brimhall webinar 12-8-2010.ppt · 12/8/2010 · An Introduction to Functional Diagnosis DickenWeatherby, ND & John Brimhall, DC 12/8/2010

An Introduction to Functional DiagnosisDicken Weatherby, ND & John Brimhall, DC

12/8/2010

http://www.FMTown.comhttp://www.BrimhallSeminars.com

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Welcome!

The 4 Quadrants of Functional Diagnosis

Sxs of a Functionally Disturbed Patient

• Fatigue or low energy

• Digestive disorders

• Allergies

• Reduced immunity

• Hormonal dysfunction

• Sleep disturbances

• Anxiety or depressive tendencies• Reduced immunity

• Infertility

tendencies

• Weight fluctuations


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What Is Functional Diagnosis?

Why Should You Bother?


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The Four Essential Questions

Question # 1

Is there a dysfunction in this patient? If so where is it?If so, where is it?


Question # 2

What are the sources or causes of the dysfunction?dysfunction?


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Question #3

What individualized treatments are needed?needed?


Question # 4

When has function been restored?


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The Functional Diagnosis Hierarchyh ll i

1. The organs of the GI (digestion, absorption, mucosal barrier)

2. The gallbladder3. Adequate detoxification and

elimination (liver kidneys and

6. Adrenals7. Thyroid8. Sex Hormones9. Inflammation0 h S

Assess The Following:

elimination (liver, kidneys, and large bowel)

4. Optimal nutrient levels: tissue minerals , vitamins, and EFAs

5. Blood Sugar Regulation & Oxidative Stress

10. The Immune System11. Cardiovascular System12. Kidney and Bladder

Quadrant #1

Functional Signs andSymptoms Analysis


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Are You Re‐inventing the Wheel?

4 Common Problems

1. Spending too much time asking questions.

2. Not knowing what to do with all of the information they gather.

3 N l ki h i i i l hi i3. Never looking at the initial history again.

4. Using symptoms as their primary means of tracking progress.


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Health Assessment Questionnaires

• Tracking symptoms over time

• To encourage compliance

• To chart progress

• Substantiate the changes in their symptoms

• Assess Symptom Burden

Quadrant #2

Functional and NutritionalPhysical Exam Skills


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A Y T hi YAre You Touching YourPatients Enough?

Functional and Nutritional P.E.

Skin Examination• Acne in adults

• Dilated capillaries

• Bumps on arms

• Dermatographism

• Low wound healing• Low wound healing

• Skin tags

• Vertical creases on forehead


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Nail Examination

• Spooning of the nails

• Soft nails or poor growth

• Cracking of the tips of the fingers

• Red tips to fingers

• Ridging of the nails

The Mirrors of the Body

• Reflexology• Auricular Medicine• Pulse• Tongue

Ski• Skin• Applied Kinesiology• Neurological Reflexes


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The HCL Point

The Enzyme Point


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Quadrant #3

Functional In‐Office Testing

In‐Office Testing: Advantages• Easy to do

• Results back immediately

E t t t• Easy to re‐test

• Gateway testing


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What are some of the tests you can do in‐office?

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Functional Urinalysis Tests• Urine pH• Urine Specific Gravity• Bowel Toxicity test • Urine Sediment TestUrine Sediment Test• Urine Calcium• Urine Adrenal Stress Test


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Other In‐Office Lab Tests• Oxidata Free Radical Test

• Salivary pH

• Dr Bieler’s test

• Zinc taste test

• Zinc challenge

• Kane’s mineral testing

• Tissue mineral• Dr. Bieler s test

• Gastro test

• Metabolic pH Testing

Tissue mineral assessment

Summary of the Benefits• Easy assessment of dysfunction• “Gateway” test • Results are immediate • Testing is easily performed • Reference point to make sure treatment is working• Reference point to make sure treatment is working• No expensive equipment• A great source of additional income


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Quadrant #4

Functional Blood Chemistry Analysis

What You Need To Know

Blood Testing Is One of The M t I t t FDM T lMost Important FDM Tools

for the Identification of Functional Disorders and for Disease Prevention


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Blood Chem & CBC Analysis‐Th F i l A hThe Functional Approach

• Oriented around changes in physiology and not pathology.

b d i l h i l• Ranges based on optimal physiology

• Use of tighter ranges

Some Other PointsSome Other Points

• Patterns and trends

• Fitting it into your FDM practice

• Approaching the Analysis


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Sample Case‐34 year old female presents to clinic complaining of fatigue,

weight gain, infertility, poor skin, and a history of increased cholesterol. Past hx. of oral contraceptive use. On Physical exam showed a BP of 106/68, pulse 82, weight 142 lbs, tenderness in RUQ, rest of abdominal exam unremarkable, Q, ,skin: bumps on arms, generally dry skin, flaky on upper arms, nails weak and split. Chem screen and CBC: Cholesterol 210, uric acid 1.03, thyroid panel normal, CBC normal.

Only two values outside the reference range:

U i A id 1 3 (3 0 5 5)

Sample Lab Case

Uric Acid 1.3 (3.0 – 5.5)

Cholesterol 5.30 (3.36 – 5.20)Some reasons for a decreased uric acid?

Fanconi’s syndromeWilson’s syndromeSIADHHeavy metal poisoningMalignancies (Hodgkin’s or

multiple myeloma)Deficiency of xanthine oxidase


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Complete Functional Analysis Using Foundational Hierarchy

GI dysfunction (Hypochlorhydria/ gastric inflammation, Pancreatic insufficiency, dysbiosis): globulins, alk phos, MCV, WBCs, Eosinophils, monos

Liver/Biliary dysfunction with EFA need: TGs, LDL, Monocytes

Minerals: Magnesium, molybdenum and zinc: uric acid, Alk phos, GGT

Vitamin Need: (Anemia‐B12/folate, B6): HGB, MCV, RDW, GGT, uric acid

Blood Sugar: Pancreas glucose, LDH

Blood sugar: Adrenal hypofunction: Potassium, glucose, LDH

Renal insufficiency: Phos, BUN/Creat ratio

Immune insufficiency: WBCs, Monos (recovery)

The Main Role1. The prevention of disease and dysfunction

2. The early detection of disease and dysfunction

3. Advanced patient specific treatment techniques


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Treatment Must…

• Address the underlying cause

• Respect biochemical individuality

• Focus on restoring physiological functiong p y g

• Cause no harm

Benefits to the Patient• Improved quality of health

• Reduced costs

• Reduced suffering

• Increased likelihood of a cure

• Reduced incidence of premature aging, mortality, and morbidity


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S f l I l i fSuccessful Implementation of Functional Diagnosis

Requires a System


Requires Support


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Requires Tools

Who Will Benefit?• Patients with inflammatory conditions

• Patients with energy issues

• Patients with blood sugar dysregulation

P i i h di l di• Patients with cardiovascular disease

• Hormonal issues

• Dermatological conditions


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Special Closing December 15th, 2010

Documents

brimhall webinar 12-8-2010.ppt · 12/8/2010 · An Introduction to Functional Diagnosis DickenWeatherby, ND & John Brimhall, DC 12/8/2010