Optimal Health & Wellness

Optimal Health & Wellness Functional Medicine Consultations and treatment plans that focus on Root Cause Owner/Physician: Johnny Gomes, D.O. Wellness Nurse: Sue Gomes, R.N., B.S.N.
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Office Manager: Micah Beaver

Functional & Lifestyle Medicine Education - Empower Yourself and Take Control of Your Health

Functional Medicine uses an integrative approach with an emphasis on identifying root causes that lead to an individual's illnesses and poor health. By addressing these, through modifications in lifestyle factors and other triggers of dysfunction, it is possible to improve, reverse, or even eliminate many of these conditions. It is an holistic approach with a focus on every aspect that makes us who we are. We are presently ill-served by the conventional model of utilizing a pharmaceutical treatment for every condition, "a pill for every ill", focused on suppression of symptoms rather than a cure, all while the disease process continues unabated. While there is a time and place for medications, they are now used as the primary treatment in the majority of these chronic medical conditions. History shows that this has only led to further disease progression. Improving people's lives through lifestyle modification - dietary changes, proper nutrition, effective exercise, stress management, targeted supplementation and optimized sleep - attention to the mind, body & spirit - you can achieve dramatic changes in your life. Our goal is to help individuals to thrive, not just survive, by providing this knowledge. We offer an educational experience focused on the prevention or management of chronic medical conditions. This knowledge enables one to take control of their own health and empowers the individual to improve themselves. This educational experience can be provided in our office, your home or a public venue. We offer individual, family or group lectures and discussions that are targeted to your area of interest, individualized for you and your target audience. The body is capable of healing itself.... We help you learn how. For more info, visit our website: www.optimalhealthwnc.com
Call us at (828) 536-0320 for more info or
Email us at Optimalhc1@gmail.com

Happy Birthday Amber Shiflet!To the best wellness coach and personal trainer—thank you for inspiring strength, confidenc...
01/14/2026

Happy Birthday Amber Shiflet!

To the best wellness coach and personal trainer—thank you for inspiring strength, confidence, and healthier lives every single day. Your passion, energy, and genuine care change people from the inside out. We are so grateful for the way you lead, uplift, and empower this community.

Here’s to another year of transforming lives, crushing goals, and shining bright. Wishing you a day as amazing as the impact you make! 🌿✨

I saw a young lady for her follow-up appointment today. She is in her 30s with significant weight concerns and lipedema...
01/13/2026

I saw a young lady for her follow-up appointment today. She is in her 30s with significant weight concerns and lipedema. We started working together at the beginning of October. It has been just over 3 months since the initial consultation.

Body composition:
Since that time, she is down 50 lb of body weight.
Body fat has decreased by 35 lb.
She feels better, less inflamed, and has more energy.

Blood pressure:
Initial blood pressure was 168/98.
Current blood pressure is 122/78.
No medications were started.

This has been accomplished solely with dietary change and some supportive supplementation. No peptides. No caloric restriction. No starvation diet. Exercise has not yet been started, and it is something we are now going to implement.

We focus on doing what is best for our patients, addressing underlying metabolic imbalances, nutrient deficiencies, inflammatory mediators, and hormonal Imbalances that get to the root cause of the issues. We are not against using GLP-1 (peptides) if it can help move the needle and improve things with regard to disease risk and optimizing body composition. It is never our starting point. We may consider it after several months, if there is a plateau, significant struggles with improvement, or persistent findings of insulin resistance and inflammation. We are not a weight loss clinic, so we do not focus on quick fixes. We address the “why” and let the body heal itself.

I am incredibly proud of this young lady. She has put in an amazing effort and is witnessing the effects. She has been working with Amber, our health coach, for interval support. I fully anticipate we will see significant further improvements between now and our follow-up appointment in a few months.

This is ALL Gluten- Free and I hear it’s amazing! Plus, a generous non profit organization where profits, help people i...
01/13/2026

This is ALL Gluten- Free and I hear it’s amazing! Plus, a generous non profit organization where profits, help people in need in a variety of ways! Give them a try!

MENOPAUSAL HRT: Our approach to management is designed to do so safely, effectively, with the goal of improving symptoms...
01/11/2026

MENOPAUSAL HRT:

Our approach to management is designed to do so safely, effectively, with the goal of improving symptoms, optimizing hormone balance, and assisting in preventing certain diseases.

Medical organizations, including the North American Menopause Society (NAMS) and the NHS, generally recommend the "lowest effective dose" to manage symptoms while minimizing potential side effects and risks.

There are multiple safe and effective modes of Administration, and we discussed these with you at the time of your appointment. We only provide topical estrogen (no pills). Our practice does not use pellet therapy. We utilize testing to determine levels of the hormones, evaluate balance between the hormones, and to assist in adjusting doses. The hormone replacement options chosen are based on what is needed.

Why the "Low and Slow" Approach Works
Starting low and titrating (adjusting) up offers several practical benefits:

Minimizes Side Effects:
High starting doses can cause sudden breast tenderness, bloating, nausea, or breakthrough bleeding as the body adjusts to new hormone levels.

Finds Your "Sweet Spot":
Hormone absorption is highly individual. What works for one person might be too much or too little for another. Starting low allows you to find the minimum amount of hormone needed to stop your symptoms.

Reduces Risks:
While modern HRT is generally safe for most, keeping the dose as low as possible further minimizes the risk of rare complications like blood clots or cardiovascular issues. These are not often seen with bio identical hormones using transdermal estrogen and natural progesterone.

Psychological Adjustment:
Especially for mood-related symptoms, a gradual increase allows you to monitor how your mental health responds without the "rollercoaster" effect of a high initial dose.

The Typical Timeline

Initial Phase:
Start on a low-dose patch, cream, gel, or pill.

Observation:
Stay on that dose for 8 to 12 weeks. It can take this long for your body to reach a "steady state" and for symptoms like hot flashes or night sweats to fully subside.

Evaluation:
If symptoms persist after 3 months, the dose is increased incrementally.

Long-term Maintenance:
Once symptoms are controlled, you typically stay at that dose and review it periodically with your provider.

Important Nuances
While "low and slow" is standard, there are a few exceptions:

Premature Menopause (POI):
If someone enters menopause very early (before age 40), we often start with higher doses because the goal is to replace the high levels of hormones the body should still be producing to protect bone and heart health.

Vaginal-Only Symptoms:
If the only concern is local (e.g., vaginal dryness), we usually skip systemic HRT entirely and use low-dose vaginal creams or rings, which have almost no systemic absorption.

It is essential that you obtain your regularly scheduled screening evaluations (e.g., mammography, Pap smear). Our goal is to provide hormone support safely, and this guide guides our approach.

01/10/2026

My role should not be a Need to Convince you to make changes to improve your health. That’s on you.

Everyone seems to like to blame LDL Cholesterol, yet almost 50% of heart attacks are in those with normal LDL. How can t...
01/10/2026

Everyone seems to like to blame LDL Cholesterol, yet almost 50% of heart attacks are in those with normal LDL.

How can the cause of a disease not be present yet contribute to the disease? Maybe, if it's not the actual cause.

Association is not causation. It's like blaming a firefighter for causing the fire because they were there when the building burned down.

Inflammation causes heart disease.
Insulin Resistance causes inflammation.
The dysfunction that follows causes disease.

You can't statin your way out of this. It requires making changes to diet and lifestyle. Tough dose of reality.

A welcomed addition to our regional community!
01/10/2026

A welcomed addition to our regional community!

THE MAKING OF METABOLIC DISEASE⸻1. Initiating FactorsInputs / Risk Drivers • Genetic susceptibility • Excess visceral ad...
01/10/2026

THE MAKING OF METABOLIC DISEASE

⸻
1. Initiating Factors

Inputs / Risk Drivers
• Genetic susceptibility
• Excess visceral adiposity
• Chronic caloric excess (high refined carbs, fructose)
• Sedentary lifestyle
• Chronic stress → ↑ cortisol
• Sleep deprivation
• Inflammation / gut dysbiosis

⸻
2. Cellular Insulin Resistance Develops

At target tissues (muscle, liver, adipose):
• ↓ Insulin receptor signaling
• ↓ GLUT4 translocation (muscle & fat)
• ↑ Hepatic gluconeogenesis
• ↑ Lipolysis in adipose tissue

⸻
3. Compensatory Hyperinsulinemia

Pancreatic β-cell response:
• ↑ Insulin secretion to maintain euglycemia
• Temporary normalization of glucose
• Chronic insulin elevation becomes pathogenic

⸻
4. Metabolic Dysregulation

A. Glucose Pathway
• Postprandial hyperglycemia
• Fasting hyperglycemia
• Progression to prediabetes → type 2 diabetes

B. Lipid Pathway
• ↑ Free fatty acids (FFAs)
• ↑ Hepatic VLDL production
• ↑ Triglycerides
• ↓ HDL
• Small, dense LDL particles

C. Adipose Dysfunction
• Adipocyte hypertrophy
• ↑ Pro-inflammatory adipokines (TNF-α, IL-6)
• ↓ Adiponectin

⸻
5. Chronic Inflammation & Oxidative Stress

Mechanisms:
• ↑ NF-κB signaling
• ↑ Reactive oxygen species (ROS)
• ↑ Advanced glycation end products (AGEs)
• Endothelial inflammation

⸻
6. Endothelial Dysfunction

Vascular Effects:
• ↓ Nitric oxide (NO) bioavailability
• ↑ Vasoconstriction
• ↑ Arterial stiffness
• ↑ Platelet activation
• ↑ Adhesion molecule expression

_____
7. Pro-Atherogenic State

Plaque Formation
• LDL oxidation
• Macrophage foam cell formation
• Smooth muscle cell proliferation
• Plaque instability

⸻
8. Cardiovascular Disease Outcomes
• Hypertension
• Coronary artery disease
• Myocardial infarction
• Stroke
• Heart failure (especially HFpEF)

⸻
9. Progressive Metabolic Disease

Feedback Loop (Worsening IR)
• β-cell exhaustion
• Type 2 diabetes mellitus
• Non-alcoholic fatty liver disease (NAFLD → NASH)
• Metabolic syndrome

↺ Feeds back to worsen insulin resistance

⸻
Insulin Resistance → Hyperinsulinemia → Inflammation → Endothelial Dysfunction → Atherosclerosis → Cardiovascular Disease

Simultaneously:
Insulin Resistance → Dysglycemia + Dyslipidemia → Metabolic Disease

⸻
Insulin resistance is not just a glucose disorder—it is a vascular and inflammatory disease that precedes diabetes by years.

This is a common education piece I discuss in the office regularly. Insulin resistance seems to be the most common theme...
01/09/2026

This is a common education piece I discuss in the office regularly.

Insulin resistance seems to be the most common theme for most of the conditions I address. It is also one of the most poorly understood conditions, because it is a metabolic imbalance, not a defined disease.

There are three primary driving mediators behind insulin resistance. These are dietary factors, chronic inflammation, and chronic stress. Each of them can contribute independently to the imbalance. When combined, they work synergistically.

We focus on addressing all of them simultaneously when treating the patient. None of it involves medication. For some people who diet is the primary factor, but for others it may be stress or sleep quality, or chronic inflammatory conditions like autoimmunity or infections. Whatever the cause, it needs to be addressed to fix the problem. You cannot medicate your way out of this.

Working with a medical provider that understands these concepts, and how they contribute to the symptoms and conditions you are dealing with, can make a huge impact on your health and longevity. Do not settle for the status quo. It does not have a very good track record.

These are all one condition affecting multiple organs. We've just been fooled into believing they're different condition...
01/09/2026

These are all one condition affecting multiple organs. We've just been fooled into believing they're different conditions that need to be treated with multiple drugs.

Address the root cause and you address them all. Believe it or not, it's not rocket science.

Not a week goes by that I do not discuss this topic in the office. It might even be every day. We focus on obtaining the right labs, that bring us to the right conclusion, to focus on the correct treatments, and achieve the optimal outcomes.

We were advised. It was the guidelines. The government cared about us. The science showed us. We were told it was good f...
01/09/2026

We were advised.
It was the guidelines.
The government cared about us.
The science showed us.
We were told it was good for us.
A healthy 12 servings per day of grains.

They fostered addictions to refined and processed carbohydrates and junk foods; They promoted the big food companies; Provided our children with garbage that led to epidemic obesity and disease as teens and adults.

Many still can't even see it.

Read This Carefully, Then read it again. Share it if you wish.
01/09/2026

Read This Carefully,
Then read it again.
Share it if you wish.

Address

113 Davis Street
Glen Alpine, NC
28628

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm

Telephone

+18285360320

Website

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Owner/Physician: Johnny Gomes, D.O. Wellness Nurse: Sue Gomes, R.N., B.S.N. Functional & Lifestyle Medicine Consultations - Empower Yourself and Take Control of Your Health Functional Medicine uses an integrative approach with an emphasis on identifying root causes that lead to an individual's illnesses and poor health. By addressing these, through modifications in lifestyle factors and other triggers of dysfunction, it is possible to improve, reverse, or even eliminate many of these conditions. It is an holistic approach with a focus on every aspect that makes us who we are. We are presently ill-served by the conventional model of utilizing a pharmaceutical treatment for every condition, "a pill for every ill", focused on suppression of symptoms rather than a cure, all while the disease process continues unabated. While there is a time and place for medications, they are now used as the primary treatment in the majority of these chronic medical conditions. History shows that this has only led to further disease progression. Improving people's lives through lifestyle modification - dietary changes, proper nutrition, effective exercise, stress management, targeted supplementation and optimized sleep - attention to the mind, body & spirit - you can achieve dramatic changes in your life. Our goal is to help individuals to thrive, not just survive, by providing this knowledge, searching for root causes of your symptoms and addressing them through a lifestyle approach while minimizing the need for pharmaceutical interventions. We offer functional medicine consultations focused on the prevention or management of chronic medical conditions. We provide you with the knowledge that will enable you to take control of your own health and empowers you to improve yourself, to heal. Our consultations can be provided in our office, your home or a public venue. We offer individual, family or group appointments. Contact us for pricing.

We also provide educational lectures and discussions that are targeted to your areas of interest, individualized for you and your target audience. These are provided at $250 per lecture / small group discussion. The body is capable of healing itself.... We help you learn how. We offer the testing to identify root causes and the recommendations on how to address them. Take back control of your own health journey and begin to feel “well” again. For more info, visit our website: www.optimalhealthwnc.com Call us at (828) 279-7998 for more info or to schedule an appointment Email us at Optimalhc1@gmail.com