Wellness, Actually

From the activity tracker on your Apple Watch to the sustainably sourced CBD oil you buy for your aching joints to the almond milk or oat milk or pea milk or tiger nut milk (it’s a real thing) in your latte, wellness is all around us. (Gwyneth Paltrow has, famously, built a $250 million empire called Goop on it.) It’s especially all around Denver, where the density of wellness options is second only to New York City, according to fitness and wellness membership program ClassPass’ nationwide analysis.

That makes sense when you consider the Centennial State’s outdoor-centric lifestyle, which has long been intertwined with a holistically healthy mindset. “It’s somewhat of an indirect line,” says Sheila Liewald, a staff acupuncturist at the Center for Integrative Medicine at Good Samaritan Medical Center. “If you’re an outdoors enthusiast, you’re probably aware of your health.” The upshot: Colorado’s Lululemon-swaddled citizens are a prime audience for emerging wellness treatments and products.

5280 March 2019
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But entrepreneurs and Paltrow aren’t the only ones jumping on the wellness wagon. Local physicians are increasingly turning to nontraditional treatment options, too, or referring patients to those who can provide them. In one of the few long-term surveys of complementary and alternative medicine (CAM), Kaiser Permanente Colorado tracked patients who visited its CAM clinics between 2007 and 2014. In the first year of the study, all participants sought out the services on their own, without referrals from doctors. By the end of the program, Kaiser physicians had sent patients to the CAM clinics 3,200 times.

But what actually qualifies as “wellness”? We asked local practitioners and health entrepreneurs how they define the rather amorphous term. The continuous thread in their responses was that wellness is about addressing not just physical, but also mental and spiritual, health. “[It’s] a state where body, mind, and soul are poised to support whatever the individual defines as his or her life purposes and heart’s desires,” says Lauren Grossman, the medical director of UCHealth University of Colorado Hospital’s Integrative Medicine Center. “One person may want to be able to walk across the street without his oxygen tank, [another to] obtain her college degree or prepare to climb Mt. Everest.” In other words, wellness is an evolution of health, an understanding that different modalities can make different people feel better. In the following pages, we sort through the crystals and chiropractors to provide the context you need to figure out just what—if any—aspects of the wellness world you want all around you.

Illustration by Marina Munn.

Wellness Wisdom: “Integrative,” “Complementary,” “Alternative”

These words are used to describe modalities, like acupuncture, outside the realm of traditional medicine. Generally, they mean the same thing, although “alternative” is falling out of favor because if a treatment works, it shouldn’t be considered secondary. Integrative medicine—medicine that “focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches and disciplines to achieve optimal health and healing”—became a board-certified speciality in 2013.

Like Minds

These local events make it easy to find your wellness tribe.

Women’s Weekend of Wellness | March 7 to 10
Colorado Springs’ Broadmoor started out as a casino in the late 19th century but quickly transformed into a resort that promised “continuous participation in rejuvenating, health-giving, open-air pastimes.” The modern Broadmoor still emphasizes well-being, particularly for the few days each year when yoga and fitness instructors, productivity experts, and others help women find empowerment via healthy living. From $925, broadmoor.com

Healing Days | April 13
This year-old gathering of mind-body experts introduces novices to the world of complementary medicine. The April shindig in Aspen will feature 12 to 15 healers practicing everything from meditation to energy medicine (think: chakras and crystals). $30, healingdays.com

Wanderlust Denver | August 10 to 11
This will be the Wanderlust empire’s first two-day festival in Colorado—part of a new slate of urban events. Expect the yoga, lectures, and healthy dinners that are signature elements of the Wanderlust brand. From $251, wanderlust.com/denver

Health On Demand

True Nature Healing Arts Center. Courtesy of Shawn O’Connor Photography.

For decades, those looking to improve their health went to two places: the doctor’s office or the gym. Now you can work on your wellness anywhere.

At Home

Home is where the heart—and lungs and liver and brain—is at Lincoln Park’s Mariposa District. The recently redesigned public housing complex is one of a growing number of wellness-oriented developments that aim to improve residents’ health through design and amenities. Colorado boasts at least 15 of these communities, including Bucking Horse Ranch in Fort Collins, Sterling Ranch in Littleton, and Anthem Highlands (for families) and Anthem Ranch (for adults 55 and older) in Broomfield. But 450-unit, mixed-income Mariposa (more units are coming) is the most impressive local example. Among the healthful features: The developer, Mithun, widened the staircases and moved them in front of the elevators, creating a visual imperative for residents to walk to other floors instead of ride; farmers’ markets, cooking classes, yoga sessions, and mental health support groups are on-site; and Mariposa has even hired someone to ensure residents schedule their medical appointments and get to them on time.

In the Workplace

American employers miss out on $530 billion each year thanks to illness-related lost productivity. Little wonder 75 percent of employers nationwide now offer health-related benefits beyond just insurance. In Colorado, that can mean medical care at the office, like at Thornton’s Appliance Factory, where 400 employees have virtual access to a Kaiser Permanente physician and can use medical equipment such as a scale, thermometer, and blood pressure cuff in a room connected to their building. Other companies have instituted workplace wellness programs, an old idea that’s experiencing a resurgence. “They started out primarily exercise- or physically focused,” says Sandra Crews, a health strategist for UnitedHealthcare, who says 70 to 90 percent of the large Colorado employers she works with have instituted workplace wellness programs. “Now they include things like mindfulness and financial well-being, more community engagement.”

On Vacation

Taking a week off to escape to the mountains is no longer just about getting away; it’s often about getting healthier, too. Many resorts now present a slate of in-house wellness services—chiropractic care, hypnotherapy—for guests to take advantage of. At other resorts, wellness is the focus: Carbondale’s True Nature Healing Arts gives guests access to yoga, meditation, and breathwork classes as well as its Peace Garden, Reflexology Path, and organic cafe. If that’s too touchy-feely for you, check out the globe-trotting list of resorts and adventures on the Denver-based Wellness Tourism Association’s website to find your ideal R & R Rx.

Charting the Alternatives

Holistic health options in Denver are more diverse than an REI Garage Sale. But which ones really work, and for what conditions? We talked with local practitioners and national researchers to learn more about some of the Mile High City’s popular complementary modalities—and to determine whether or not your Flexible Spending Account (FSA) or Health Savings Account (HSA) will reimburse you if you try them.

Acupuncture
Using needles to stimulate various pressure points on the body

Science says: It’s best used for nausea and vomiting after surgery or chemotherapy. Many practitioners recommend it for chronic back pain, too, but scientific studies have seen mixed results.
Potential risks: Infections, punctured organs, central nervous system injuries; other risks for those with blood disorders or pacemakers
Colorado regulations: Acupuncturists must have a license to practice legally. For that, they’ll need to have completed an accredited diploma program in acupuncture and Oriental medicine and passed a certification test. That usually takes three to four years.
FSA/HSA? Yes

Chiropractic Care
Manual manipulation of the joints based on the theory that everything is connected through a neuromusculoskeletal system

Science says: This modality can help relieve chronic low back pain. There’s some evidence that you can use it for neck pain and migraines as well, but more research needs to be done in those areas.
Potential risks: Headaches, exhaustion, and rare serious side effects like stroke
Colorado regulations: Chiropractic practitioners must have a license. But first they’ll need to have graduated from an approved chiropractic school (usually four years) and passed a board exam that covers eight different disciplines.
FSA/HSA? Yes

Hydration Therapy
Being infused with vitamins and minerals through an IV

Science says: Hydration therapy can help correct deficiencies in important vitamins, such as B12 and iron—or maybe help offset the impacts of a night of heavy drinking.
Potential risks: Infections, bruises, bleeding, and blood clots
Colorado regulations: The FDA doesn’t regulate infusions, and there’s no licensing procedure for IV clinics in Colorado. In September, the Federal Trade Commission charged Texas-based iV Bars (which had a Vail clinic) with making “deceptive and unsupported health claims.”
FSA/HSA? No

Cannabidiol (CBD)
A nonpsychoactive compound—i.e., it doesn’t get you high—in the cannabis plant

Science says: In June, the FDA approved its first CBD drug, Epidiolex, for two severe forms of epilepsy. Some studies have also shown that CBD might be helpful in reducing anxiety and inflammation (and thus, pain).
Potential risks: Dry mouth, drowsiness, low blood pressure, lightheadedness, and liver issues; Epidiolex has its own set of risks
Colorado regulations: The Colorado Department of Public Health and Environment sets the rules for consumable products with CBD in them, ensuring they have clear labeling and don’t contain more than 0.3 percent THC (the compound that does get you high).
FSA/HSA? No

Cryotherapy
Exposing the body to extreme cold, usually through contact with liquid nitrogen

Science says: Cryotherapy works to get rid of warts and other growths. There is no data to definitively support claims that it combats muscle soreness.
Potential risks: Frostbite, burns, and eye and nerve injuries—potential side effects so serious the FDA has warned against whole-body cryotherapy
Colorado regulations: There are none.
FSA/HSA? No

Reiki
A type of energy medicine during which Reiki masters place their hands on or above the body to try to coax it to heal

Science says: Devotees swear by it for everything from pain to anxiety relief to improved digestive function, but there is no hard evidence to suggest it actually fixes anything.
Potential risks: None
Colorado regulations: There are none.
FSA/HSA? No (but massage is eligible)

Crystals
Stones that elicit different types of energy

Science says: Followers believe these gems can help you can gain confidence, balance, and good vibes, but there’s no science to support any of this.
Potential risks: None
Colorado regulations: There are none.
FSA/HSA? No

Wellness Wisdom: Boulder

The Front Range town has been a wellness mecca since the 1890s, when a sanitarium that had opened to treat tuberculosis patients—it initially featured bizarre treatments like enemas—evolved into a resort and spa that decreed hiking up Mt. Sanitas was the best medicine.

Control Substances

Illustration by Marina Munn.

Science says placebos can actually work. So where does that leave doctors and their prescription pads?

In the past, medicine has collectively waved off New Agey integrative practices such as, say, crystals as simply placebos, modalities once thought to only have psychological effects. Now, though, research is revealing that placebos can have a tangible impact on our bodies as well as our brains, sometimes even clearing up puzzling chronic ailments that haven’t responded to scientifically backed medications.

If placebos do, in fact, work, a whole new realm of thinking about how to treat ailments would open up—along with opportunities for modalities without robust evidence behind them to gain traction. But it also leaves room for unethical entrepreneurs to make concerning claims about unproven methods (e.g., coffee enemas as the solution to breast cancer—yes, it’s happened) and charge exorbitant prices for them.

All of that puts providers in a difficult spot, especially given the public’s hunger for a different health paradigm. (In 2012, the most recent year for which data is available, an estimated 59 million people nationwide spent money on complementary therapies.) Lauren Grossman at UCHealth University of Colorado Hospital’s Integrative Medicine Center has handled the dilemma by hiring a research director to conduct more studies on integrative therapies while also offering some services that don’t have evidence to support them—among them Reiki and healing touch, a type of energy medicine that’s similar to Reiki—at no cost.

Others are less inclined to invest in unconventional treatments. Although adults can make whatever informed choices they like, says Linda Rosa, a retired nurse and the executive director of Advocates for Children in Therapy (an organization that opposes practices that have not been validated within psychotherapy), physicians shouldn’t provide placebos to patients of any age. “We really only want to give treatments that are demonstrated to have some benefit,” she says. “In general, things do need to have a good body of evidence in order for it to be part of medicine.” One thing isn’t up for argument: Colorado’s thousands of wellness practitioners—and their patients—will be keenly watching to see how this debate develops.

On Track(ing)

How local wellness-monitoring startups are helping doctors translate data into better health.

Data tracking has quickly become the technology industry’s new frontier, thanks to wearables like Fitbits that count your steps and calculate your heart rate. But what are people to do with all of this newfound knowledge at their wrists? Several Centennial State companies are helping connect those troves of health data to the individuals who can use them best: physicians. “You can look at your glucose data all you want,” says Jeffrey Mutchnik, the digital marketing manager for Denver-based Cliexa. “But a lot of that information is only really important to your doctor.” Cliexa has built an app for patients with chronic conditions that syncs with wearables and incorporates whichever metrics a physician requests—heart rhythm for those with cardiovascular issues, glucose levels for diabetics—into the patient’s electronic medical record (a health history and profile). Similarly, Denver’s SleepImage has invented the only FDA-approved device to measure sleep quality; it records your body position and the electrical activity of your heart. The gadget then uploads its data to a cloud service that provides recommendations to patients’ doctors about symptoms they might want to further investigate, like unusual breathing patterns. It’s this type of tech that’s making you healthier, one step (or breath or heartbeat) at a time.

A Return to Roots

Monika Nuffer. Photo by Caleb Alvarado.

A University of Colorado course draws on herbal origins to educate burgeoning pharmacists about integrative medicine.

In 2017, Americans spent $8.1 billion (yes, with a b) on herbal supplements—a dollar amount that’s been steadily increasing for more than a decade. To people like Monika Nuffer, a clinical pharmacist and herbal specialist at UCHealth University of Colorado Hospital’s Integrative Medicine Center, that means it’s time for medical providers to learn more about complementary approaches. This past fall she launched an integrative health and medicine graduate certificate, which focuses on herbs and supplements, for pharmacists in the University of Colorado’s Skaggs School of Pharmacy and Pharmaceutical Sciences. We caught up with her this winter to talk about complementary modalities in other cultures and why patients aren’t always honest with their docs about exactly what they’re taking.

5280: How did you first become interested in integrative medicine?
Monika Nuffer: I was born in the Czech Republic and then moved to lots of places around the world. In all the other settings where I’ve lived, integrative medicine as we know it wasn’t considered “alternative.” It was one of the options for standard care. As I was applying to pharmacy school in the United States, I was so excited to learn about traditional medicine and marry that with all the complementary treatment, but the curriculum wasn’t as robust as it should be.

Is that why you decided to create a certificate at the School of Pharmacy?
Partially. We’ve actually been offering an elective for students on integrative medicine. It’s a hybrid course—some parts online, some parts in person—that includes field trips like going out to a health food store and being a secret shopper to appreciate how a consumer might encounter a product. The course has been filled with a waitlist for every offering. We realized there’s a demand.

What does the program involve?
We do an introductory course and an evidence-based medicine course. We also teach students how to evaluate the literature. There’s a lot of information out there, and it’s really hard understanding what you’re looking for. In the spring, we do a pharmacology course—getting to the root of herbs—and the culminating course is the clinical application, where they take everything they’ve learned and are able to say, “I have a patient with disease X; can I use supplement Y?”

What are some of the challenges involved when patients use these kinds of complementary approaches?
Studies show that a little over 72 percent of patients don’t report their use of integrative therapies to their providers, and that’s alarming. There’s a lot of speculation as to why that happens. There are times when patients don’t think they should share that: It’s a natural supplement. I’m just getting a massage…. Or they might be fearful in sharing that with a traditional provider, who may think it’s witchcraft or hocus-pocus. I’d rather have a provider refer to someone who knows a bit more and could educate a patient, rather than saying, “That’s a bunch of crap.” That closes the communication. If a provider doesn’t want to talk about the supplement, the patient’s probably not going to share anything else.

Sensitive Skin

Courtesy of Ailleia.

Americans spent $2.7 billion on self-care stuffs in 2012, the most recent figure available. And skincare is a huge part of self-care; after all, your epidermis is your largest organ. That’s why, in 2015, Kathryn Murray Dickinson opened Aillea, in Larimer Square, stocked with toxin-free beauty products. Here, her tips for keeping your mug (and hands and legs) soft and sans chemicals.

Look for phenoxyethanol in ingredient lists. Many so-called “clean beauty” companies switched from parabens to this preservative when the former became taboo. Unfortunately, it’s not any better for you; it’s been linked to allergic reactions and even has caused nervous system issues in breast-feeding babies when it was used in a nipple cream.

Be careful with essential oils. Essential oils are not inherently toxic. They’re simply strong—so folks with ultra-sensitive skin should probably stay away.

Don’t forget about your makeup.Your makeup should also be free of sulfates, parabens, and, if possible, synthetic fragrances. Dickinson loves Kjaer Weis’ cream foundation, Clove & Hallow’s liquid lipstick, and Lily Lolo’s pressed shadow.

Feel Goods

Mood-, mind-, and body-mending Colorado goodies to help improve any bad day.

Juju Be Gone’s Black Box
When Mercury goes into retrograde, it’s tempting to reach for two pints of Sweet Action’s salted butterscotch. Opt instead for this cheeky, artery-friendly package of spirit-lifting treats: a candle scented with peony, wood sage, and sea salt; a smudge bundle with sage, palo santo, a selenite crystal, and a feather; and a tray to use in the smudging ceremony. And, OK, maybe pair it with just one pint of ice cream. $50, jujubegone.com

Mary Jane’s Medicinals’ Heavenly Hash Bath
We get emails about new CBD companies nearly every day, but Mary Jane’s Medicinals founder Dahlia Mertens is no rookie. She got into nonpsychoactive cannabis compounds back in 2009 and has spent a decade honing her formulas. Exhibit A: the nirvana-inducing Heavenly Hash Bath, made with Epsom salt, Dead Sea salt, lavender, chamomile, peppermint, grapeseed oil, and, of course, cannabis leaves. $17, maryjanesmedicinals.com

Ethan’s MCT Shots
Medium chain triglycerides (MCTs)—fats found in palm kernel oil and coconut oil—rocketed onto the scene when biohacking company Bulletproof started putting them in coffee for an energy boost. Now, Boulder-based Ethan’s is elevating this trendy lipid with convenient shot-size bottles. Grab the turmeric ginger flavor for a pre-workout snack or the matcha version to power through your afternoon. $48 for a 12-pack, ethans.com

Mighty In Good (MIG) Sleep Balm
When counting sheep isn’t cutting it, turn to MIG Soap & Body Co. for some zzz’s. Its balm combines two forms of REM sleep–inducing chamomile with essential, olive, and castor oils and beeswax sourced from an apiary near MIG’s Colorado Springs shop. Dab it on wherever you need a calming influence to help you drift off to dreamland. $20, migsoap.com

Colorado Threads’ Native Yoga Pants
Our homegrown choice for the comfort-as-fashion trend is Denver’s Colorado Threads. The company makes its yoga pants out of recycled plastic water bottles, and its manufacturing process produces fewer CO2 emissions than that of pants made out of cotton or polyester. We’re currently crushing on the Native style in burgundy or olive green, but watch for new colors to come out later this year. $74, coloradothreads.com

Wellness Wisdom: $4,200,000,000,000

Estimated value of the global wellness economy in 2017