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Welcome!

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True Root Causes of Dis-Ease:Functional Medicine Fundamentals

Part 2

This presentation is copyrighted by Purpose Inc. with all rights reserved, available for student reuse strictly subject to the terms outlined in the SAFM student program agreement.

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Today’s Agenda

v Quick Reminders: Stage-Settingv Sympathetic Nervous System Dominancev Cellular Hypothyroid Functionv Chronic Stress Mechanisms of Disease

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Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

“Functional Medicine is a science-based, personalized healthcare approach that assesses and treats underlying causes of illness through individually-tailored therapies to restore health and improve function.”

- Dr. Mark Hyman

Defining Functional Medicine4

numb symptomsmanage diseasenumb symptomsmanage disease

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Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

v Diagnosis

v Mechanisms

v Dynamics

v True Root Causes

What’s In A Name?5

o e.g. type 2 diabetes

o e.g. pancreatic beta cell failure

o e.g. insulin resistance, fatty liver, fatty pancreas, o hypothyroid function, microbiome imbalance, autoimmunity

o e.g. crap food, toxins, stress

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Putting the Puzzle Pieces Together

We are not designed to beStressed, Toxic, Inflamed, Infected, Malnourished, & Unrested

and yet still easilyThrive, Grow, Reproduce, be Thin, feel Well,

Eat Anything we want, enjoy perfect BMs, and have Great Sex.

This combination would be Not Natural.

Why are we struggling?Nutrient-poor Food, Toxins, Stress

Even when aware, we lack Education, Inspiration, and Empowerment support!

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Interconnectedness can be a Vicious Cycle10

o Loaded with refined carbohydrates, fructose, inflammatory fats

o Promotes oxidative damage to cell membranes, interferes with enzymes that drive cellular metabolism

o Increases blood sugar and insulin demand separate from food

v Crap Food o Doesn’t give Nutrients, Looks like a Toxin, Increases stress.

v Toxinso Deplete nutrients, Increase stress, Impair metabolism/detoxification.

v Stresso Depletes nutrients, Impairs digestion, Impairs detoxification.

GENES

ILL-NESS

WELL-NESS

BIOCHEMISTRYENVIRONMENT

Choices Choices

?

Given our Choices, is it really a wonder we struggle with so

much chronic dis-ease?

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Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

v Sympathetic Nervous System Dominancev Gut v Insulin Resistancev Cellular hypothyroid functionv Xeno-endocrine Disruptionv Immune Hypervigilance

Most Common Dynamics of Dis-ease 11

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H = Hypothalamus (neural & immune tissue)P = Pituitary (neural & endocrine tissue)A = Adrenal (endocrine tissue)T = Thyroid (endocrine tissue)G = Gonadal (endocrine tissue)

Thoughts

Environment

Stress/Immunity

Metabolism

Reproduction

“Life is about 10% what happens to you and about 90% how you react to it.”

- Charles R. Swindoll

Fundamental Interconnectedness

Hypothalamus& Pituitary

Thyroid

Adrenals

Gonads

HPATG : an Axis of Interconnectedness

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v Sympathetico Fight-or-Flighto Increased focus and alertnesso Increased metabolic activities to

prepare body for emergency activityo Designed to be short-term exceptions

for survivalv Parasympathetic

o Rest-and-Digesto Relaxed external muscles. Increased

digestive activities to store energy for future use. Immune function.

o Designed to be our primary statev Most organs and glands in the body

have receptors to receive impulses from both modes(either inhibitory to “stop work” or stimulatory to “work harder”)

Image Credit: Sunshineconnelly at English WikibooksLicense: https://creativecommons.org/licenses/by/3.0/legalcode

Two Nervous System Modes

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….. Ref. Range _____ Cortisol profile

Free Cortisol Patterns of Extremes14

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The Dance of Melatonin & Cortisol

v Cortisol falls off dramatically during the day & is lowest during the night.o Low level allows deep sleep. Elevated

night-time cortisol impairs slowest wave sleep and reduces REM cycles and reduces melatonin synthesis.

o 2-4am cortisol rise is a common cause of awakening (or “hot flashes during the night”).

o Melatonin and the act of sleeping both inhibit cortisol production.

o Low melatonin production (or insufficientsleep) at night increases day-time cortisol.

o Too much stimulatory brain activity (glutamate) directly impairs melatonin synthesis (as do excessive light, esp. blue wavelengths) and intense exercise (which typically raises cortisol for 1-2 hours)..

o Sleep Hygiene is key!

* https://www.ncbi.nlm.nih.gov/pubmed/12519889 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242827/ . The box in the diagram represents the typical (8) sleeping hours. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747608/

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The Adrenal/Thyroid Connection

https://restorativemedicine.org/journal/thyroid-hormone-transport-into-cellular-tissue/

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Elevated Cortisol (Hyper-stimulated Stress Axis)

Depressed Cortisol (Under-stimulated Stress Axis)

v Hypervigilantv Overly alert, doom'n'gloom preoccupationv Insomnia (racing mind)v Poor digestion, “irritable” gutv Hypertension, Racing heartv Lower bone densityv Depressed immune system (may get sick easily)v Anxiety (often along with Depression)v “Wired and Tired”v Here you will find many patients with chronic

Anxiety, T2 Diabetes, Metabolic Syndrome. Higher fasting glucose?

v Consider: Sympathetic Dominancev Perhaps higher sodium/chloride, lower

potassium

v Exhaustion, perhaps debilitating fatigue (not recoverable with short-term increase in sleep)

v Lethargy, Malaisev Weakness, myalgia, pain, inflammationv Depressionv Hypotension, dizziness upon standingv Hypoglycemiav Low pulse ratev Low motivationv Here you will find many patients with PTSD,

allergy/asthma, chronic autoimmune disorders, pain disease (CFS, Fibro), postpartum depression. Lower fasting glucose?

v Consider: Parasympathetic Dominancev Perhaps higher potassium, lower sodium and/or

lower chloride.

Unabated Stress

Fatigue, Mood swings, Poor sleep, Hypothyroid function

As purposeful, regulatory, self-preserving action IN THE BRAIN, not intrinsic adrenal dysfunction!

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Stress Hormone Interconnectedness

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Adrenal Gland Activation

v Emotional stress (especially the combination of possible/actual harm and loss of control)o Work performance, family dynamics, finance issues, peer approval, etc..o Grudges, resentment, unalleviated anger, living in the past, unexpressed emotions...o Preoccupation with what is missing, never having “enough” of something/anythingo Loneliness, social isolation, lack of social support**

v But also Physical Stress in various forms...o Infections (viral, bacterial, fungal, parasitic…)o Inflammation (e.g. arthritis), Obesityo Insufficient sleep, sleep apnea, shift work, jet lago Overuse of stimulants (e.g. caffeine***, sugar, chocolate)o Toxins (including overuse of medications)o Too much exercise (or physical trauma)o Allergen exposure. including food sensitivities.o Poor detoxification (toxin tissue storage e.g. mercury, lead)o Insulin Resistance (and Hyperglycemia) and Hypoglycemia

• Teach patients that cortisol raises blood sugar, perhaps much more than dietary carbs.o Insufficient caloric intake (think of high exercisers) or dietary carbohydrates (for unique person)****

• Your clients who have adopted a low or very low or no-carb diet must have adequate fatty acid metabolismin order to thrive, which requires B vitamins and carnitine and healthy mitochondria. Some may thrive best with 30-4o% carbohydrates vs. 15-20% (e.g. more winter squash, tubers, whole fruit). Paleo ≠ Low Carb.

A vicious cycle?A strong stress response

promotes survival, but at a cost! Chronic immune suppression can create

more stress triggers.

http://www.lifestylematrix.com/assets/1/7/The_Role_of_Stress_and_the_HPA_Axis_in_Chronic_Disease_Managment_Excerpts.pdf** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841363/ *** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/**** https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641164/ and https://www.ncbi.nlm.nih.gov/pubmed/20860883

Chronic18

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Our Contentv Scientific rigor. Referenced content. No “cliffs notes”. Curated published research.

Allows for a variable geek factor. v Practical application know-how of functional medicine science, the “devil in the detail”.v Knowledge and tools about both Rapid Relief and Root Cause resolution. v Practice, practice, practice via real-life, complex case exploration.

Expanding your learning by Doing. Into the pool!v Repetition. Creating rich, sustainable knowledge. Repetition breeds retention. v Flexible delivery to meet your unique needs. Timing, formats, approach. v Continuous, career-long learning and community

Our Practitioner Familyv Diverse, global (55 countries), multi-modality (15+)v Warm, supportive, engagedv Respectful

The SAFM Difference19

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This presentation is copyrighted by Purpose Inc. with all rights reserved, available for student reuse strictly subject to the terms outlined in the student program agreement.

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True Root Causes of Dis-Ease:Functional Medicine Fundamentals

Part 2

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