What can I expect from a Functional Medicine consultation?
Our goal is to provide you with an education on the physiology of your specific health concern, screening to try to uncover the potential “root cause” of your problem, and create an individualized protocol (including diet, lifestyle, and possibly supplements) to help restore your normal physiology. We know that we have done our job if you have the tools that you need to take control of your health.
How do I get started?
A health assessment begins with a free 15 minute phone consultation to determine if we can be of assistance with your health concerns. After completion of our documentation and review of your test data, we will schedule an initial consultation to determine the best course of action to try to uncover the root cause of these issues.
What do we accomplish during a Functional Health initial consultation?
First, we review your pertinent history, signs and symptoms, and lab test results to determine possible dysfunction. We present our findings to you in a fairly detailed manner so that you may gain a thorough understanding of the current state of your health and what steps need to be taken to improve it. Second, we fully evaluate the effect of lifestyle choices. Third, we move onto diet were we discuss dietary strategies for maintaining proper blood sugar/insulin and hydration levels. Fourth, we then look for any specific food and environmental intolerance/sensitivity and possible assimilation issues that may be undermining your health. Fifth, we look at any underlying dysfunction and start supporting the most pressing issues. Finally, we help develop a protocol with you that include interventions found best suited for your body while observing your personal preferences. Additional testing may also be recommended based on our findings.
What types of health issues do you screen for?
In our experience, we have found that the following are highest in priority in helping you return to normal physiology.
Determination of gastrointestinal disorders. This area has been shown many times to be the first affected by dysfunction and has far reaching effects outside the GI tract. Remember the old saying, “You are not what you eat, but what you assimilate”. Intestinal permeability may decrease the ability to correctly obtain nutrients from the food that we consume. In addition, a digestive tract that is compromised may allow antigens to enter the body which may initiate an immune system response in other areas of the body. In screening for GI health, we consider issues such as food intolerances, ineffective digestive enzymes, low HCL, dysbiosis, parasites, yeast, inflammation, and many others that may be compromising the GI system.
Determination of blood sugar and adrenal dysregulation. Our blood sugar and stress are two of the most important drivers of the endocrine system (and visa versa) and may effect everything from blood pressure to our sex hormones!
Determination if markers of oxygenation dysfunction may be present. Without oxygen are bodies can’t function which makes by iron binding/transport/storage and red blood cell quality extremely important.
Verification of optimum levels of essential fatty acids, vitamins and minerals. Essential for many of the metabolic processes within the body.
Adequate hydration. Chronic dehydration is very common and cause havoc to our health. We not only look for overall hydration but whether there is adequate amount located inside of the cells where the metabolic processes occur.
Thyroid health. The thyroid impacts physiology in almost every part of the body. In addition, autoimmune thyroid must also be considered since it is an immune system dysfunction (not thyroid) and must be managed accordingly.
Immune health. Is there inflammation or underlying infections such as bacteria, virus or parasites that could be compromising your health? It is also just as important to consider possible autoimmune issues as they are becoming more prevalent.
Determination of optimal detoxification pathways. Our bodies are constantly trying to clear out environmental toxins. But detoxification is more than just exogenous or outside factors. If our detoxification pathways are not optimal, we may have problems even performing required tasks such as clearing out hormones. Compromised pathways may also cause us to develop sensitivities to everyday things that previously had not bothered us or create vague symptoms throughout the body.
Normalization of hormones and neurotransmitters.
Neurotransmitter and hormones affect much more than just our mood and can affect physiology throughout the body.
Cellular, Mitochondrial Health and oxidative stress
We look for cell membrane integrity which is the fundamental component of health as well as for potential mitochondrial dysfunctions which can affect health throughout.
Genes and Single Nucleotide Polymorphisms
Genetic variances or SNPs may affect the way that your genes function. Imagine a gene as a piece of stranded wire. If the strands within the wire break, the integrity of the entire wire is compromised. SNPs can influence how genes function leading to health issues.
Brain Inflammatory Patterns
Brain issues affect function throughout the body. We look for patterns of acute and chronic neuroinflammation.
What is the philosophy behind Functional Health?
Functional Health is a little different than most wellness practices. We look at health from four standpoints: Functional Medicine, Clinical Nutrition, Evidenced Based Practices, and Epigenetics. Putting all these pieces together has allowed us to assemble an effective method in which to help you optimize your health.
What is Functional Medicine?
A functional medicine based model allows us to look beyond labels and symptoms to help determine what possible biochemical or physiological imbalances may be affecting an individual’s health. The body is composed of highly interrelated systems. Therefore, physiology can be affected by many systems throughout the body. Functional medicine provides scientific tools to allow us to look at the body from a functional or optimal perspective rather than from a disease based model. You may ask, “Why this is so important?” Say you experience fatigue. Is it due to lack of sleep, problems with dietary intake, anemic patterns, endocrine system imbalances such as the adrenals or hormones, detoxification, immune, brain, mitochondria or GI issues? As you can see, there may be multiple reasons for the same set of symptoms. A disease based approach might look at the fatigue independently and recommend a protocol based on the symptom alone. It is the tenet of functional medicine to determine where the imbalance may be occurring so that interventions can be initiated.
What is Clinical Nutrition?
Let’s start by explaining the difference between clinical nutrition and dietetic science. A dietitian’s emphasis is to look at the composition of one’s diet and determine if the macro and micro nutrient content meets the recommended daily allowance or daily intake based on a particular standard. This approach is designed to promote health through general dietary means with modifications for conditions such as allergies, diabetes, Celiac disease, etc. A nutritionist’s emphasis is to determine how the components of one’s diet and environment are affecting the biochemical and physiological metabolic processes of the body and if these changes promote or degrade an individual’s health.
A clinical nutrition model looks at a combination of factors. Genetics and stressors are very important to one’s overall health and requires individual interventions rather than general ones. Many of us tend to think of stress as mental or emotional, but stressors are anything that effects the physiology of the body including allergens (food and environmental), parasites, viruses, dehydration, lack of essential fatty acids or specific vitamins or minerals, electromagnetic fields, etc. The role of a clinical nutritionist is to determine which stressors are affecting the body and to then help support the body through a combination of diet, environmental, and lifestyle changes.
What is Evidenced Based Nutrition?
Evidenced Based Practices assures us the protocols offered have been shown in the scientific literature to have the greatest promise in helping to restore the body back to optimum health. Our goal is not to sell you supplements, but to provide needed support that has been shown to have helped the most people given the same type of symptoms, in as close to the same set circumstances, with an effective dosage for the shortest period of time, or to provide the most effective lifestyle/dietary changes.
What is Epigenetics?
Last, but not least, is our genetic makeup. We have over 19,000 genes which is our personal biological map. Although they never change, the expression of these genes can be modified via environment and our lifestyle choices. Therefore, if you have family history of diabetes, heart disease, Parkinson’s, etc., you may not be destined to express it. The expression of over 70% of our genes may be modified by changes in our environment.
Why do you utilize blood testing and how is functional blood chemistry analysis different than standard blood testing at the doctors office?
There are many methods to determine where physiological/biochemical imbalances lie. History and symptoms give us a great starting point. But how can we determine functionality? Laboratory testing can be an objective way to determine if normal physiology is occurring. But what is considered normal? You go to your doctor and they run a blood test reporting that everything is in the normal range. But what does that really really mean?
Labs use data based on folks that have had testing performed at their facilities in the last year. Have you been to a draw station or doctor’s office lately and noticed who was there? Yes, sick people! When your doctor states that your labs are fine, the data is based on being within 95% of the folks seen during the last year. So you can leave knowing that you are healthier than most sick folks, but does that make you HEALTHY?
In addition, each lab bases the marker ranges on the clients visiting their particular facility so there may be different ranges between various labs companies as well as differences of ranges within the same testing company due to lab geography. This may result in you being deemed healthy by one testing facility or lab but not by another.
How is FBCA different? First, we look at your data within narrower lab range. The data is pooled from healthy individuals to look for physiological optimal ranges rather than disease ranges. Most practitioners only look at markers outside of the laboratory ranges. Our goal is to find biochemical imbalances BEFORE they develop into a disease state.
Another very important difference is that while reviewing biochemical data, scientists discovered patterns of individual markers that closely aligned to common disorders found in the body. For example, say you have symptoms associated with your gastrointestinal tract. Most conventionally trained physicians may say that not much information can be ascertained with blood markers. By utilizing functional blood chemistry analysis we may be able to see patterns associated in high probability with conditions such as low stomach acid, parasites, etc. If necessary, we may then suggest additional diagnostic testing. GI issues are just one of the many imbalances(dysfunction) that may be uncovered by looking at blood marker patterns rather than just focusing on individual test values.
Finally, our basic blood panel is much more comprehensive than most health care providers order. This provides us with the opportunity to perform a more comprehensive analysis since you can only see what you look for! It is better to obtain one good panel, one time, so we can determine systemic influences rather than trying to put together data taken months/years apart that may not correlate.
To see how it works, check out our video at https://youtu.be/9si3PZO4dvQ
Why do you utilize genetic testing and nutrigenomics?
Blood testing tells us what is happening in the body, but DNA may provide clues as to why. Even though we can’t change our genes, epigenetics shows that we have the ability to turn genes on/off as well as adjust the levels at which they work. About 70% of our genes may be controlled with diet and lifestyle changes. Nutrigenomics outlines specific interventions designed to help create healthy genetic expression.
By combining genetic information and blood testing, we may be able to determine not only the possible genetic weaknesses, but whether physiology is being affected. Testing is very affordable and can provide invaluable insight into your health.
Why do you test for food sensitivities?
Most folks think food allergies present as rashes, hives, or asthma.That is pretty far from the truth. Severe allergic reactions may demonstrate those symptoms, but the common food sensitivities don’t show up on regular allergy tests of the skin or blood.
When we consume foods that our bodies don’t like, they may cause an inflammatory response. One reason for this is that due to our genetics and environment, many of us have developed something caused leaky gut. This creates openings in the intestines which can allow food to travel through walls of the intestine into the rest of the body. The body recognizes these as foreign invaders and mounts an immune system response. Sometimes these food particles are very similar in structure to various tissues in the body which the immune system mistakes for the food. This may lead to autoimmunity against that tissue or organ. For example, gluten and Hashimoto’s thyroid are highly associated in the medical literature
The sad part is that foods such as dairy and gluten release chemicals into the body (especially in the brain) that cause a person to crave them, much like a narcotic. In fact, morphine-like substances are released into the brain each time a glass of milk is consumed, and causes a molecular reaction that may remain for weeks. Gluten responses can last for months to those who are susceptible. Wouldn’t you want to know?
Why is bioimpedance analysis so important?
The Biomarkers 2000 bioimpedance analyzer (BIA) is an FDA approved electronic device which applies a small 50-kilohertz current through the body using sensor pad electrodes placed on the right foot and right wrist. There are over 2000 published research studies utilizing BIA technology as a marker of health. BIA also offers us an independent method of monitoring the efficacy of your protocol.
BIA testing provides information such as body cell mass, fat-free mass, extracellular mass, fat mass, intracellular and extracellular water as well as phase angle, basal metabolic rate, reactance, resistance, etc. to provide us with a picture of your overall body composition (is your distribution healthy?), hydration status (do you have enough and is it where it should be?), and cellular integrity (are they healthy?).
Lean body mass is not just important for good looks but is necessary for overall health. According to an article published in JAMA by Dr. Roubenoff, “Muscle is the major source of protein for functions such as antibody production, wound healing, and white blood cell production during illness. If the body’s protein reserves are already depleted by sarcopenia (muscle loss), there is less to mobilize for illness.” We all want more vitality and functional capacity for as long as we can have it. We all want more metabolically active tissue (lean body mass) and less metabolically inactive tissue (fat mass). We all want our cells to be like plump, juicy grapes as opposed to dried out raisins.
Another useful important marker, phase angle, provides cellular health and integrity information. Within the last few years there have been several published papers in major journals depicting phase angle as the best indicator for prognosis of survival for patients with cancer, AIDS, and kidney disease. A normal distribution of tissue and fluid in the body is associated with immunity, high function, and longevity. An abnormal distribution of tissue and fluid in the body is associated with susceptibility, effects of disease and aging, low function, morbidity, and mortality.
Finally, proper hydration is vital to fundamental metabolic processes throughout the body. You may be drinking enough water, but is it inside the cells where the metabolic processes occur or outside the cells leading to swelling and toxicity?
What is Advanced Functional Medicine testing?
Sometimes we need to delve a little deeper into the biochemistry of the body to help us find the root cause. We utilize the most effective test methodologies available. Advanced testing includes hormone testing, DNA stool Analysis, autoimmune testing, organic acid testing, food allergy testing, genetic testing, etc. Let’s discuss just a few of the commonly ordered tests..
DNA stool testing determines if bacteria, yeast or parasite (or all) imbalances may be the source of GI issues. There are 100 trillion cells in your body, but only one in ten is human. The rest are bacteria, fungi, viruses and other microorganisms, i.e. your microflora. Any imbalance in the ratio of these may lead to symptoms both inside and outside the GI system.
Organic acid testing is a way to measure whether your body is getting and using nutrients to drive optimal health. Nutrients are protecting agents. Just as your car has additives and devices that protect it, nutrients serve to protect your heart, brain, and other critical organs. Like a car’s gauges warn of potential problems, your body has a buildup of certain chemical indicators, known as organic acids, that can alert you to potential problems.
Hormone testing is by far the best method for determining bioavailable sex and adrenal hormone levels. When blood tests are used, they do not reflect what is happening at the tissues. This is because blood reports both the bound and free hormone levels. Urinary testing reports the bioavailable amount as well as how it is used and detoxified.
Autoimmune and Gluten Sensitivity Testing Panels may disclose not only whether you have a problem with gluten, but possibly with many of its “cross cousin” foods. It may not be enough to be gluten free if you also react to food such as corn, oats, etc.. The autoimmune testing looks at organs and enzymes throughout the body for autoimmune issues.
Do you have a specialty?
We specialize in helping to uncover the root cause of your health issue. Since biology is interconnected, all systems in the body must be evaluated.
How does your evaluation differ from that of other health care providers?
Since we believe in systemic interactions, we may take a more global approach. Let’s take the thyroid as an example. Most practitioners believe thyroid dysfunction is limited to the gland itself and look only at the levels of total T4 and its relation with the pituitary gland. We believe dysfunction may also be influenced by factors outside of the thyroid gland. Therefore, we focus on both the production and utilization of thyroid hormones by screening for inadequate dietary cofactors and/or gluten intolerance as well as the interactions with the brain, pituitary, immune system, adrenals, sex hormones, GI system, etc. These systemic influences may lead to inadequate thyroid hormone synthesis, binding globulin problems, T3 conversion issues (the active hormone), receptor site insensitivity, autoimmunity as in Hashimoto’s, inability to detoxify hormones, as well as other effects.
The second important difference is that Functional Medicine and Clinical Nutrition requires years of study and clinical experience to implement effectively. We have over 15 years experience working directly with clients.
Third, we spend more time than most insurance model health care providers have available to dedicate to the health of one client. Our evaluation takes up to 3 hours to allow us to gain a better understanding of influences that may be specifically affecting you. Our initial consultation covers everything that is normally offered in multiple visits by other providers, saving you both time and money.
How does a remote appointment work?
Since our practice relies heavily on laboratory testing to help pinpoint metabolic imbalances, testing can be easily performed in the comfort of your own home with the exception of blood testing which must be drawn and processed at your local Labcorp facility.
Consultations are offered by phone or our HIPPA compliant online video meeting service.
Being remote, we are able to offer evening and weekend consultations outside of our normal office hours to meet your needs.
What dietary changes will I have to make?
The most important thing you will have to do is to watch “what, how, and when” you eat. By this, I do not mean counting calories, but by avoiding foods that you have an intolerance to. These foods may have an effect on your body for days after you consume them. According to leading experts, foods such as gluten may affect physiology for up to 8 months. Contrary to popular belief, it is usually the protein in the food and not the lack of a particular enzyme that leads to intolerance. The good news is that with the exception of gluten and true allergic foods, many of these items may usually be reintroduced into the diet after a period of elimination. “How” refers to the the composition of our meals. In order to control the blood sugar/insulin response in our body, each meal or snack should consist of carbohydrates, protein, and fat in a generalized ratio. “When” is also important. For many folks to keep their blood sugar stable, they must remember to eat every few hours whether or not they are hungry. Just a small balanced snack may make the difference in one’s overall health. It is also especially important for everyone to eat within one hour after waking. Following these simple rules may help reduce chronic inflammation that may be responsible for degenerative disease.
Another important consideration is food quality. Organic and humanely grown livestock are far more nutrient dense that today’s conventionally grown/raised foods. Foods that are GMO have unknown effects throughout the body and processed foods contain items such as as high fructose corn syrup, preservatives, and bad processed fats that are not beneficial to the health of our bodies. If in one’s budget, we strongly urge you to avoid these types of foods.
Finally, we cannot overlook the importance of hydration. It is a major source of energy in our brain and is involved in numerous metabolic reactions throughout the body. Lack of hydration has been linked to many of the dysfunctions/diseases that we are facing today. In addition to drinking ample amounts of water, the body requires salt so it does not retain water but instead, lets it flow out of the body to act as a natural flushing mechanism.
Why are lifestyle factors so important?
Diet, sleep, and exercise, are probably more powerful than any supplement could be.
For instance, sleep is vital for so many functions including protecting our mitochondria/dna/brain/
Will I have to take supplements?
Sometimes the body becomes so dysregulated that temporary support may be needed to allow the body to heal. Other times, genetic weaknesses are passed down or become expressed due to environmental exposure. We believe in the power of food as medicine and offer supplementation only as necessary.
How long will it take before I begin to feel better?
This is a difficult question to answer. Since underlying causes for dysfunction are unique to each person, we cannot put a time-frame on your healing process. Some folks feel differences in as little in as a few weeks, whereas others require a much longer time period. Since it took time for the body to achieve its current level of health, it stands to reason that it may take time to return it back a healthier state.
It is important to recognize a few things regarding the healing process. First, it is up to you how diligent you are going to be making the necessary lifestyle changes. For example, we do not offer “diets” but make recommendations to avoid foods that are degrading your health and promote eating the ones that enhance it. If you cannot be true to this, you may not see the results that you are looking for. Our job is to educate, you are the “healer”. You might want to ask yourself these questions before you begin…….
How willing are you to:
- Make dietary changes?
- Take nutritional supplements each day if required?
- Modify your lifestyle (ie: work demands, sleep habits, etc.)?
- Engage in regular exercise?
- Have periodic lab tests to assess progress?
- Do you have a support network or will family pressures make it too difficult to make changes?
If you are honestly not ready to make these changes at this time, it’s okay. It is probably best that you to save your money and utilize your time with other endeavors until you are able to make this commitment to yourself. But if you are, the changes to your health can be dramatic.
Another issue that some people encounter is that they may feel worse before they begin to feel better or that they start to develop new symptoms such as bloating, gas, etc. This is usually due to a die-off from toxins such as bacteria, yeast, parasites, etc or detoxification reactions. Our philosophy is to work slowly while gently supporting your body to minimize these types of reactions.
Our last thought is that the body is like an onion. As you start to feel better and become more active, you may notice different symptoms. Again, we will work with you as the body “unmasks” itself to help alleviate these as well.
What is the difference between a CCN, CNS, and other nutritionists?
The Certified Clinical Nutritionist (CCN) and Certified Nutrition Specialist (CNS) designations are two nationally accredited certifications for nutritionists that require an individual to meet specific academic and professional requirements including passage of an extensive national proficiency examination and continuing education.
A CCN must have a minimum of a BS degree in a health related field and have completed a specific series of advanced coursework offered by the accreditation board as well as 900 hours of internship (the requirement for the internship for a MS holder may be waived depending on the curriculum from the institution in which they received their degree).
The CNS certification is similar to the CCN but requires a minimum of a Master’s degree in Human Nutrition (or MD, DO, ND, NP, R.Ph, etc. with nutrition emphasis), and complete at least 1000 hours of supervised clinical experience.
Does your program work for everyone?
We don’t make any promises but sometimes we get results just because we look at your health from a totally different perspective. Click here to read experiences from a few of our clients.
Do you accept insurance?
Unfortunately, we do not accept insurance at this time.