting in septic shock. This occurs when you secrete endotoxin from facultative anaerobes, otherwise called oxygen-tolerant bacteria, which shouldn’t be in your gut.<\/p>\n
<\/p>\n These pathogenic bacteria secrete a very virulent form of endotoxin, also known as lipopolysaccharides (LPS), which cause inflammation if they translocate across the compromised gut barrier into the systemic circulation. Leaky gut, or a disturbed microbiome, is considered by Herskowitz to be one of the foundational contributors to chronic disease.<\/p>\n
<\/p>\n Herskowitz explains, \u201cI think that everyone that’s doing poorly and failing to thrive has a biome issue and a leaky gut issue, almost 100% \u2026 And in the standard allopathic intensive care units, it’s not considered a foundational issue.\u201d When Herskowitz treats cancer patients, he says, they\u2019re often in a state of failure to thrive.<\/p>\n
<\/p>\n \u201cThey’ve gotten so burdened by so many different layers of toxicity, that their system cannot keep up anymore enough,\u201d he says. \u201cAnd \u2026 that’s eventually due to mitochondrial failure throughout the body.\u201d<\/p>\n
<\/p>\n
<\/p>\n Chronic diseases often result from a buildup of toxicities and a lack of nutrition and healing in the body to compensate for them. \u201cAll these toxicities affect every cell of the body simultaneously,\u201d Herskowitz says.<\/p>\n
<\/p>\n \u201cSo, we all have relative strengths and weaknesses. And that comes up as to what organ is going to be the most involved. But we all have to almost decide whether we’re going to release these toxins on a day-to-day basis, otherwise our concept of longevity is going to be badly estimated.\u201d<\/p>\n
<\/p>\n Herskowitz estimates that 80% to 90% of the U.S. population has metabolic syndrome, which increases the risk of heart disease, stroke, and Type 2 diabetes. Obesity is another epidemic. Both are due to several factors, including toxicity that started more than 50 years ago as the food supply became increasingly processed. Herskowitz explains:<\/p>\n
<\/p>\n \u201cThis is where you get to the concept of an infinite number of toxicities, feeding a system that only has a finite way of cellular responses \u2026 it’s the seed oils [containing] linoleic acid<\/a>, it’s the ultraprocessed foods and snacks. So, when you go to a general store today \u2026<\/em><\/p>\n<\/blockquote>\n
<\/p>\n The overwhelming majority of the food that’s sold there is not to be for human consumption \u2026 and then the concept of our farming system has evolved toward efficiency\u00a0\u2026 listen, industry is not our friend. It’s not our partner \u2026 their job is to sell more stuff, and to do so in an efficient way.<\/em><\/p>\n<\/blockquote>\n
<\/p>\n \u2026 I watched it over 45 years, I mean, \u201870s, \u201880s, 90s, this stuff is getting worse. Now the most difficult group to get an appointment with in the hospital is not the cardiology department, because it’s usually the largest department, but it’s endocrine and rheumatology, neurology.\u201d<\/em><\/p>\n<\/blockquote>\n
<\/p>\n In other words, exposure to ultraprocessed foods and other toxicities is wreaking havoc in the body, leading to widespread chronic disease. \u201cIt causes havoc within the communications network, so that hormones go awry, inflammation goes awry and the detoxification system is overwhelmed,\u201d Herskowitz explains.<\/p>\n
<\/p>\n \u201cThis leads to all the different disorders \u2026 it’s a straightforward thing \u2026 you have this nutrient depletion, which obviously \u2026 you’re more susceptible to everything. And then each of us is reaching our limit, so to speak.\u201d<\/p>\n
<\/p>\n
<\/p>\n Herskowitz often sees patients when they\u2019re very ill \u2014 but they don\u2019t start out this way. He often looks back into their medical records over 25 years to see their past medical history. People who end up with serious diseases like Alzheimer\u2019s disease often have far more \u201cnuisance symptoms\u201d over the years. This includes symptoms such as toenail fungus, indigestion, occasional diarrhea, hyperactivity or even high blood pressure.<\/p>\n
<\/p>\n In Herskowitz\u2019s experience, his Alzheimer’s patients had 2.5 times more nuisance symptoms compared to a control group that didn’t have Alzheimer’s. This reflects Herskowitz\u2019s own clinical observations from his practice, not a peer-reviewed published study. \u201cIt’s consistent with this toxicity type of concept,\u201d he says. \u201cWhen you’re toxic, you have all these little things going on, and you don’t pay attention to them, because they’re not severe.\u201d<\/p>\n
<\/p>\n However, they\u2019re clues that something is off balance in your body, which can likely be addressed in the early stages. Unfortunately, most physicians aren\u2019t looking for these types of systemic problems.<\/p>\n
<\/p>\n
<\/p>\n One of the challenges facing longevity medicine is figuring out what to measure in order to get an idea of how old you really are \u2014 meaning your biological age, which is how well your body is functioning compared to your chronological age, the actual number of years you’ve been alive. Biological age can be younger or older than your chronological age depending on your lifestyle, environmental factors, and genetics.<\/p>\n
<\/p>\n Herskowitz believes oxidative stress is one useful measure to show where you are in a given moment in time over time. At his center, they use a urine test called 8-hydroxy-2-deoxyguanosine (8-OHdG) as a biomarker for oxidative damage and they use the lipid peroxides as a marker. He also uses tests to measure chronic immune function, mitochondrial function, and senescent cells.<\/p>\n
<\/p>\n Senescent cells are cells that have stopped dividing and entered a state of permanent growth arrest without undergoing cell death. These cells can no longer replicate, but they remain metabolically active.<\/p>\n
<\/p>\n Senescence is a natural part of the cellular lifecycle and serves as a mechanism to prevent the proliferation of damaged cells, which leads to cancer. However, the accumulation of senescent cells over time contributes to aging and various age-related diseases. According to Herskowitz:<\/p>\n
<\/p>\n \u201c[We look for] concepts of the subtlety of how the immune system is being suppressed. And it’s not the current CBC [complete blood count]. It’s more on the chronic side. So how does it deal with biological toxins? And that’s more a journey into the complement immune cascade, which deals with chronic infection, chronic biological toxins and how to deal with it.<\/em><\/p>\n<\/blockquote>\n
<\/p>\n So, measures of complement cascades for autoimmunity as well. And then probably the biggest one, other than mitochondrial function and oxidative stress, to me is if we can measure the number of senescent cells we have in our body at any time. The higher it is, the worse you’re doing.\u201d<\/em><\/p>\n<\/blockquote>\n
<\/p>\n Herskowitz also uses markers of metabolic pathways that measure glucose metabolism. \u201cIt’s not as simple as glucose,\u201d he says. \u201cIt’s more inflammatory\/metabolic\/hormonal,\u201d or the fact that patients are so nutrient deficient that their system isn\u2019t generating sufficient energy. Further, on a day-to-day basis, Herskowitz uses serum ferritin level<\/a> as an important marker of health.<\/p>\n
<\/p>\n I have also long stated that serum ferritin, which measures stored iron, is one of the most important tests that<\/a> everyone should have done on a regular basis as part of a preventive, proactive health screen.<\/p>\n
<\/p>\n
<\/p>\n Meanwhile, Herskowitz described an innovative test for tumors that helps improve treatment decisions. Many people with cancer capitulate to taking chemotherapy, either because of fear, their own choice, or direction from loved ones or their oncologist.<\/p>\n
<\/p>\n Many alternative practitioners treating cancer patients say their biggest challenge is the fact that virtually no one comes to see them before they take chemotherapy, which they believe can compromise their body\u2019s healing abilities.<\/p>\n
<\/p>\n Herskowitz, who uses antioxidants, nutrition, photobiomodulation, intravenous therapies, and other strategies for cancer, details a test he believes may change the way chemotherapy is given in the U.S.:<\/p>\n
<\/p>\n \u201cThere’s a new innovation you should be aware of. And that’s taking a slice of the tumor itself on the biopsy side, articulating the various genomic mutations, and looking for the same genomic mutations in the peripheral blood. Now, it’s not a new generation of circulating tumor cell counts, and this is all different generation. So, the goal here is, say, I’m on chemo.<\/em><\/p>\n<\/blockquote>\n
<\/p>\n I don’t want to be on it, unless it’s working. Whether it’s high-dose chemo, or even low-dose chemo, I want it to be working on my behalf. And unless these markers are going down, I’m going to switch. I can tell my oncologist to switch because the genomic data are universally accepted by any oncologist in any university setting.<\/em><\/p>\n<\/blockquote>\n
<\/p>\n And I think that’s going to change the way chemotherapy is given in the United States over time. These are approved tests for advanced cancers, and now they’re moving to get approvals for all cancers of any kind.\u201d<\/em><\/p>\n<\/blockquote>\n
<\/p>\n
<\/p>\n In his decades of clinical experience, Herskowitz says he\u2019s seen our overall capacity for cellular function becoming less efficient. \u201cPracticing now is just different,\u201d he says. For instance, less than 2% of the population used to have autoimmunity, but now he believes it\u2019s somewhere between 10% and 20% \u2014 and we could be reaching a tipping point.<\/p>\n
<\/p>\n \u201cI don’t know where we’re going to be in 10 years \u2026 people are still functioning, which is remarkable\u00a0\u2026 [but] I think that we’ve lost most of our reserves. Our reserve function is relatively gone. So, maybe more than 50% of our reserve function has now gone over the last four decades,\u201d he says, referring to not only biological resiliency but also metabolic and mitochondrial function. Fortunately, there\u2019s still hope to turn health around.<\/p>\n
<\/p>\n \u201cMitochondrial biogenesis is possible, at some point, so I think we still have a lot of hope that right now we can reverse by going clean. And the cleaner you go, the better you’ll feel anyway,\u201d Herskowitz explains. The fact is, your body has unbelievable resiliency provided you identify what\u2019s causing your problems and address it, including by eliminating ultraprocessed foods from your diet and reducing your exposure to other toxicities.<\/p>\n
<\/p>\n You can find out more about Herskowitz\u2019s strategies for longevity and chronic disease at his website Anataramedicine.com<\/a>. As mentioned, we’re going to be working together in the future so Herskowitz can further direct his knowledge and insights into correcting the faults in the system. He adds:<\/p>\n
<\/p>\n \u201cI can tell you one thing. I’ll end it like this. There’s a lot of secrets going on, there’s a lot of mystery. There’s a lot of things we don’t know very much about. And the worst thing a doctor can do is have an arrogant attitude. They understand everything. And I think that as long as we remain open and honest now, and remain lifelong learners, we will all be in better shape.\u201d<\/em><\/p>\n<\/blockquote>\n
<\/p>\nMicrobiome Issues, Leaky Gut Linked to Failure to Thrive<\/h2>\n
Patients Overwhelmed by Toxicity and Nutritionally Depleted<\/h2>\n
\n
\n
\n
Why You Should Pay Attention to \u2018Nuisance Symptoms\u2019<\/h2>\n
Tests to Measure How Old You Really Are<\/h2>\n
\n
\n
Innovative Test for Cancer Treatment<\/h2>\n
\n
\n
\n
Cellular Function Is Becoming Less Efficient<\/h2>\n
\n