Dr. Erika Krauss, Glenville Concierge Care
Where did you grow up and how did you get into medicine?
I grew up in Long Island in Great Neck, and Bayville. I had a strange fascination with hospitals. I visited hospitals a couple of times during high school. I felt very comfortable and at the same time excited by the action and energy. This was when the idea of becoming a doctor first manifested. I followed a pre-med track in college, although I majored in psychology. I spent the first two years unsure if I would pursue medicine or go for a doctorate in psychology. Then, in the summer between my sophomore and junior years, I did an externship at NYU Rusk Rehabilitation Center and became certain medicine was the path I wanted to pursue.
I went to medical school at NY College of Osteopathic Medicine in Old Westbury, NY. I was drawn to the idea of being an Osteopathic physician because I liked the idea of the mind-body connection. The focus of the training is the concept of supporting the body’s inherent ability to heal itself.
Tell us about your family.
I have been married since 2002 to my husband Ralph. He works in financial services. I have two sons, Nick and Charlie. Nick is 18 years old and a freshman at the University of Vermont. Charlie is a junior in high school, who recently decided he wants to be a doctor, as well (for years he wanted to be a veterinarian), so I am very excited about that! We love to ski together, although my sons have both surpassed me at this point. My sons and I also like to run. This summer we plan to run in a half marathon together in Vermont. This will be the first year the three of us do this together.
What is your specialty?
I am a board-certified Internist. I did my Internal Medicine residency at Saint Vincent’s Hospital in Manhattan. In keeping with my interest in Integrative Medicine I have done additional training through conferences over the years. In 2015, I completed a fellowship and board certification in Metabolic and Nutritional Medicine through A4M. Then in 2018, I became board certified in Integrative Medicine by the American Board of Medical Specialties.
What is Integrative Medicine?
There are many ways to describe it, but I like to think of it as serving two overarching principles: 1) helping people maintain optimal health and preventing disease through lifestyle modification, including proper diet, exercise, sleep, stress management, and overall emotional wellness. 2) treating disease when it occurs, by looking for the root cause and not just treating the symptoms.
Medicine has become very specialized. Sometimes patients have a specialist for every body part and a medication or treatment for each of these parts. My role is to piece them together and treat them as the whole person they are, instead of having different silos for each condition.
One important aspect of functional medicine is uncovering the root cause of symptoms. Oftentimes, traditional labs don’t elucidate the problem and patients are told “everything looks good,” yet they don’t feel well. However comprehensive these labs may be, they cannot detect subtle deficiencies in nutrients very well. Using nutritional testing, I am often able to uncover imbalances that are causing many of their symptoms. The treatment often comes down to having the patient make changes in their diet and lifestyle factors, such as stress management and exercise.
You’ve mentioned “preventing disease before it begins,” – tell us how one addresses that with a patient?
At Glenville, we spend a great deal of time during the physical exam in my office talking. I get a good sense of their habits – eating, sleeping, movement and activity, stressors and mental health. I work with them on optimizing their routines. I find many patients are aware that they should be eating a healthy diet with little refined sugar and low saturated fats and they know that they should be exercising regularly. However, they will often neglect the importance of sleep and have a hard time managing stress. All these factors together are very important for preventing disease, which would include conditions like metabolic syndrome or “pre-diabetes” (as well as Diabetes), hypertension, high cholesterol, heart disease and cancer, to name a few. So many studies have shown the importance of lifestyle optimization in prevention of chronic conditions.
We need to think about family history as well, but just because we have a strong family history of heart disease does not mean we are doomed to get it. It may raise our risk, but we can now assess genetic risk much better than we used to. We no longer rely solely on cholesterol levels but need to look at things like Lipoprotein (a), which is a hereditary particle within our cholesterol that can raise our risk of cardiovascular disease, if elevated. Knowledge is power. If we find out that we’re at higher risk for a particular condition, there is much we can do to lower that risk.
Is it best to start young?
It’s always best to start as early as we can, but it is never too late. When we’re young, we feel invincible and tend to not think about these things very much. We have more motivation to work on them as we get older, maybe when we see friends and other people our age struggling with these conditions.
For my patients older than 60, it’s important for them to keep active. Especially working on strength training, which is something that many people are not comfortable with. We lose 2-4% of our muscle mass as we age, even starting as young as 40. Muscle strength is so important. We need to be able to catch ourselves from falling, stoop down to play with grandkids, and continue to do activities that are meaningful to us, like skiing or golf.
Talk a bit about women’s health and what you discuss with your patients.
Heart disease is the leading cause of death in women worldwide, but more than half of Americans are not aware of this. 90% of heart disease is preventable by modifying risk factors.
Other important issues for women are hormonal health, including menopause. The question of hormone replacement has been controversial throughout the years, being touted as the answer to all that ails you in the ‘80’s and 90’s. Then, hormone replacement was vilified by the Women’s Health Initiative initial results in 2002. These days, it has made something of a comeback as we re-examine those results. To summarize a very complicated topic, starting early (within 5 years of menopause) is the safest option. It has benefits for bones, brain health, libido, and heart health.