Well­ness Won­der­land

Coast­lines, cul­ture, cui­sine – and med­i­cal mecca? Thai­land has emerged as a health-care hub with a blend of ge­netic science, pro­gres­sive treat­ments and per­son­al­ized care. Viia Beau­ma­nis signs up

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Why Thai­land has emerged as a medi-tourism hub

I’M IN BANGKOK hooked up to a ma­chine that’s re­veal­ing the health of my blood. My fin­ger pricked, a drop smeared on glass, the re­sults are pro­jected onto a large screen. Dr. Kwon Han Jin sits across the desk in his crisp white lab coat, scru­ti­niz­ing clus­ters of mag­ni­fied cells for ab­nor­mal­i­ties.

“You’re de­fi­cient in iron,” he says, eye­ing the mon­i­tor. “Bor­der­line ane­mic.” This is true. Over the past year I’ve been plagued with ex­treme es­tro­gen spikes and thus su­per-amped cy­cles that in­clude fun things like hy­per­pig­men­ta­tion and pe­ri­ods that last 90 days. Yes, you read that right. As well, I’m among the 20 per cent of the pop­u­la­tion that doesn’t ab­sorb vi­ta­min B12 prop­erly, which ex­ac­er­bates the symp­toms: fa­tigue, dizzi­ness, brain fog. Kwon then in­forms me that I’m not con­sum­ing “any­where near enough” wa­ter. Also true – my en­dur­ing hydration reg­i­men be­ing cof­fee, then wine. A friend re­cently passed me a full glass with this ad­vice: “Wa­ter. It’s for drink­ing.”

Next, I’m at­tached to the Oberon, a biofeed­back de­vice (not li­censed for sale in Canada) that sur­veys my whole body, a process in­vented decades ago by the Rus­sians to ob­serve the ef­fects of space travel on the or­gans of cos­mo­nauts. Var­i­ous sec­tors are scanned and im­aged – brain, heart, lungs, stom­ach, kid­ney, di­aphragm, spleen, liver, pan­creas, in­testines, gall­blad­der, blad­der. The sys­tem has steadily ad­vanced over the years, thanks to well­ness-ob­sessed Ger­mans, in­no­va­tions in com­puter science and the in­te­gra­tion of tra­di­tional Chi­nese medi- cine (TCM), which quan­ti­fies the qi (en­ergy) of var­i­ous or­gans into the anal­y­sis for pre­cise, com­pre­hen­sive as­sess­ments. With this method­ol­ogy that skep­tics would dis­miss as mod­ern snake oil the scan re­sults flag my lungs for pend­ing em­phy­sema, even though I hadn’t re­vealed any­thing of my med­i­cal his­tory. Like that I’ve smoked a pack a day for the last three decades. Or how my great-grand­fa­ther ex­pired from that dis­ease, thanks to a life­long pen­chant for Bull Durham roll-ups.

Wel­come to the Brio Clinic, staffed with board-cer­ti­fied spe­cial­ists who tar­get the body at a cel­lu­lar level, tai­lor­ing in­di­vid­ual pro­grams for each client. Opened in 2014, it treats 5,000 clients an­nu­ally with a com­pre­hen­sive menu of ge­netic tests and al­ter­na­tive ther­a­pies. The well­ness cen­tre tar­gets every­thing from di­a­betes, can­cer and au­toim­mune dis­or­ders (MS, lu­pus, fi­bromyal­gia, arthri­tis) to glau­coma, her­pes and plain old aging. Em­blem­atic of Thai­land’s up­mar­ket med­i­cal fa­cil­i­ties, it’s glossy and beige as a lux­ury spa. Tucked into the In­ter­Con­ti­nen­tal, where its clien­tele can re­lax in fives­tar com­fort while, say, hav­ing their blood chelated via a cy­cle of in­tra­venous in­jec­tions of ethylene­di­aminete­traacetic acid (ETDA), a chem­i­cal that binds to mer­cury, lead, arsenic and other harm­ful me­tals in the blood­stream, which are then ex­creted through uri­na­tion. Ap­proved by the U.S. Food and Drug Ad­min­is­tra­tion (FDA) as a treat­ment for metal poi­son­ing, al­ter­na­tive med­i­cal clin­ics, like the Brio, also di­rect chela­tion at off-la­bel use, even as­sert­ing that ETDA teth­ers to artery-block­ing plaque as well, to re­duce the risk for heart dis­ease.

Launched by Thai busi­ness­man Bobby Kit­tichai­wong, the Brio is the first of sev­eral clin­ics slated for world­wide open­ings from Bangladesh to the Philip­pines. Each will act as a satel­lite clinic to Villa Med­ica, a Ger­man re­treat at the fore­front of fresh cell ther­apy (FCT) for five decades. The prac­tice, pi­o­neered in the 1930s, is the process of ex­tract­ing or­gans from sheep em­bryos for in­jectable so­lu­tions of “restora­tive” live cells. Evan­ge­lized by the treat­ment af­ter he be­lieved

it cured his mother of blood can­cer, Kit­tichai­wong pur­chased the Ger­man clinic for $22 mil­lion in 2009, then poured seven more into its ex­pan­sion. Five years later, he launched the Brio in Bangkok.

Im­prob­a­bly, it was the col­lapse of Thai­land’s econ­omy in 1997 that led to its rise as a global med­i­cal mecca. With Western­ers keen for ser­vices com­par­a­tively cheap abroad, Thai­land be­came a go-to hub for an ar­ray of pro­ce­dures: den­tal, plas­tic surgery, hip re­place­ments, IVF, or­gan trans­plants. Bum­run­grad In­ter­na­tional, South­east Asia’s lar- gest pri­vate hospi­tal, priced by­pass surgery and a week’s stay at US$19,000 com­pared to at least US$80,000 in the United States. Equipped with trans­la­tors, a travel desk, VIP suites and an in­ter­na­tional pa­tient cen­tre, in 2002 the Bum­run­grad was the first hospi­tal in Asia to be ac­cred­ited by the Joint Com­mis­sion In­ter­na­tional (JCI), an as­so­ci­a­tion that en­dorses rig­or­ous stan­dards of care in more than 90 coun­tries. Thai­land now has 64 JCI-ap­proved fa­cil­i­ties. By 2014, Bangkok was re­ceiv­ing al­most one mil­lion medi-tourists an­nu­ally.

While be­spoke DNA di­ag­nos­tics tease with hope­ful pos­si­bil­i­ties, stud­ies find no ev­i­dence that chela­tion ther­apy ben­e­fits car­diac pa­tients, and fresh cell ther­apy (FCT) is not with­out crit­ics. How­ever, new stud­ies with stem cells, and now in the re­lated field of blood cell treat­ments, are piquing a wave of in­ter­est. In 2014, Stan­ford Univer­sity neu­ro­sci­en­tist Tony Wyss-Co­ray found that el­derly mice, fol­low­ing in­fu­sions of blood from young ones, pre­sented in­creased neu­ron growth. Could plasma trans­fu­sions com­bat de­men­tia? Gri­fols, a global phar-

maceu­ti­cal con­glom­er­ate, is cur­rently fund­ing phase II clin­i­cal tri­als of young plasma as an Alzheimer’s sta­bi­lizer. In­spired by re­search that found aging could be re­versed when old mice were flushed with youth­ful blood, the Cal­i­for­nia start-up Am­brosia is now pump­ing cus­tomers full of plasma drained from healthy young­sters – a pur­ported foun­tain of youth that’s be­come such a cult ther­apy in the af­flu­ent tech world that it’s been sat­i­rized on the HBO comedy, Sil­i­con Val­ley.

Which all sounds great. Putting aside any creep­ing un­ease that, be­tween cell ther­apy and plas­tic surgery, the planet is poised for a fu­ture pop­u­lated by a master race of rich peo­ple who never get sick, age, or pos­si­bly even die while the lam­en­ta­ble poors wizen like old pota­toes, cash-strapped and dis­ease-rid­den.

Back in Thai­land, un­der the ban­ner of func­tional medicine, a brand of in­te­gra­tive care rooted in natur­opa­thy and TCM now turbo-charged by DNA se­quenc­ing, prac­ti­tion­ers tackle phys­i­o­logic per­for­mance. They de­crypt an in­di­vid­ual’s ge­netic code – one that, when func­tional, pro­motes health and when dys­func­tional, causes ill­ness. While Western tac­tics rely on drug ther­apy, func­tional medicine favours a holis­tic ap­proach, pre­dic­tive and pre­ven­ta­tive, that in­cor­po­rates hered­i­tary fac­tors and cel­lu­lar per­for­mance while stress­ing the con­nec­tion be­tween poor bi­o­log­i­cal func­tion, nu­tri­tion, life­style and chronic dis­ease.

The es­sen­tial cor­ner­stone of func­tional medicine is easy to grasp and sim­ple to ap­ply. Diet is cru­cial. Re­cent re­search on the mi­cro­scopic or­gan­isms of the gas­troin­testi­nal tract has borne out the doc­trine’s long-held core the­sis: nu­tri­tion is the lynch­pin of well­ness. Nur­ture healthy gut bac­te­ria and you can sidestep check­ing into clin­ics to have your di­a­betes re­versed via cell ther­apy, or bat­tling can­cers with ovine em­bryo in­jec­tions. Yes, it’s heart­en­ing to know that 21st-cen­tury science now of­fers a range of dy­namic new ap­proaches to dis­ease. But it’s equally com­fort­ing to re­al­ize that over­all well­ness and longevity looks to be as sim­ple as what you eat.

JOHN STE­WART’S BE­LIEF in al­ter­na­tive well­ness is grounded in a life-chang­ing per­sonal cri­sis. A Van­cou­ver na­tive now in his 60s, Ste­wart co-founded Ka­malaya, Thai­land’s func­tional medicinebased re­treat, on the coast of Koh Sa­mui in 2005 af­ter his busi­ness part­ner (and wife), a spe­cial­ist in func­tional medicine and TCM, cured him of “fa­tal” liver dis­ease af­ter a spe­cial­ist told him to put his life in or­der.

“The di­ges­tive sys­tem is con­nected to the brain. There are more nerve end­ings in your gut com­mu­ni­cat­ing with your body than in the en­tire ner­vous sys­tem,” ex­plains Ste­wart. “The gut’s bac­te­ria, four tril­lion cells col­lec­tively known as the mi­cro­biome, reg­u­late hor­mone and neu­ro­log­i­cal func­tion. What we’re learn­ing now will change med­i­cal science. It will be re­clas­si­fied as an or­gan.”

Im­bal­ances in the mi­cro­biome have now been linked to al­most ev­ery ill­ness – phys­i­cal, emo­tional, and men­tal. Last year, re­searchers at the Univer­sity of Texas MD An­der­son Can­cer Cen­tre found that pa­tients who re­spond to treat­ment for ma­lig­nant melanoma have more di­verse gut bac­te­ria than non-re­spon­ders. Stud­ies at Ja­pan’s Ku­mamoto Univer­sity show that esophageal can­cer pa­tients who test pos­i­tive for a cer­tain bac­te­ria have in­fe­rior sur­vival rates. A study at Cor­nell Univer­sity re­vealed that the weight of mice could be changed by more than 15 per cent sim­ply by al­ter­ing their in­testi­nal bac­te­ria. These im­bal­ances are now be­ing con­nected to every­thing from autism to de­pres­sion, prompt­ing the Univer­sity of Michi­gan, for ex­am­ple, to run clin­i­cal tri­als on how diet al­ters gut mi­cro­biota and, pos­si­bly, in­flu­ences bipo­lar dis­or­der.

“The di­ges­tive sys­tem is con­sid­ered the sec­ond brain in tra­di­tional Chi­nese medicine, which has al­ways viewed di­ges­tive health as piv­otal to our health and vi­tal­ity for cen­turies,” says Ka­rina Ste­wart, a Prince­ton grad­u­ate who pur­sued a master’s de­gree in TCM and ad­di­tional train­ing in func­tional medicine be­fore co-found­ing Ka­malaya with her hus­band. “Seventy to 80 per cent of our im­mune sys­tem is lo­cated in the di­ges­tive sys­tem, as this is where our bod­ies come in con­tact di­rectly with the out­side world, much like our skin on the sur­face of our bod­ies. When the in­testines be­come in­flamed, there’s a cor­re­spond­ing ef­fect of in­flam­ma­tion in the ner­vous sys­tem and brain. De­pres­sion and mood swings, au­toim­mune dis­or­ders like arthri­tis, lu­pus, MS and Parkin­son’s. What we eat, drink, breathe goes di­rectly into our body so the im­mune sys­tem has to be strong.”

Ex­am­in­ing 18 di­verse cul­tures, in­clud­ing tra­di­tional ones in Africa that in­gest zero re­fined sugar or

pro­cessed food, Stan­ford pro­fes­sors Justin and Erica Son­nen­burg found that those fur­thest re­moved from a Western diet had the health­i­est tummy mi­crobes, in­clud­ing many that were com­pletely miss­ing from the Western stom­ach. Co-au­thors of 2015’s The Good Gut, they de­fine this “mass ex­tinc­tion event” as one caused by poor diet, an­tibi­otics and our First World ob­ses­sion with over­ster­il­iza­tion. In a 2017 in­ter­view with NPR, Jens Wal­ter, a mi­cro­bi­ol­o­gist at the Univer­sity of Al­berta, agreed that this ex­plained, “all these dis­eases, you know, they have sky­rock­eted in the last 50 or 60 years.”

I’ve al­ways been a healthy eater. I’d also viewed diet as a straight­for­ward calo­ries-in/calo­ries-out af­fair, an in­dul­gence here, rec­ti­fied by re­straint there. Ed­u­cated about the mi­cro­biome, I have an in­stant paradigm shift in my think­ing about food. A new un­der­stand­ing that what­ever I in­gest isn’t sim­ply pass­ing through but, in fact, has a last­ing ef­fect. I swear off fac­tory-farmed meat of any kind, some­thing I’d been lean­ing to­ward for a while. I still have meat on oc­ca­sion, sourced from or­ganic, free-range farms, and wild fish.

“Thai­land has been in­vest­ing in or­ganic agri­cul­ture for over a decade,” says Ka­rina of her adopted coun­try, which be­gan mov­ing its food pro­duc­tion to chem-free farm­ing as of­fi­cial pol­icy in 2006, al­though there is much more to ac- com­plish. “In the West, an­tibi­otics are in the wa­ter, in fac­tory-farmed meat, and they de­stroy your mi­cro­biome.” That said, even in the West, main­tain­ing a fresh, or­ganic, an­tibi­otic-free diet has been sim­pli­fied given the wave of healthy-eat­ing out­lets. From week­end farm­ers mar­kets and Freshii cafés on ev­ery corner through the now agree­ably dis­counted Whole Foods (thanks, Ama­zon!), pure food is not as costly or as tricky to source as it once was. Diet is crit­i­cal to the gut-brain axis but, Ka­rina adds, sleep and stressre­duc­tion are also es­sen­tial: angst hor­mones like adrenalin and cor­ti­sol af­flict gut bac­te­ria.

CU­RI­OUS TO SEE what’s be­hind Ka­malaya, I check in to the lush com­pound spread across eight acres of flow­er­ing jun­gle, equipped with a state-of-the-art fit­ness fa­cil­ity, an ar­ray of pools, ex­ten­sive spa and yoga pav­il­ions. My first day be­gins with a visit to the natur­opath. I item­ize my is­sues for Marissa Bren­nan, who’s from Toronto of all places. I’m bloated, re­tain wa­ter, have puffy eyes. I’m flooded with es­tro­gen. As­sign­ing me an or­ganic, plant-based detox diet, Bren­nan also ad­vises omega-3 sup­ple­ments and in­structs me to drink no al­co­hol (or­ganic wine is avail­able in the restau­rant) while flush­ing my­self with min­eral-rich rooi­bos tea and two litres of wa­ter a day. And a sched­ule: acupunc­ture, lym­phat- ic drainage and Chi­nese ab­dom­i­nal mas­sage, pu­ri­fy­ing ses­sions in the in­frared sauna and steam room, daily yoga and meditation.

By Day 3, the jig­gly-wig­gly fig­ure and puffy eyes have been ban­ished. Pounds fall off – much of it wa­ter, now that my body isn’t hoard­ing what few drops it gets, but also thanks to a menu of or­ganic su­per foods that’s so var­ied and de­li­cious, I never feel de­prived. A week later, I check out, lean and clean. In­spired, I add fer­mented flu­ids – miso soup, kom­bucha tea – to my post-Ka­malaya rou­tine to help re­in­force healthy tummy bac­te­ria.

Three months later, a once ded­i­cated steak-and-mar­tini girl, I’ve gone or­ganic pescatar­ian, and also “con­sciously un­cou­pled” from gra­tu­itous daily wine drink­ing. I start the day with fruit and hot lemon wa­ter or a shot of ap­ple cider vine­gar to get my en­zymes go­ing. I no longer have puffy eyes. I’m 12 pounds lighter though no change in ex­er­cise, just the usual brisk dog walks. My men­strual cy­cle has reg­u­lated. As have my moods. The dark patches on my face from sur­plus es­tro­gen are fad­ing. I don’t hit the snooze but­ton three times. I’ve swapped yo­gurt for ke­fir, which has a bazil­lion more pro­bi­otics. I pop omega-3s. I down two litres of wa­ter ev­ery day.

But I am still smok­ing. No­body’s per­fect. thai­land­tourism.org

Med­i­tate on this: Ka­malaya Koh Sa­mui

Treat­ment pods at up­mar­ket Brio Clinic ( brio-clinic .com/en), lo­cated in the In­ter­Con­ti­nen­tal Bangkok

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