How to Use a Functional Medicine Practitioner

I have visited this subject in previous blogs but I have just read a very interesting case study of two patients with horrible fibromyalgia issues and I think the subject must be broached again and again. If you or anyone you know suffers from the wracking pain of fibromyalgia and the resulting exhaustion of the accompanying chronic fatigue you, too, would feel my fervor regarding the subject of functional medicine/integrative medicine. However, everyone or better said anyone with medical issues such as autoimmune disorders, cardiac issues, infertility, cancer, etc. can benefit from seeing a functional medicine practitioner, a licensed MD who specializes in functional/integrative medicine and will from here on out be referred to as a FMP.

Typically when a person visits their general practitioner or even a nurse practitioner the medical person will look at a brief medical history of the patient they see before them. They will have been given no more than 15 minutes to visit with this person and provide a diagnosis and I am told sometimes the doctor never takes their hand off the door knob. How much thinking or caring goes in to a diagnosis given on the run? The easiest path is always the path of least resistance and hardly anyone will or can resist taking a miraculous little pill, so guess what? This medical person will reach in to their pocket and pull out a pad of paper, scratch some words on it, sign it, give it to you with instructions to take it to your pharmacy of choice and send you on your way.

Do you know (or have you experienced it personally) that some people end up taking pharmaceutical products that actually counteract each other? Or that they end up with a cupboard full of pharmacy products that are costing them (or us) a bomb but they haven’t even addressed the medical issue? The case study I just read was depressing as these two women had been put on psychiatric medicines, pain medicines, acid reflux medicines, etc. (and I am not exaggerating about the etc.) and still their symptoms did not abate and both cases got much worse. They both thought they were losing their minds and the medical people they saw corroborated their suspicions instead of doing the right thing.

This is the point where you as the patient have to have done your homework. You have to understand that this physician means well but medicine is a big business now and there are bills to be paid and equipment to be used to pay those bills, so they want to use them be it in a surgical setting or elsewhere. They don’t or won’t take time to thoroughly examine your situation and if and when you start asking questions (because you have done your homework) they will get irritated and downright rude. I have heard that people are told “you aren’t a doctor” or “do not mention that name again in this office” if they ask questions or mention people like Joe Mercola. If this ever happens to you, excuse yourself, grab your clothes and leave. Go home, turn on your computer, Google “Functional Medicine Practioners” and make an appointment with the one nearest to your location.

Why? You will instantly see the difference because the first thing you will do is fill out a health history like no other you have ever filled out. I seem to remember that Dr. Rob Bruley’s was 24 pages long and included questions like “Do you clear your throat often?” or “Have you experienced any major life changes recently?” right down to the number of daily bowel movements you experience. These questions will be carefully examined by your FMP before you are even seen in the office and a course of action will only take place after you have also had at least one hour and a half appointment in their office, face to face. Don’t be taken aback by the offer of a glass of water, or even a tissue to wipe away your tears of relief. Someone is finally listening to you and they don’t even have their fingers on the door knob.

Next the FMP will try to make things better as soon as possible but this may not be an overnight solution. They may prescribe pharmaceutical products to temporarily alleviate your anxiety or pain, after all they are MDs, so they do understand that once in awhile a pill really does help. What they will do that your GP doesn’t do is try to find the underlying problem not just apply a bandaid that will eventually fail and leave you with a gaping hole again filled with aches and pains that will require one more pill with all of its side effects and conditions. You will most likely have a full blood panel ordered, a 4 stage stool test, mucosal barrier tests and heavy metal tests. You may also need an Estronex test or Cortisal/DHEA test or even an Iodine loading test. The tests requested by the FMP will depend on how you filled out that lengthy questionaire and what tests they feel will peel off the layers and expose the underlying cause of your problem. Your insurance may or may not pay for all the tests but if you are seriously ill the cost of the tests is nothing when compared to giving in and losing this battle altogether. Don’t forget there are a plethora of case studies out there where people have sought treatment, been given treatment at great expense, the treatment fails and they go bankrupt trying to pay for failed allopahtic care. Bite the bullet and pay for the tests you need it will be cheaper in the long run.

Once the tests results are back your FMP will schedule up to 3 hours of time to thoroughly discuss a plan of action. You will walk out of the office feeling drained (admittedly of money as well as emotions) but positive. Someone has listened to you, taken action and hope reigns anew. In the case of these two women in the study I read they had both suffered for years with paralyzing pain, dizziness and anxiety. They both were on some of the strongest pain meds you can take and neither one got relief without increasing the strength or adding this pill or that pill and those just exacerbated other issues. When they finally found a FMP and followed through with recommended tests they found that they were both taking zero pharmaceutical products, their pain was gone and their future rosy. Just in case you are interested, one had undiagnosed autoimmune thyroiditis and the other had a bacteria that was harbored in the mucosal lining of her intestinal tract. Both patients were treated in very different ways despite having the same issue of fibromyalgia and both had successful outcomes.

When considering this recommendation remember I am a lay person just like you, I am not a doctor. I have health concerns much the same as you do and I see a FMP because he was the only one who understood that I understood and would listen to me and work with me. He was never threatening or condescending and I can honestly say I have never seen his fingers touch a door knob for anything except to keep  our discussion private and to allow me to leave when I feel all questions have been addressed.

Feeding Your Thyroid

My latest update on Facebook from Janie Bowthorpe was basically a continuation of her disagreement with Forest Pharmaceuticals and their changing the formulation of Armour Thyroid and Janie’s successfully getting many people to switch to Naturethroid and Westhroid. It is all getting old to me and I will apologize right now to any readers that offends and tell you that I am grateful to Janie Bowthorpe for her very informative book Stop The Thyroid Madness. I have a different take on the subject of the new formulation causing relapse in everyone and I will share it with my readers.

Early this winter I finally talked my very open minded doctor, Rob Bruley, in to prescribing Armour Thyroid instead of my compounded pharmaceutical T3 and T4 because we were not resolving my hypothyroidism issue after more than a year of constantly increasing my dosage. Admittedly he reluctantly did it, but he did it and told me I had to take a 3 grain dose of Armour Thyroid which by the way had to be special ordered at Target pharmacy (I tell you because it is useful information). 3 grains was equal to the T3 and T4 I was taking that wasn’t working very well although we had corrected several aspects of my thyroid malfunction. At that time I also started a bio-identical testosterone cream and progesterone tablet because those hormones were low in a recent hormone test I had taken.

I don’t want to quote exact times here because it is all a blur of history but approximately 6 weeks later I was having heart palpitations and sudden jolts that would awaken me in the middle of the night. I started taking half a 3 grain tablet at that time and when I called Dr. Bruley he agreed that this was the right thing to do, so he prescribed a blood test  which showed my T3 was now too high, T4 was okay and the TSH was within range although on the low side. I continued on 1 1/2 grains and when I had the next blood test I didn’t take my Armour the morning of the test as it will affect the T3 reading according to Janie and I was not in the mood to take any higher dosage. I was now feeling rather hyper at times and for instance if I was writing something it would almost look scribbled because I was writing too fast (my own test) so I knew I was a little over medicated but the test would tell.

That test came back with both T3 and T4 within range but my total TSH was .3 which indicates suppressed thyroid. I have since cut my half tablet in to half which amounts to 3/4 grain of Armour Thyroid. I will need a blood test in a few weeks but I can tell you that I still feel a little hyperthyroid. On 3/4 grain my heart palpitations are almost non-existent but at times I feel agitated like I need to run a marathon but I don’t run anymore.

Now to my point, the newly formulated Armour has seemingly corrected my thyroid problem greatly reducing my need for thyroid stimulating hormone. I don’t take it sublingually anymore because most of my digestive issues are resolved by not eating grain of any kind and drinking kefir every day. Swallowing Armour allows for slow release of the thyroid stimulating hormone. If and when I did what Janie suggested and took the tablet sublingually I would get a jolt in the morning that was uncomfortable and if I took some early afternoon when it had worn off I was too hyper to relax by bedtime. Swallowing it with my morning tea works perfectly for me I have sustained energy during the day and I am ready for bed at night.

I am now taking Alpha Lipoic Acid (300 mg) twice a day (with breakfast and supper) as well as a B-Complex vitamin for energy and liver health. If you take ALA you must add a B Complex as the ALA lowers your levels of the B vitamins. I also take 200 mcg of a sodium selenate/selenomethionine supplement. When I feel an energy lag I have a great B12 supplement called ProBoneO by Life Enhancement (Dr. Wright). I eat a diet free of gluten, with lots of greens, fresh eggs, avocados, grass fed meat, etc. My conclusion is that by balancing my hormones and taking the right supplements (no excipients or fillers), following a gluten free diet and staying away from excititoxins I am healing my thyroid.

Instead of complaining about the reformulation of Armour Thyroid I would tell you to try it. If it doesn’t work or you start to experience hypo symptoms again follow this advice before you change to Naturethroid or Westhroid:

Balance all your hormones not just your thyroid hormone.

Eat a gluten free diet full of greens which can be from Barley grass and Alfalfa grass or greens from the garden that are raw or lightly steamed. Add homemade kefir with no sugar added for a health gut.

Throw away supplements that have excipients and fillers as they negatively affect your immune system and create a bio film that keeps you from absorbing the supplement.

Judiciously stay away from MSG which means making your own fresh food with no boxed convenience foods and reading The MSG Myth.

Exercise using the T-Tapp method as she concentrates on cleaning your lymph system and allowing your body to heal itself.

If you do all these things and still suffer from hypo symptoms then it is time to try something new. If you choose not to try these steps first don’t cry foul on Forest Pharmaceuticals point your finger at the real guilty party, you.

Peri significance

This article may contain very few facts and figures but I feel I have something to share that women who find themselves peri-forty might find interesting. You may not want to hear this but your peri-menopause years are encroaching and no one talks about the effect the changing hormones will have on you, well at least very few medical people look there first when things start going a bit wacko in your forties. To be honest, after thirty things are already changing but more slowly and less obviously, so I have arbitrarily picked forty as a number that is peri your menopause years.

There are many words containing the prefix peri- and generally it means around, enclosing, surrounding but also “a lovely person”. Hmm, I like that last one so I am mostly going to adopt the Persian definition which has a lot to do with mythical fairies. When I became a “lovely person” in my mid-forties not one person medical or not mentioned that my “loveliness” might be my changing hormones. In fact, my very well meaning daughter mentioned discreetly that I might need anti-anxiety meds, so off I went to a female physician who willingly gave me a prescription for Paxil and never once mentioned that what I was experiencing might be a fluctuation in my hormones.

I took those seemingly harmless little pastilles for almost two years and then one day I realized I was still crying. Worse than the tears though I seemed to have developed weakness in the muscles of my thighs (not a listed side effect) and I quickly weaned myself off that Pharmaceutical magic bullet. I also started reading voraciously everything I could find on hormones and a sort of metamorphosis began. I think things have changed in 10 years as there are great sites that offer women explanations for their changing bodies like Women to Women and Mercola.com,  but at that time it was hard to find anything in the conventional media about those pesky hormones. In fact, it wasn’t that long ago that no one mentioned the unmentionable-menopause.

I think it is vital that when you find yourself sitting in the middle of your livingroom floor crying for no reason, when you can’t sleep because you are having panic attacks in the middle of the night, you look first at your thyroid numbers (all five of them do not settle for just TSH) and then balance your raging hormones or vice versa.  Compounded bio-identical hormones are the ticket to a successful trip through the next few years for you “lovely” women and Suzanne Somers has researched this subject very thoroughly and has a lot of good facts and figures. You don’t have to buy in to everything she has to say but her basic knowledge is well researched according to my functional medicine doctor. Personally, I believe that my out of balance hormones probably sent my thyroid down a very tortuous route and landed me in thyroid purgatory for many years but that is my theory alone. What I do know is now that my hormones are more balanced my thyroid is suddenly much easier to regulate.

If you are a woman feeling “lovely” in your forties or fifties and wondering why you feel so wacko and out of sorts find yourself a functional medicine doctor and do it yesterday. Functional medicine doctors always have you fill out detailed health histories that can be 25 pages or more in length and your answers are invaluable to them. They will run blood panels that will leave your phlebotomist gasping but again the minutiae of those blood tests will tell them volumes. Why have everyone pointing at you saying you are a little wacko when you are a Peri at heart. You can regain your confidence and feeling of self worth with just a little help.

Armour Update

For those who are interested I have done some research with the help of my functional medicine doctor, Rob Bruley in to the formula changes of Armour Thyroid. As there is quite the buzz about this at the site http://www.stopthethyroidmadness.com I think it is good for all of us who take Armour Thyroid to be informed.
Forest Pharmaceutical did willingly talk to Rob Bruley, M.D. and told him there was a formula change within the last year. They did not change any of the active or inactive ingredients. What they did change was the amounts of two inactive ingredients. They decreased the amount of anhydrous dextrose and increased the amount of cellulose. Rob said that the increased amount of cellulose may have the effect of increasing the thyroid effect from a given dosage as I have had to really decrease my dosage of Armour Thyroid.
I had asked Rob about taking it sublingually as recommended at STTM, so he posed the question to them. They responded that they are asked this question frequently but they have no data to prove or disprove relative absorption of the product sublingually vs. swallowing. Therefore, they cannot endorse this route of administration. They say it was never intended to be taken sublingually. Rob also asked about gluten and they said it is gluten free (hurrah!). They also said they use no dyes because they use titanium dioxide as a lightener.
Now I conclude from all of this that one can still take it sublingually if desired, and I do most of the time. However, I also think that it is entirely possible that they tweaked the amount of anhydrous dextrose just enough to make the taste less pallatible when taken sublingually because they know people are doing it and they don’t want to be sued for misuse of the product. We are, after all, a very litigious society and they do have to cover their butts (pardon the expression).
If anything the increased cellulose should cause it to be better absorbed as the tablet will get to the stomach more intact and I know from using cellulose caplets that the cellulose disappears after just a few seconds in water, so it clearly will not last long in stomach acid.
Another issue a person could have with sublingual adminstration is a burst of T3 when you take it and a sudden drop in energy a short time later. As there are days when I don’t want to bother with taking it several times I find swallowing it and getting a slower release easier.
I hope this information is helpful and fairly presented. Please leave any questions or statements by clicking on “comments” and I would love to share what you have to say with other readers.

Natural Thyroid versus Big Pharma Synthroid

There is a big debate going on at the online site Stop The Thyroid Madness (STTM) because Forest Pharmaceuticals has altered the formulation of Armour Thyroid. Janie Bowthorpe, author of STTM and natural thyroid advocate, is all a twitter because allegedly the new formula is causing hypothyroid symptoms to return and the taste is awful. I am bothered because I just started Armour Thyroid and have seen good results (my t-3 has gone too high even) and I have decreased my dose by half of what it was with compounded thyroid. I have seen tremendous improvements from my days taking Levothyroxine, so I would love to hear from people on their experiences good and bad.

I have been letting my Armour melt under my tongue or in my vestibular area as Janie recommends and really have nothing to complain about. Does it taste like a piece of candy? No. Do I need everything to taste sweet? No and if you do you need to look at your diet and get rid of the sugar. Is the texture chalky? Yes but it is medicine. I do have a health problem and if a little chalky tasting tablet helps me feel better I am all in favor of it. The other issue that Janie brings up in her book STTM is that different times and seasons may necessitate more or less Armour (or some other natural thyroid) is it possible that the folks needing more grains with the new Armour thyroid are suffering from seasonal issues and not the alleged decrease of porcine thyroid or the addition of other ingredients that make up the tablet made by Forest Pharmaceuticals.

I must say that first of all Forest Pharmaceuticals needs to talk to Janie Bowthorpe. Quit refusing to speak to her because she has an online site or whatever your reasons are because you are creating a problem of confidence where there may be no need. All of us should have the right to talk to someone who has the answers about any medication we take and refusing to talk to her shows your childishness and typically inconsiderate behavior of every other arrogant pharmaceutical company. It is frightening for anyone who takes a pill for a certain quality of life and we need answers.

To Janie and the other voices complaining about the taste and texture, get over it. Also if the dosage has changed there must be a control group to determine this and not just one voice here and one voice there saying they have had to increase their dosage or that their hypo symptoms have returned. Do they, for instance, have allergies that their body might be fighting off as it is now spring? Did they have some recent incident, such as a death in the family, that could trigger return of symptoms? Have they just returned from an overseas trip because that taxes the body and causes hypo symptoms to become exagerated? Jane and John Q. Public cannot just start making accusations against Forest Pharmaceuticals without more substantial evidence that the new Armour Thyroid really has diminished abilities because all they do is scare the rest of us in to making a decison that could ultimately harm us not help us.

If you are interested in this ongoing Armour debate tune in to STTM and be a vocal participant. Twitter about the issue, put it on your Facebook page, in general call attention to the problem, openly discuss the issue with others who have a vested interest and in the end you will hopefully be able to make an educated decision that you can then discuss with your physician and make a change or stay with Armour. It is ultimately up to you to take control of your health.

Selenium and your Thyroid

Just a brief note regarding Autoimmune Thyroiditis. I was reading “Reducing Thyroid Antibody Titers” this morning on a site at http://www.suite101.com and came upon the following valuable information:

Selenium is deficient in both autoimmune hypothyroidism and hyperthyroidism. Magnesium is deficient in hyperthyroidism and contributes to arrhythmia’s.  Copper is deficient in autoimmune hyperthyroidism. Zinc is decreased in autoimmune hypothyroidism. Calcium can be deficient in both hypothyroidism and hyperthyroidism. Essential fatty acids and oil soluble nutrients such as Vitamin D are deficient in many autoimmune conditions, including thyroid disorders.

I find the Selenium deficiency very interesting because Selenium is crucial in helping the body naturally detoxify all the chemicals and hormones we unnaturally put in it and expose it to. If you have any thyroid disorder it might behoove you to ask your physician about Selenium. If said physician says they know nothing about this deficiency refer them to this article. It is recommended that you include 200 mcg of Selenium a day in the form of Selenomethionine, as that was found to be the most effective in reducing thyroid peroxidase antibodies (TPO). One should not exceed 400 mcg of total Selenium as it can be toxic.

It never hurts to assist your bodies natural detoxification process and Selenium is an essential trace element you shouldn’t be without.