Functional Medicine

A Procedural Overview By Dr. John Rees

The Philosophy
Traditional medicine attacks disease Functional medicine attempts to restore and balance normal physiology. The thought is a balanced, strong body can heal itself.

What doesnt work

Replacing medicines with supplements Using the Internet to diagnose yourself Treating symptoms with supplements Believing the over the top claims on supplements ( no single supplement fixes everything or even a lot of things) Short term trials of alternative medicine approaches It typically takes 6 to 12 months

What Does Work

I utilize a Seven Pillar approach developed by Dr. Stuart White The seven pillars in order of importance: hormonal/neurological, glycemic regulation, bioterrain, inflammation, immune system, circulation and digestion. Supplements, diet change, exercise, stress modification and sleep enhancement are all part of the program

Pillar 1 Endocrine/Neurological

The most powerful and important system to optimize to achieve health and vitality. Strengthening and balancing includes the following: Correcting HPA axis hypothalamus/pituitary/adrenal (also ovaries, testis, prostate, thyroid, etc.) Normalizing and balancing Hormone levels Optimizing cellular response to hormones, thus preventing or correcting hormone resistance

Pillar 2 Glycemic Control

Single most stressful job of the adrenal glands is controlling blood sugar Has become an issue due to the food we eat Single biggest lifestyle changes required to correct this pillar. They include eating better and exercising more. Tremendous change can occur in a short amount of time with right approach.

Pillar 3 Bio-terrain

Term to describe the mineral content of the body. Imbalances result in PH (acid/base) changes in the body Deficiencies produce imbalances in the seven pillars. Makes large symptom impact when addressed, but takes longer to stabilize.

Pillar 4 Inflammation

Another pillar strongly impacted by lifestyle. Dependence on grain products as major source of food is the primary driver of inflammation. Poor fat choices also contribute. Good fat anti-inflammatory, bad fat pro-inflammatory A major cause of disease and a major determinant of disease progression and severity.

Pillar 5 Immune System

70% of immunity comes from the GI tract. Imbalances can lead to allergies and/or immune weakness resulting in infection, both acute and chronic. Major player in all auto-immune diseases along with inflammation. Strengthening is easy, balancing is tricky

Pillar 6 Circulation

Cardiovascular disease is still the number one cause of death in the United States. Dyslipidemia is a major precursor. Inflammation is what makes dyslipidemia dangerous Cholesterol is not the devil.

Pillar 7 Digestion

For food and supplements to make you healthy, you have to have optimal digestion. Poor digestion leads to poor GI tract immunity, see earlier slide. Digestion and assimilation are pivotal in the seven pillar approach. Digestive disruption is one of the leading causes of frailty in older Americans.

So what do we do?

The first and most important step. Computerized history Symptoms are grouped into major physiological systems and a numerical score obtained. This allows for the patient to easily track response over time. Oral history Gives the patient the chance to fill in the blanks on what they think is important.

Step 1 - History

Step 2 Laboratory work

Functional evaluation of blood tests can be different then medical evaluation. Functional evaluation looks at physiological optimum levels. The normal ranges listed are designed to show disease. If it is outside of range, pathology exists.

Normal vs. Optimal

Symptoms and other signs of dysfunction often start before abnormal readings are obtained. Therefore, non optimal values are closely evaluated Treatment attempts to move people into optimal ranges.

Functional vs. Normal Lab Values

Normal range of TSH ( Thyroid Stimulating Hormone)
Normal Range 0.35 to 5.5

0.35

5.5

Functional vs. Normal Lab Values

Normal range and abnormal ranges of TSH (Thyroid Stimulating Hormone)
Normal Range 0.35 to 5.5 Abnormal Range 0 to 0.35 and 5.5 or greater

0.0 0.35

5.5 or greater

Functional vs. Normal Lab Values

Normal range, abnormal and optimal range, of TSH (Thyroid Stimulating Hormone)
Normal Range 0.35 to 5.5 Abnormal Ranges 0.0 to 0.35 or 5.5 or greater Optimal Range 1.0 to 2.5

0.0 0.35

1.0

2.5

5.5 or greater

Additional Testing Measures

Hair Analysis Saliva Testing Stool Testing

Hair Analysis

Gives us the mineral content of hair Ratios of certain minerals gives us the effects of certain hormones at the cellular level Heavy metal toxicity can be evaluated Protein metabolism can be evaluated

Saliva Testing

Tests level of free hormones at tissue level Different from protein bound blood levels Cheaper, so a greater number of tests can be performed Often picks up hormone irregularities before they show up on blood testing Safe and reliable

Stool Testing

Shows problems with parasites Shows problems with pathological bacteria and fungus Shows ratios of normal healthy bacteria to determine if dysbiosis is present Reveals inflammatory markers for both upper and lower gastric levels

Treatment Approach

When all history and testing is concluded, a physical exam is performed Potential vitamins are selected and muscle testing is used to further select treatment protocols. Lifestyle changes are suggested and encouraged at the appropriate time including diet, exercise, sleep and stress management The patient is sent home with typically a months supply of supplements and a follow up exam is scheduled. Patients have access to the Dr. thru the month if any questions or concerns should arise. The patient is given at least a monthly chiropractic adjustment to help restore the Pillar 1, hormonal/neurological

Follow up Exams

Patients are seen on a monthly basis. Histories are repeated and symptom resolution is quantified and explained New possible supplement protocols are identified and then selected thru muscle testing. Lifestyle changes continue to be evaluated, emphasized and encouraged. A chiropractic adjustment is performed A new regimen is given and the patient is scheduled again for the next month.

Treatment Progression

Monthly evaluations are performed until health goals are achieved Lab work is repeated when appropriate to determine objective improvement Lifestyle changes are continually emphasized and monitored Once health is achieved the patient is transitioned into a maintenance program and seen in the future on an as needed basis.

Outcomes

Vitality restored peace, creativity, joy Not just not sick. Disease manifestation is avoided or lessened in severity Symptom resolution Lab results are improved Often medications can be discontinued or lowered in dosage Weight loss is almost always achieved Overall physical conditioning is achieved Pain and inflammation levels are lowered

Outcomes Continued

Mood levels are improved Activities and hobbies are resumed Libido is improved. All in all, most people feel several decades younger at the end of the treatment approach. New healthier lifestyles are learned and understood, and habits are formed to maintain improvement long term

Milton Chiropractic Dr. John Rees 113 Union Street Milton, Delaware 19968 302 684-1995 302 684-1559 fax email: jrees@firststatehealth.com