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Integrative/Functional Medicine

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FOOD SENSITIVITY TESTING and
The FIT Test by KBMO Diagnostics


In my medical practice, we look for root causes of symptoms and chronic disease, rather than focusing on simply treating symptoms with prescriptions. This is what sets Integrative and Functional Medicine apart from traditional Western Medicine. 

b2ap3_thumbnail_inflammation.jpg Inflammation is one of the main root causes of nearly everything I see wrong with my patients.  Food is a primary trigger for inflammation and should be considered as playing a large role in most symptoms, chronic disease, and autoimmune disease.  Like I often say to my patients:

Every time that you eat, you are making a decision to either
increase or decrease inflammation in your body.


FOOD SENSITIVITIES & SYMPTOMS
First things first, we are not talking about food allergies.  Food allergies are mediated by an IgE immune system reaction, which produces immediate and often serious or life-threatening symptoms that require immediate medical attention.  In contrast, food sensitivities (also referred to as food intolerances) are mediated by an IgG immune system reaction that is more delayed and generally less serious. Reactions may take up to 3 days to develop, and the IgG antibodies can remain in your body for up to three weeks.
Click here to read more about Food Allergy vs. Food Sensitivity

With food being a primary driver of inflammation, and inflammation underlying most symptoms, the argument could be made that food may be a trigger of nearly any symptom in the body!  The most common symptoms that I see in my practice that have a strong association with food include:

  • b2ap3_thumbnail_Abdominal-Pain-Is-It-Appendicitis_article_main.jpgRashes, Acne, Eczema and other Skin Conditions
  • Joint Pain
  • Digestive Issues, including IBS
  • Headaches
  • Fatigue/Energy and "Brain Fog"
  • Autoimmunity of any kind
  • Hormone Imbalance
  • Weight Gain
  • Mood Disorders, including Depression, Anxiety and more

 

DETERMINING FOOD SENSITIVITIES
Traditionally, the Comprehensive Elimination Diet has been considered the “gold standard” for determining food sensitivities. The Comprehensive Elimination Diet involves removing the food, drink, and additives that are most commonly associated with inflammation and symptoms, including:

  • b2ap3_thumbnail_Donuts.jpgGluten/Wheat
  • Dairy
  • Sugar
  • Eggs
  • Soy 
  • Corn
  • Peanuts
  • Nightshade Vegetables
  • Citrus Fruits
  • Caffeine 
  • Alcohol

The Comprehensive Elimination Diet needs to be done for at least three weeks (if you recall from above, the IgG antibodies associated with food sensitivities can remain in the body for three weeks, this allows time for them to "flush out").  After this time foods may be re-introduced one at a time while monitoring for an increase in symptoms.  For those patients who are able to complete a Comprehensive Elimination Diet, the process can be life-changing.  In my patients who complete this process, I frequently see a dramatic reduction in symptoms, improved energy and mental clarity, and better sleep. However, for many others, this process can be difficult or nearly impossible.


FOOD SENSITIVITY TESTING and the FIT TEST
One of the most common Food Sensitivity laboratory tests (and the one I have previously used) involves measuring IgG antibodies in the blood to a variety of foods.  The presence of these IgG antibodies indicates an immune system reaction to that food.  While the information on an IgG food sensitivity test can be useful, I have found several problems associated with this testing:

  • Some patients have so many IgG food reactions that they could not possibly remove these many foods from their diet.
  • We cannot always correlate a positive IgG food reaction directly to inflammation or a patient's symptoms.
  • These tests can be expensive!

FIT = FOOD AND INFLAMMATION TEST
b2ap3_thumbnail_KBMO.jpgThe FIT Test by KBMO Diagnostics is, in my opinion, the next generation in Food Sensitivity Testing.  Rather than simply measuring IgG antibody reactions, the FIT Test measures IgG and Complement-mediated Immune Complexes.  Translation = by adding the measurement of immune complexes the FIT test may more accurately identify the foods that are actually causing inflammation in the body.  

Other benefits of the FIT Test:
  • The FIT Test measures sensitivities to up to 132 different foods,  as well as coloring and additives.
  • The FIT Test can diagnose increased intestinal permeability, or "Leaky Gut", through the identification of a positive Candida immune-complex response.
  • There are less positive reactions to work with, allowing patients to more easily remove inflammation and symptom-triggering foods.
  • In addition to the 132 item option (currently $275), the FIT Test offers a more-affordable 22 item option which includes the most commonly identified food and antigen triggers (currently $100).*
Click here to learn more about the FIT test, see a list of the foods tested, and view a sample report.

Are you interested in the FIT Food Sensitivity Testing?  Do you have questions?  Feel free to send me an email at This email address is being protected from spambots. You need JavaScript enabled to view it. or contact our office 231-638-5585.

*I do not make any profit of the FIT Test, or any other laboratory test offered in my practice. Any costs associated with laboratory testing are related to the laboratories themselves.



Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

 
 
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ADVANCED LABORATORY SPOTLIGHT:

THE NutraEval PLASMA ® TEST

A Comprehensive Test for Identifying Nutritional Deficiencies, Toxicities, Gut Imbalances, and More

by Genova Diagnostics


b2ap3_thumbnail_nutreval-fm-nutritional-test-blood-urine-small-1.pngThe NutrEval® laboratory test by Genova Diagnostics is one of the most commonly ordered specialty laboratory tests in my practice. This test serves as an excellent starting point for evaluating nutritional status and investigating the root causes of chronic illness, as well as a useful follow-up tool to measure how well lifestyle changes and supplement regimens are working.


OVERVIEW

The NutrEval® test is an advanced nutritional analysis designed to reveal nutritional imbalances or inadequacies. NutrEval Plasma® evaluates the functional need for antioxidants, B-vitamins, minerals, essential fatty acids, amino acids, digestive support, and other select nutrients. The test also provides insight into gut health, heavy metal toxicity, mitochondrial function and more.


YOUR REPORT INCLUDES:

Metabolic Analysis (urine organic acids)
Urine organic acids are not something I learned about in Medical School. This analysis, often utilized by Naturopathic Physicians, measures metabolites in the urine that reflect processes going on in your body. This analysis provides insight into:
  • Digestion
  • Bacteria and/or Fungal Overgrowth in the Gut
  • Mitochondrial Function (cellular energy production/Krebs Cycle)
  • Neurotransmitter Balance (stress/mood)
  • Functional B-vitamin Need (not measured values in your body but rather a measurement of how your body is utilizing these vitamins)
  • Need for Detoxification Support
Plasma Amino Acid Analysis (essential and non-essential amino acids, plus intermediary metabolites)
The Amino Acid Analysis represents a 21-day “window” into your protein intake and amino acid balance. I use this section most often to:
  • Evaluate protein intake, digestion and absorption.
  • Evaluate amino acid balance in relationship to mood disorders.

Essential and Metabolic Fatty Acids (red blood cell essential and non-essential fatty acids, including Omega-3 and Omega-6 fatty acids) The Fatty Acid Analysis is a red blood cell measurement, representing approximately 100-120 days prior to testing. When interpreting these results with patients, I am able to accurately identify what type of diet they are following, which types of oils they are cooking with, and whether or not they are supplementing with fatty acids. This section can provide valuable insight insight for diet and supplement recommendations for:
  • General Wellness
  • Inflammatory Disorders
  • Cardiovascular Risk
  • Mood and Brain Disorders

Oxidative Stress Analysis (blood and urine biomarkers indicative of oxidative stress) Oxidative Stress represents the balance of antioxidants and free radical damage in the body. When describing Oxidative Stress to patients, I often describe it as “rusting” on your cells and DNA. This analysis measures markers of this “rusting”, as well as levels of Glutathione, a powerful antioxidant that plays key roles in healthy aging and detoxification (learn more here). Our levels of Glutathione are determined by both our genes and our lifestyle, so if low levels are detected, we can implement protocols for improvement.

Learn more about Glutathione HERE.

Elemental Markers (both mineral nutrients and toxic metals in red blood cells or plasma) This section provides direct measurements of minerals and heavy metals. Mineral results can be used to identify mineral deficiencies or excess. Heavy Metal results can be a useful screening tool, if elevated levels are identified, provoked urine heavy metal testing is often recommended. Analyses measured include:
  • Copper
  • Lead
  • Magnesium
  • Mercury
  • Manganese
  • Antimony
  • Potassium
  • Arsenic
  • Selenium
  • Cadmium
  • Zinc
  • Tin
  • Mood and Brain Disorders
b2ap3_thumbnail_LabTesting.jpg


SPECIMENS:

First-morning urine and a blood draw at a participating laboratory.

COST:
  • Varies per insurance.
  • Covered completely by many Medicare plans.
  • Commercial plans require and out-of-pocket co-pay of $200-300.
  • Not covered by Medicaid.

Note: I do not profit off of ordering this (or any other) laboratory test. Any co-pay goes directly to Genova Diagnostics.

Visit the Genova Diagnostics Website and view a Sample Report HERE.  



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like advanced laboratory testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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b2ap3_thumbnail_SupplementSwap3.jpgIf you take nutritional supplements, the changing of seasons is a great time to clean and organize your supplement cupboard and re-think your routine. The demands on your mind and body vary with the seasons, and adjusting your supplements to meet seasonal needs can help you to look and feel your best all year long!

Check out these “Summer Supplement Swaps” from my personal routine to help you get started:

SWAP OUT IMMUNE SUPPORT FOR ANTIOXIDANTS

During Winter months I take Vira-Resist herbal immune support daily to fight off coughs, colds, and flu. In the Summer months, I take a break from my immune support and tighten the cap and store the bottle in a cool, dark cupboard.

Summer months bring the potential for increased oxidative stress from sun exposure, summer cocktails and restaurant meals. To fight the effects of oxidative stress I increase my antioxidant routine, adding extra Antioxidant Support Formula, which contains the powerful antioxidants Selenium, Alpha-Lipoic Acid, and N-Acetyl Cysteine, as well as Milk Thistle, which helps to protect my liver from potentially damaging effects of summer cocktails. I also add extra antioxidant-rich Vitamin C in the form of Buffered Vitamin C (which is more gentle on the stomach) to help protect my skin from sun damage and boost collagen synthesis.

ADD EXTRA MINERALS

Summer = Sweat. Combining the increased perspiration of summer with regular infrared sauna use puts me at risk for excess mineral loss, so I add extra Zinc and Magnesium to my routine to replenish losses. In addition, I am liberal with my use of sea salt to replenish minerals and stay hydrated.

KEEP YOUR VITAMIN D DOSE IN CHECK

For myself and many of my patients, a hefty dose of Vitamin D is recommended during Fall and Winter months. During Summer months, with increased sun exposure, this may not be necessary. I check my 25, OH Vitamin D levels and adjust my dose of Vitamin D3 as necessary. Why is this important? You can overdose on Vitamin D! Vitamin D is one of four fat-soluble vitamins (along with Vitamins A, E, and K), so levels can build up in your system and become toxic. It’s important to know your number!

Here’s to a happy, healthy Summer!

Carin Nielsen, MD


Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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b2ap3_thumbnail_Alpha-lipoic-acid.jpgWHAT IS ALPHA-LIPOIC ACID?

Alpha-lipoic acid (sometimes referred to as ALA) is a co-enzyme found in every cell of the body, and is used to turn glucose into energy. Alpha-lipoic acid also functions as a powerful antioxidant, attacking "free radicals". Free radicals are produced in the body as a byproduct of energy production, and cause harmful chemical reactions that can damage cells, organs and tissues, and make it harder for the body to fight off infections.

Alpha-lipoic acid is the only antioxidant that is both water and fat-soluble, which means it has access too all parts of our body to attack free radicals and prevent oxidative damage. Alpha-lipoic acid also helps to regenerate other powerful antioxidants and make them active again.

WHAT IS ALPHA-LIPOIC ACID USED FOR?
  • Diabetes, Pre-Diabetes and Insulin Resistance
  • Peripheral Neuropathy
  • Heavy Metal clearance
  • General Antioxidant Support
Researchers believe Alpha-lipoic acid helps improve insulin sensitivity. More simply put, Alpha-lipoic acid may make it easier for your body to use blood sugar for fuel. Alpha-lipoic acid is also used to treat the symptoms and delay progression of diabetic and alcoholic peripheral neuropathy. Studies show Alpha-lipoic acid binds with toxic metals, such as mercury, arsenic, iron, and other metals that act as free radicals. Because alpha-lipoic acid can pass easily into the brain, it may help protect the brain and nerve tissue, researchers are investigating it as a potential treatment for stroke and other brain problems involving free radical damage, such as dementia.

HOW TO SUPPLEMENT: ADULTS
  • General antioxidant support: 50-400 mg per day
  • Diabetes and diabetic neuropathy: 600-800 mg per day

PRECAUTIONS/POSSIBLE INTERACTIONS


Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a health care provider. Side effects are generally rare and may include insomnia, fatigue, diarrhea, and skin rash.

Alpha-lipoic acid has not been studied in children, pregnant or breastfeeding women and is therefore not recommended for use in these populations.

Caution:
  • If you are diabetic or have low blood sugar, as Alpha-lipoic acid many lower blood sugars further.
  • If you are an alcoholic, or have Vitamin B1 (Thiamine) deficiency, as animal studies have shown that Alpha-lipoic acid may lower Vitamin B1 levels.
  • If you are on thyroid medication, monitor thyroid levels as Alpha-lipoic acid may reduce thyroid hormone levels.
  • If you are on chemotherapy, you should check with your oncologist prior to using Alpha-lipoic acid.
SOURCES:
  • University of Wisconsin Integrative Medicine - Supplement Samplers
  • University of Maryland Medical Center - Complementary and Alternative Medicine Guide
  • Oregon State University, Linus Pauling Institute - Micronutrient Information Center



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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b2ap3_thumbnail_BLOG_Human-Heart1.jpg

Have you or a loved one been diagnosed with high cholesterol? Have you been prescribed a statin medication? Functional Medicine provides a framework to determine why you have high cholesterol, assess other cardiovascular risk factors, and outline a treatment plan that is cu
stomized for your individual needs.

1. FUNCTIONAL MEDICINE ASKS THE QUESTION- WHY DO YOU HAVE HIGH CHOLESTEROL?

b2ap3_thumbnail_Blog_cholesterol-artery2.jpg

As Functional Medicine physician and best-selling author Dr. Mark Hyman likes to say, “High Cholesterol is not a Lipitor deficiency”.

Before jumping to a prescription, Functional Medicine asks the question why? By addressing the root cause of your elevated cholesterol you may be able to avoid medication and lessen cardiovascular risk.

Obviously, diet can play a big role in elevated cholesterol, but there are other factors that may be contributing to or causing high cholesterol that a Functional Medicine doctor considers, including:

  • Genetics
  • Hormone Imbalance (especially thyroid and insulin/blood sugar)
  • Hidden Infections
  • Toxicity (especially heavy metals)


2. FUNCTIONAL MEDICINE GOES BEYOND THE STANDARD LIPID PANEL WITH ADVANCED LABORATORY TESTING.

Why do we even care about high cholesterol? Because of risk for heart and vascular disease! Yet many physicians base risk and treatment decisions on a standard lipid panel alone.

Functional Medicine uses Advanced Laboratory Testing to get a more accurate assessment of risk and to develop individualized treatment plans that are not simply focused on statin medication.

b2ap3_thumbnail_ExampleLipidPanel_Click.jpgLDL cholesterol is typically referred to as “bad cholesterol”, but not all LDL cholesterol is created equal!

Advanced Laboratory Testing measures the size and number of your LDL particles - which is a better predictor of heart and vascular disease risk. If you have small, dense “sticky” LDL particles, these are much more concerning than large, buoyant “beach ball”-like particles, which carry less risk. In addition to measuring the size of your LDL particles, Advanced Laboratory Testing measures another type of lipid protein called lipoprotein(a). Lipoprotein(a) is a highly atherogenic “troublemaker” that has a strong genetic component and does not readily decrease with diet change or statin drugs. Knowing your lipoprotein(a) levels can help to direct a more individualized treatment plan.

What is LDL?
LDL is a “carrier protein”. Its job is to “carry” cholesterol particles around the body.

LDL isn't always "bad" because your body needs cholesterol!

Cholesterol is an important component of cell membranes and has an antioxidant effect on the brain. Cholesterol is also an important “building block” from which we make our hormones and Vitamin D.

LDL cholesterol itself isn't necessarily a bad thing, yet when LDL cholesterol is in an inflamed environment, your risk of heart and vascular disease increases.

Advanced Laboratory Testing measures the factors that make your LDL cholesterol more of a problem:

  • Inflammation (think of as “fire” in your arteries) measured with hsCRP and fibrinogen
  • Oxidation (think of as “rusting” in your arteries) measured by myeloperoxidase or oxidized LDL
  • Glycation ( think of as “sugar coating” LDL and making it stickier) measured with fasting glucose, insulin, and HbA1c

Advanced testing can also look for signs of plaque formation in the arteries - measured with LP-PLA2 activity laboratory testing, or imaging studies such as carotid artery ultrasound or coronary calcium CT scoring.


3. FUNCTIONAL MEDICINE OFFERS TREATMENT FOR HIGH CHOLESTEROL THAT GOES BEYOND STATIN DRUGS.

b2ap3_thumbnail_Blog_vegetables.jpgDon’t get me wrong, a Functional Medicine doctor may prescribe statin medications if indicated, but not as first-line therapy. These days it seems almost a “knee-jerk” reaction for doctors to prescribe statin medications at the first sign of elevated cholesterol. In fact, statin drugs are one of the most frequently prescribed classes of medication worldwide and account for hundreds of billions of dollars in revenue for pharmaceutical companies.

Once you’ve determined why your cholesterol is elevated, and what other risk factors are present, Functional Medicine then outlines a treatment plan that is individual for each patient, based on this information.

Food First!

Diet is first and foremost in the treatment of high cholesterol and the discussion of heart and vascular disease risk. This doesn’t have to be difficult! The principles of a heart-healthy diet can be broken down to a few simple goals:

  • reduce the “white stuff” (sugar and processed and refined carbohydrates)
  • avoid unhealthy fats
  • eat more plants
  • choose high-quality protein sources

Functional Medicine does not believe in a “one-size-fits-all” diet approach. Based upon a person’s genetics, testing results, and the current state of health, various diet plans may be recommended, including:

  • A low glycemic load diet, such as “The Blood Sugar Solution” by Dr. Mark Hyman
  • A modified Mediterranean Diet such as the Institute for Functional Medicine’s Cardiometabolic Food Plan
  • A plant-based diet such as Rip Esselstyn’s Engine 2 Diet
  • A “paleo” diet such as Chris Kresser’s “Your Personal Paleo Code”

Laboratory studies are re-checked about three months after making diet change to assess the impact on disease risk.

Beyond Diet

Moving “beyond diet”, a Functional Medicine treatment plan for high cholesterol will focus on the underlying causes listed above, and the results of Advanced Laboratory Testing, and may include:

  • Treatment of low thyroid to achieve optimal thyroid levels (not simply “normal range”)
  • Stress-reduction and mind-body tools to lower cortisol output
  • Weight reduction to lower blood pressure and reduce sleep apnea
  • Treating insulin resistance and lowering blood sugars
  • Treating infections in the gut and restoring gut balance
  • Antioxidant support to reduce oxidation stress
  • Detoxification/chelation of heavy metals
  • A regular exercise program to increase cardiovascular fitness


Carin Nielsen, MD Integrative MedicineDo you have questions about a Functional Medicine approach to High Cholesterol or Cardiovascular disease risk? Are you ready to get your own evaluation started? If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

 
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