Practice Spotlight: 
Dr. Timothy Arnott, MD, ABFM
The “why” of Lifestyle Medicine for the holiday season.
Julie’s Story
(Julie enthusiastically shared her story and authorized the use of her name)
When Julie first picked up the phone to call Dr. Arnott, she had been bed-ridden for almost seven years. Weak and wracked with pain, she struggled to make it out of bed long enough to take a shower, or, with the help of her husband, to her next doctor's appointment.
Her story began twenty-five years earlier with pain and fatigue that no one could, at first, diagnose. She was put on prednisone for her severe asthma, but Julie saw more than fifteen doctors before she learned that she had fibromyalgia, a condition that she had never heard of before her diagnoses. She was put on narcotics for the fibromyalgia, and more medications were given to counter the side effects of the prednisone. Julie’s life twisted into a downward cycle of medication side effects, pain, exhaustion, and desperation.
For a few years, she tried to keep up with her work, but increasingly she found herself unable to leave home. Then she lost the strength to move around their home, and finally it became difficult to even get out of bed without assistance. Her loving husband moved his mortgage brokering business to their home so he could care for her. Together they continued to search for help, seeing more doctors, receiving only more prescriptions.
Dulled by a regimen of about 25 prescriptions including opiates, anti-depressants, anti-anxiety medications, sleeping aids, and prednisone, hope had finally been renewed by an encounter with a friend, who also had fibromyalgia. Julie wondered how her friend looked so healthy. The friend advised her to call Dr. Arnott.
Dr. Arnott describes his private practice in Paradise, California as a standard primary care practice with a focus to inform and motivate patients to make “needed lifestyle changes that will reduce their dependence on the medical profession and pharmaceutical industry.”
Dr. Arnott sees an average of 20 patients per day, and works 4 ½ days per week at his clinic. Being in private practice has many challenges, and Dr. Arnott credits the grace of God for the successes he has enjoyed so far. He is encouraged when patients come in to tell him “how much better they feel, how much healthier their family has become, what health parameters have improved, what conditions have resolved, all because they took the time to learn a better way to live.”
Dr. Arnott states: “A patient who follows a healthy, whole-plant food, super food-focused, vegan diet, enjoys daily sweating exercise, drinks generously of water, avoids harmful chemicals, indulges in 7 to 8 hours of rest each night, including 2 ½ or 3 before midnight, spends much time out side in fresh air, and takes adequate amounts of vitamin D and B12 has a potential to become a centenarian and be robust and sharp to boot.”
Yet his message is aimed further than just the immediate health of the body. “Giving patients information about living 120 years is marvelous”, but he encourages his patients to experience full health in other dimensions of their life as well, especially when this includes a deep faith in Divine power.
Clinical Advice
Dr. Arnott offered many practical tips for small private practices to serve their patients and remain financially viable.
“Probably the most important fact for economic survival was the truth that if you take care of Medicare patients with hypertension, hypercholesterolemia, and either hypothyroidism or diabetes, you should understand and apply proper coding. If you are under-coding, you will have a hard time surviving.”
“Another practice tip, we were losing a lot of patients because the six tests we ordered at their first visit had a price tag of nearly a thousand dollars. Patients were angry with me, not the lab for charging so much, or their insurance for paying nothing, so, we met with one of our labs, explained how it was not in their best interest for our clinic to lose patients in this way, and negotiated dramatically (1/4th to 1/5th) lower cost for our most frequently ordered tests, and now, patients compliment us on the cost of their labs. Even a small practice can negotiate, but it takes patience and perseverance.”
Regarding the labs, Dr. Arnott orders:
“ a CBC with diff, CMP, hsTSH, FLP, 25-hydroxy vitamin D, and vitamin B12 +/- PSA. For those with diabetes we add hemoglobin A1c with reflex Glycomark +/- microalbumin/creatinine.
I find patients almost invariably with three abnormal values, high LDL, low B12, and low vitamin D. Vitamin D is the most difficult to bring up. I now place patients on vitamin D2 50,000IU twice a week for two months, then, once a week thereafter, as I have not found OTC products effective at bringing vitamin D levels to 50 ng/ml. If patients take sublingual B12 and chew it, or let it dissolve in their mouth, B12 levels normalize quickly to 1100 pg/ml. As for LDL, it is all over the map.
Be vigilant and persistent about bringing vitamin D levels to 50 and vitamin B12 levels to 1100. Patients love how they feel when these levels move from normal to optimal!
I have patients that have adopted a vegan diet and have LDL below 80 and total cholesterol in the 150s. Others are on medication and still have not discovered that medication without a plant-based diet is often ineffective. Obviously, I love it when patients choose the best diet. When they do, most, never want to return to their old ways, but, they choose it out of their own life experience, which seems to help them stick to it.”
Dr. Arnott advises: “Total cholesterol will come down to the 150s or below and 25 pounds can be shed in 6 months when patients adopt a healthy, whole-plant food vegan diet.”
Future Goals
Dr. Arnott writes: “I am very excited about the opportunity that has opened up to start our very own lifestyle center right here in Northern California. I am in the process of forming a 501(c)3. Afterward, we will begin raising funds toward the purchase of an ideal 27-acre property and large home, ideal for a smaller, residential lifestyle medicine center. So, my wife, Sylvia, and I have lots of work ahead of us, but, we are very excited about getting back into residential lifestyle medicine, which has rewards that are unknown and untouched in other venues.”
Evangelist for Lifestyle Medicine
Dr. Arnott advocates education as a primary goal. “You might call me an evangelist for lifestyle medicine. It flows out. I cannot stop talking about the wonderful things that I have learned about nutrition, exercise, rest, sunlight, water, and other things that I learned from my father, a strong advocate of lifestyle medicine, from my work and study at Lifestyle Center of America, from books, such as Proof Positive, by Drs. Nedley and DeRose, Eat to Live, by Dr. Fuhrman, and countless medical journal articles that I was privileged to read while at Lifestyle Center of America.”
Dr. Arnott supplies his patients with handouts and offers them a recommended reading list to better inform and motivate them “toward optimal health practices, including a plant-based diet, and programs scientifically proven to reverse diabetes and coronary artery disease (i.e., N. Barnard, C. Essestyn).”
He also has his own book titled “Dr. Arnott’s 24 Realistic Ways to Improve Your Health” which he sells to his patients for a nominal cost. “Many patients have told me personal health benefits from this read. I have also been given the opportunity to provide this kind of lifestyle medicine education once a month at a free clinic for patients who have little or no access to allopathic care, much less to lifestyle medicine. It has been very rewarding to see a patient’s face light up when they hear information about caring for their body that they never encountered before.”
His clinic “is inundated with lifestyle medicine information and motivation at every turn. I constantly seek ways of using the patient’s diagnostic data to open their eyes to their need for lifestyle change”.
This approach worked well for Julie. Dr. Arnott remembers her coming in “to room three, where I have the vegan food guide pyramid picture.”
At Julie’s first appointment, Dr. Arnott explained that he had discovered a correlation of low vitamin D levels and fibromyalgia and ordered the bloodwork for Julie. As expected, her vitamin D level was low. “I had none in my system.” Julie says. She immediately began a regimen of prescription strength vitamin D : 50,000 i.u. twice weekly.
After about two weeks, Julie was not only able to get out of bed, but she could do “normal things, like go grocery shopping!”
The next step was to reduce the number of medications she was taking. Dr. Arnott researched all her prescriptions carefully, and came up with systematic approach to gradually take her off her battery of high-powered drugs. After about one year, she is off all the medications except those for her asthma, and her vitamin D supplement. She off prednisone entirely.
During this time, Dr. Arnott recommended integrative services to help her with her lifestyle change. She was referred to experts in diet and exercise, and is pleased to report that she has lost 70 pounds and enjoys an exercise regimen which includes walking and yoga.
Julie writes: “Dr. Arnott has been vigilant in monitoring my progress through follow-up visits and detailed review of my blood work and prescriptions, now, every 3-4 months. At the beginning of treatment, he saw me on a monthly basis until my condition became stable.”
Julie remembers the attitude of the doctors she met before she met Dr. Arnott. None of them listened to her. After awhile, the effect of the medications on her brain made her “a zombie” and she became too weak to voice her concerns. Her husband tried to convince them to look for alternative forms of treatment, but all of them insisted on merely “telling us what to do”.
Dr. Arnott was the first one who listened. They worked as a team to restore Julie’s health, and this was surprising and encouraging to Julie. As Julie says: “Dr. Arnott gave me the tools to get better… I am a part of the reason that I am well.”
Julie now enjoys an active lifestyle, serving her community in volunteer projects and passionately shares her story with others struggling with fibromyalgia.
ACLM Disclaimer: Our Practice Spotlights are intended to provide examples of Lifestyle Medicine in practice. We recognize that Lifestyle Medicine practices vary widely, and inclusion in Practice Spotlight is not intended to imply official endorsement of individuals or practices.
