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.

Boning Up on the Facts

I hope my friend Carla won’t mind if I take a cue from her for today’s blog but she was pondering osteoporosis and its affects on her aging mother. I have osteopenia which means when I had my Dexa scan done there was some thinning of my bone but not enough for my functional medicine doctor to concern himself with. To quote him ” it is a normal thinning of bone”. My mother had osteoporosis and this was evidenced by the change in her general height. That said, she really never did break a bone until she was 90, and she fell more than any other person I know. When she did tumble from her walker at the nursing home she fell right on her left elbow and it did break. It was surgically corrected, and once they took the darned pin out it healed and she acted like she had never had a break. Mother started taking one of the Pharma drugs in her 80’s and it may have helped but it also may have contributed to some wasting in her jaw bone that caused her to lose some teeth. I guess we will never know and that is what the Pharma world counts on. I am left pondering my mother’s osteoporosis thanks to Carla and here are my ruminations.

I believe that my osteopenia and my mother’s osteoporosis were primarily caused by undiagnosed Celiac’s disease. We were a family of bread eaters and cereals, you name it there wasn’t a grain that wasn’t eaten at our house all in the name of healthy eating. Mother had the ability to clear her colon in seconds as her doctor told her “with any kind of stress”. I think we would now call that IBS and mother had it her entire life but not one person thought to alter her diet. I think of all the nutrients she didn’t absorb and I am no longer in wonder at her osteoporosis or for that matter her dementia. I have blamed my similar issues on anything and everything, that is until I started reading and then took to heart everything that Joe Mercola and others were putting out there about grain consumption. Once I eliminated grain from my diet, allowing for the occasional treat, my digestive issues all but disappeared.

Calcium is supposed to build strong bones. Well milk was huge at our house and mother dutifully drank her glass of milk at almost every meal ostensibly “for her bones”. Mother also took her tums. Pasteurized milk is truly useless and that “healthy” drink, skim milk, is just pure sugar and does little more than cause insulin resistance in the individuals who drink it (my father drank gallons of the stuff but ate no sweets and little bread and died with undiagnosed diabetes). In other words, calcium is not the only answer and most of us get plenty of calcium in our diet from various vegetables and if not lactose intolerant from cheese, cottage cheese, etc. What is often is missing is Magnesium to balance the calcium intake and Ionic Fizz and Peter Gilham’s Calm both easily add magnesium to your diet. I love my raw milk kefir and have some most mornings in my smoothie. By the way, there is no pasteurized milk in my house if I can help it but that is a recent revelation (last 10 years) and pasteurized skim milk used to be a constant in our refrigerator and I, too, took Tums regularly.

Mother exercised in her fifties but only then and it was always walking. She worked harder than anyone I know and had more energy than anyone I know but she didn’t actually do weight lifting or any kind of exercise that would cause percussion of the bone and a pulling of muscle on the bones. Lesson learned is exercise your muscles and pound a little on your bones with exercise like running, walking, climbing stairs, etc. T-Tapp actually does it all and also improves your mirror image.

Mom ate a lot of fish especially in her later years as they lived on the shores of Lake Superior but fish is notoriously high in mercury and she was still eating her oatmeal and bread, so whatever goodness she was supposed to get from her fish was washed down the loo. Omega 3 oils are vital to healthy bones and the best kind of fish oil I know of is Vital Choice Salmon Oil. It is a deep orange it is so rich in astaxanthan from krill, has a pure taste and is undistilled and has undetectable levels of mercury.  Omega 6 oils need to be minimized at least in the summer (we may have increased need for some if we live in the northern climes).

Mother judiciously avoided sunshine. She slathered on sunscreen, put a large brimmed hat on her head and covered every inch of her body with thick fabric. In her last years she was seldom exposed to sunshine and when she was she squinted and asked to go back inside. I never had her Vitamin D levels checked but I wish I would have as it is easy to do and is so important. Vitamin D levels should be at least 50-60 ng/ml and even higher if you have any health challenges like cancer or even a virus. My functional medicine doctor ordered the test for me originally but now you can order your own online at the Vitamin D Council site. It is so cool that at my local Healtheast hospital (Woodwinds) you can walk in to the hospital lab and ask for a Vitamin D3 test without doctor’s orders and for $40 find out for yourself. It may be true of a lab near you and it pays to ask. Once you know your D3 levels you may need massive amounts of D3 to get your levels up (up to 50,000 mg temporarily) but you might just need daily exposure to midday sunshine. Sunshine prescription: 15-20 minutes midday sun on as much exposed naked skin as you can decently manage. In the north our sunshine is only effective from May-September unless you live at high altitude so another option is the Sunsplash from Mercola not only will it help your body produce its own Vitamin D all year you will also walk around with a healthy glow.

Lastly, Mom took a daily multiple vitamin but we know now those really aren’t adequate and with her digestive issues it was mostly a waste of her time and money. What she really needed were a host of minerals and vitamins that would have helped her keep her bones strong. Vitamin K2 is vital, selenium, boron, copper, zinc and B12 (a vitamin many of us have unhealthily low levels of) are all necessary to build and keep bone strong. Recently, I found quite by accident a product developed by Jonathon Wright called ProBone-O by Life Enhancement. It has no fillers or magnesium stearate and is easy to use as you just drop it in the vestibule of your mouth, let it sit 20 seconds and then swallow, even the digestively challenged will absorb the nutrients.

I can’t change things for my mom as she died in March at the age of 91 but maybe my ruminations can help you or someone you love. All of the experts I mention have numerous articles about bone health on their websites and they have all proven to be quite reliable. It really is up to you to bone up on your health.