There is a question we believe clinicians should ask more often before recommending a therapy:
What exactly are we trying to accomplish?
It sounds obvious. But in wellness medicine, treatments can sometimes become destinations rather than tools. A patient hears about NAD, vitamin C, glutathione, ozone, acupuncture, a supplement, a peptide, or another therapy and naturally asks “Would this be good for me?”
Our answer is usually another question, “What are we trying to change?”
Because the treatment itself should rarely be the starting point. The patient should be.
Start with the physiology, not the menu. Fatigue is a good example. Fatigue is not a diagnosis. It can be associated with sleep disruption, anemia, nutrient insufficiency, thyroid function, glucose regulation, mitochondrial energy production, medications, stress, cardiovascular disease, deconditioning, or many other factors.
Giving every person with fatigue the same “energy IV” would therefore make very little clinical sense. The more useful questions are:
Why is this patient fatigued?
Which biological systems appear to be involved?
What can we objectively evaluate?
And only then, which intervention is appropriate?
That is the difference between purchasing a wellness treatment and developing an individualized care plan. Different patients may need very different levels of care. Over time, we have found it useful to think about treatment in several phases.
Some patients come to Katallage with quite complex medical concerns and require a more intensive clinical strategy. That might include physician-directed therapies used as part of oncology support, cardiovascular or metabolic care, environmental illness, or our Brain Wellness program addressing dementia and Alzheimer’s disease.
Other patients do not need an intensive protocol. They may benefit from what we think of as restorative support—addressing nutrient needs, hydration, recovery, metabolic health, nutrition, or cellular energy when clinically appropriate.
And then there is a third group that wellness practices sometimes overlook, the maintenance patient. These are patients who have already done significant work.
They may have completed an intensive series. Their symptoms may have improved. Their metabolic markers may be better. Their body composition may be changing. Their original treatment goal may have been achieved. At that point, the correct answer isn't necessarily, “Keep doing everything.” It may be, “Let's reassess.”
The goal is not perpetual treatment. We think this distinction is particularly important in integrative medicine. Our objective should not be to make patients dependent upon increasingly complicated wellness protocols. Our goal should be to help patients become healthier, stronger and with more quality of life. That means a treatment plan should have an exit strategy—or at least a reassessment strategy.
For example, A patient receiving frequent therapy may eventually transition to less frequent maintenance. Someone receiving targeted nutrient support may no longer need it once the underlying issue has been addressed. A nutrition plan should evolve as metabolic health improves. An exercise prescription should change as strength improves- progressive overload right? A supplement regimen should be periodically reviewed rather than accumulating indefinitely with bottles and bottles of capsules.
This is why we often think of care as a continuum:
Assess > Treat >Measure > Adjust > Maintain
Not, Treat > Treat >Treat > Treat.
Sometimes the best intervention is foundational. There is also a tendency in healthcare, both conventional and integrative care, to become fascinated with sophisticated therapies and protocols. We understand why. They are interesting. We are interested in them too. Bright and shiny and new evidence and results are intriguing.
But sophisticated therapy does not replace physiology. If someone is losing muscle, we still need to talk about protein and resistance training. If someone is insulin resistant, we still need to address metabolic health. If sleep is poor, that matters for many body systems. If the patient isn't moving, that matters. If stress physiology is chronically activated, that matters. Nutrition, movement, sleep, metabolic health, relationships, and behavioral patterns remain remarkably powerful interventions.
IV therapy, ozone, acupuncture, nutritional supplementation, and other integrative treatments should complement those foundations—not replace them.
The most important question may be: What comes next?
As we approach the end of the year, we think this is a valuable question for patients already engaged in care. If you have been working on your health for the past six months, ask yourself, “What has actually changed?” Have your symptoms improved? Has your strength changed? Has your visceral fat changed? Are your metabolic markers moving in the right direction? Have you reached the goal that originally brought you into treatment?
And perhaps most importantly, “Do you still need the same plan?” Sometimes the answer is yes. Sometimes we need to intensify treatment. Sometimes we need to change direction. And sometimes the patient is ready for maintenance. All four can be appropriate outcomes. The purpose of individualized medicine is not to provide the greatest number of therapies. It is to identify the right next step for the person sitting in front of us.
That is our October focus at Katallage Wellness Clinic: Check your baseline. Review your plan. Schedule your next step.
Because a treatment should always answer a larger question, “Where are we trying to go—and how will we know when we get there?”