Prevention is truly better than cure. And what better way to prevent sickness than to know what is healthy and what is not. But with all the delicious options with undisclosed effects. It's easy to fall into the unhealthy path. In this episode, the owner of Innovative Health & Wellness Center, Dr. Cindy Howard talks about the importance of educating ourselves on what eating healthy means and their unique model of treatment focused on patients’ individuality in order to determine the treatments that will encourage each individual body to heal itself. Tune in to find out more about their integrated and holistic approach to healing.
I have Dr. Cindy Howard of the Innovative Health & Wellness Center. Thank you, Dr. Howard, for being here.
It's great to have you here. Do you see like I'm hosting the show? It is fantastic to be here. That's what happens after a long day of treating patients.
Tell us a little bit about where you are, what you're doing, certifications. Medicine is certainly evolving. We'd love to hear a little bit more about what you're doing.
Several years ago, I completed chiropractic school, and decided I wanted to be a little more broad-based and all encompassing. I went through a lot more education and got what we call a Diplomate in Internal Medicine and Nutrition. As a result of that, I've run a broad-based practice. The way I describe it is anything you would have gone to see your general practitioner for, we do here at Innovative, except we don't do any prescription meds and any surgery. Also, Illinois will not allow us to deliver babies. Those three things are off the table. Everything else is pretty much fair game. That's how we practice.
You mentioned Illinois. Where are you in Illinois?
I'm in the Southwest suburbs, Orland Park. We're about 25 miles out of Chicago. I'm licensed here in Illinois. I'm also licensed and practice occasionally in Florida as well.
Especially during winter, right?
Yeah. That humidity out there is just enough to send me back even sometimes in the cooler months.
This is interesting too. As a chiropractor, when you went back for additional education, how much time did you have to commit then doing the secondary?
The Diplomate programs encompass about 300-plus hours a piece. It's a weekend course. Once you're done with school, you don't have to go back full-time. What's interesting in the chiropractic realm is a lot of what we learn in the Diplomate program gives us additional education, but depending on the school we graduate from. A lot of it we get at a basic level at some of the chiropractic colleges too. The scope of practice allows for the way we practice with or without the letters, which is interesting. The letters give us a little more credibility, a lot more education, camaraderie within the team, and the network of doctors that take the work that we do to the next level to make sure that patients are getting the right care.
In terms of what you're seeing and doing right now, where are you seeing a lot of patients? What age ranges? What do you find is going on right now?
Medicine has really taken a pretty significant shift. It has become very corporate.
I treat all ages. I see from the minute they pop out, if mom and dad will bring them, to the elderly. The majority of people, probably being between 20 and 60, which is still a broad group obviously. It's been interesting, especially in my community, medicine has taken a pretty significant shift. It's become corporate. A lot of the small mom-and-pop offices have been bought out by larger corporations that are being dictated to in terms of, “This is how we elicit care. These are the only treatments. You follow a textbook protocol type model.”
A lot of patients, which is why we're getting a broad base of ages, they're looking for something different. It’s almost like that old GP. Back in the day, probably way before you and I were born, the GP used to visit the house and it was individualized medicine. You talk to the patient, learned what was going on, and figured out how to best take care of them. I find that the trend is moving back toward that although we don't make house calls. We still provide that type of individualized care that you don't get in the corporate medicine world anymore.
When folks are coming to you, do you have a questionnaire or a protocol you start with? What does that look like so that folks can understand what this looks like, the things that they could start to think about as they're trying to get their hands around their own health and wellness?
It's fun and interesting because when we talk to a potential new patient, the first initial questions are, “What are you coming in for?” We always want the top three concerns that a patient might present with. We have a whole questionnaire that looks at different systems in the body that a lot of times will point the patients in directions they didn't even know they needed to go, and realize that maybe there are some things that are common but not normal. You'll hear me say that a lot.
Whenever people have symptoms, it's their body's way of telling them something is wrong. They'll choke that thing up to like, “I have PMS. All my friends have PMS. I have hot flashes. Of course we have hot flashes, that's pre-menopause. I'm exhausted, but I have six kids. I'm supposed to be exhausted.” The reality is none of that's true. It's just that a lot of these symptoms become common versus normal. Normal is you have no symptoms at all. There's no reason to see me, although there's a caveat to that.
The questionnaire helps guide us in two ways. One for the patient to realize there might be more issues, and for me to know what direction to also take them. Let's say a patient comes in with generalized fatigue. There are 20, 30, 40 different reasons you could be tired. You certainly aren't going to address every single reason all up front. If I can be specific to that individual's needs, it gets us to that answer, that underlying cause a whole lot faster, which is great for the patient.
What do you do with fatigue or menopause? Does it all come back to needing additional things to help your body calm down at night? Is it inflammation? I've certainly got a lot of friends that this is a hot topic right now, both of those for sure.
You asked two separate questions that play a role, although fatigue is part of hormonal changes. Whenever there are symptoms, something is wrong. We get brushed under the rug a lot, or we get that prescription, “Here, take this. I hope that helps. See you in a few months. If it doesn't, call me.” It's about figuring out where patients are broken.
Let's take the hormone route for a second. We think about the main hormones: estrogen, progesterone, testosterone. Let's say we're deficient or we don't have good relationships of those two, and then we get on one of those, whether it's prescription or natural. What a lot of people don't realize is there are underlying reasons those hormones may not be balanced. For example, if the adrenals aren't working well and we're low on DHEA, that helps us produce estrogen and testosterone. That might be the piece we're broken.
We might have an underlying thyroid condition that wasn't worked up appropriately by a doctor because they didn't run all of the thyroid numbers, all of the different components of thyroid, and the thyroid might be affecting the adrenals that affect the hormones. Yet maybe the pituitary isn't happy, and that's why the thyroid isn’t working well. Maybe it's about nutrients and we're not getting the proper nutrients. We're deficient in iodine or selenium or B vitamins. That's starting to cascade that then eventually leads us to the hormone disruption.
It's almost like peeling back a layer of an onion. Sometimes it's as simple as that outer layer, you just need a little extra progesterone. Sometimes it's getting to that core of the onion as to what the cascade was that started that effect that gave you that symptom. It’s oddly complicated, and yet sometimes can be simple if you just know where to look.
Do you find that you have to start with a blood test or are there other ways to go about this? Sometimes those are painful and expensive.
They can be. There are lots of approaches. I'm a lab girl. I love blood work and saliva testing. We use urine metabolite testing, especially in hormones as well. Fatigue is funny because it could be hormone, cardiovascular, or a urinary tract infection you didn't even know you had. It could be as simple as you're not sleeping well or you're overconsuming caffeine.
The testing helps me to confirm what I think, which is important. As much as I always think I'm right, I'm wrong a couple times a year. I want to confirm what I think. It also tells me how far off you are. Even if I assume let's say you need something, do you need more than I think which could inhibit you from getting well because I don't dose appropriately?
The testing is important. However, you're correct, there's always a price tag to everything. Money is always a discussion because we have to decide where we spend our money. We're careful about working with inpatients budgets. At the same time, there are a lot of things that we can do off of the questionnaires, a good history, a good physical to make recommendations too without the tests. As much as I'll always tell you I love them and I'm going to encourage them, that doesn't necessarily mean that you can't be helped.
It's always been on my wish list. I'm a numbers and a data geek myself. I wish there was more I could do in the privacy in my own home with a saliva test or urine test. I happened to believe that the science is there. I hope that solutions like this come to fruition sooner rather than later.
We're working on some great solutions. There are a lot of home tests too. Some of the difficulty with that is the average person doesn't know the quality of the test. Not all tests are created equal in terms of how they're run or exactly what is run even though it falls under this umbrella topic. The second problem is these companies don't have the ability, nor should they or can they, to treat. You get all this information, which is awesome, but if you don't know what to do with it in the right way, it's just information that sits on a piece of paper.
Having the right practitioner who can help guide you to the right testing if you choose to do it and then how they interpret it is important. The other thing is even if you can get an interpretation, you’ve got to know what's going on with the individual person. If I look at four lab tests and got the exact same results, it doesn't mean I would treat the exact same way because it depends what that patient is experiencing and what we're trying to accomplish.
This is certainly a big topic too of folks that I'm chatting with. How would you approach something like depression, anxiety, and ADD? It can be anywhere from kids to teenagers to adults. We're all feeling pressured. How would you hit something like that?
It's unfortunate. It walks through the office way too often now, especially after the last couple years. I always start those conversations with something that is important. I always look at the person sitting across the table for me and I say, “All of the things that you just shared with me are not your fault.” That's an important way to start because I don't believe that anybody wakes up wanting to not pay attention in class or feeling sad or anxious because they have to do something. We still have to be responsible for our behavior, but sometimes we can't always control what gets exhibited. That's number one.
Two, it does come down to the physiology and the chemistry of the body, not only the brain, but the gut and the immune system. Almost any topic you can throw at me, it comes back to what broke in the body? What's not working correctly? Where are we missing the puzzle piece? Where does the puzzle piece not fit? All of those analogies of when we can figure that out, the label of anxiety, depression, ADD, pick one, now all of a sudden goes away because we know what caused the label in the first place.
Unfortunately, sometimes there are lots of causes. It's not always just one direction. For example, let's say we talk about gut health. We look at the microbiome, we balance the good bacteria, and we look at digestion and absorption and inflammation. We think, “That should have a good balance and work its way back up to that gut-brain chemistry.” We also could have deficiencies in the brain chemicals we're producing, or we could be eating something that's causing what we call cytotoxicity in the brain that gets us all wired and anxious. It's all those little connections that make such a huge difference that if we fix them, problem solved. We all feel great.
If you really want integration, functional medicine, and individualized care, you have to search for a practitioner that is cash-based.
When I was in college, I felt down and not on top of it. I went to the student health center and they said I wasn't producing enough serotonin. They put me on Prozac. It took me well over twenty years to get off of it because every time I tried to get off of it, it made me crazy. What I since found out is that I feel similarly crazy when I eat too much pizza or I drink too much beer. There's probably something related to the fact that my gut does not like it when I take in high amounts of wheat, which makes me feel crazy. That probably would've been a better discussion to have as a freshman in college when I was eating a lot of beer and pizza. It’s interesting.
I've always said that if we ate well, probably about 80% of my practice would go away truly. Bad food is good for business. It's getting worse with all the genetically modified foods, with all the lack of information about what we're putting in our mouth, the chemicals, the additives. We sometimes don't know. A lot of people out there don't even know what healthy is.
It's funny, I had a young boy who came to see me years ago. We always go over diet. When a patient says to me, “I eat healthy,” I never believe them. I'm like, “Tell me what you eat and then we'll decide if it was healthy or not.” The mom relates the story how he's pretty picky. For lunch, he's got to choose between hot dogs and pizza puffs. She gives him the pizza puff because it's the healthier choice. I'm thinking, “Maybe she's rationalizing the tomato sauce.” I'm trying to figure out how it’s healthy.
I looked her straight in the face and I said, “Will you just give the kid a hotdog? At least he has some choices.” At that point, it didn't matter. The pizza puff and the hotdog still weren't going to give him the nutrients that he needed. It's that example of where she thought the pizza puff was a much healthier choice that got me thinking that we truly don't know. Most people walk through life not understanding what healthy choices are. That education is essential. Food inflames us.
Your example is a perfect one. Wheat, dairy, sugar, corn, there's the whole laundry list. There are some obscure ones like blueberries and almonds and things we'd never tell people not to eat that still can be inflammatory. What a simple thing to have solved for you if we cleaned up the diet early and prevented twenty years of a prescription med that probably depleted a whole lot of other nutrients and caused some other issues?
With families walking down the door, is there anything that you're like, “Don't forget to?” Do you always like doing a probiotic or an omega or a multivitamin? What do you like or dislike? What do you think about gummies that are out there that seem to be all the rage?
If I do nothing else, a multivitamin is a great idea, understanding that it's not therapeutic. It fills in little gaps. If you're low in something, we're going to have to do something extra. That's number one. I love a probiotic, but at the same time, it's interesting because everybody seems like is on a probiotic now. You have to look at the strains that are in a product and you've got to see the quality of the strains. We can get too much good bacteria as well causing issues like small intestinal bacterial overgrowth and other symptoms.
I do love the probiotic. I do love the fish oil. It's great for heart health, skin, brain health. One of the things that I always look at that way too is the quality and what's in the fish oil. A lot of fish oils can go from being anti-inflammatory to pro-inflammatory over a period of time. It’s a dirty little secret in the nutrition industry that not everybody knows. There are a lot of bad quality fish oils.
Back to the presence of DHEA, is that correct?
No, DHEA is your adrenal hormone. You're looking at EPA and DHA. You want a little bit of GLA with it, either in your product or as a secondary product to keep that as an antioxidant, as an anti-inflammatory, rather than becoming pro-inflammatory.
How does someone find the GLA? Do you have any brands that you like that provide that GLA in the omegas? Is there also a vegan one? A lot of folks are asking a lot of questions now about where to find decent products.
It's hard. My recommendation usually is to do a little bit of borage oil. If you're taking fish oil and you just need that little extra, you pick up a borage oil as a separate product from your favorite manufacturer. That's a great way to do it. The other nice thing to help from an absorption standpoint, which is my fourth thing if somebody comes in, is vitamin D. That helps because they're both fat soluble. When you take the D with the fish oil with a fat in your diet, the absorption rate is going to be better too. That can help it increase.
With my own kids when I was going through this, the doctor was specific that it should be a vitamin D3 and not just a vitamin D. Is that your opinion on this?
You want the active form of D, so yes definitely D3. On occasion, we want that with vitamin K as well. Typically, we test. If somebody is deficient, we throw in more K. If they're adequate, we don't. A lot of these patients get thrown on that 50,000 IU of D2 once a week, and it doesn't change their active bioavailable D. It also doesn't keep them steady throughout the week either. I'm a big fan of daily recommended IUs. That can range based on levels, but we’ve got to make sure we're getting the right form.
I've chatted with a lot of doctors now that are struggling because they want to treat patients the way they want to treat them, but they can't get things through the insurance company. Now they're turning to things like subscription pay or cash pay. Do you have any thoughts or opinions on any of this when folks are trying to find it? Do you do a search in Google for an integrative health or a functional health? What do you do if you're reading and you're like, “Okay, now what?”
I went cash many years ago. The insurance companies were putting me out of business. I’ll share with you an interesting story to make my point. A lot of insurance is based on Medicare reimbursement. Medicare will not cover a vitamin D test unless you are vitamin D deficient.
How do you know if you’re vitamin D deficient?
We guess and we lie on the form. We can't do that as practitioners. It's interesting because even if we're not deficient now, it doesn't mean we're not deficient a year later. Unfortunately, most of the time, there are still some great practitioners out there doing insurance work. Most of the time, when you're in a cash-based practice, the beauty is the only person that I need to answer to is my patient. If my patient is on board, they trust me, they want something, we get it done versus me having to justify to an insurance company. I hate to say this out loud, but talking them out of something, knowing that I'm not going to get paid for it is not a great way to practice.
I sit in that room, and whatever you need and we decide together, we do. If you want integration, functional medicine and individualized care, you're going to have to search out probably a practitioner that is cash-based. There are a lot of great practitioners in different aspects of medicine, but in the chiropractic realm, we always recommend to another DABCI, which are the letters that stand for Diplomate of the American Board of Chiropractic Internists. We're trained that way to do all of these different types of things. We're a little selfish, we like to refer within our own profession. We've got some great practitioners even in our own neighborhood that don't have DC behind their name that we love and we co-treat with. It's the direction. Things are moving if you want what you want.
Do you serve folks on a subscription model where it's like, “I trust you, I know I'm going to have to do this,” but constantly paying to show up? Is there a way to pay an annual fee? Do you find there are solutions around that? Is that still too hard to build together?
No, it's interesting. There are a lot of practitioners that do that successfully. I'm not one of them. I've always been a fan of you get what you pay for. There are two sides of that. If you do a subscription, there's probably a little bit more adherence. You've prepaid for it. Maybe you'll use it. I also think there are a lot of patients then that pay for stuff that they never get. I'm not comfortable taking money for a service I didn't provide even though you know the rules of the subscription.
I've always done where we sit down, we uncover the need of the patient, we meet the need, we lay out a plan. Not that there isn't a plan, but what you come in for, you pay for. We work that way because sometimes I find that patients need more or less too, depending on what they need. To me, those subscriptions, and this is a personal opinion, feel a little bit more one-size-fits-all.
Don't settle to live with symptoms or to be told to just deal with it.
I'm starting to see all kinds of different solutions. It's neat for folks to be able to hear it from you directly.
That's the way I'm comfortable practicing, but if a patient also prefers that, then I'm not the right practice. That's okay too. The beauty of having different models out there is if they want that access to a subscription, then we've got to find them the right doctor to do that.
From your standpoint too, when folks come in, do you find that there's a typical timeframe to start seeing some initial results? For me personally, the doctor had told me, “It's going to take a year to get things straight.” I was like, “A year?” For us, we saw some small incremental changes within 6 to 12 weeks, but it was a year before it was like, “We're good.” I'm not trying to lead the conversation except to ask, do you find that there are certain things that have shorter timeframes to recovery versus longer?
I do. It's funny because there are patients that are a massive project, and they walk back in my office six weeks later perfect. I'm surprised even after all these years of practice. I have patients that I honestly think are going to walk back in six weeks later, feeling amazing, and they're like, “Nothing is working. I'm worse.” I can answer that question both ways.
In terms of what I tell patients, six weeks is that magic number that we learn in the herbal vitamin world because we give things about that time where I expect to see something. If I put you on a protocol, you come back in six weeks later and nothing is working either, A) You didn’t do what I told you to do, B) I picked the wrong products and it's not working for you, or C) We're missing something that we need to look further. If you're 10%, 20%, 30% better and you keep riding that wave, then we keep going.
My joke is if it took you 45 to years to get here, you’ve got to give me a little bit more than 3 days to get you out. We don't need 45 to reverse it. Some patients we do work with for 1, 2 or 3 years depending on the severity. It also depends on if we find the underlying cause, because if we find that, it’s super quick. If we're still digging and looking because it's hiding, sometimes it takes a little bit longer. It's not a great answer. I'd love to tell everybody, “Give me your best six weeks and we're going to get you 80% to 100% better,” but unfortunately, it doesn't work that way.
A lot of folks are pretty clued-in to saying that they have certain food allergies. I know in our own family, we've done the back scratch and the blood work. Sometimes they overlap. Sometimes they don't. Do you find that when you're treating folks that you like one versus the other, or do you do both and then see what overlaps? It's been wild to see all this.
Foods are interesting to me. I've been doing them for a long time. It's interesting as I listen to you talk, we use the words interchangeably sometimes incorrect. There's food allergy, food sensitivity, and food intolerance. Food intolerance is like a lactose intolerance. We don't have lactase, which is an enzyme to break down the lactose. Big bowl of ice cream, diarrhea ten minutes later. We have the true allergy, which is the scratch testing. I still think that's the gold standard. Even though we do have blood tests, I still think that the scratch is a step above. I refer out to that. In my practice, we don't do that. We would send to an allergist to do that.
The food sensitivity testing is much harder, more complicated, and unfortunately, all over the industry where people have access to some good and some poor information. A sensitivity is going to affect you from the moment you eat the food up until about 72 hours later. Food sensitivities can run on different antibody pathways what's known as an IgG, which is the most commonly run. Those are those $99 tests that are out there. IgA, which is a smaller percentage. Sometimes IgM, cell-mediated immunity.
There's also a way to test what's called a Food Zoomer, which is new technology where we take a food and we break it down to its polypeptide protein. For example, let's take dairy. If we consume dairy, cow’s milk is a whole protein, a lot of us don't react to it as a whole protein, but cow’s milk gets broken down into casein and weigh, and then a lot of little proteins underneath that you've never heard of. When you digest milk, you drink it, it doesn't go down as a whole protein, it gets broken up. Sometimes we can have patients that then trip the test just on casein or on weigh, and we would miss it as a whole protein.
In the food sensitivity world, it's pretty amazing how we've come pretty far to start looking to get a little bit more specific and detailed through that digestive process to make sure we don't miss anything on patients. It's been fun because we've picked up on things on some of these Food Zoomer tests that the other labs are missing. When patients think they should get well from eliminating certain foods, they don't always until we get the full picture. It's pretty cool to see what's going on that way.
Thank you. Is there anything else that I forgot to touch on or anything that you want to add that is an important piece in health and wellness across any age group?
If I was going to give a little bit of advice to anybody reading, it's make sure that A) You ask questions, B) You are comfortable with the provider you pick. We might know a lot and we still might not be the right fit for you. At the end of the day, don't settle. To live with symptoms or to be told, “It's just old age. We're getting older. We have to live with that stuff. He or she'll grow out of it when they're ten years old. Wait a few years and it'll be fine.” It makes me sad to learn that people are told to deal with things.
My advice is to seek out practitioners as many or as few as you need to hear you and to have that conversation to understand that there is an underlying issue and to offer you some guidance in order to help get to the bottom of it. At the end of the day, we should feel fabulous until we're 102. We lay down and we don't wake up because the heart gave out. What I would hope for everybody is that you seek that out and don't settle for feeling icky.
Thank you, Doctor. Do you treat folks remotely in case they can't make it out to Illinois?
Yeah, I do. That's a tricky thing. It depends how that works. We do some Telehealth. It depends on where you're located from the standpoint of what we're capable of doing because it comes under licensure. There are some things we can do under a health coaching type aspect as well, where we can still help where we're not rendering diagnosis per se and going that doctor route. It depends where people are located, what we can offer, but certainly happy to have the conversation and see if we can help. If we can't, find your practitioner in your area too, so at least you have somebody local.
How do people find you, Doctor?
The office phone number is (708) 479-0020. We're all over Instagram and Facebook too. You can pull up Innovative Health & Wellness Center to find us. We've got a little green man. We call him Wellness Dude. If you see him, you’ve got the right place. The website is InnovativeHWC.com.
Thank you so much for being with us. We appreciate it.
It’s my pleasure. This was great. Thanks.