Hormones & Thyroid

Leaky Gut


Leaky gut is a condition where the integrity of the gastrointestinal tract has been
compromised or damaged. In medical terminology this is described as increased intestinal permeability. This decreased barrier function has been linked to a number of autoimmune conditions such as MS, Celiac and Hashimoto’s, as well as asthma, eczema, allergies and the autism spectrum disorders. Leaky gut can be traced back to the use of immunizations, antibiotics and the
ever-changing environment of our resident gut bacteria – growing increasingly deficient in beneficial flora.

Common Causes of Leaky Gut

✓ born Caesarian
✓ born vaginally to mother with low beneficial vaginal bacteria
✓ immunizations prior to the repopulation of bacteria
✓ frequent antibiotics
✓ poor diet
✓ excessive grain consumption
✓ gluten consumption
✓ NSAIDs(aspirin, ibuprofen, acetaminophen)
✓ birth control pills
✓ steroid drugs
✓ chemotherapeutic drugs
✓ antacids
✓ excessive stress or trauma
✓ genetics

 

Note: autoimmune conditions do not cause leaky gut; it is likely the other way
around; with leaky gut being a trigger for the expression of autoimmunity.

Symptoms of Leaky Gut

✓ ADD / ADHD
✓ arthritis
✓ asthma
✓ autism-spectrum disorders
✓ autoimmune conditions
✓ chronic fatigue syndrome
✓ eczema
✓ failure to thrive
✓ food allergies and intolerances
✓ inflammatory bowel diseases
✓ irritable bowel syndrome
✓ joint and collagen problems
✓ faulty liver function
✓ malnutrition
✓ multiple chemical sensitivities
✓ skin disorders, including acne
✓ mental health challenges including depression and anxiety

Note: All health begins in the gut!

 

 

Lifestyle Treatment for Leaky Gut:

✓ chew food well
✓ try to avoid eating when anxious or rushed; eat in relaxing or pleasant environment
✓ avoid antacids of all sorts
✓ avoid antibiotics whenever possible (explore options carefully and remember to weigh the cost/risk benefits)
✓ stress management/reduction techniques


Food Treatment for Leaky Gut:

✓ avoid high inflammatory foods – sugar, gluten, dairy
✓ remove food sensitivities particular to that individual (IgG testing or elimination diet)
✓ incorporate fermented foods like sauerkraut, kimchi, miso, coconutyogurt and kefir
✓ incorporate fresh ground flax
✓ add bone broth, collagen or gelatin

Supplemental Treatment to Consider for Leaky Gut:

✓ probiotics
✓ aloe vera juice (2-4oz) or aloe vera extract
L-glutamine
digestive enzymes
✓ work to identify and replace micronutrient deficiencies
✓ vitamins A and D or FCLO (fermented cod liver oil)
✓ glutathione (can be taken in the form of organic non-denatured grass-fed whey, if tolerated)
berberine
✓ ginger

Functional Testing when Leaky Gut is Suspected:

✓ If allergies are suspected, have a full IgE panel run to rule those foods and environmental substances out
✓ IgG food sensitivity testing
✓ Comprehensive Stool Test including Secretory IgA level
✓ Organic Acids Test for yeast, metabolic and overgrowth concerns
✓ Small Intestinal Bacterial Overgrowth (SIBO) hydrogen breath test

*NOTE: There is a direct test for Leaky Gut through Cyrex labs called Array 2 Intestinal Antigenic Permeability Screen. Though this test is pretty cool we rarely recommend it because it is assumed in most cases listed above.

If you suspect that leaky gut is behind some of your health issues, highly consider getting a 2-part consultation with our Functional Nutritionist. 

A STEP-BY-STEP APPROACH TO HASHIMOTO'S THYROIDITIS

Hashimoto's Disease is one the most common causes of thyroid problems, particularly hypothyroid. However it is also one of the most commonly missed and mistreated causes as well. Hashimoto's is diagnosed most commonly by lab testing that reveals elevated antibodies on a lab test. It can also be diagnosed with an ultrasound or biopsy report.  There is no definitive way to completely rule out Hashimoto's because it would entail biopsy of 100% of the thyroid. When Hashimoto's Disease is found it is a lock for an autoimmune process in which the immune system has triggered the thyroid as a foreign invader and is trying to destroy it. This point is critical because it is NOT inherently A THYROID PROBLEM. Let me repeat this foundation point: Hashimoto's Disease is not primarily a thyroid problem. It is an immune system malfunction.

Possible Symptoms of Hashimoto's Thyroiditis:
✓ Weight gain or weight loss (because thyroid hormone output can fluctuate early on)
✓ fatigue
✓ brain fog
✓ hair loss
✓ dry skin
✓ thinning of outer 3rd of eyebrows
✓ palpitations
✓ tremors

Not A Thyroid Problem

Let me explain further. Conventional training has taught me and other practitioners that we treat Hashimoto's disease no different from any basic hypothyroid condition; we replace thyroid hormone.  However in Hashimoto's the thyroid is really just the innocent bystander who got falsely accused of a crime he didn't commit. The immune system is the real culprit who is misguided and killing the thyroid. If that critical component is not at the core of your thinking, treatment and further investigation then you are treating as superficial as you can get. The sad reality is that most people don't even get a diagnosis for years because it is not even looked for when symptoms are present. 

So What Do I Do? 

If you have been diagnosed with hypothyroidism and never had your antibodies checked, the first step is get them checked and make sure you get an ultrasound.  The antibodies you need to request are TPO (thyroid peroxidase) and TGB or TAA (Thyroglobulin Antibodies). If you request these from your medical provider they should be happy to run them for you. If not, look for someone who will. You are paying them. They work for you. The ultrasound is a screen to look for something really abnormal that needs further investigation like a biopsy. Thyroid cancer is relatively common and needs to be looked for or you won't find it. 

Educate Yourself

Secondly, educate yourself! Don't blindly assume others will do what's best for you. Everyone is different and you won't even know the right questions to ask your practitioner if you haven't done some reading. You will have to wade through some things online but you will find some good info if you look.  Stop the Thyroid Madness and Facebook groups like Hashimoto's 411 are popping up often helping people get educated. One of the first areas you will want to educate yourself on is the link between the immune system and the digestive system. In other words, your diet matters significantly! With any autoimmune disease the most important place to start the healing process is through using food as medicine.  Don't tune out here. Seventy to eighty percent of your immune system lines your digestive tract. If there is an unhealthy barrier system due to lack of sleep, processed foods, gluten, stress, or over-training then every time you eat you may possibly be damaging and over-working your immune system. Read about "leaky gut" or increased "intestinal permeability" and work toward an autoimmune paleo diet (AIP). 

Find an Advocate

Self education is foundational but does not negate the need of finding a health care practitioner who can take you deeper.  The reason why is because you will need to investigate deeper as to how to heal and balance your overly reactive immune system. If you don't, there is a risk of additional autoimmune diseases presenting in your future. Supporting gut healing, hormonal balance and inflammation in the body can not only improve your symptoms but it can also prevent future disease processes that are dependent on these broken systems.   Functional Medicine's philosophy is built on finding the underlying cause rather than just treating symptoms. If you can find a Functional Medicine practitioner near you, you will gain one of the best teammates you can hire.  Functional lab testing is essential to rule out digestive pathogens (i.e. bacterial infections, parasites, candida, overgrowth of opportunistic infections), hormonal imbalances (i.e. Hypothalamic Pituitary Adrenal dysfunction, estrogen dominance), or detoxification issues affecting your mitochondrial health and neurotransmitter production. These tests are typically around $500 total out of pocket but can provide a huge direction when it comes to focus on healing the body. 

Medications Versus Supplements

If you catch Hashimoto's early, there is a chance you can avoid needing thyroid replacement medications. However, it is not the worst thing in the world if you do need thyroid support. There are two main options for prescription support: synthetic medications (synthroid/levothyroxine, cytomel/liothyronine) or natural dessicated medications (Armour, Nature-throid, Westhroid). Most people do better on the natural dessicated glandulars but this is when you need a practitioner who is thoughtful and will work with you until you find the right medication for you. Once a new medicine is started you will want to recheck your labs in 4-6 weeks to see how you are responding and keep your practitioner abreast on how you feel. Very few general practitioners are thoughtful in this area but I was blessed to learn under a very thoughtful DO and he taught me a lot in this area about listening to patients and being a constant learner. Thank you Dr. Simonak! 

So if you have discovered Hashimoto's early and are not terribly symptomatic (weight gain, fatigue, brain fog, dry skin, hair loss...) then you should go hard after the root cause and see if you can facilitate healing with supplement protocols.  This should be lab based. Blindly supplementing can at times be dangerous and make things worse. But again, do not feel bad if you need a medication. Thyroid medications are not terribly expensive and for the most part are safe to be on long term. If you are a young female looking to get pregnant it is vital that your thyroid levels are optimal and this sometimes requires frequent lab checks and tapering of medications. 

Final Thoughts

While you are working with your thoughtful PCP or Functional Medicine Provider to heal the root cause of your Hashimoto's Disease, you may also want to consider looking into Low Dose Naltrexone (LDN). There are not many medications that I am excited about but this is one. The risk to benefit ratio is amazing and can help balance the immune system while the body is healing. It may not be needed long term but may prove very helpful at reducing your antibody count and need for increasing medication dosages. 

Educate + Teamwork = Healing

Here is the winning equation again. Get serious about self-educating. Let me know if you want additional reading material and I can recommend several books and websites. Next start looking for your teammate/health detective who can help you look deeper. And get to work! Don't sit on the sidelines and wait for someone else to take care of you and don't even rely on a medication or supplement protocol. Your choices each day to eat a clean nutrient dense diet, think positively, go to bed early, and exercise will be the most potent prescriptions you can fulfill! 

For Further reading, check out this very thorough article from Verywell.com on thyroid disorders.  

Functional Fertility - Part 2

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How Methylation, Homocysteine and Nutrients Affect Your Fertility

Please read Part 1 of this blog as well if you or someone you know if having fertility issues. In summary of Part 1 - Optimal hormone production and timing is critical to have assessed and corrected as a foundation to any fertility treatment.  In today's blog we will dive into another important aspect: Methylation and Nutrient Levels. Methylation is a term that describes a process that is constantly occurring millions of times per minute throughout your body when a methyl group is added in the place of a hydrogen atom.  Adding a methyl group could then in turn lead to numerous outcomes but the big picture is that it is constantly making, maintaining and repairing your DNA. If this is not happening optimally for the reasons we will discuss shortly, risks of almost every modern disease process go up significantly.  Epigenetic signaling could potentially trigger mutations in genetic codes, autoimmune diseases, cancer cell proliferation secondary to altered ability to keep oxidative stress minimized and so on.  When it comes to fertility, nutritional status and particular nutrients are vital to not only conceiving but optimal maternal and fetal health. 

MTHFR, Homocysteine, and Folic Acid

MTHFR is a hot topic. I won't rewrite my former blog but please have this gene checked by your PCP.  Even if you have only one mutation request a follow up fasting serum homocysteine level. A mutation in the MTHFR gene can significantly affect methylation and homocysteine can build up in the blood. Elevated homocysteine has been proven to increase the risk of a cardiovascular event which is an inflammatory process. Any chronic inflammatory process is not good for you or your potential baby and could compromise a healthy pregnancy. Direct links have been found between elevated homocysteine and miscarriages.  Dysfunction in this area is also commonly behind low thyroid function (hypothyroidism) which is also linked to difficulty maintaining a healthy pregnancy. 

This same methylation pathway significantly affects folate and B12 metabolism.  If these pathways are malfunctioning because of mutations and/or toxic burden then inactive forms of folate (i.e. folic acid) could potentially prove harmful and no amount of inactive B12 (cyanocobalamin) will improve a B12 deficiency. 

As you can see above, nutrients like B12 and folate are critical in healthy conception and healthy babies. Folate deficiencies have been implicated in neural tube defects for decades but just in recent years has genetic testing proved that a significant portion of the population will have an even more significant problem with folate metabolism with MTHFR gene mutations. If you or someone in your family has one or two gene mutations then please find a medical provider who is well versed in this area and will watch your fasting serum homocysteine levels closely (optimal is thought to be <7 at this time) and will recommend a solid prenatal vitamin pack that contains active B12 and folate and optimal EPA/DHA (omega 3s). Here is the one I recommend from Orthomolecular below. Contact me if you need access to order it through our website. 

Does the Male Partner's Health Matter In Fertility? 

Of course! More than most of us even realize! Women usually take all the blame on themselves when conception becomes difficult but very commonly it is not their fault at all. If males are not healthy internally then their sperm will not be either and this means that they will not have the count, motility or structure in order to even reach the female's egg or penetrate it.  Poor diets high in processed grains and a lack of phytonutrient dense vegetables promote weak sperm. Add on top of that high stress, lack of sleep, and lack of exercise and you have a recipe for infertility from the male's side. Take a look at this nutrient wheel for Male Fertility.  

Men, take the lead on this one and get your self checked out by a local functional medicine provider who can look at your nutrient levels and talk with you about any lifestyle modifications that will improve your overall health and your fertility. Get on a good multi-vitamin daily and help your wife with making healthy food choices. Let me know if you want to stop wasting money on over-the-counter one-a-day vitamins and I can point you to some solid options that will actually benefit your body. Here is my current favorite foundational multivitamin pack for men. You can get it shipped to you from our online Orthomolecular store if you are interested. Email me for details. 

Testing recommendations for any fertility case

  • MTHFR - this can be drawn by your PCP
  • Fasting Homocysteine Level - Always get this if you have had any trouble with miscarriages or if you have a MTHFR gene mutation
  • Organic Acid Testing - This will give you a very good glimpse at nutrient needs and let you know if your MTHFR gene mutation is significantly affecting your methylation status. This test is used by most Functional Medicine providers because it gives so much information into your health. 
  • Routine Labs plus thorough thyroid panel - to screen for anemia, liver, kidney, electrolyte or thyroid imbalances. 
    • Thyroid labs (minimal) - TSH, Free T3, Free T4, Rev T3, Anti-thyroglobulin antibodies and Thyroid Peroxidase Antibodies (TPO)
  • Month long salivary hormone panel - See part 1 of this blog
  • Adrenal Stress Profile - Source of many hormonal imbalances and fertility problems
  • GI Pathogen Testing - BioHealth and Diagnostic Solutions offer great stool testing
    • The health of your gut is vital and must be part of any long term health support
Overview of all the info you get back from an Organic Acids Test (OAT). It really is an amazing test.&nbsp;

Overview of all the info you get back from an Organic Acids Test (OAT). It really is an amazing test. 

 

Links for Further Self Study

Please email us with any questions or comments. This is in no way a comprehensive blog on the topic but tries to cover big things that are easily overlooked. Let us know if there is another aspect to this that you would like us to blog on. 

Functional Fertility - Part 1

Is It a Timing or Production Issue?

So many things can disrupt a female’s hormonal cycle and therefore ovulation that it is amazing any pregnancies occur. I contribute that fully to the grace of God. Stress and oral contraceptives are among the biggest offenders. Women are all too quickly put on birth control pills when there are having any unwanted or uncomfortable cycling issues and these pills almost always wreak havoc on the natural timing and production of hormones that every woman should have. This disruption in timing and production can make conceiving a massive challenge. However, the good news is that it is pretty easy to find these abnormalities and correct them with a functional medicine approach and the right testing.  

A Delicate Situation

This is obviously a delicate and difficult topic for those experiencing difficulty conceiving and there are many factors that can play into the process besides just timing and production of hormones. We will save most of those for a future blog but I wanted to start with optimizing female hormonal cycles first because it is one of the most common causes of fertility issues. Other factors that play in are nutritional status of the male and female.  Sperm motility and quantity is completely dependent on how well they are nourished. The female's eggs (fertilized or not) are protected by certain nutrients in the diet and possibly supplements as needed. A diet high in fast food and soda will leave the body nutritionally deficient and an obvious disadvantage to conceiving. Again we will leave that for a future blog. Even considering some genetic or anatomical disadvantages, optimizing the hormone timing and production will improve the possibility of conception significantly.

How Stress Affects Your Female Hormones

Stress in any form will put the body into the stress response. The stress response was created by God to aid in our survival in stressful situations like famine or escaping the attack of a wild animal. Therefore the stress response is actually a survival response. What happens when the body is trying to survive? Another evidence of a brilliant designer is seen here. If you were trying to survive in a situation where food is sparse and you are having to move your family hundreds of miles to a place where hopefully the situation is better, the last thing you need to be focusing on is reproducing right!? Your body will divert its attention away from making sex hormones like testosterone, estrogen, progesterone and DHEA to make survival hormones like cortisol and adrenaline. Your body will also down regulate your metabolism so you don’t burn calories as fast to conserve and help you survive! Evolutionary chance or brilliant Design? Cover your eyes if you don’t want to see the obvious.

The big point is that any chronic stress will deplete the body over time of its sex hormones and cause hormonal imbalances leading oftentimes to an estrogen-dominant state. Take a look at the chart below. Progesterone is used to synthesize cortisol and therefore will drop fastest during chronic stress. DHEA pathway will also get less attention thereby dropping the testosterone and estrogen levels but not as far as progesterone. This will lead to all sex hormones typically being low but in a relative estrogen dominance. This can definitely be confusing and needs more than a paragraph but in summary,  estrogen dominance is not good. Though it is somewhat over-simplified you can do more reading on this topic by researching "Pregnenolone Steal." It will lead to PMS symptoms, abnormal cycles and bleeding, difficulty conceiving, and increased risk for estrogen driven cancers like uterine, breast and prostate (for the men reading this). 

 

Is PMS normal?

PMS has almost become a household term and an expected time of the month where men stop speaking for several days and children hide in their closets until the storm passes. This is NOT NORMAL. Let me repeat myself...This is NOT NORMAL. Hormonal fluctuations during a female cycle should be smooth and the main noticeable symptom should really only be increased libido around the fertile time of each month. If Dr. Jekyll and Mr. Hyde exist inside of you, please seek out  a functional medicine provider and get your hormones balanced. You really want to see what your entire cycle looks like so find someone who does full month long salivary hormone panels.  

Healthy Cycles = Healthy Fertility

The two main problems within a female cycle that will make conception nearly impossible are a TIMING issue or PRODUCTION issue. By timing, I mean that ovulation is not occurring around day 14 like it should. If you are ovulating on day 3 instead of day 14 then you have almost no time to build up an endometrial lining to house a fertilized egg (aka: a baby!). If you are ovulating too late then your body didn’t have time to have a good progesterone spike and sustain the endometrial lining. Here is an example of poor timing. 

 

As you can see with the two spikes of progesterone that should follow a estrogen rise signifying ovulation, this patient almost looks like she may be ovulating twice - both at the wrong times! Look at a picture below of what a normal cycle should look like. After the hypothalamus and pituitary cause a spike of Luteinizing Hormone ovulation occurs. This delicate cycle can be easily disrupted with years of poorly managed stress and birth control use. The good news is that it is always wanted to get back into balance again and sometimes it does not take as long as you might think.

 

Another common abnormality seen on the month long panel is an insufficient amount of progesterone spike after ovulation occurs. This is unfortunately a common and easily corrected cause of recurrent miscarriages. If you have had one or more miscarriages please visit us or someone who can look at a month long salivary hormone panel on you. Also ask your PCP to run a genetic test called MTHFR and get a fasting serum homocysteine level to make sure there is not a gene mutation that needs significant nutritional support and likely a switch in prenatal vitamins. A urine organic acids test would also benefit you to further look at methylation status and possible nutrient needs. This will be discussed further in Part 2 of Functional Fertility.

Healthy Adrenals = Healthy Hormones

While stress definitely disrupts the female hormone cycle, it is simultaneously disrupting the Adrenal Hormone production. This is critical to grasp because if you try to fix the hormonal cycle without addressing the broken HPA axis (Hypothalamic-Adrenal Axis) then you will spin your wheels. When the stress response is brought under control and adrenal hormone production is supported and balanced, the body’s natural production of sex hormones can be restored! Hence the importance of stress physiology. Please read through some of the other blogs on adrenal health and try to make it to one of our monthly Group Visits on Restoring Balance: Stress Hormones and Your Health. Click HERE to get more info.

One Big Piece of the Puzzle

Though hormonal timing and production issues are not always the root cause of fertility issues, they are one of the most common and a great place to start. Nutrition of both spouses is also critical and will be the topic of the next fertility blog so stay tuned. It is also important to not ever place our complete trust in anything other than God. Sometimes we will never find an answer to the “why” behind our trials but remind yourself of this: God is always working things out for His glory and the good of His people. Do your part and take action. Steward your body well. Eat clean. Give your body adequate rest. Don’t try to play God by worrying about everything. But in the end, no matter what comes your way, trust in the Sovereign Creator and Sustainer of life, Jesus. He is worthy to be praised even if we never receive another blessing from His hand. Here is a good time for a book recommendation. Trusting God: Even When Life Hurts by the late Jerry Bridges is one of the best reads for your soul if you are struggling with recurrent pregnancy loss or any other trial.

 

 

 

 

 

 

PCOS: A Functional Medicine Approach

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PCOS is an abbreviation for Polycystic Ovarian Syndrome. This name is a little misleading because it entails a constellation of symptoms. Cysts on the ovaries are only one of many components to this complex syndrome. It is also misleading because it creates a label that feels like it can’t be changed and can lead to a hopeless feeling once the diagnosis has been given. This is similar to how diabetics get labeled and then often times succumb to the false notion that this is their lot and medical therapy is the only hope to try to keep the disease process at bay. Though medical diagnoses are needed and can be helpful, they can also often be very paralyzing and prevent people from finding ways to heal their body and prevent progression without always needing to rely solely on medications.

PCOS is an area where functional medicine shines. The conventional approach to PCOS relies on a medication or two in an attempt to try to manage the symptoms of blood sugar instability, elevated testosterone and DHEA levels and often increased acne and facial hair.  When the approach is solely medical, it is easy to miss the opportunity to get deeper and address things at the root cause instead of putting on band-aids that only cover things up.  If you or someone you know suffers from the side effects of PCOS and has not had much improvement with medications alone, please read on and pass this on to others.

PCOS tends to have several commonalities across the board. There tends to be several digestive issues going on. Though women may not be plagued with severe digestive symptoms, often there are multiple underlying food intolerances.  Gluten is often the worst and most common one. Grains of any kind also tend to cause a worsening of the inflammation that is going on in the GI tract. Therefore removing all grains for a period of time often provides significant healing opportunities. Much work can be done on the gut without even the need for lab testing and medical therapies. However, often it can be very helpful to get a few tests done to see what additional therapies would be beneficial and speed up the healing process. The majority of female hormones are made by the ovaries and therefore cysts in the ovaries could obviously cause a hormonal mess. The secondary place female hormones are made is in the adrenal glands which also manages our stress hormones. PCOS can lead to loads of stress, affecting adrenal function and further disrupting female hormone balance. Testing the adrenals and also getting a month long saliva test of estrogen and progesterone levels will show just how imbalanced the hormones are and likely show several areas where bio-identical progesterone at specific times during the month could show huge improvements in symptoms, including fertility!

As mentioned earlier, the GI tract has a huge potential for improving or perpetuating symptoms. Therefore testing this body system would also be very wise and could reveal a number of problems including dysbiosis (bacterial imbalance), pathogens (bugs) or bacterial overgrowth. The last body system to consider supporting is the body’s detox pathways. The main test for this is a urine Organic Acids Test. It not only shows detox issues but also nutrient needs, methylation concerns, neurotransmitter markers and mitochondrial energy markers. Amazing test but I’d probably do that one last if not in the budget up front.  Let me summarize the recommendations below:
 

PCOS Action List

  • Clean up diet - Remove grains (including gluten), dairy, soy, and sugar
  • Highly consider doing a Whole30 (see whole30.com) as a jump-start
  • If not significantly improving with dietary changes alone:
    • Meet with a functional nutritionist
    • Get functional lab testing done with your functional medicine practitioner
      • Adrenal Stress Profile
      • Month long female hormone panel
      • GI Pathogen Screen

I hope this short blog proves helpful for you or someone you love. If we can be of any service to you please send us a message and schedule an appointment to start looking deeper into how to support your body’s healing processes.

 

Why our culture desperately needs Functional Medicine?

 

I guess before this blog can really be written, an initial question must be asked and answered: What is Functional Medicine? Here is a quote from the Institute for Functional Medicine who is one of the leading organizations training practitioners in this model of medicine:

“Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century.”

The keywords in these short two sentences are “underlying cause” and “systems-oriented approach.” It is a model built on the idea that the body is designed to function together in systems and if one system loses it integrity then a cascade of systems can suffer thereafter. This is why functional medicine practitioners like the one I train under, Dr Kalish, says that symptoms are distractions at best.  By the time a symptom surfaces it could be 2 or 3 body systems down the line from the original body system that was compromised. Hence the need for high quality and reliable lab testing. See image below for a snapshot at how complicated finding a root cause may be.

 

To summarize - functional medicine uses functional lab testing to seek out the root causes of health issues. Now we can move on to the title of the blog: Why our Culture Desperately needs Functional Medicine?

Treating symptoms is not in and of itself a bad thing. A cough is keeping you up all night compromising your immune system even further. A cough medication may be beneficial short term to help get some sleep and get your immune system back up. However other times, treating a symptom can have significant health consequences down the road. An easy example of this is the conventional approach to heartburn. Even though studies have shown that 8-9 out of 10 people who experience heartburn are actually lacking in stomach acid, we are taught to give all 10 people a medication that will further deplete their stomach acid. This may very well help the symptoms but in no way does it hardly ever treat the cause. And the majority of the time the person goes on thinking everything is ok but now they can’t properly break down proteins or absorb vital nutrients like B12, iron and minerals without adequate stomach acid.  Therefore getting to the root cause and eradicating or correcting it often leads to better function and lasting health.

Our conventional approach to headaches is similar. We’ve just been conditioned to pop a Tylenol or Advil with a headache and minimize the symptoms. This may not be a big issue is you only get a headache once a year but for those that get headaches frequently, this is covering a much deeper problem. Frequent headaches are NEVER normal even if you have a family history of migraines and you have been told you inherited them. Allergies and autoimmune diseases fall into a similar category. An imbalanced immune system can over-react to the environment or even self.  Of course again there is often a genetic component but again this is never normal and never should be just medicated to cover up the symptoms. The immune system needs support and balance. And often there needs to be deeper investigation into what may have triggered the immune system imbalance. Is there an underlying leaky gut caused by adrenal dysfunction that has led to immune compromise that needs to be healed? If so, then healing this underlying cause may very well take care of the symptoms instead of just covering them up.

Our culture is growing more busy and less rested every year. New technology. More ways to be connected. We work more and sleep less. We buy things we can’t afford and then have to work more to pay for them. Our relationships grow shallower with the delusion that we have more friends thanks to social media explosion and notifications interrupting almost every conversation.  Kids are developing sleep disturbances due to phones living in their beds with them. And if that’s not bad enough, we eat convenience fast food that has nearly zero nutritional value because we don’t have time to prepare real food. Therefore our bodies are starving for the essential nutrients they need to function properly. And then we wonder why we feel terrible, have no energy, can’t lose weight and have digestive issues. We are almost all chronically inflamed on the inside. And remember that Americans die of diseases like heart disease, cancers, strokes, diabetes that have their root in inflammation!

This is no surprise to anyone with their eyes open but still worth pondering and wondering what in the world can fix something this broken.  Do we need more medications to be developed? Maybe but is that going to really fix anything? Are we deficient in anti-depressants or TUMs? Of course not but again we’ve trained ourselves to want a quick fix but often the quick fix really doesn’t fix things well or for very long. Hence the deep seeded need for Functional Medicine in our culture. Things have to change at the root. Families have to learn the importance of communal eating - joining around the dinner table again (without twitter and facebook) and enjoying a real food nutrient dense meal. We have to re-learn how to simplify life, get good sleep and have fun. And often we need a practitioner who can help us identify these things and then test and correct the imbalances our life choices have developed over years of abuse. Sometimes these types of practitioners can be hard to find but can be found if you know where to look. The Institute for Functional Medicine has a directory of any practitioners being trained under this model. The Kalish Institute (where I am being trained) also has a directory. And sometimes old-fashioned asking around may be all you need to find someone who thinks this way.

 

A final caveat is that functional medicine does not replace the need for a strong conventional family doctor, specialists or the possible need for surgical interventions.  It just means that the conventional medical model is not based on looking for root causes, it's based on diagnosing and then treating (usually with a pharmaceutical product). Lifestyle nor nutrition is emphasized in the medical training that the majority of medical doctors or mid-level providers receive. If you have a doctor/provider who talks to you about removing gluten,sugar and processed foods from your diet, you’ve stumbled onto a rare jewel! Don’t let them go. Use functional medicine as a tool to dig deeper if you still don’t feel great despite your labs and check-ups saying you should. There is likely an underlying cause that just hasn’t been uncovered yet.

Are You a Skeptic?

If you are much like me, you grew up with the mentality that you can trust conventional medicine. Doctors are trained well and have your best interest at heart and you never really thought twice about whether a medicine prescribed to you was good for your health or not. Some on the other hand are natural skeptics about everything and especially anything to do with their health.

I’m not in any way opposed to western medicine. Nor do I think that the majority of physicians have any malintent.  Actually quite the opposite. I praise God for conventional medicine practitioners. Our son, Elias, recently was hospitalized at Cooks Children’s Hospital in downtown Fort Worth due to a rare liver disorder that we are still investigating weeks out.  His emergency care was outstanding and likely life-saving. His specialists have been equally amazing. Surgeons and ER docs save lives daily and internal medicine practitioners are solving medical mysteries daily. However, I am also a natural skeptic.

Skepticism can be healthy or harmful. If it paralyzes you and you never move forward in any direction then it will harm you. If it leads you to think and research and seek out answers then this it is a virtue. My skepticism ran high during PA school when I got to the pharmacology courses. Thankfully, my professor was also kind of a natural skeptic too and always pointed out how the clinical trials were done and how easily results could be skewed and really taught us to read these trials with a very scrutinizing mind. He showed us drug companies could run numerous trials that showed their medications to be more harmful than helpful and only publish the one(s) that showed their drug as efficacious and safe.

Now this is not to say that all medications are bad just because the system is broken at best. Medications can be lifesaving. Antibiotics save lives but can also cause significant health issues if used inappropriately. Without insulin, type I diabetics would still only survive a few years after diagnosed when now they can live virtually normal lives! With any medical decision the big question is: Does the benefit outweigh the risk? If a medical intervention is low risk but is very likely to benefit you then it’s a no brainer. The water gets very muddy quickly however when the risk and benefit ratio is very tight. Moderate risk of harm and moderate risk of benefiting you.  This is the time to put your skepticism glasses on and ask the right questions and research yourself. Being a healthy skeptic will go a long way when it comes to your health.

What is killing most Americans? The way most Americans will leave this life will not be due to some freak accident. It will be due to cardiovascular disease and cancers. No medicine can change a person’s lifestyle or prevent cancers from forming. Our body was designed to function well when treated well and will break down when abused. This does not mean that all disease and cancer was from bad life decisions but it does mean that our lifestyle choices matter. And they matter a lot. Any athlete knows if they over-train and don’t rest optimally, they will get hurt. This is a simple concept that is so lost when we think about our diet, sleep, and stress management. Poor diet? High chronic stress? Sleeping 4 hrs/night? Your immune system WILL be compromised and you will have a high risk of getting very sick. Of course genetics play a large role in our health but epigenetics (aka lifestyle choices) are much more powerful to how these genes will be expressed. If you don’t believe this go online and read the hundreds of thousands of people who have put autoimmune diseases into remission with dietary changes alone. There are some cultures who don’t even have cases of heart disease and it kills over half a million Americans a year!  

All this to say, be a healthy skeptic! Find a Primary Care Physician who is lifestyle-medicine  minded and uses medication judiciously. I’ve been blessed to work for two amazing DOs in Fort Worth who think this way. Do your research and ask around. And if you are making good lifestyle choices but still struggling with weight, fatigue, hormone imbalances, mood issues, or digestive complaints despite a full negative workup, seek out a Functional Medicine Practitioner who is trained to help you search out the root cause of your symptoms.  You have to be your own biggest health advocate. You can’t rely on your doctor who sees you once or twice a year to just prescribe you medications to help your symptoms. If you don’t know what functional medicine is, stay tuned…

Jake