FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, April 24, 2025

An Integrative Orthomolecular Medicine (IOM) Approach to Reverse Type 2 Diabetes, Chronic Urinary Tract Infections, Renal Insufficiency, and Parkinsonism in a 94-Year-Old Patient: A Case Study

Judy Onghai, M.Ed, Ph.D., Richard Z. Cheng, M.D., Ph.D.

Highlights:

• Reversal of Renal Function Decline:
  The patient's eGFR improved from 39 to 81 mL/min/1.73m², with significant resolution of bilateral hydronephrosis and avoidance of dialysis-demonstrating that nutritional and metabolic interventions can restore kidney function, even in advanced age.
• Neurological Improvement:
  Parkinsonian symptoms notably diminished, with enhanced mobility and responsiveness. This suggests that mitochondrial support and antioxidant therapy may help reverse neurodegeneration in elderly patients.
• Restoration of Glycemic Control:
  HbA1c dropped from 7.0% to 5.4%, and insulin therapy was discontinued. Stable glucose levels were maintained solely through ketogenic feeding-indicating that metabolic reprogramming can reverse type 2 diabetes.
• A Model for Multisystem Recovery:
  This case exemplifies how Integrative Orthomolecular Medicine (IOM) can simultaneously reverse damage across multiple systems, offering a safe, effective, and personalized therapeutic approach for the elderly.

Abstract

A 94-year-old woman with a long-standing history of type 2 diabetes mellitus (T2DM), chronic urinary tract infections (UTIs), renal insufficiency, and Parkinsonism experienced significant clinical improvement after adopting an Integrative Orthomolecular Medicine (IOM) protocol. Despite decades of conventional care, her condition deteriorated following pneumonia and recurrent infections. Under the guidance of Dr. Richard Cheng, the patient initiated a ketogenic diet, high-dose vitamin and micronutrient supplementation, and supportive therapies including red light therapy and bladder irrigation. This multifaceted IOM approach resulted in remarkable improvements in glycemic control, renal function, immune balance, and neurological status-demonstrating the potential of IOM in reversing chronic, multi-system illnesses even in advanced age.

Introduction

Modern medicine has made significant strides in managing chronic diseases, yet many elderly patients with multiple conditions continue to deteriorate under standard care. Conventional therapies often overlook the root causes of chronic degeneration, such as oxidative stress, mitochondrial dysfunction, toxin accumulation, and nutritional deficiencies.

Integrative Orthomolecular Medicine (IOM) offers a solution-oriented framework that emphasizes restoring biochemical balance through therapeutic nutrition, detoxification, metabolic support, and lifestyle interventions. This case study illustrates the practical application and impressive results of an IOM protocol in an elderly woman with T2DM, CKD with renal insufficiency, Parkinsonism, and recurrent infections.

Case Summary

The patient, a 94-year-old woman (163 cm in height and 50 kg in weight, BMI of 19.1), had lived with T2DM and hypertension for over five decades. In March 2022, she was hospitalized for bacterial pneumonia and a urinary tract infection, after which she developed difficulty swallowing and Parkinsonian symptoms. Despite insulin therapy (28 units of basal insulin daily), her blood sugar remained poorly controlled. Repeated UTIs required frequent antibiotic use. Her renal function continued to decline, with bilateral hydronephrosis and eGFR falling to 39 mL/min/1.73m².

In late 2023, her family consulted Dr. Richard Cheng, who designed and supervised the implementation of an IOM protocol customized to her condition and nutritional needs. (Figures 1-5).

IOM Protocol and Interventions

1. Ketogenic Diet (via Tube Feeding)

A ketogenic formula was developed using whole eggs, whey protein isolate, MCT oil, avocado oil, and beef bone broth. The aim was to reduce glucose exposure, induce ketosis, and enhance mitochondrial function-critical in reversing insulin resistance and reducing systemic inflammation.

2. Orthomolecular Supplementation

Daily supplementation included:

• High-dose vitamin C (5,000 mg/day)
• Vitamin D3 (5,000-10,000 IU/day)
• Vitamin K2 (MK-7, 45 mg/day)
• Omega-3 fatty acids (2-4 grams/day)
• B-complex vitamins
  These addressed age-related nutrient deficits, supported antioxidant defenses, and restored immune and mitochondrial function.
• Magnesium glycinate - 1000 mg/day

3. UTI Management

Instead of relying solely on antibiotics, the patient was treated with:

• Methenamine and fosfomycin for infection prevention
• Cystoclysis (sterile bladder flushing via catheter)
• Local red light therapy to support mucosal healing and reduce inflammation

4. Renal and Protein Support

Protein intake was increased from 49 g/day to 68-70 g/day, carefully balancing renal load with anabolic needs. This approach supported tissue repair, immune function, and maintained nitrogen balance without compromising kidney function.

Clinical Outcomes

• Blood Glucose Control:
  HbA1c improved from 7.0% to 5.4%, and insulin therapy was discontinued. Glucose levels remained stable on ketogenic feeding alone.
• UTI Reduction:
  Although bacteria occasionally appeared on urine cultures, the patient showed no clinical signs of infection-no fever, leukocytosis, or elevated blood pressure-indicating improved immune defense and reduced inflammatory burden.
• Renal Function Recovery:
  eGFR rose from 39 to 81 mL/min/1.73m². Bilateral hydronephrosis resolved significantly, and the patient avoided dialysis.
• Nutritional and Functional Gains:
  Weight stabilized, energy levels improved, and the patient demonstrated better mobility and responsiveness, with reduced signs of Parkinsonism.

Discussion

This case demonstrates that even in extreme age and advanced disease, reversal-not just symptom control-is possible when the root causes are addressed. The ketogenic diet reduced glucose toxicity and inflammation, while orthomolecular supplementation restored critical biochemical pathways. Red light therapy and cystoclysis provided additional immune and tissue support.

Resistance from conventional providers, particularly regarding insulin discontinuation, reflects broader systemic challenges. Yet the dramatic improvements underscore the need for greater openness to integrative strategies that go beyond pharmacological management.

Key Takeaways

• IOM works-even in the elderly: Metabolic and nutritional interventions can reverse chronic conditions traditionally considered progressive or irreversible.
• Root cause reversal beats symptom suppression: Addressing inflammation, nutrient deficiencies, and mitochondrial dysfunction delivers better long-term outcomes.
• Caregiver empowerment matters: The family's involvement was critical in navigating options and implementing the IOM protocol successfully.
• Systemic change is needed: Mainstream care must evolve to include evidence-based orthomolecular approaches, especially in chronic disease and aging.

Conclusion

This case supports the application of Integrative Orthomolecular Medicine (IOM) as a transformative approach to managing and reversing complex chronic diseases in the elderly. A personalized program of ketogenic nutrition, micronutrient repletion, and targeted therapies resulted in substantial functional recovery in a 94-year-old woman with T2DM, CKD, Parkinsonism, and chronic infections. Broader clinical adoption of IOM in geriatric care is urgently warranted.

About the Authors

Judy Onghai is a health advocate and integrative health writer focused on chronic disease and aging.

Richard Z. Cheng, M.D., Ph.D. - Editor-in-Chief, Orthomolecular Medicine News Service

Dr. Cheng is a practicing physician based in the USA and China, specializing in integrative and orthomolecular approaches to health. His clinical interests include nutrition-based therapy, functional medicine, low-carb medicine, and anti-aging medicine. He also works internationally as a health consultant and educator

Keywords: Type 2 Diabetes, Chronic Urinary Tract Infections, Kidney Disease, Parkinsonism, Ketogenic Diet, Functional Medicine, Geriatric Care, Hypertension, Case Study

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