The patient: “Meredith,” now 98 years young, first came to see me when she was 68.

Why she came to see me: Meredith and I first met when she came to see me for relief from troubling constipation. She was so frustrated with her primary care doctor, who offered no suggestions for relief. She was an avid tennis player, and a fellow tennis player recommended that she see me to figure it all out.

How I evaluated her: I explained to her that regardless of how inept she felt her MD was, he needed to be part of our care team. Her routine office visits, lab work and specialty consults would need to be driven by the MD (and would be reimbursed by Medicare). She brought copies of her primary care doctor’s treatment notes and a list of her medications, which we used as a good starting point for care. As it turned out, her primary care doctor had prescribed an iron supplement for a mild iron deficiency, and I surmised that the iron pills are what constipated her.

How we addressed her problem: Meredith’s blood tests confirmed “iron deficiency anemia.” Rather than the prescriptive iron from her doctor, I addressed this with a protein-bound iron and a digestive enzyme complex. This helped her digest and absorb the supplemental iron as well as iron in the food that she ate.

The digestive enzymes I prescribed also improved her capacity to digest and absorb dietary protein and as well as the supplemental calcium and magnesium that I also prescribed. Often seniors are deficient in not only iron, but calcium and magnesium as well. I suspected that this was the case with Meredith as she had developed a “mild blood pressure problem” of late. These additional supplements would help with that.

The patient’s progress: Besides resolving her constipation, Meredith’s enhanced gastro-intestinal function allowed her slight hypertension to disappear and her primary care doctor could withdraw the antihypertensive drug he had prescribed.

Over the next three decades, Meredith’s activity level slowly decreased, her vision waned (she is, after all, nearly 100 years old), but her improvement in digestion, iron levels and hypertension persisted. I had prescribed additional supplements from time to time, including B vitamins and vitamin D3, as most seniors need both, and she has remained faithful with her calcium magnesium and digestive enzyme supplementation.

I met her in my parking lot yesterday where the driver from her assisted living residence dropped her off for a “wellness checkup” with me. She insisted on walking up the flight of stairs rather than taking our elevator. Seeing her doing so well confirmed my approach of supporting individual health (what I call providing actual health care) to address disease and minimize the ravages of aging.

As Meredith’s case shows, if we treat the person and her presenting symptoms by helping underlying function improve, often the symptoms lessen, and general wellbeing improves. We do much better trusting the innate wisdom manifesting in the body’s normal physiology and trying to support and enhance this rather than second-guessing and suppressing troublesome bits and pieces and hoping for a long-term benefit—the approach I see from too many conventional doctors.

To learn more, visit Dr. Andy Rubman’s website,

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