FUNCTIONAL medicine

We live in a world of toxic stress. Cell phones, jobs, kids and aging parents lead to a constant revving of the adrenal glands. Cortisol levels go high, irregular or low. Blood sugar becomes dysregulated and eventually the bottom begins to fall out. You might start to have problems falling asleep or staying asleep, crave salt, experience afternoon fatigue, dizziness if you stand up too quickly or begin to experience headaches with exertion or stress. You might begin to perspire more easily, gain weight under stress and wake up tired even after 6 or more hours of sleep. All these are symptoms of adrenal stress and fatigue. Although blood testing can be useful, my preferred method to evaluate adrenal health is the Adrenal Stress Index by Diagnostechs.

Adrenal recovery takes time and effort. First you must identify and remove external stressors including toxins and infections. Then you have to address internal stressors like poor digestion and an imbalance of GI tract flora. A few key areas to promote recovery include a regular sleep schedule, avoidance of stimulants like caffeine and maintaining good blood sugar control. In addition nutritional status needs to balanced and optimized. The use of adaptogenic botanicals can also be useful in promoting healthy and robust adrenal health.

Compromised adrenal health, irregular hormones, environmental exposures and aging are but a few of the causes of thyroid problems. Assessing thyroid health is much more complex than simply running a TSH, the standard medical assessment. If you are tired and sluggish, feel cold all over, require excessive amounts of sleep, gain weight even with low calorie diets, tend to be constipated, lack motivation, experience morning headaches that wear off as the day progresses, have thinning of the eyebrows or other signs of hair loss, notice dry skin and are mentally sluggish then you deserve to have your thyroid evaluated thoroughly. This starts with a physical examination and palpation of your thyroid and includes an array of lab tests that evaluate for autoimmunity (e.g. a "self" attack on the thyroid -this accounts for the majority of low thyroid cases) and further assesses important markers of thyroid health like reverse T3, Free T3, Free T4, Total T4 and iodine. In many cases, I'll also look for confounding factors like iron deficiency and low vitamin D levels.

Restoring thyroid health depends upon the specific needs of each patient. Key areas include lifestyle, diet, exercise and specific nutrient recommendations as well as the use of adaptogenic botanicals.

Digestive problems are one of the most common complaints that I work with. While symptoms of heartburn can often be addressed quickly with dietary changes and digestive support not all patients have it so easy. Irritable bowel disease, Crohn's, ulcerative colitis, irritable bowel syndrome, leaky gut syndrome, diverticulitis, diverticulosis, small intestinal bacterial overgrowth (SIBO), leaky gut, chronic diarrhea and constipation require a deeper level of evaluation and willingness on part of the patient to make substantial changes to diet. In my experience, I find food sensitivity testing to be very helpful and utilize test panels through Cyrex and Meridian Valley Laboratories. SIBO is evaluated through a breath test and intestinal permeability (leaky gut) can be assessed using Cyrex Laboratory's Array 2.

Some of the most helpful information in difficult situations can come from a comprehensive stool analysis. These are expensive tests but the information learned can be pivotal. My preferred test for stool evaluation is the a comprehensive evaluation by Genova. To learn more click the links - Genova GI Effects with zonulin.

The impact of xenoestrogen exposure from the environment is one of the factors leading to hormonal symptoms in both men and women. Xenoestrogens are a type of hormone that imitates estrogen and can disrupt normal endocrine function. Women may experience changes in menstrual cycle length, pain and cramping during periods, scant or heavy blood flow, breast pain and swelling, pelvic pain, irritability, acne, facial hair growth, hair loss or thinning, hot flashes, mental fogginess, mood swings, depression, shrinking breasts, disinterest in sex and other frustrating symptoms that negatively influence quality of life. Men can also experience hormonal symptoms associated with imbalances such as low testosterone or high estrogen that effect ability to concentrate, sexual function and interest, weight gain, moodiness, muscle soreness, mental fatigue and sweating. Depending on the situation I will recommend either blood, urine or salivary testing to evaluate hormone levels and balance.

Blood sugar related problems can lead to a myriad of health concerns - diabetes being the most troubling outcome. Early on, however, many patients will first experience symptoms of low blood sugar. Clues that you may be experiencing a blood sugar problem are craving sweets during the day, irritability if meals are missed, depending on coffee to get you going in the morning, light-headed if meals are missed, fatigue relieved by eating, feeling shaky or jittery, easily agitated, nervousness, poor memory, blurred vision, craving sweets after meals, frequent urination, increased thirst or appetite and difficulty losing weight.

Disorders of blood sugar are evaluated through fasting laboratory testing and in many cases I will recommend also evaluating cardiovascular risk factors like cholesterol, triglycerides and other heart disease and stroke risk factors. Many blood sugar disorders can be successfully supported by making strict dietary changes, exercising regularly and utilizing specific supplements.

Children and adults with a diagnosis of Attention Deficit Hyperactivity Disorder may benefit from a thorough functional medicine evaluation to identify potential imbalances and underlying drivers. For example, an individual with genetically induced high histamine levels may experience an increase in symptoms of ADHD after consuming foods high in histamines. Evaluation may include food sensitivity testing, micronutrient analysis, organic acids testing from Great Plains labs, heavy metals, comprehensive stool analysis, mold testing, genetic testing for MTHF, COMT, CBS and other variations that influence metabolism, detoxification and biochemistry.

Very advanced testing for PANS and PANDAS can be performed using the Cunningham Panel from Moleculera labs. When the clinical diagnosis of an autoimmune neuropsychiatric disorder is made or suspected, the Cunningham panel can provide objective laboratory evidence by measuring autoantibodies associated with certain neuropsychiatric illnesses.