Sick and Tired?... Get to the Root Cause of Complex Chronic Disease

Transcription

1 Sick and Tired?... Get to the Root Cause of Complex Chronic Disease Susan Blum, MD Owner, Blum Center for Health Patrick Hanaway, MD CMO, Genova Diagnostics

2 Patrick Hanaway, MD Susan Blum, MD Michelle Maddux, ND

3 Technical Issues Clinical Questions Clinical Questions will be answered during the final fifteen (15) minutes of the webinar. 3

4 KEY Messages Nutritional deficiencies are at the ROOT of most complex, chronic diseases Macronutrients (protein, fats and carbs) and micronutrients (vitamins and minerals) are required to improve health Metabolism happens : Physiologic function (e.g. digestion) Macronutrient needs (amino acids & essential fats) Micronutrient needs (i.e. functional need for vitamins, anti-oxidants, and minerals) 4

5 KEY Messages Nutritional deficiencies are at the ROOT of most complex, chronic diseases 5

6 Patient History Case Study 19 yo Female Increasing fatigue, especially over past 6 months; since starting college + depression Unable to compete in college, returned home No Meds Celexa, prescribed by Pyschiatrist Slight improvement in mood, no change in fatigue Taking no supplementation Diet: Vegan throughout high school, now pescaterian over the past year 6

7 Patient History Case Study 74 yo Male Increasing fatigue, with depression and anxiety No Meds Lipitor, Fosamax, Valium, Testosterone Previously Diet: Dec reased protein intake Social/ Family History: House Husband, wife of 23 years is breadwinner Son died of 50yo in 2009 sadness. 7

8 Diagnosis = Fatigue Investigate Underlying Dysfunction Nutritional Decreased energy production (Kreb Cycle) B-Vitamin deficiencies Nutrient elements deficiencies Amino Acid deficiencies (neurotransmitter precursors) Hormonal Abnormal Adrenal Function Abnormal Thyroid Function Gastrointestinal/ Immune Digestion/ Absorption Imbalance Inflammation/ Immune Dysregulation 8

9 Evaluates overall nutritional status of your patient. Provides personalized recommendations for supplementation of: Anti-oxidants B-Vitamins Minerals Essential Fatty Acids Digestive Support Amino Acids Vitamin D (Add-On) 9 NutrEval Provides

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20 Assessing Nutritional Status Epidemiology (NHANES) Clinical Experience Laboratory Measures Objective Data Motivational for Patients Individualized Treatment Facilitates Monitoring & Follow-up 20

21 Optimist Approach 21

22 Percentage of all Individuals >2 yo NOT meeting 100% US DRI 1. Zinc 73.3% 2. Calcium 65.1% 3. Magnesium 61.6% 4. Vitamin A 56.2% 5. Vitamin B6 53.6% 6. Iron 39.1% 7. Vitamin C 37.5% 8. Folate 33.2% 9. Thiamine 30.2% 10. Riboflavin 30.0% Cordain L. Origins & Evolution of the Western Diet: Health Implications for the 21st Century. Am J of Clinic Nutr

23 Biochemical Individuality Roger Williams first coined the term biochemical individuality in 1956 to explain genetic variability in disease susceptibility, nutrient needs, and drug responsiveness among otherwise seemingly healthy people Williams RJ. Biochemical Individuality: The Basis of the Genotropic Concept. New York, NY: John Wiley;

24 Biochemical Individuality Our analysis of metabolic disease that affects cofactor binding, particularly as a result of polymorphic mutations, may present a novel rationale for high-dose vitamin therapy, perhaps hundreds of times the normal dietary reference intake (DRI) in some cases... Feeding high doses of the vitamin raises the tissue cofactor concentrations ti and thereby increases the activity of the defective enzyme. Ames, BN et al. Am J Clin Nutr. 2002;75:

25 Metabolomics You are here! 25

26 Metabolomics Assessing CoFactors 26

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29 SO, Doctor Blum... How does it really work in practice?

30 Diagnosis = Fatigue Dr. Susan Blum s Fatigue Evaluation Is it Nutritional? Is it Hormonal? Is it toxins or food sensitivities? Is it a chronic infection? 30

31 Diagnosis = Fatigue Dr. Susan Blum s Fatigue Evaluation Is it Nutritional? What are you eating? Evaluate diet; esp. sugar, protein, and vegetables How are you eating? Prevent changes/ spikes in Cortisol levels. Are there nutritional deficiencies? From poor dietary choices or poor digestion? Objective evaluation with NutrEval then correct. Consider role of amino acid precursors if there is concomitant MOOD disorder (depression/ anxiety). 31

32 Diagnosis = Fatigue Dr. Susan Blum s Fatigue Evaluation Is it Hormonal? Thyroid TSH, free T4, free T3, rt3, & anti-thyroid antibodies Adrenal Adrenal Salivary = diurnal variation of Cortisol DHEA-S in serum Sex Hormones Especially Testosterone 32

33 Diagnosis = Fatigue Dr. Susan Blum s Fatigue Evaluation Is it toxins or food sensitivities? Environmental and dietary history is essential RBC Elements gives evidence of recent exposure Heavy metal testing (urine), if no improvement Detox elimination/challenge diet Test foods and support the liver This is both diagnostic and therapeutic 33

34 Diagnosis = Fatigue Dr. Susan Blum s Fatigue Evaluation Is it a chronic infection? If WBC is low, test for chronic infections Targeted test (Lyme, CMV, EBV) or general screen If history of CMV, HHV, Lyme then test for reactivation Treat with immune support, including gut restoration 34

35 Patient History Case Study 19 yo Female Increasing fatigue, especially over past 6 months; since starting college + depression Unable to compete in college, returned home No Meds Celexa, prescribed by Pyschiatrist Slight improvement in mood, no change in fatigue Taking no supplementation Diet: Vegan throughout high school, now pescaterian over the past year 35

36 Results Overview 36

37 Supplement Schedule 37

38 Antioxidants 38

39 Functional Nutritional Evaluation Personalized Treatment Anti-Oxidants Evidence of minimal need for: Vitamin A/ β-carotene Vitamin C Vitamin E/ Tocopherols Alpha-Lipoic Acid CoEnzyme Q-10 Glutathione Plant-based Anti-Oxidants Reflects overall need for anti-oxidant support via foods and plants 39

40 B Vitamins 40

41 Functional Nutritional Evaluation Personalized Treatment B-Vitamins Moderate need for B-Vitamins B1 25mg qd B2 25mg qd B3 30mg qd High need for B-Vitamins B6 50mg qd 100mg given B9 Folinic Acid 1200mcg qd 400mcg of activated folate given B12 MethylCobalamin 1000mcg qd 41

42 Functional Nutritional Evaluation Personalized Treatment Essential Fatty Acids Initially gave Cod Liver Oil Testing demonstrates that Ω-3 fats OK 42

43 Functional Nutritional Evaluation Personalized Treatment Digestive Support Add Probiotics 25billion (yes, billion) cfu qd Add Digestive Enzymes to promote complete digestion of proteins... Check CDSA

44 Functional Nutritional Evaluation Personalized Treatment Digestive Support 44

45 Krebs Cycle 45

46 Functional Nutritional Evaluation Personalized Treatment Bottom Line Balanced whole foods diet Digestive Support Probiotics Digestive Enzymes Custom amino acid blend Supplement: B-Vitamins i (B 1, B 2, B 3, B 6, B 12, Folate) Cod Liver Oil (maintenance) Vitamin 2000 I.U. qd 46

47 Functional Nutritional Evaluation Personalized Treatment 3 months Fatigue much improved I m a new person. Diet improved and increased exercise tolerance Working out, happy, ready to return to college. Custom amino acids stopped. B-Vitamin and digestive support = on-going 47

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49 Patient History Case Study 74 yo Male Increasing fatigue, with depression and anxiety No Meds Lipitor, Fosamax, Valium, Testosterone Previously Diet: Dec reased protein intake Social/ Family History: House Husband, wife of 23 years is breadwinner Son died of 50yo in 2009 sadness. 49

50 Results Overview 50

51 Supplement Schedule 51

52 Antioxidants 52

53 Functional Nutritional Evaluation Personalized Treatment Anti-Oxidants Evidence of minimal need for: Vitamin A/ β-carotene Vitamin C Vitamin E/ Tocopherols Alpha-Lipoic Acid CoEnzyme Q-10 Glutathione Plant-based Anti-Oxidants Reflects overall need for anti-oxidant support via foods and plants 53

54 B Vitamins 54

55 Functional Nutritional Evaluation Personalized Treatment B-Vitamins Low need for B-Vitamins B1 25mg qd B2 25mg qd Moderate need for B-Vitamins B6 25mg qd B9 Folinic 800mcg qd High need for B-Vitamins B3 50mg qd B12 MethylCobalamin 1000mcg qd 55

56 B Vitamins 56

57 Functional Nutritional Evaluation Personalized Treatment Minerals Moderate need for Magnesium Moderate need for Manganese Moderate need for Copper High need for Molybdenum Multi-Mineral Blend given. 57

58 Functional Nutritional Evaluation Personalized Treatment Essential Fatty Acids Initially gave Fish 1gm qd Testing demonstrates that Ω-3 fats OK 58

59 Functional Nutritional Evaluation Personalized Treatment Digestive Support Add Probiotics 25billion (yes, billion) cfu qd Add Digestive Enzymes to promote complete digestion of proteins... Check CDSA

60 Functional Nutritional Evaluation Personalized Treatment Amino Acid Support Urea elevated Check renal function 60

61 Krebs Cycle 61

62 Functional Nutritional Evaluation Personalized Treatment Bottom Line Balanced whole foods diet Digestive Support Probiotics Digestive Enzymes Custom amino acid blend Started with Tyrosine and Tryptophan Custom formula after kidney function cleared Supplement: B-Vitamins (B 1, B 2, B 3, B 6,B 12, Folate) Vitamin 2000 I.U. qd 62

63 Results Overview 63

64 Functional Nutritional Evaluation Personalized Treatment 3 & 6 months Nutrititional improvement Increased energy Off all meds that he presented with Developed pneumonia Deterioration of energy after infection Adrenal and hormonal support given Unmasking of underlying depression Targeted neurotransmitter pathway support Mind-Body Therapies initiated B-Vitamin and digestive support = on-going 64

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66 KEY Messages Nutritional deficiencies are at the ROOT of most complex, chronic diseases Macronutrients (protein, fats and carbs) and micronutrients (vitamins and minerals) are required to improve health Metabolism happens : Physiologic function (e.g. digestion) Macronutrient needs (amino acids & essential fats) Micronutrient needs (i.e. functional need for vitamins, anti-oxidants, and minerals) 66

67 Questions & Answers Register for upcoming LiveGDX Webinars 67

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72 Review Previous LiveGDX Webinars Sick & Tired: Understanding di the Root Causes of Fatigue Sept. 21 st : Stress, Vitamins and Fatigue with Dr. Kathy O Neil-Smith Oct. 19 th : Mitochondrial Dysfunction & Energy with Dr. James Howton May August, 2011 PreD & CV Health 72

73 Future LiveGDX Webinars Hormone Essentials: Using the Right Tool to Understand d Hormonal Balance February March April May 73

74 Sick and Tired?... Get to the Root Cause of Complex Chronic Disease Susan Blum, MD Owner, Blum Center for Health Patrick Hanaway, MD CMO, Genova Diagnostics