We’re in the midst of the most serious epidemic of chronic disease humans have ever faced. Six in 10 adults in the United States have a chronic health condition, and four in 10 have two or more. (1) Seven of the top 10 causes of death in 2010 were chronic diseases, and two of them—heart disease and cancer—together accounted for almost half of all deaths. (2)
While some of these problems (like heart disease) are fairly well-understood by conventional medicine, others are more mysterious. Conditions like Irritable Bowel Syndrome (IBS), chronic fatigue, diverticulosis, fibromyalgia, and autoimmune disease together affect hundreds of millions of people around the world, but in most cases, patients are told that the causes of their condition are unknown and simply prescribed drugs to manage the symptoms.
But is it really true that we don’t know what causes chronic illness? Certainly, there are particulars related to each specific illness that we don’t yet understand. But I would argue that we do, in fact, have a solid grasp on the most important factors that contribute to virtually all chronic disease. This means that it is within our power now to prevent, and even reverse, many of these conditions.
Do you know the eight underlying causes of most chronic disease? Check out this article to find out and learn how Functional Medicine can solve them. #functionalmedicine #unconventionalmedicine #kresserinstitute
The Functional Medicine Systems Model
As many of you know, I train clinicians in Functional Medicine through the ADAPT Practitioner Training Program. In preparing for that program, I created a “unified theory” of what causes disease that I call the Functional Medicine Systems Model. I’d like to share that with you here, and use it as a springboard for our discussion.
As the diagram illustrates, the interaction between an individual’s genome, epigenome, and exposome is at the core of what determines our health.
The genome is our complete set of DNA, containing all of the information needed to build and maintain the human organism.
The epigenome consists of chemicals that modify the genome in a way that tells it what to do, where to do it, and when to do it. These modifications do not change the underlying genes, but they can be passed on to future generations.
The exposome represents the sum total of all non-genetic exposures an individual experiences from the moment of their conception through the end of their life. It includes the food we eat, the water we drink, the air we breathe, the chemicals we’re exposed to, the social connections we have, and the environment we live in.
To use an analogy, the genome is like a piano; the epigenome is like the sheet music, and the exposome is what determines how the music is written and performed. The quality of the piano will certainly affect the sound that it produces. But the finest piano in the world will still sound terrible if the sheet music and performance are terrible. Likewise, a virtuoso pianist performing a Mozart piece will not be at her best playing a poor-quality piano.
In the same way, genetics do play an important role in human health and disease. However, we now know that the exposome (and its influence on the epigenome) is far more significant in most cases. In fact, it is responsible for more than 90 percent of human disease. That is why the exposome is at the core of the Functional Medicine Systems Model, and should always be the first thing addressed regardless of the patient’s complaint.
The modern diet, lifestyle, and environment affect the expression of our genes and lead to pathology, which in turn cause disease and symptoms in the patient.
But what are those pathologies?
The Eight Core Pathologies That Underlie All Chronic Disease
I believe that virtually all diseases and symptoms that we experience are caused by one or more of the following eight core pathologies:
1. Gut Dysfunction
Gut dysfunction includes small intestine bacterial overgrowth (SIBO), infections (e.g. parasites, pathogenic bacteria, viruses), low stomach acid, bile, and enzyme production, intestinal permeability, and food intolerances.
2. Nutrient Imbalance
Nutrient imbalance includes deficiency of nutrients like B12, iron, folate, magnesium, zinc, EPA/DHA and fat-soluble vitamins (most common), and excess of nutrients like iron (less common).
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3. HPA Axis Dysregulation
HPA axis dysregulation includes regulating the communication between the hypothalamus, pituitary, and adrenal glands, and balancing the production of hormones associated with those glands (e.g. DHEA, cortisol)
4. Toxic Burden
Your toxic burden includes exposure to chemicals (e.g. BPA, phthalates, etc.), heavy metals (e.g. mercury, arsenic), biotoxins (e.g. mold/mycotoxins), or impaired detoxification capacity due to nutrient deficiency, GI issues, or other causes.
5. Chronic Infections
These include “stealth” infections by tick-borne organisms (e.g. Borrelia, Babesia, Bartonella, Erlichia), intracellular bacteria (e.g. Mycoplamsa, Chlamydophila), viruses (e.g. HHV-6, HPV), and dental bacteria.
6. Hormone Imbalance
Hormonal imbalance can include those associated metabolism (e.g. insulin, leptin), thyroid, and gonads (e.g. estrogen, progesterone, testosterone).
7. Immune Dysregulation
This includes autoimmunity, underactive immune function, and chronic, systemic inflammation.
8. Cellular Dysfunction
Cellular dysfunction can refer to impaired methylation, energy production, and mitochondrial function, and oxidative damage.
These pathologies (and the exposome-genome-epigenome interactions that lead to them) are at the root of everything from obesity, to Hashimoto’s thyroiditis, to asthma, to autism spectrum disorders, to depression. The understanding that the same eight core pathologies underlie most modern, chronic diseases has profound implications for how we should address these conditions.
In conventional medicine, the focus is often on diseases and the symptoms; it works “from the outside in.” For example, let’s say that you go to the doctor for your annual exam and your blood tests reveal that you have “high cholesterol”. The most likely outcome in this situation is that you’ll be prescribed a statin, and in some cases be told to exercise more and eat better. There is rarely any serious investigation into what caused the high cholesterol in the first place.
High cholesterol is a symptom, not a pathology. The pathologies that can lead to high cholesterol include poor thyroid function, intestinal permeability, disrupted gut microbiome, chronic viral or bacterial infections, insulin and leptin resistance, and nutrient imbalances—to name a few. If I find high cholesterol in a patient, we will examine all of these potential pathologies, and of course, we will also look at how the individual’s genetics, diet, lifestyle, and other factors related to the exposome may be contributing to them. Once we have addressed all of the core pathologies, the cholesterol levels typically normalize on their own.
Whether the patient’s main complaint is infertility, fatigue, sinusitis, or skin problems, I will focus on these eight core pathologies because I know (from both clinical experience and research) that they are the most likely underlying causes of their condition. In my practice, most of my patients are dealing with not just one of these pathologies, but several.
As you can see, this is a fundamentally different approach than what is typically done in the conventional setting. The downside is that it requires a lot more testing and investigation up front, which can be costly and time-consuming. The upside—which obliterates any of the downside considerations—is that it becomes possible to not only prevent but even reverse many chronic disease conditions without the need for taking medication for the rest of your life.
Unfortunately, the Functional Medicine approach is not yet embraced within the conventional healthcare model. But I believe that is changing. The prestigious Cleveland Clinic established the Center for Functional Medicine, directed by Functional Medicine pioneer Dr. Mark Hyman. This is a big step toward mainstream acceptance of Functional Medicine, and the research the center is engaged in will almost certainly lead to even broader recognition.
I think health insurance companies will also see the benefits of Functional Medicine. They’ll recognize that spending a little more money up front to properly diagnose and treat the root of the problem will lead to enormous savings down the line.
These changes aren’t going to happen overnight, and we still have a lot of work to do. But the tide really is starting to turn!
If you’re a healthcare practitioner and you’re interested in training in this approach, learn more about the ADAPT Practitioner Training Program.
If you’re struggling with a chronic health problem and are interested in learning more about this approach, click here to learn more about how the team at the California Center for Functional Medicine can help. The membership-based health transformation service offered by CCFM is 100 percent virtual, and it’s designed to offer you the support, tools, and team you need to get well.
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Hi Chris
You saved me in a round about way. Your practice was closed last September, so I googled functional MD. I found someone in Santa Cruz who hss helped get to ” root “. Demylinating poly neuropathy caused by 2 cell mutations mthfr & c- something. Paleo of course, methylguard, vit.,D, vsl3, on thyroid med, bp, & celexa still. Horrific rash slowly dissipating. Now must detox high high lead starting Monday. I have a lot of the 8 & yrs spent last 6 mo. EFT
Healing past traumas. I am slowly getting better. Wortied about the lead detox. Thanks fir allllll your help!!
Hi Kristen, I live in Santa Cruz and am looking for a good FM doctor, would you mind sharing who it was you liked in SC?
Thanks,
Dave
Wish I knew why some insurances will only pay for doctors to give you pills for the rest of your life. Instead of covering someone that will fix your health problems for life !! Never made sense – Never will ..
Maybe the insurance companies along with the western medicine model in general don’t want to get people well; they want us to stay sick so we will continue to give them business. Time for a new paradigm in the world of medicine in this country.
Hi Diana,
I like what u commented.. Why not people take care of their health and boost up immune system. Prevention is better than cure..
I believe it is done for their convenience and or gain. Some may really believe it to help, and some just don’t care in my opinion. It is up to the individual or their care giver to determine the validity of the practicing physician. I have a permanent brain injury which may have derived from taking the prescribed medications. I have since drastically altered my diet and stopped taking most of 12 pills a day! Big Parma has big bucks but I do not support it any longer. I can walk, talk and drive again. I am 52 years of age
believe it or not as part of the PPACA/Obamacare there are several provisions to drive large insurers toward population disease management – aka accountable care organizations. Rather than reimbursements paid by treatment reimbursements are distributed by population outcomes.
Health insurers do not make money when you file claims. They want doctors to move toward preventative treatments.
Chris, I really like the concentric circle diagram. It’s intuitive in that many symptoms are often seen or felt at the surface or point of discomfort, but that it often takes some peeling of the onion skin to get to the core/root cause.
Your list of 8 pathologies provides a structured approach to help me better understand and wrap my mind around all of the moving (and some broken) parts.
The fact that stress, anxiety, any negativity contributing to the problem is depicted as residing in the center is consistent with how we often suppress it inside, deep down in our guts.
My problems are hormonal and I can’t find a blood pannel that groups what I need cost effectively for bi weekly draws. I have a nonunion fracture as well. 36 is not too old.
Gut bacteria are so important I almost died for lack of them.
I had Ulcerative colitis for 16 years I did what the Dr. told me took drugs etc wound up on steroids that left me pre-diabetic. Then I was given a round of antibiotics that was followed shortly after by a massive flare up. I was literally bleeding to death. I was offered more drugs including methotrixate and I just thought enough. I spent months researching and trying the alternatives many diets which lead me to the specific carbohydrate diet, that got me well enough to really start looking for answers.
In the end I resorted to doing a fecal microbiota transplant using my husband as a donor. I did 4 transplants over 5 days and then like a miracle I got better.
I have since discovered that a solution made from well rotted compost filtered through kitchen paper and simply drunk is a really good way of restoring your gut bacteria, and its free! No Colitis symptoms since!
Wow, I would be very careful about drinking compost liquid. There could be all kinds of nasty things in that, like clostridium botulinum, which is found in all soils, etc.
Could you please explain what really helped you ?
a solution made from well rotted compost ?
“All the Kings horses and all the Kings men, couldn’t put Humpty Dumpty together again”.
Chris, your list sums up exactly what has happened to me over the last 30 years, and also the piece by piece solutions that are finally putting me back together again.
For me building good health is like building a house. If the foundations are not solid, all the other stuff you plaster over it is irrelevant and will eventually crumble. When you restore a house you always start at the foundations.
Your site is my ‘go to’ reference as it is meticulously researched and balanced. You speak truth, and you always speak it carefully. I am so glad you are going to train other practitioners because it is badly needed. Natural practitioners also suffer from the knee jerk, piecemeal approach of mainstream practitioners. In fact their practice model mimics it. I’ve never had one of them tell me they will start from the foundations and work upwards. Practitioners need to explain the process of recovery at the outset, that it’s a partnership, that it will take trial and error – and time. It’s up to the patient if they sign up for the journey.
The functionanks for the summary.
Since my teens allergies gradually increased to the point of destroying my quality of life. Basically had post-nasal drip like a fire hose most of the time. Additionally, I suffered from ever worsening cold-air exercise induced asthma – which was getting pretty scarey. GP and allergy specialists were useless.
One day I happened to take some magnesium for some muscle cramps – and noticed that my asthma pretty much disappeared. I couldn’t believe all the time and money wasted on a problem so easily solved. Later I tried Paleo and my allergies pretty much vanished too. Probably dairy was the culprit. Life changing.
Hi. Good article. I am nervous BC I suffer from 7 of the 8. The good news is I have a functional doctor. The bad news is she doesn’t differentiate much. For my MTHFR she said just take methyl B12,probiotics and NAC but I feel even worse. I keep weight gaining despite a clean aip diet. I wish she would dig further but I don’t feel she knows more. I feel too overbearing when I ask questions about my labs and digestive issues but I am in pain for so long….Rifaximin and vsl#3 made me worse too that she suggested.
You’ve been given the standard approaches, but most practitioners don’t yet understand the more sensitive patient who will react badly to many of the standard approaches and amounts of various supplements given. Further, most practitioners won’t understand the deeper fundamentals of her case and what makes her more sensitive, then what to do instead that will be effective and safe.
Don’t feel like you’re being overbearing or otherwise inappropriate when you request more interpretation of your tests. Here’s where the practitioner has to know their patient, to know how much detail and time to give test interpretation in the consultation. Many patients don’t care to learn about their tests and just want a simple bottom line and treatment approach, others want some info but are easily overwhelmed and don’t take good notes, and still others are very smart and want to learn as much as possible. It’s a spectrum. The practitioner may want to schedule another visit if more time is required. If you’re seriously interested in learning more about your functional testing and not just buying tests because the practitioner wants the results for their own consideration of your case, mention that upfront when you’re checking out a new practitioner. Say what you’re looking for, and see if that’s a good fit for both of you. There is also a lot of introductory test interpretation info available online, which allows you to do homework so you’re better prepared to ask relevant questions next time you talk with your practitioner.
It’s normal to be passive and to learn many things the hard way when you’re first transitioning into a naturopathic and/or FM approach to healthcare. With experience, you become a more savvy, pro-active patient. Don’t be afraid to ask questions and engage in dialogue — you can learn a lot about how the practitioner thinks and how they want to practice. Check fit, communicate, check fit, communicate.
What would you recommend for symptoms of fatigue, panic, depression and ibs? A friend of mine is suffering a lot. She was getting some help from ssri but still she is not well.
Any good advices?
I am not a health or medical practitioner but have been taking back care of my health since following mainstream health guidelines lead to a heart attack and a life saving stent 6 years ago. Chris Kresser has been a huge help along the way among others.
Here is some advice from an unqualified person unfamiliar with details of your friend’s condition:
1) Ween yourself off the ssri’s immediately; they play merry hell with all your bodily and psychological functions—especially your gut—as I’m sure you’ve noticed. If this idea freaks you out, gradually substitute St.John’s Wort but get off that drug road! I could—from personal experience—say that ssri’s are evil but that’s not very dignified and just my personal opinion so I won’t mention it here.
2) a.Eliminate all grains from your diet. b. eliminate all sugar from your diet even greatly limiting fruit. c. try eliminating virtually all starches. Find out about acellular carbohydrates and resistance starch and think for yourself. Become a disciplined experimenter while acknowledging your reactions if that’s fun.
3) Prepare your own food using fresh ingredients—NO processed food. Use organic produce when possible. Always cook high roughage food like Kale and broccoli. Raw lettuce is fine. Eat grass fed (grass finished) happy animals and their products (eggs, butter) and ESPECIALLY their fat! Start taking fish oil or Krill oil today! Google LCHF.
4) Walk (NOT jog) at least twenty continuous minutes a day at least 6 days a week, hopefully with at least a block of uphill. Don’t make a production out of this, just head out and then think about it while you walk. This is the greatest help for #5.
5) Become a sleep connoisseur. At least 8-9 hours a night in a DARK cool room. No computer (or smart phone) or TV an hour before “lights out” (read by crummy old fashioned light to get drowsy, no full spectrum!). I still take (the amazing) valerian at bedtime but look forward to eliminating that and it doesn’t work well for some people.
These non-invasive steps cost nothing extra and will get your friend well on the way to wellness while seeking an effective health professional.
-Pete
I too have been wanting to see a functional med. nutritionist /dietitian , and pretty much covers the same things you talked about here . I’m under contract with my reg. GP were she has to give me a reference , before my insurance will approve it. At leas the nutrition part would be covered, I’m willing to pay for what testing needs to be done.
My GP is really dragging her feet and keeps almost running out the door when I mention it. She calls them money grabbers and quackery and it’s not real medical doctor advice .. I have brought it up twice so far and she always tells me lets talk it over on your next visit – I will have more time . It’s getting Old , I don’t think she ever will do it. She doesn’t want me cured or get healthier ,cause I won’t need her any more !!
Diana,
Keep in mind that a dietitian/nutritionist referred by a conventional doctor is most likely a *Registered* Dietitian (RD) or *Registered* Dietitian Nutritionist (RDN) who’s training program, while rigorous, is funded in part by pharmaceutical companies, large processed food corporations, soda corporation, dairy industry, etc., so they offer a mix of healthy and unhealthy (pharma and food industry supporting) advice.
*Certified* Nutritionists (CN) programs take no such funding and offer a Functional approach. A good CN will have graduated from an NANP accredited school (National Association of Nutrition Professionals). Often CN’s get their degree/certification through distance programs (online) due to the relatively small number of NANP accredited schools.
That said, there are RD’s who have learned to reject the industry funded protocol, but if they practice in a truly Functional way they will not be allowed to work in hospitals or conventional practices.
The reply to this comment is true. That RD’s don’t necessarily practice functional medicine/nutrition. But the last paragraph is also true-that some do! I am one such nutritionist and there are many others too. Just make sure the RD you pick is “functional and integrative”. Insurance will cover an RD 😉 http://www.diannerishikof.com if you are interested
While it’s true that functional medicine RD’s don’t typically practice in a traditional allopathic setting such as a hospital, their training consists of a 4 year bachelor of science degree plus a one year or longer internship program whereby they learn the concepts of clinical (hospital based) or community based nutrition. Except for a week long stint at the dairy council which I protested, there was absolutely no big pharma or corporations influencing my education and training. Also, the number of integrative/functional medicine RD’s is vastly on the rise which is good because they have the science and medical background of 5+ years to build on.
Diana,
I think Susan is correct and that you’d be sent to a registered dietician who is likely to use the same general philosophy as the doctor who sends you. So I recommend that you head out on your own prepared to pay out of your pocket and deal with the awkward situation of having at least two competing schools of medicine and health.
There is nothing short of a revolution happening in health science and medical practice and it’s the doctors who will bear the brunt of the conflict as discoveries by their patients are imposed upon them. Let’s hope we don’t just wind up trading one set of ignorance and prejudice for another.
-Pete
Great article, thanks. While I completely agree that all of these are causes of illness, in my experience, I have come to believe that it goes even deeper, and that the REAL root causes are emotional, mental, and spiritual. I suddenly started having lots of health issues that I’d never had before, right after I had an emotional trauma about 10 years ago. No matter what I did (I’m all natural and organic – no allopathy or processed foods, chemicals, etc), nothing got better until I finally realized this and started doing lots of emotional, mental, and spiritual work. If you dive into the world of EFT (Emotional Freedom Technique), you’ll find this to be true over and over again – allergies, illnesses (some “incurable”), CFS, fibromyalgia, and much more, resolving after addressing the non physical issues. 🙂
Based on the comments, I can see that I wasn’t as clear about this as I hoped.
The causes of disease and symptoms are in the core of the circle: exposome + genetics/epigenetics. Exposome includes both internal factors (like psychology, emotions, etc.) as well as external factors (air pollution, chemicals, etc.). These influences then manifest as specific pathologies or mechanisms.
Put another way, the pathologies are the physiological expression of the causes—diet, lifestyle, environment, attitude/emotions/spiritual factors.
And all of these factors can simply be broken down into what negatively or positively affects you, be it food, chemicals, emotions, thoughts… It is up to each individual to determine those parameters. I, for example, like spiders (positive), many people see them as an eight-legged critter that needs to get out of their house (neutral) and many fear them beyond reason (negative). Each of these perceptions is going to induce a certain degree of stress, first in the mind then physically. The same can be said of food. I don’t have any problems eating gluten (positive), for many others this constitutes a devastating health problem (positive). In trying to diagnose a problem, first start with simplicity and work towards the complex.
Sorry, I meant negative for the devastating health problems with gluten. Feel free to change that.
Hi Chris,
I’m happy and so relieved to know that you are finally letting people know what is at the root of some devastating conditions! I personally know what it’s like to suffer from severe CFS for several years only to find out later that it was really the result of extreme gut dyspiosis that developed when I wasn’t aware that shouldn’t have taken a lot of antibiotics at the same time I was trying to get over a bad case of strep throat when I was in Mexico. CFS caused my immunity to plummet and I didn’t now what was wrong with me for too long. I’m happy to say that I recovered when I followed a restricted diet and took high doses of probiotics. The world needs to know what causes CFS so it can be prevented in the future. The CFS wore down my adrenals too, so I now am slowly recovering from hypoadrenalism, which is a huge challenge as well. Thanks, Chris!
Hi Chris,
I was diagnosed with MS in 2003 after being what I considered quite healthy (no overt health issues) for most of my life. In retrospect, there were subtle signs of dysfunction. I changed my diet in 2006 (GF, CF, low sugar, soy free) and am working towards a Paleo diet (following Wahl’s Protocol. Despite dietary changes and supplementation, my MS symptoms seemed to worsen, so last year I undertook extensive biochemical testing (UTM, UEE, HMT, CSA, UAA, MAP, hormones, biopterin) along with DNA testing. What I discovered was that I have all 8 pathologies you identified! As a result I am methodically addressing them, but realize that this may be a long process (6-7 years) before I can be healed. I experience a lot of Herxheimer reactions to new supplements, so it hasn’t been easy. But because I do know how “messed” up I am, I can be patient.
Hi Chris, I had in total 5 years intensive antibiotics due to Lyme Disease. Last autumn after I ate, I had severe joint pains/burning skin/cognitive defects. Recently I read one of your articles on oxalates. I joined the Try Low Oxalates FB group. I now realise I had a diet high in oxalates, thinking it was healthy. My doctor gave me drips of vitamin C and vit D so I was probably producing them endogenously. Last week due to Yersinia, I landed in hospital. Now I have burning, crawling sensation on my skin, sometimes burning muscles, bones even and as if my brain is full of glue. No one here as ever heard of oxalates, but worse they are not willing to learn. They sent the pain specialist who’s given me Lyrica. I will see the neurologist too. They reject my feeling that the problem is my gut flora and a build up of oxalates in the body. How I get out of this hell (sorry, but it is currently)? I’m in northern Germany.
Kathryn,
Sorry to hear you’re going through this! You may already know since you joined the yahoo group, but antioxidants are really important. I’d try NAC or CoQ10 for starters, if you look up antioxidants at the yahoo group you can see what everybody else has used.
Have you tried Epsom salt baths? Sometimes it can help.
I’d be careful with the Lyrica, a lot of members had worsening problems after taking it.
I hope you start to feel better soon!
That’s kind you write, Dee.
N-Acetyl-Cysteine gave me unbearable brain fog/brain pressure. I was told it contains sulphur so maybe I have an intolerance. I’ve just started Acetyl-L-Carnitine. I take Ubiquinol which is CoQ10. I take Epsom Salt baths up to 3 times a day to cope with the pain. But this is no life. I want my life back.
The hospital only offered Lyrica and vit B. Vit B I’ve been taking since last year.
I still think damaged gut flora is the problem but a range of probiotics, including VSL3, has not helped. So tired of this.
Dear Kathryn,
So sorry! The only thing I can think of is maybe trying some oral magnesium as well (just avoid the glycinate form as it can convert to oxalate), and maybe checking the forms of B vitamins that you’re taking, i.e., methylcobalamin instead of cyanocobalamin, folate instead of folic acid etc. It sounds like something (or things) is affecting your nerves and I had some benefit from magnesium and B vitamins in the past when I was having nerve issues. Also, I think if you are taking too much B6 or the P5P form, it can cause the oxalate to start leaving your body too quickly, which might exacerbate symptoms or cause new ones.
I realize you have a lot going on that can be causing the burning and crawling sensations, but I would recommend asking about reflex sympathetic dystrophy, just in case. Early treatment makes a big difference. I was lucky I only went for months, not years, without a diagnosis, but if it is caught early on, some people go into remission.
I wish you the best and will remember you in my prayers.
You’re very knowledgeable, Dee. And with a heart. Thank you. You’re right about the vitamin B6/P5P. I think I was taking too much and reducing oxalate intake too quickly, which caused too much dumping. I’m thinking the burning pain in my skin/bones/muscles and brain feeling clogged up could be oxalic acid / oxalate crystals. It seems the most likely explanation given my medical history / dietary history / blood results. It’s just no doctor has the time to look in detail at these factors and no one here has heard of oxalates not relating to kidney stones. Worse or bizarre, I find, is that no one is willing to learn. I can mention RSD but my overwhelming experience so far is that doctors here aren’t so good at listening to patients. I just wish I could get my brain clear then I think I would be able to cope much better. I have magnesium hydrogen citrate and Tri-magnesium dicitrate. Am hoping they are ok. I need to get on a controlled low ox diet, which eventually I should be able to do with a low ox health coach I’m in skype contact with. Any more ideas to clear my brain, do let me know! Thank you for your prayers. They are very much appreciated.
Hi Kathryn,
I’ve never heard of problems with the forms of magnesium that you have, hope they work for you. I have read that magnesium l-threonate is good for the brain. I think there are a couple of studies available at pubmed.
I’m wondering if you’ve been checked for heavy metals? I believe Susan Owens wrote a little bit about oxalate chelating heavy metals, and there was a doctor who needed to slow down her patients chelation therapy, because that in combination with the low oxalate diet was making the heavy metals come out too quickly. I seem to remember hearing years ago that mercury toxicity can cause burning pain. And it has a very strong effect on the brain.
Have you already tried starting with really small amounts of probiotics? Some people say starting small and working up worked well for them.
I started reducing the oxalate in my diet too quickly, too. I had uncomfortable symptoms for several months, but I got off easy compared to lots of people. I’m just glad that it didn’t seem to make my kidney stones worse. I hope your Skype coach can help. It is really hard to figure out or even remember what to do when you’re really ill.
I have a hard time understanding how doctors can be so closed-minded. It leads to frustration and suffering for patients, and I really don’t understand how they can be so uninterested in new information that is coming from studies all the time. I find scientific studies fascinating, and in regard to health, you would think more doctors would be eager to have new ways to help their patients.
If you at any point suspect RSD, I really recommend looking up one of the RSD groups. I think RSD dot org was the first one I found. RSDfoundation dot org has a German version of the site, if that helps. Some practical things for RSD: refrain from icing the area (very bad for RSD!) and try to start massaging the areas with the worst burning pain if you can, it can help to start retraining your nerves/brain so it doesn’t expect horrible pain from even the lightest touch. I really hope it isn’t RSD, and part of me hates to even bring it up, but I try to warn anyone with the symptoms so they don’t have to go through what I did, or worse.
Don’t lose hope! These really horrible health problems can improve, even when it doesn’t feel like they ever will. There was a period of time when I really didn’t know how I was going to get through the excruciating pain of RSD, but I have had so much improvement.
Dear Dee,
Early in the year, I had chelation 8x for heavy metals and a challenge test (which nearly killed me as it drained me of minerals) showed negative for heavy metals, as did a hair analysis test. My doctor was convinced originally that it was heavy metals. It helped slightly but I now think it was chelating oxalates.
I’ve been in contact with Susan Owens.
I used probitiocs since August of last year: first low levels, then finally VSL3. I think I used too much in the end and it caused oxalate dumping. Nothing worked however ultimately. I’ve just started at low levels again.
Just having someone who acknowledges that the condition exists helps. No one here, medical or otherwise, has heard of it. The ‘problem’ is I don’t have kidney stones but there is published research from Susan Owens that oxalates don’t form kidney stones in 100% of cases. Doctors here believe absolutely that they do.
That’s so very true that it’s “really hard to figure out or even remember what to do when you’re really ill”. I struggle very very desperately with cognitive functions, but look normal. I make huge effort to communicate then people say but “you’re communicating fine’. No! My brain feels like a stone and I can’t think fully by a long long way!!!!
I identify TOTALLY (don’t usually use capitals) with your paragraph on how doctors can be so closed-minded when it causes such great suffering for patients. If they haven’t learned it in their studies they can’t do anything. But science is always developing. I though being a doctor was all about getting people healthy.
No one would ever look into a diagnosis of RSD. I struggled like crazy to get a diagnosis of Lyme/neuroborreliosis 8 years ago, even though the symptoms were raging. I was almost in a coma until a doctor recognised it and could read the blood results properly. He then treated it with long-term antibiotics. I find it incredible to find myself in the same situation again.
I have all preconditions for secondary hyperoxaluria, one positive 24h urine test, symptoms but no doctor is interested as it means reading up a lot and then in English (I’m in northern Germany).
It’s interesting that RSD talks of previous injury. Often I wonder if the Lyme damaged my nerve endings so that when I get another condition the nerves hurt in the same way. The brain pressure is horrendous and like Lyme.
Thanks so much! With self-medication (how come I’m forced to do this) and no support from a doctor I’m finding it extremely hard-going.
Best wishes, Kathryn
Have you seen Alessio Fasano’s lecture: The Gut is not like Las Vegas.? YouTube. Very Interesting.
Hi Chris,
I am beyond thrilled that you will be making an announcement soon about the course! I am wondering if you have had a chance yet to decide if you have to be a licensed practitioner to take the course? I am a Certified Nutrition Consultant and Educator. Beyond that, I have a tremendous amount of other complimentary health education in the last 16 years, but no license.
Thank you so much!!
thanks SO much for highlighting functional medicine!
dr. melissa ponce esguerra and i have been working closely with each other since october of 2014. she helped me address my hashimoto’s diease, infertility, and she helped me discover my hormone imbalance and adrenal fatigue through an extended female hormone panel (umm, why didn’t we start there in the first place?!). sometimes i wonder how our journey would have changed had we thought of taking this step but what’s done is done, right?
i am in the best health of my life. my TSH levels are in normal range again, my thyroid-antibodies have decreased dramatically, i’m sleeping better, my energy levels sustain me throughout my day, and my cycles are 28 days on. the. dot. my cycles were very unpredictable and ranged from 30-37 days, and i owe it all to dr. melissa. she was/is my guide, and i am forever indebted to her for proving to me that i was capable of self-healing. i am a testament to the power of taking your health into your own hands, and seeking the support and guidance of those that share similar values and philosophies. even better, all of this was done by means of major lifestyle changes, natural supplements, herbs, and essential oils.
I AM 73 YRS OLD AND HAVE A GFR OF 54 AN D KIDNEY STONES. I AM GETTING UTI INFECTIONS CONTINUOUSLY AND BLEEDING. ANTIBIOTICS ONLY WORK SOME OF THE TIME. MY UROLOGIST WANTS TO DO SHOCK WAVE THERAPY TO BREAK UP THE STONES BUT I HAVE MAJOR CONCERNS. I CANNOT HAVE THE RISK OF DAMAGING MY KIDNEYS OR BLADDER DURING THIS PROCEDURE AND I AM ALSO OBESE AND HAVE A HEART MURMUR AND HAVE HBP.
WHAT IS YOUR OPINION? DO I CONTINUE TO FIGHT THE UTI INFECTIONS WITH VARIOUS ANTIBIOTICS AND LOSE BLOOD AS I ALMOST DIED 90 DAYS AGO FROM RENAL FAILURE DUE TO ANEMIA SO NOT A STRONG PERSON.
I HAVE A LOT OF FAITH IN WHAT YOU SAY AND NOT MUCH AT ALL IN THE 6 MEDICAL DOCTORS THAT TREAT MY ISSUES. PLEASE RESPOND AS I HAVE ACTIVE HEMATURIA NOW AND GRAM POSITIVE COCCI IN THE CULTURE DONE YESTERDAY. THANK YOU.
Hi Marian,
Kidney stones are terrible I’m sorry you’re dealing with them on top of everything else. I highly recommend the Trying Low Oxalates yahoo group run by Susan Costen Owens. It gives you access to the most up to date and comprehensive oxalate food list I have been able to find. There is tons of info available there and the members are really helpful with questions. I passed at least 3 stones after starting to reduce the amount of oxalate in my diet, and the CT scan I had done showed my kidneys stone-free. The lowoxalate dot info website has info and simplified food lists you can look at. If you decide to try it, don’t reduce the amount too quickly, as that can cause some really unpleasant symptoms. They usually recommend you estimate what your previous intake was, and then reduce by 5-10 % per week.
For the UTIs – you might try 50 ml of cranberry juice 2 times a day, along with 500 mg of L-methionine 3 times a day. There was a study done that showed that treatment could be just as effective as antibiotics. I have heard d-mannose recommended as a treatment as well, although I believe that one is specifically targeted towards e coli.
Hope you are in a better health situation soon.
Regarding insurance, the problem is that functional medicine is a long-term approach, and insurance companies have no financial incentive to cover it. Insurance companies favor quick fixes and putting off costs that may happen later because people and companies change insurance plans so often that an insurance company that covers a large up-front cost for functional medicine isn’t likely to see the benefit in reduced premiums for those patient down the road; there’s a good chance those people they invested in will be on another insurance plan by then. Add to that the short-term (quarter-by-quarter and stock price driven) incentives for insurance companies and the obstacles to getting traditional insurance coverage of functional medicine are huge. So even with the Cleveland clinic raising the profile of functional medicine, there’s a fundamental business change that needs to happen before insurance companies have the financial incentive to cover functional medical care.
The mygreeninsurance mentioned above looks like a positive step, specifically because it focuses on non-traditional health care. Even if there were other insurance plans focusing on non-traditional health care, these insurance providers will most likely make their investment back if people switch from one of these plans to the other. So it’s possible the answer to the insurance issue is the establishment of new insurance companies and plans focusing on functional and non-establishment medicine, rather than a hope or push for traditional insurance companies to cover plans which are better for the patients but potentially worse for their bottom line.
Hi Chris,
Thank you for all of your amazing and thought-provoking articles.
I have read your work for the past couple of years and have decided to pursue a career in Naturopathic Medicine and will start school this Fall!
I am eager to start helping people the way you do. You are such an inspiration to me and I thank you for all of your hard work!