Improving Chronic Conditions With Functional Medicine and Genetics
The current approach for the treatment of neuropathy has not been very successful. There are millions of people that suffer with this condition all across this country. There are several reasons for this failure in part because there are so many causes of neuropathy and in part because the treatment is not directed towards the whole body. The field of medicine addresses symptoms, diagnosing the problem and then prescribing a medication that hopefully will suppress the symptoms.
The cause is rarely found or for that matter rarely searched for. What is required is a whole body approach. A cure for neuropathy will never be found if we continue with our current approach.
A whole body approach for example for the diabetic neuropathy would be to prescribe dietary guidelines to normalize the HbA1c or the blood sugar levels. Exercise would be prescribed to improve the insulin sensitivity. Supplementation would be recommended to assist in the reduction of inflammation, repairing of the cell and nerves, improve digestion and assimilation, detoxification and elimination.
This approach would be slightly different and personalized for that individual dependent upon their causes, lab markers and of course their genetics.
Genetics is proving to be a game changer when working with chronic patients. It allows us to interpret potential vulnerabilities in methylation, (the utilization of B vitamins and Folate), detoxification, ability to handle chemical toxicity or pesticides, production of choline a necessary component in the myelin, and the body’s ability to produce glutathione the major antioxidant.
When I evaluate the root causes of all chronic issues including neuropathy I always look at these 6 factors: Inflammation, Methylation, Mitochondrial Health, Detoxification, Genetics and Autophagy.
With all chronic disease including Peripheral Neuropathy these six areas must be addressed along with diet and lifestyle changes.
Anti-inflammatory or Nutrient Dense Food Program
Eliminate or Reduce Exposure to Toxins
Treatments and therapies are much more effective when they are personalized to that individuals particular problem. Is it methylation, mitochondrial dysfunction? I will say methylation will directly affect the mitochondria as well as detoxification.
When the mitochondria are affected, remember this is the battery; the energy of the cell, the first place it will affect is the brain and nervous system. It is our most energy dependent system in the body. The second place it will affect is the immune system and then finally the muscular system.
Dependent on what genetic snps we have there are certain supplements that help to restore mitochondrial health. It could be NADH, D-ribose, COQ10, Ubiquinol, Magnesium, Carnitine or Alpha Lipoic Acid.
The solution is slightly different for everyone and there is no one size fits all. We have to determine which of these or a combination of these 6 factors are affected and provide support nutritionally along with the lifestyle factors mentioned above. I strongly believe that with the right approach a cure could be found for those that suffer with Peripheral Neuropathy.
I am taking the proceeds from my book “Understanding, Managing and Improving Your Peripheral Neuropathy,” which can be purchased on Amazon, and have begun to do research on genetics and neuropathy.
The Functional Medicine Doctor is the best qualified to assist with the needs of the chronic patient.
Dr. Veselak is a graduate of the Functional Medicine University and has extensively studied in post -graduate courses Genetics and Functional Neurology.
In our clinic we specialize in Chronic Degenerative Conditions including Peripheral Neuropathy.
We consult with individuals from all over the world. If you have interest in this please email Dr. Veselak at firstname.lastname@example.org or Call our office for an appointment. 805 482-0723
METABOLIC SYNDROME: DIABETES, OBESITY AND FATIGUE
Metabolic Syndrome affects nearly one third of all adults putting them at a greater risk for heart attack, stroke and type 2 diabetes. Individuals with metabolic syndrome generally live a sedentary lifestyle and have poor dietary habits.
What Is Metabolic Syndrome?
If an individual has 3 of these 5 risk factors they have metabolic syndrome
Why Is It So Common?
There are several factors that can lead to Metabolic Syndrome. To begin with we need to address the Standard American Diet. This is very high in high fructose corn syrup, trans fats, hidden sugars, refined carbohydrates, gluten and refined vegetable oils.
We also have to address all the environmental toxins that we are exposed to. These include BPA from plastics, pesticides, phthalates and heavy metals.
It has also been argued that our food is much less nutrient dense coupled with the amount of processed foods we consume creating deficiencies in vitamins, minerals and fatty acids.
Chronic stress whether is emotional, physical or environmental can lead to increase in cortisol levels which in the long term can cause blood sugar abnormalities as well as it can affect the permeability of the gut.
Ultimately this makes us more fatigued leading to a lifestyle that is more sedentary but eventually can impact normal sleep patterns.
What Happens When Our Cells Become Resistant To Insulin?
The main job of insulin is to deliver sugar to our cells to produce energy. When insulin becomes elevated due to the dietary, environmental, physiological and psychological factors mentioned above the cells become resistant to insulin and glucose or the blood sugar elevates in our blood stream.
When insulin resistance occurs this will not only impair glucose metabolism and elevate blood sugar, which is extremely inflammatory to the body and brain but it will also affect blood pressure, cholesterol levels, triglycerides and obesity. It can even lead to hormonal issues, PCOS, and liver disease.
What Are The Symptoms of Metabolic Syndrome?
What Can Be Done To Fix This?
To begin with dietary changes have to be made. There are several diets like the Paleo or Ketogenic that can provide benefit to the individual that has metabolic syndrome.
Here are some general guidelines:
Eat More of:
Eat less of :
What Nutritional Supplements Help?
What Other Factors Help With Metabolic Syndrome?
Can It Be Reversed?
Yes! Through diet, exercise and lifestyle modifications it is reversible. By following our recommendations we have been able to reverse metabolic syndrome and type 2 diabetes. This will improve not only their symptoms, but their quality of life.
If you are suffering from any chronic disease or from chronic pain this is a fundamental step that must be addressed for improvement to take place.
If you would like additional information please call our office at 805 482-0723
Or take the free health assessment on our website Pacificfunctionlhealth.com
Leaky Gut: The Impact on Chronic Disease
Intestinal hyper-permeability or “leaky gut”, is a condition in which macromolecules leak either between the cells or “tight junctions or through cells that line the gut called enterocytes.
This can lead to systemic inflammation and can lead to many chronic diseases. The most common endotoxin is LPS or lipopolysaccharide which, is a gram-negative bacteria.
Conditions Associated With Leaky Gut:
What Are The Causes of Leaky Gut?
Stress has proven to be one of the most common factors in creating intestinal permeability. This can be emotional, physical or chemical. Other common causes are antibiotic use, NSAIDs, and proton pump inhibitors such as Prilosec or Prevacid. Certain lifestyle factors such as chronic alcohol consumption, smoking, lack of sleep or over training can cause leaky gut.
How Do We Test For It?
A simple lab test to measure leaky gut is to measure two sugar molecules, Lactulose and Mannitol. The Lactulose is a larger molecule is not readily absorbed and Mannitol is smaller and easier absorbed. Although this test is relatively inexpensive it is not entirely accurate as it does not measure the immune response. Also, ingesting the sugar molecules can be reactive if the patient has SIBO.
There is another test that we often recommend it is Array 2 from Cyrex Labs. This test will measure LPS, which will indicate infiltration of endotoxins through the intestinal barrier into the circulation.
It also measures Occludin and Zonulin. Occludin in a protein that keeps together the tight junctions making the intestinal wall not permeable. Zonulin is a protein that is responsible for regulating the permeability of the intestines.
The Array 2 will also measure Actinomyosin that helps regulate intestinal barrier function.
What Can Be Done To Fix The Leak?
As a Functional Medicine Practitioner we will run the proper tests to assess whether you have the leak. Then we will employ lifestyle choices such as managing stress with Neurofeedback, Heartmath, Vagal Nerve Stimulation and co-managing with a Therapist. Other lifestyle choices such as reducing the intake of alcohol, proton pump inhibitors and NSAIDs will be beneficial. We also stress the importance of good sleep and proper exercise techniques to avoid over training.
We incorporate strategies to increase secretory IgA levels. This will help to minimize the endotoxin LPS as it is our first line of defense and will minimize and neutralize the effects of LPS.
Nutrients that we use to increase secretory IgA levels are Colostrum, Omega Fatty Acids, Glutathione, Glutamine, Glycine and Zinc.
Next it is important to strengthen the intestinal lining or mucosal barrier. We recommend Threonine, Serine, Proline and Cysteine to increase the mucin or mucous production.
The final step is to improve the microbiome. With leaky gut we lean towards the spore based probiotics. Common probiotics lactobacillus and bifidobacteria have difficulty surviving due to the acidity of the stomach. Generally, we recommend Megaspore Biotic as it has been clinically proven to reduce leaky gut associated with chronic diseases.
Strategies that effectively handle leaky gut is a fundamental step in the process of treating chronic disease and pain.
Anxiety: Neurofeedback and Hemp Seed Oil
It has been estimated that approximately 40 million adult Americans suffer from generalized anxiety disorder, panic disorder and social anxiety disorder. Based on these estimates from the Anxiety and Depression Association of America, this means that approximately 1 in 5 people will develop some type of anxiety condition sometime in their lives. These numbers are staggering, making it the most common mental illness in the United States.
There are many causes of anxiety disorders may be caused by environmental factors, medical factors, genetics, brain chemistry, substance abuse, or a combination of these. It is most commonly triggered by the stress in our lives.
In our clinic we address several of these possible factors. First we analyze genetics and look particularly at the MTHFR, COMT, MAO and GAD snps. Through proper personalized nutrition these can be minimized or neutralized.
Next we address environmental exposures and levels of toxicity, heavy metal, chemical as well as bacterial or viral overload.
With regards to stress we employ techniques to balance the sympathetic nervous system or the “fight or flight”, with the parasympathetic nervous system, “rest and digest”. We teach you methods to stimulate the Vagus nerve and help your body deal with stress.
Therapy can also be an important intervention with chronic stress and anxiety. We work with a team of therapists to guide you through this process.
It is important to manage anxiety from a metabolic standpoint, with diet and lifestyle recommendations. We have found that some adaptogens like Ashwaghanda or polypehnols can prove to be beneficial.
Recent research also suggests that hemp seed oil might be an alternative to some of the medications to relieve emotional distress.
Finally we incorporate Neurofeedback. Simply stated this has been by far the best therapeutic intervention we have employed with our anxiety patients. While the patient comfortably watches a movie, Neurofeedback will change the brain wave activity lowering it from a high beta pattern to more of a relaxed alpha state.
If you are experiencing anxiety and are looking for a comprehensive alternative, than call our office at 805 482-0723.
Antibiotics such as Cipro, Levaquin, Avelox are a group of antibiotics called Floroquinolones. They are among the most commonly prescribed antibiotics in the United States.
With this class of antibiotics there are great risks that can come from taking these so make sure that when prescribed these that your condition is a serious one and not a minor problem like a UTI or sinus problem.
When I consult with people all over this country, several of the chronically ill have been “floxed” as has been termed, damaged by the Floroquinolones. These individuals have had a neurotoxic reaction due to the ability of fluoride to penetrate the blood brain barrier and attack the brain.
I initially learned about this toxicity while researching for my book on Peripheral Neuropathy, “ Feet Don’t Fail Me Now.” Peripheral Neuropathy is just one of many problems that can occur due to this toxicity. More common symptoms are tingling, numbness, vertigo, loss of balance, memory issues, tendon ruptures, joint pain, ringing in the ears, rapid heart beat, intolerance to heat or cold, rashes.
So individuals that have been compromised by genetic susceptibilities, MTHFR, methylation, detoxification and the ability to handle chemicals and or toxins properly get a dose of these fluoride quinolones and this creates an inflammatory state in the body affecting the nervous system, musculoskeletal, gastrointestinal, and autonomic and cardiovascular system.
As we have learned with Genetics they can be turned on and off by diet and lifestyle changes. With floroquinones there can be an immediate reaction and or a cumulative effect where it actually will build up in the system and can affect you years down the road.
Is it possible that taking Cipro created the Peripheral Neuropathy or Tinnitus years down the road? Is this what idiopathic neuropathy is? Where there is no known identifiable cause but it is a chemical toxicity caused by an insult to our peripheral nervous system.
It has also been reported that this can than cause an increase in oxidative stress and consequential mitochondrial damage. This creates an incredible amount of fatigue, as the mitochondria function is to produce ATP, the energy of the cell. In my research with treating thousands of patients I have come to learn how important the mitochondria is for restoring a person back to health. In the past I would focus on adrenals and thyroid, which still play an important role, however if the mitochondria are not healthy than the body cannot protect itself from the continual onslaught of oxidative stress and the ability to produce energy, there will be no recovery.
Genetics does play a part. Besides the MTHFR gene, the CYP, NDUF, G6PD, NOS, CAT and SOD are important snps for methylation, detoxification and mitochondrial health.
There is no known cure for Floroquinolone toxicity however supporting the mitochondria, reducing oxidative stress, reducing brain inflammation, glutathione support and improve the detoxification pathways is a great place to start.
Functional Medicine focuses on finding the root cause of the problem. When discovered solutions become much clearer.
The more we learn about methylation and MTHFR we realize how important B12 is. I am going to discuss the different types of B12 as it relates to methylation, absorption and genetics and which type might benefit you.
There are four types of Vitamin B12, Cyanocobalamin, Methylcobalamin, Adenosylcobalamin and Hydroxocobalamin
The first, Cyanocobalamin is not very good and we recommend never using it. It is synthetic or a man made form of B12. It takes the body more steps to convert it to a useable form of Hydroxyl B12. Cyanocobalamin is commonly found in energy drinks.
Methylcobalamin is an active form of B12, which helps with the metabolism. It is basically cobalt attached to a methyl group. It is beneficial in methylation because it activates an enzyme called methionine synthase. This helps the myelin sheath of nerves as well as it helps to make red blood cells. Methionine synthase also plays a very important role in converting Homocysteine into methionine. This helps reduce the amount of Homocysteine in the body, which can at high levels cause cardiovascular as well and neurological damage.
Methionine is also utilized through the MAT enzyme to convert it to SAMe. It is the body’s major methyl donor, which is very significant for the breakdown of neurotransmitters (COMT) and breaking down histamines (HNMT).
The best dietary sources of B12 are animal products such as Meat, Poultry, Fish and Eggs. It is very common for people to be deficient in B12. Primarily because of the complex process that is required to absorb it, methylate it and assimilate it. For B12 to work properly it much combine with methylfolate as part of the methylation process to make methionine synthase. Individuals with the MTHFR gene are already functioning at a 20-50% reduction in converting folate to methyl folate.
Some other causes of B12 deficiency are: Vegan Diets, Antacids, Bariatric surgeries, Alcohol and Pernicious Anemia.
The lab tests MCV and MCH if elevated suggest a B12 or Folate deficiency.
Too much of methyl B12 can cause megaloblastic anemia. A condition where you have high amount of red blood cells, hemoglobin and hematocrit in your CBC blood lab tests.
Adensosylcobalamin is the mitochondrial form of B12. It is great for energy and can be utilized for a person that is experiencing fatigue throughout the day. It can also be successful for the individual that exercises and experiences more muscle aches and fatigue following exercise.
Methylmalonic Acid is the gold standard test, to see if the patient is deficient in Adensosylcobalamin. A high methylmalonic acid suggests B12 adenosyl deficiency.
Hydroxocobalamin is most beneficial to lower Nitric Oxide levels. If there is an abundant amount of nitric oxide in the body this creates too much ROS, reactive oxygen species. It is not uncommon to see elevated nitric oxide levels with chronic fatigue and autoimmune issues. To complicate matters are the eNOS and SOD snps. Generally, supplementing with SOD and Hydroxycobalamin are beneficial to lower the ROS and the nitric oxide levels.
Dependent on various SNP’s (single nuclear polymorphisms) at the COMT and VDR certain combinations can prove effective as outlined by Dr. Amy Yasko. I have followed her formula with success in my Functional Medicine/Genetic Coaching.
COMT V158 VDR Taq B12 Types well tolerated
— ++ (TT) All three types of B12
— +- (Tt) All 3 with less methyl B12
— — (tt) Hydroxyl and Adenosyl B12
+- ++ All 3 types with less methyl B12
+- +- Hydroxy and Adenosyl B12
+- — Hydroxy and Adenosyl B12
++ ++ Hydroxy and Adenosyl B12
++ +- Hydroxy and Adenosyl B12
++ — Hydroxy B12
I recommend Pure Encapsulations Adenosyl/Hydroxy B12 liquid.
It can be found on my website store in liquid or capsule form. https://www.purecapspro.com/drmichaelveselak/pe/products/product_details.asp?ProductsID=2312
Difficulty Losing Weight
Through the years I have coached several patients to help them lose weight. However, every so often a more difficult one comes along exhibiting signs of hormone, glucose and insulin imbalance. Over time I have been fortunate to learn how to break through some of these barriers and begin to identify the real causes of why they are unable to lose weight despite cutting calories and exercising.
Initially, I thought that the individual was not 100% being upfront with me with regards to diet and exercise. We started to monitor them closely documenting all food intake and exercise. What we discovered was quite revealing.
The major cause of weight loss resistance was inflammation. Inflammation originating in the cell affecting the mitochondria, the receptor sites for all hormones and vitamins and the nucleus, which is where the replication of DNA takes place.
Probably the greatest change I have seen in my 30 plus years in practice, is the level of toxicity in each patient. When I first started practice the adjustment was powerful and it could in of and by itself eliminate the stressors emotional, physical and chemical resulting in the vertebral subluxation. However, in recent times are bodies are over burdened with this toxic load from cosmetics, hair dyes, water supply, pesticides in food and just overall pollution. This bombardment has led to not only to a part of the population that is resistant to losing weight but also a dramatic increase in Autoimmune Conditions, Autism, Alzheimer’s and Thyroid Conditions.
All of the patients that I coach with regards to weight loss have tried other forms of dieting without much long -term success. Primarily, it is because we need to teach the body to become a fat burning machine and increase energy.
There are several ways we can achieve this and I will tell you the approach is slightly different for everyone. We utilize techniques to modify your diet to eliminate food triggers as well as modifying and varying your approach to food and eating.
It is necessary to eat whole foods, organic preferably. Also we need to incorporate strategies to allow our body to adapt to different situations. In recent years we have incorporated techniques such as modified fasting, intermittent fasting and on occasion block fasting.
There are numerous research articles on the benefits of fasting and varying the schedule of eating so our bodies are not so predictable. These benefits include: Reduction of Insulin Resistance and glucose sensitivity; Enhanced Immune System; Increase Human Growth Hormone which has anti aging properties; Improving Digestive Health and Improving Cellular Inflammation.
Remember I said the cellular inflammation is at the core of most modern day illness.
Intermittent Fasting or varying the schedules of when to eat as stated above has profound health benefits. When I began to implement this strategy the results with my coaching clients were clearly identifiable. We were able to take the body and shift its focus from burning sugar to burning fat.
Losing weight suddenly became easier as our cell walls became less toxic and in turn less resistant. Energy levels increased, sleep patterns improved, fat burning accelerated.
Our body will also prefer sugar burning to fat burning because it is easier and too much glucose will be toxic to the cell. During our normal day it is imperative that we drastically reduce our carbohydrate intake to make sure the shift stays in fat burning mode rather than sugar burning mode.
Read the labels and glance at the sugar and carbohydrate content. With huge glucose spikes we create more cellular inflammation ultimately increasing the resistance of the cell to hormones and vitamins causing an inability to not only feel good but too lose weight.
An increased amount of inflammation in the body will cause more oxidative stress, placing more burden on the body. Of course there is never one quick fix or one size fits all plan to help everyone. There are some people that their genetics leads them to more oxidative stress and the body’s ability to remove these harmful free radicals.
This is why I like to analyze the DNA through 23andme, so we can see exactly the hand we are dealing with to personalize our approach for each individual. Again, when employing this comprehensive strategy conditions such as the inability to lose weight, neurodegenerative diseases, autoimmune issues, ADHD, and anxiety has become much easier to support.
Ketosis is the ideal state we would like to achieve with our intermittent, modified or block fasting. This promotes healing and fat burning. Ketosis does not have to be a permanent state. We have individuals that go in and out of ketosis with good results.
On occasion there are a few individuals that their toxic burden is so great they will not shift into ketosis and do not experience the same results with regards to health and weight loss. With these individuals we will “carbo load” them, still maintaining good carbs, no grains and sugars.
While the food intake and maintaining a state of fat burning is very important, it is also important to begin the process of removing the toxins. We utilize certain supplements to help detoxification and support the body in recovery. This might entail supporting the liver, gall bladder, adrenals, thyroid and or kidney.
Most of us have been convinced that detoxification occurs with a 3 day or 5 day cleanse or a juice fast. Detoxification, phase 1 and phase 2 occurs on a minute, by minute basis. It needs to be addressed and supported through good methods of dieting which we have discussed along with proper supplementation and support to help control the cellular toxicity and inflammation.
The final component is exercise. It is important to change your routine and do not get stuck performing the same exercises every single day. There has been a lot of research in regards to High Level Intensity Training. This type of exercise makes our body more efficient for burning fat, losing weight and increasing the overall metabolism.
If you are interested in our coaching program, call the office at 805 482-0723.
We are the only facility in Ventura County that addresses the patient from a Structural, Metabolic, Neurologic and Genetic Viewpoint.
FIND THE CAUSE!!!
We are all well aware of how important sleep is in our life. We have heard the saying that we can live without food but we cannot live without sleep. Sleep is the time when our body begins its regenerating process. It allows us to refuel or recharge our energy storage as well it assist in tissue regeneration.
When an individual does not get enough sleep it affects many systems in the body. First it increases inflammation, affects blood sugar leading to insulin resistance or diabetes type 2.
Ideally for maximum health benefits we should try and get 7-8 hours of sleep per night.
There are a few things that can affect this. Hormones such as cortisol, which is produced with an increase in stress. This stress could be physical, chemical, or emotional. Cortisol has an inverse relationship with melatonin, the hormone that helps us sleep. We should have a lot of cortisol in the morning and very little melatonin and as the day progresses there should be less cortisol and more melatonin.
Light, especially blue light will affect this. Even lights in your room or a full moon will inhibit the production of melatonin.
If you are having difficulty sleeping here are some tips.
Recently, I have been doing a lot of research and studying on the brain. During my research I was exposed to the use of Low Level Light Therapy for cognitive enhancement. Since in our practice we are supporting patients with early signs of dementia, concussions and traumatic brain injury, I was extremely pleased and overwhelmed by the amount of studies conducted on LLLT discussing its impact on the cells and the mitochondria.
In our office we have and utilized 3 different types of LLLT , dependent upon the area we are treating.
Laser therapy is effective because it exposes injured tissue to a coherent light at specific wavelengths that has been proven through research to be effective in pain relief as well as cognition in the brain. The best part is it stimulates the bodies ability to heal itself through photo biomodulation without any side effects. There have been more that 3000 published studies displaying the effectiveness of low level laser therapy.
I have been using Cold Laser in my office for approximately 10 years now. I have without a doubt found it the most effective therapy modality for the treatment of sports injuries such as tennis elbow, plantar fasciitis, knee pain and shoulder pain.
The term “cold” laser is used instead of Low Level Light Therapy, because the photons from the laser do not generate heat. Therefore it can not damage tissue or cause sensation of heat.
There are two other great benefits besides the fact that it is extremely effective. First as we just mentioned it is non- toxic, it does not interact with medications and create side effects. Second it is non-invasive.
How Does Laser Therapy Work For Cognitive Therapy
There have been studies that conclude its impact on increasing BDNF, Brain Derived Neurotropic Factor. BDNF has been proven to reconnect neurons. So with neuroplasticity our main objective is to reconnect neurons that are degenerating and improve communication.
It has also been proven to increase Nerve Growth Factor and Stem Cells.
Our body has built in mechanisms that deal with free radicals and the formation of protein misfolding which occurs in some neurodegenerative diseases. This degeneration can occur for many reasons but some of the most common are inflammation, lack of oxygen, decrease in circulation, increase in blood sugar (insulin resistance or diabetes), and too much ROS (Reactive Oxygen Species)
Studies on LLLT have shown to
Low Level Therapy Combined With Proper Exercise and Support
When LLLT is coupled with proper exercise of the joint or brain based therapies to improve function and neuroplasticity the results are even better. In our clinic we perform a comprehensive neurological examination assessing potential functional limitations of different lobes of the brain. Our rehabilitation then can be very specific to target those areas and improve the neuroplasticity.
Functional Neurology allows our brain to integrate more efficiently and effectively.
We also will recommend supplements to help improve the cognitive function and reduce inflammation . Supplements such as Tumeric, Resveratrol, Omega 3’s, PQQ, and phosphatidylcholine.
Conditions That Benefit from LLLT
Improving Bonde Density
Today we are going to discuss the Thyroid Gland and the 6 Patterns of Hypothyroidism
In our office we see a lot of patient with Thyroid Dysfunction. We always ask the 3 basic questions. When did you first notice you had symptoms? How long did it take to get Diagnosed? How often do you change your Dose?
Most of our patients have tried everything to get their energy back and to feel good again.
Thyroid Problems are often not diagnosed for 2 reasons. First doctors do not run enough markers. Secondly the lab ranges are too wide. We utilize functional ranges 1.8- 3.0 for the TSH.
The current medical model, which is a 50 -year old model falls short in fully identifying the cause of the thyroid condition. It is based upon a limited number of lab markers focusing on TSH and T4. How can you manage the thyroid without all the information?
As you will see in the next few minutes there are several other lab markers that need to be addressed to determine the actual cause of the thyroid problem. Our complete thyroid panel includes TSH, T4, Free Thyroxin index Free T4 l Free T3l; T3 uptake; Reverse T3; TPO and TBG antibodie; TSH, antibodies and TBG levels.
When necessary we will also run other labs to determine the cause. Proper testing is crucial. A complete metabolic panel including all the thyroid tests described above along with liver function, anemia, blood glucose levels. Hormone tests, Salivary cortisol levels; Cyrex testing for gut permeability issues, stool testing looking for infections, yeast or parasites. We also at times will run an organic acids test.
Other testing we may recommend is genetic testing and the MTHFR gene, Hair analysis to evaluate copper and mercury toxicity and deficiency of essential nutrients.
To understand how to support the thyroid it is extremely important to know how the thyroid works. Then when we discuss the 6 patterns of hypothyroidism it will become clear where the problem arises.
THE SYMPTOMS OF THYROID DYSFUNCTION:
The thyroid supports bone metabolism, immune system, brain and nervous system, endocrine system, GI function, liver and gall bladder, growth and sex hormones, fat burning, healthy cholesterol levels and proper stomach acid.
EVERY CELL IN YOUR BODY HAS A THYROID RECEPTOR!
Overview of the thyroid gland and how it is converted.
It all begins in the Brain, The hypothalamus releases a hormone TRH (Thyrotrophic Releasing Hormone – to the Pituitary Gland. The Pituitary gland the signals the release of TSH thyroid stimulating hormone) this is what is tested on lab work.
The pituitary gland also regulates the release of other hormones- ACTH to the adrenal glands; You can see the Adrenal glands are responsible for the release of Cortisol, Progesterone, aldosterone, DHEA, epinephrine and norepinephrine. Pituitary gland also releases Lutenizing hormone and follicle stimulating hormone to the ovaries and testes which helps control the menstrual cycle and testosterone
To make Thyroid Hormone the Thyroid gland needs iodine and Tyrosine. T4 is 4 molecules of iodine and one of Tyrosine and T3 is 3 molecules of iodine and one tyrosine. The thyroid produces 93% T4 and 7 % T3
To transport the molecules they hop on a taxi cab which is called TBG or thyroid binding globulin. This taxi cab transports it to the liver where T4 is converted to T3 the useable form of T3.
60% of T4 is converted to T3 in the liver. Selenium is also extremely important in the conversion of T4-T3
20% in the gut and 20% in other tissues As you can see it is essential to have not only a healthy liver, gut, pituitary , adrenals, but we also need iron, iodine, selenium, zinc, magnesium and tyrosine to make it all happen.
Once again they bind to a protein TBG to carry it to the cells. Free T3 is the active form of thyroid hormone. EVERY CELL IN THE BODY HAS A RECEPTOR SITE. The cell is dependent on methyl groups, viamin A and iron for absorption.
The 6 major Thyroid patterns:
1 The first pattern is PRIMARY HYPOTHYROIDISM
If the pituitary gland senses the thyroid isn’t doing its job, it will pump out extra TSH, giving the thyroid a kick in the pants.
Primary hypothyroidism is a true dysfunction of the thyroid gland and is the only pattern of hypothyroidism that can be effectively managed with thyroid replacement hormone – unless its autoimmune Hashimoto’s. Then is an immune issue and needs to be supported as such. If tissue destruction is severe, replacement hormones prevent complications due to deficient thyroid hormones. However, if the health care practitioner detects primary hypothyroidism before the damage is too far gone and approaches it nutritionally, the condition can be reversed in the majority of the people delaying the need for medication, if its required at all. If the TSH does not come down to normal after the nutritional protocol the hypothyroidism may be so advanced that thyroid medication is the only recourses.
The lab range is .5-4.5, functional range is 1.8-3.0. anything above lab range of the TSH is considered Primary Hypothyroidism.
The second pattern is HYPOTHYROIDISM SECONDARY TO PITUITARY HYPO FUNCTION
(Low T3, High Cortisol)
This is a very common pattern of functional hypothyroidism. Here TSH will be low (below 1.8) although not as low as with primary hypothyroidism but you will still have symptoms. Chronic stressors are at the root of this pattern because they fatigue the pituitary gland at the base of the brain. Then the pituitary fails to signal the thyroid to release enough TSH to stimulate activity. In other words, the thyroid gland may be perfectly fine but nobody is telling it to go to work because the pituitary is asleep on the job. Pituitary hypofunction is usually the result of one of four things.
An active stress response (poor diet, inadequate sleep, too much caffeine, high carbs chronic inflammation, viral or bacterial infections are just a few factors which wear the body out
Postpartum depression. It’s not uncommon for women to dip into a low thyroid state after pregnancy, because pregnancy amplifies the demands on all hormonal systems in the body, keeping the pituitary busy 24/7.
The third pattern is THYROID T4 UNDER-CONVERSION
(Low T3, High Cortisol)
This is a common pattern associated with chronic stress and excess production of the adrenal hormone cortisol. Here the body makes plenty of T4 but too much cortisol prevents the body from being able to convert enough T4 to T3, the form of the thyroid hormone the body can use. An elevated cortisol level suppresses the conversion of T4 to the useable form of T3.
Another common cause is deterioration of the body’s cell membranes in response to chronic infection or inflammation. Cell membranes are in charge of multiple functions, including the conversion of T4 to T3. Chronic inflammation causes lipid peroxidation, in which harmful free radicals damage the cell walls. And damaged cell walls hamper thyroid conversion. Finding the cause of the inflammation are keys to the support.
The 4th pattern is THYROID OVER-CONVERSION
(High Free T3, Decreased TBG)
This pattern is found with insulin resistance and polycystic ovary syndrome (PCOS), since excess testosterone production accompanies these conditions. Reversing insulin resistance reverses hypothyroid symptoms. This pattern also arises in those who already have developed Diabetes (DM) and are taking insulin. Gaining control over blood sugar, any insulin needs with diet, supplementation and exercise are critical.
The 5th pattern is THYROID BINDING GLOBULIN ELEVATION
(Low T3 Uptake and low or normal Free Thyroxine Index (FTI))
This pattern is often found with oral contraceptives or estrogen replacement therapy.
Thyroid hormones hitch a ride through the bloodstream on thyroid binding globulins (TBG). Since thyroid hormones in the blood bind to excess TBG’s, not enough free hormone is available to enter the cells. Clearing the body of excess estrogen addresses hypothyroidsim.
6 THYROID RESISTANCE
(Thyroid panel WNL, Elevated cortisol)
This is another stress related pattern in which the pituitary and thyroid glands function normally and make the right amount of hormones but the hormones are not getting into the cells to take affect. Symptoms of hypothyroidism show up. Elevated levels of cortisol, in response to stress, cause the cells to become resistant to thyroid hormones.
Functional Medicine Approach
Based upon our functional medicine lab findings we will offer support to the thyroid, adrenals, liver, gut, blood sugar, anemia or autoimmune regulation.
We must address nutrient deficiencies, food sensitivities, adrenal dysfunction, gut dysbiosis and liver detoxification issues.
I completely understand how you feel if you are frustrated and have no energy. A lot of our patients with thyroid issues felt the same way.
if you have any questions email me at email@example.com,
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