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b2ap3_thumbnail_Abdominal-Pain-Is-It-Appendicitis_article_main.jpgI first met Todd* with his wife in October 2016. He had been diagnosed with Crohn's disease (an autoimmune inflammatory bowel disorder) three years prior.  His symptoms included abdominal pain and loose stools with blood and mucous.

During our first visit, I learned that during the time his symptoms began Todd had been under increased stress with an upcoming wedding, a change in employment, and home renovations.

He had originally been treated with sulfasalazine, a common prescription medication for Crohn's, however, the medication made him nauseated and his symptoms were not well controlled. He had been unable to increase the dose as recommended due to side effects.

Todd continued to have frequent loose bowel movements within 15 minutes of eating, often associated with mucus and blood. He was experiencing sharp localized abdominal pain with activity, and the pain was limiting his ability to perform his physically strenuous job as an electrical lineman.

Prior to our first visit, Todd and his wife had already explored holistic options for his treatment. He had tried digestive enzymes, probiotics, and homeopathic remedies without relief. He had also completed a two month trial of a gluten-free diet but was unsure if that made any difference.

At our first visit, I ordered a comprehensive laboratory evaluation to screen for:
  • Inflammation
  • Nutritional deficiencies
  • Anemia
  • Hormone balance
  • Candida/Yeast
  • Celiac disease
I also ordered Functional Stool Testing.

While waiting for results, I recommended that Todd begin a four-week Comprehensive Elimination Diet, and provided educational materials and book recommendations for support with this.

Blood testing revealed low levels of zinc, and significant vitamin D deficiency, but was otherwise normal. Functional stool testing indicated significant intestinal inflammation and low levels of "good" gut bacteria.

Recommendations were customized for Todd based on his laboratory results (no more “guessing game” when it comes to supplements):
  • Vitamin D (which supports the immune system response)
  • Zinc carnosine (a key factor in the health of the intestinal lining)
  • Fish Oil (a natural anti-inflammatory)
  • Immunoglobulin powder (derived from colostrum)
  • VSL#3 - A high-dose prescription-grade probiotic (this brand has solid evidence supporting its use in the treatment of Crohn’s)
I also prescribed Low-Dose Naltrexone (LDN), an opioid antagonist that has an outstanding safety profile and has shown promise in the treatment of Crohn’s in both adults and children with minimal side effects.

Two months after initiating diet changes, LDN and targeted supplementation, Todd reported his pain improved by at least 50% with some pain-free days and improved energy. While still experiencing blood in his stools, he described it as much less than before.

I recommended he add a glutamine/aloe combination to promote further healing of the intestinal lining.

b2ap3_thumbnail_intestines.jpgAt six months Todd reported that he continued to experience significant improvement and was very pleased with his progress. He described his pain as minimal, with only minor flares "nothing like it was before”. He had good energy and stamina and was no longer having any work pain. He had become a “believer” in his regimen of supplements and LDN, having forgotten them on two nights, each time with a symptom flare.

While bowel movements had earlier been improved, he had since noticed increased blood and mucus in his stools, so a low dose of Sulfasalazine had been restarted.

He continued to cautiously experiment with his diet, determining his “trigger foods”.

This past fall I was able to meet with Todd and his wife for his one-year follow-up. He reported great energy and stamina, no work pain, and no blood in his stools.

While still on the low dose of Sulfasalazine, it was a dose that did not give him side effects and his symptoms as a whole were nearly resolved. Follow up laboratory testing showed normalized levels of iron, zinc and Vitamin D.

I ordered comprehensive nutritional testing at this visit, which allowed us to customize Todd’s diet and supplement needs. His testing showed a need for B-vitamins, as well as magnesium and enhanced antioxidant support to reduce oxidative stress in the intestinal lining. Based on this testing, I also recommended he begin to reduce the amount of animal protein in his diet, transitioning to plant-based proteins.

In just one year, Todd was able to get much better control of his Crohn’s disease through changes in diet, targeted supplementation, and lower-doses of prescription medications without side effects. He had normalized bowel movements, no blood in his stool, minimal pain and improved energy. I look forward to continuing to work with Todd and his wife to optimize his nutrition, simplify his regimen as he continues to heal, and achieve further success!

*Patient names are changed to protect privacy

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many autoimmune 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.

Meet Diane*

b2ap3_thumbnail_blog_foodismed_hands.jpgWhen we first met this past September, Diane was looking for both weight loss and an Integrative/Functional Medicine approach to her Rheumatoid Arthritis. She had been diagnosed with Rheumatoid Arthritis about 6 years earlier, and she had nodules and joint pain and stiffness in both her hands and her feet. Her pain had been worsening to the point where walking was very painful and she had become more sedentary. Her rheumatologist had recently recommended she move to an expensive intravenous/infusion medication to treat her joint pain pain and avoid further joint destruction. Diane was frightened by the thought of starting these infusions, worried about potential long-term side effects. She told me that she was in the process of scheduling her first infusion but felt was doing so while "kicking and screaming".

I asked Diane to postpone her first injection and give me two weeks to guide her to results both with weight loss and reduction of join pain. Diane agreed and started a Functional Medicine approach to her care, based on the concept of using Food as Medicine.
  • After 2 weeks Diane had lost 8 pounds and was pain free in her feet. Most of the pain was gone from her hands with the exception of some mild pain in her left wrist.
  • At 5 weeks she had lost over 12 pounds and had no pain with increased movement and activity.
How did Diane achieve such amazing results in such a short period of time? She did it by changing the information she was giving her cells, removing the foods that were promoting inflammation and activating her immune system to work against her. Diane did this simply by changing her diet through the use of a comprehensive elimination diet.

Food is Medicine

b2ap3_thumbnail_blog_jan2_salad.jpgOur bodies are made up of trillions of tiny cells. These cells work together to form all of our organs, our blood vessels, our nerves, our muscles and everything else that makes us, well us!

Each cell in your body contains your complete genetic code. Depending on where the cell is in the body, the cell will read a different part of the genetic code to do it's job (muscle cells read the muscle part of the code, skin cells read the part of the code that codes for skin, etc.).

Your cells will also activate different parts of the code depending upon the information that is presented to them.

Food is information

The food that you eat provides information to the cells of your body that tells the cells what to do! Food actually does this job as well if not better than prescription medication can! The type of food information presented to your cells can change the way the cells works by activating different parts of the cell's genetic code. For example, sugar activates the genes in our cells that promote the production of inflammation.

b2ap3_thumbnail_blog_jan6_cell.jpgIs this starting to make sense? The food that you eat can either activate or "quiet down" your immune system. And, like the example above, the food that you eat can activate pathways that increase inflammation, or activate other pathways from your genetic code that reduce inflammation.

You might ask, why is it that certain foods negatively affect some people more than others? This is because we are all working off a different genetic code, or what I like to call our genetic "blueprint". This is also the reason why certain medications affect some people differently than others. Because we are all working off of a different "blueprint" (which makes us biochemically unique), we don't all respond to food in the same way. This concept is the basis for Nutrigenomics. a growing area of research that is focused on the effects of food on gene expression. We use the concepts of Nutrigenomics in my office every day when prescribing elimination diets for patients to treat various medical conditions.

The Elimination Diet
learning how foods affect your gene expression

In my office, we do not believe that there is one optimal diet that works best for everyone, because we know that based on our different genetic blueprints, we will all have different nutritional needs. We work with our patients to help them determine their own optimal diet for optimal health and vitality. An elimination diet can be an effective tool in doing so.

An elimination diet can allow you to determine how food is affecting your gene expression. More simply put, it allows you to figure out how different foods make you feel. By removing certain foods from your diet for a period of time, then re-introducing them, you can experience which foods are "working for you" and which are "working against you". Based on your symptoms or medical condition, the list of foods that will be recommended for you to remove may vary. Foods are generally removed for a period of at least 3 weeks, and then they are reintroduced one at a time, allowing 3-4 days before reintroducing another food in order to assess for delayed reactions in the body.

In Diane's case, her list of foods to remove from her diet included:
  • gluten
  • dairy
  • sugar
  • soy
  • corn
  • eggs
  • peanuts
  • nightshade vegetables
  • citrus fruits
You might look at this list and ask "well what could she eat then"? That's easy! We asked her to focus on:
  • lots of vegetables and fruits
  • clean, lean proteins
  • nuts and seeds
  • healthy fats
  • gluten-free, high-fiber starches and grains (like rice, quinoa, sweet potatoes and beans/lentils)

b2ap3_thumbnail_blog_foodismed_feet.jpgBecause Diane was also interested in weight loss, she limited her starches and grains to not more than 2 servings per day. She also utilized a vegan protein meal replacement in the morning for breakfast (meal replacement can be very helpful with the elimination diet because it takes some of the "work" out of meal preparation and provides essential amino acids).

We use elimination diets frequently in the treatment of autoimmune disease as well as a number of other conditions including irritable bowel syndrome, fatigue, brain fog, chronic headaches and weight gain.

At this point, Diane is 12 weeks into her journey. She is 15 pounds lighter. She no longer needs to consider the infusion therapy and she is still pain-free. We will be spending the next 12 weeks continuing her weight loss efforts, attempting some food reintroduction, and assessing for other underlying imbalances that may be contributing to her autoimmune disease such as the health of her digestive tract and the possibility of heavy metal toxicity. Stay tuned!

Yours in Health,
Carin Nielsen, MD

*while this represents a true story, the patient name has been changed to protect his/her identity and privacy

Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including autoimmune disorders like Rheumatoid Arthritis. Treating autoimmune 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.