Integrative Pediatrician Dr. Joel Warsh On Addressing the Rise of Chronic Illness in Children

Integrative pediatrician Dr. Joel “Gator” Warsh will be the first to sing the praises of conventional medicine. But he’ll also be the first to point you to its limitations, as well as its dangers. After years of practicing, he’s seen firsthand how the narrow perspective and overly aggressive approach of many doctors can harm patients, as well as the ways in which integrative medicine can solve problems conventional medicine can’t. The challenge now, he says, is to remove the divide between the two approaches — easier said than done, but well worth the effort. Read on to learn about the rise of chronic illness in children, how he incorporates multiple modalities into his integrative pediatrics practice, and much more.

*This is a short clip from Dr. Warsh’s interview. Click here to watch the whole thing!*

You can also listen to our interview with Dr. Warsh on The WellBe Podcast. 

Experiencing Firsthand the Connection Between Diet and Health  

Dr. Warsh grew up in Canada where, like most of his peers, he was very active. He played lots of sports, always on his way to one practice or game or another, and his busy schedule meant that he and his family ate fast food all the time. During that time, he would experience stomach issues frequently, especially when he was worried or stressed out. But, he says, “I just thought that was normal.” 

As he went through college, then medical school, then residency, the stress — and the stomach problems — grew worse, but he never considered that changing his diet might make a difference. “I never really put two and two together until I met my now-wife who is very holistic, very integrative, she eats very healthy and cooks very healthy. I started eating her food and all of my symptoms completely went away,” he says. “That to me was just so interesting. It really made me start thinking about what the connection was there.”

(Incidentally, his wife’s last name is “Intelligator,” which is how he got his nickname, “Dr. Gator.”)

Breaking the Mold as a Lone Integrative Pediatrician

While Dr. Warsh was transforming his own diet and seeing his health issues improve, he was also completing his residency, and his personal experience altered the lens through which he saw patients. During that time, there was one particular patient case that “really brought it all together for me,” he says. 

He and his team were tasked with treating a 10-year-old boy with juvenile arthritis, who was experiencing symptoms like rashes, swelling joints, and arthritic pain. None of the doctors had any idea of the cause, and labeled it simply as idiopathic. But Dr. Warsh, noticing that the boy was always snacking on junk food like chips and candy, brought up the possibility that his diet might be connected to the symptoms. “Everybody kind of just laughed it off,” he remembers. 

The child left the hospital, but two weeks later he was readmitted, and Dr. Warsh was on his team again. “This time, when I went into rounds, I did a little bit more research and I brought in a bunch of information about celiac disease,” he says. “I talked with the team and said, ‘You know, maybe he doesn’t have wheat intolerance or gluten intolerance, but look at the symptoms. They’re very similar to someone with celiac. Maybe he has some sort of other sensitivity.’ Again, everyone just laughed it off, said that was silly.”

Thankfully, the child’s grandmother had overheard, and she approached Dr. Warsh afterward, telling him that she appreciated his perspective and the fact that he was looking for a root cause rather than just treating symptoms. After the child left the hospital again, his family sought out Dr. Warsh as their pediatrician. They immediately began working on dietary changes, eliminating wheat and dairy and reducing sugar, as well as lifestyle changes like getting exercise and improving sleep. The symptoms went away, and the child never came back to the hospital again. “That, to me, was a light bulb moment,” says Dr. Warsh. From that point forward, he was committed to practicing integrative pediatrics.

Again and again, he’s seen the ways in which conventional medicine ignores the patient as a whole and jumps right to treating the symptoms. For instance, when a baby was having severe acid reflux at two months old, the doctors in his practice were quick to dole out prescriptions and order tests, and were about to order a scope (which would go down into the infant’s stomach). Only Dr. Warsh considered asking about the baby’s diet, and learned that the parents had recently switched from breast milk to a formula with a lot of dairy; by switching to a different formula, the problem went away and they never needed to put a scope down into the infant’s stomach. “It was just as simple as thinking about things more holistically and thinking about the root cause,” says Dr. Warsh.

Bridging the Conventional-Alternative Divide through Integrative Pediatrics

Once Dr. Warsh’s perspective had been shifted, he knew to put in the work to become an integrative pediatrician. His personal and professional experiences were just the tip of the iceberg when it came to root cause-based medicine, and so he took it upon himself to pursue additional training in functional medicine, homeopathy, and Ayurveda, among other holistic and integrative practices. He knew that in order to be the best integrative pediatrician possible, he wanted to bring an integrative holistic approach as a complement to his conventional training.  

Dr. Warsh is clear in explaining that he practices integrative pediatrics, meaning that he uses complementary and Eastern medicine practices alongside — not in place of  — conventional medicine. “I love conventional medicine,” he says. “We have the most unbelievable treatments that we never had in the past. We can cure cancer. We can keep someone alive who has HIV. We can do all these amazing things and doctors are wonderful, amazing people.”

However, he says, his experiences and training led him to see some big problems with the way medicine is practiced in the United States. Conventional medicine, he says, puts the focus on treating disease, whereas more integrative and holistic approaches put the focus on preventing it. He sees the value in pulling from a number of different philosophies in order to best treat each individual patient. “My ethos and what I really believe in is that there shouldn’t be Eastern medicine and Western medicine — it should just be medicine.” he says. “You need both things together and that’s the essence of integrative medicine — it’s combining those two.”

Dr. Warsh applies this holistic thinking to his practice by looking at each patient as an individual whose health is the result of many different factors. He takes a long history of every patient, looking for patterns and connections and thinking about basic lifestyle changes that can be made to address any issues. He tries to start with the basic, simple lifestyle factors you can alter. “For most people, there are a few simple things that you can do. It doesn’t matter whether you have money, whether you don’t have money, wherever you are, you can make these small changes and you’re going to see some impact,” he says.

“I don’t think medicine should be the first thing. It should be the last thing,” he says. Rather than writing a prescription when a parent comes in with a child exhibiting ADHD behaviors, for example, he first tries to rule out any underlying medical condition that might trigger these same symptoms. After that, he’ll turn to lifestyle interventions and alternative treatments, like acupuncture, yoga, or naturopathy. 

Sometimes, however, the right solution might be a conventional medicine, like steroids or antibiotics — but even in cases like that, after the acute episode has been cured, he makes sure to step back and understand why the issue occurred and what can be done to prevent it in the future. He knows that, while medicine can be incredibly helpful in the short-term, any medication taken over a long period of time can cause major problems, whether to the brain, the gut, hormones, or something else.

The Rise of Chronic Illness in Children 

In his practice, the most common issues that Dr. Warsh sees are things like ADHD, autism, allergies, and autoimmune diseases like lupus, arthritis, and Crohn’s — and, alarmingly, rates of all of these conditions are increasing. “It’s unbelievably clear how much more common these things are than they used to be,” he says, citing autism as the prime example. In the 1980s, the rate of autism was 1 in 5,000 children, and it’s been steadily rising since then, reaching a shocking rate of 1 in 54 today. “It’s alarmingly scary, and there’s something going on,” says Dr. Warsh. 

He explains that it’s unclear why autism and other diseases are on the rise, but that it’s definitely more than just improvements in diagnostic capabilities. “It wasn’t something you really heard when we were kids, and now, it’s so common. Just like allergies,” he says. “Maybe the odd person you knew had a peanut allergy but now, every school, everywhere there’s so much peanut allergy that peanuts are banned, which is scary. Why did that happen? What has changed in our environment that’s causing this to occur? Something is causing inflammation.”

Conventional and integrative pediatrics are firmly in two different camps when it comes to the rise of chronic illness in children, something that Dr. Warsh finds troubling. “They’re so far apart in this one. I think we have to start working together,” he says. In his view, the root cause is probably a combination of multiple different factors: something or things in our environment, the way we’re eating, substances in the water we’re drinking, nutritional deficiencies, etc. “My gut says it’s something with the environment, something that we’re doing, something that’s going on in pregnancy, something that we’re missing from our diets. It’s hard to say, maybe all of them,” he says. 

To better illustrate how our environments and lifestyle are contributing to the rise of chronic illness in children, Dr. Warsh brings up the bucket analogy often used in functional medicine: “There’s water streaming into the bucket, there’s a hole at the bottom of the bucket, and if everything’s okay, the water’s able to flow through. But if you have something going on, some sort of inflammation, some sort of problem, that bucket starts to fill up. And then, another problem happens, and you just can’t handle it, and it overflows. I think that’s a really good analogy and model for what’s going on with allergies, asthma, and other issues. We just have this overflow of inflammation or the water in the bucket. We can’t handle it and we get one more thing that happens and then, it just spills over. If we can decrease that inflammation, that water in the bucket, then we’re going to prevent kids from getting sick, and that’s what I see with my patients.”

Watch our full interview with Dr. Gator to hear his thoughts on when and how he prescribes antibiotics to children, why autism is actually a number of different conditions grouped under one term, the problem with steroids to treat pediatric asthma, his thoughts on different types of allergy tests, why he believes ADHD is being overly diagnosed, how to counteract any negative repercussions of C-section births, his thoughts on vaccines, and much more.

You can also listen to our interview with Dr. Warsh on The WellBe Podcast. 

The information contained in this article comes from our interview with Dr. Joel Gator Warsh, MD. His qualifications and training include graduating from Thomas Jefferson Medical College, a Master’s degree in Epidemiology and Community Health from Queen’s University, and a pediatric residency at Children’s Hospital of Los Angeles. He is currently on staff at Cedar Sinai Hospital and is in private practice as well. He is also a certified Integrative Medical Practitioner by the American Academy of Integrative Medicine. You can learn more about him here.

Citations: 

1. “Prevalence of Autism Spectrum Disorder.” Mental Disorders and Disabilities Among Low-Income Children. Washington (DC): National Academies Press (US); 2015 Oct 28. 14, Prevalence of Autism Spectrum Disorder.
2. Maenner MJ, Shaw KA, Baio J, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveill Summ 2020;69(No. SS-4):1–12.