Thomas Lewis, MD

Where Are You on the Health – Disease Continuum?

Aired on: February 26, 2021

Episode Description

Medical diagnoses are actually artificial human-made terms. In reality, we all lie on health-disease continuums. When you cross a certain point on the continuum, you then suddenly have a disease. In this presentation, we discuss the consequences of this model within the context of the current healthy / sick model. We will discuss how to measure where you are on the: 1. “risk” continuum, 2. physiological continuum, 3. pathology continuum and 4. chronic disease continuum and how the measurements provide information on how to improve your placement on ALL the continuums. We will also present case studies that show how a broad range of diagnoses improve or disappear when following the recommendations derived from this continuum model.

Where Are You on the Health – Disease Continuum?

Thomas Lewis, MD

Our health system

  • Does well with antibiotics and surgery
  • Is challenged in treating chronic diseases which account for 90 % health care costs
  • 6/10American adults have a chronic disease
  • Cardiovascular deaths have increased by 4.6 % between 2011 and 2016
  • In three cities in Colorado, cardiovascular deaths have increased by 20 % between 2011 and 2016
  • 4/10 have more than one chronic disease
  • Over 50 % of children have a chronic disease (it used to be 18 %
  • Health is a continuum
    • For example, a Kaiser study showed that for each point the morning fasting blood sugar is above 84, the risk of diabetes increases by 6 %
    • Depression is not a Prozac deficiency Prozac only treats the symptoms
    • Heart disease is not a statin deficiency statin only treats the symptoms
      • Statins can increase heart disease through increasing diabetes
    • These medications treat the symptoms and improve the biomarkers
  • Our health system can be considered disease management or “sick care.”
    • This approach does not improve longevity or mortality
    • The more the health system spends, the less we live
      • OECD statistics US spends 2.5 times on health care than other countries
      • US life expectancy is 2.5 years less
    • The French paradox
      • They eat the most saturated fats
      • Their heart disease is 25 – 33 % of that in the US
    • Cardiovascular disease and cardiovascular deaths decreases when there are large cardiologist conferences
    • Clayton  found that in mid Victorian times, if a person survived the plague past age 6 in Britain, he lived longer than British today.
      • The mid Victorians out live Americans by 5 to 6 years
    • There are fewer procedures which had been ineffective
  • It is best to look at the underlying causes and not just treat the symptoms

His approach towards chronic health

  • Disease reversal
  • Further a person is on the continuum, the harder it is to reverse
  • Diseases take a while to develop
  • We have to be proactive not to wait and react
  • No such thing as prevention; we are all on a health continuum: we need to be going in the right direction
  • The sooner we can detect these issues, it is easier to push health in a positive direction
  • Risk factors for chronic diseases overlap

His Program

  • He puts people through measurements on four continuums and given a grade on each
  • Improve the grade, health improves
    • Risk and determinants of health
      • Family history, genetic, prebirth environment
      • What is going on in your life
    • Physiological markers -55 biomarkers
      • Medical labs are based on 95 % of the population, most of whom are sick
      • Are objective: he develops a composite score
      • Your chronological temperature – your placement on the spectrum
      • Statistically connected to  Early mortality and death
      • Goal is to lower this measure
      • If you live til 80, you have 19 years of declining health
      • If you die at 100+, only have nine years of declining health
        • Have additional 30 years of healthy years
      • Looks of inflammation, immunization, clotting factors, hormone balance
  • He tries to make it economical
    • Online survey – these are modifiable
    • On hour consult

Some measurement in his program

  • WBC  white blood cells
    • Go up with infections and toxins
    • Between 4 and5.8, there is no increase in mortality
      • Higher percentage will die with WBC at 6.7
  • RDW red blood cell distribution width
    • Red blood cells last about 4 months, excreted thru feces.
    • Red blood cell is born small and dies large
    • If vessels are inflamed, these red blood cells get inflamed and get larger and the RDW increases
    • RDW increases with crp
  • Crp
    • Looks at inflammation in the lining of vessels
    • Inflammation increases, crp increases as does RDW
  • Fibrinogen
    • Circulates in body looking for cracks
    • If blood vessels are inflamed or gums bleed, fibrinogen levels increase because repair is increased due to damage
  • ESR. Sedimentation rage
    • Red blood cells should not settle
      • Every cell is a little battery
      • The sodium potassium pump creates a charge on the cell, so cells repel each other.
    • If sedimentation rate is high, have inflammation, batteries in cells are discharged
    • Is highly correlated to the gut health continuum
    • Simple way to measure electrical system in body (pH)
    • Should be 2
  • Triglycerides/ HDL
    • Measure of excess sugar/ sufficiency in fats essential to health
    • Atherogenic index of plasma  correlated with haert risk
    • Triglycerides measure of excess sugar. Want it under 80
    • HDL
      • HDL encapsulates fats and transports them
      • Measure of efficiency of fats for health
      • HDL and LDL are soap
        • Sop has a polar outside and nonpolar inside
        • LDL transports fat soluble vitamins, oils
        • HDL brings excess fats that are not used back to the kidneys and liver – sufficiency of fats essential for health
  • Neutrophil / lymphocyte ratio
    • Higher mortality rate in chemotherapy
    • Higher probability of dying from chemo when over 4 or 5
    • Is under our control
    • Neutrophils go up with bacterial infections
    • Lymphocytes go down with viruses


  • Is an embryonic outcropping of brain
  • Can see through it
  • Can gage brain health by examining eyes
  • Harvard opthomologist , Dr. Trump, found correlation with eye diseases and systemic diseases and early death  
  • Has excellent to vascular and neurological tissues
  • Brain is second most vascular organ in body: receives 25 % oxygenated blood from the heart
    • Is metabolic 
  • The most vascular organ is behind the retina
  • Is a window into neurological and vascular
  • Can see effects of treatment
  • Can see signs of Alzheimer’s disease 20 years before the symptoms in the eye
  • Nuclear Cataract is correlated with early mortality from cardiovascular diseases
    • Mortality rate is about the same as for breast cancer
  • Cortical Cataract
    • Early marker for Alzheimer’s
  • Macular degeneration
    • Dry macular degeneration Exactly same as atherosclerotic plaque
    • Wet macular degeneration atherosclerotic plaque that is bleeding
      • Typically Have multiple mini strokes which contribute to dementia
  • Glaucoma
    • Degeneration of basoganglial cells a surrogate for the hippocampus
    • Is a disease of inflammation , the pressure is secondary
    • Real cause is underlying infection
    • Alzheimer’s disease of eye
    • Alzheimer’s disease is the glaucoma of the brain


  • Who is susceptible to bad outcomes?
    • Underlying inflammation markers Leading to cytokine storm
      • ESR, lower lymphocytes, crp, fibrinogen, LDH, creatine kinase
    • Comorbid disease have higher risk for cov and chronic disease
  • Infections can be focal or systemic
  • Flu vaccine 45 % effective
  • Going from healthy to healthy can reduce risk 95 %

Poor oral hygiene

  • Can correlate with premature birth, cardiovascular disease