Functional Medicine Overview

8/2/2019 Functional Medicine Overview

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Functional MedicineFunctional Medicine

A Procedural OverviewA Procedural Overview

By Dr. John ReesBy Dr. John Rees


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The PhilosophyThe Philosophy

Traditional medicine attacks diseaseTraditional medicine attacks disease

Functional medicine attempts toFunctional medicine attempts torestore and balance normalrestore and balance normal

physiology.physiology.

The thought is a balanced, strongThe thought is a balanced, strongbody can heal itself.body can heal itself.


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What doesnt workWhat doesnt work

Replacing medicines with supplementsReplacing medicines with supplements

Using the Internet to diagnose yourselfUsing the Internet to diagnose yourself

Treating symptoms with supplementsTreating symptoms with supplements Believing the over the top claims on supplementsBelieving the over the top claims on supplements

( no single supplement fixes everything or even( no single supplement fixes everything or even

a lot of things)a lot of things) Short term trials of alternative medicineShort term trials of alternative medicine

approaches It typically takes 6 to 12 monthsapproaches It typically takes 6 to 12 months


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What Does WorkWhat Does Work

I utilize a Seven Pillar approach developed by Dr.I utilize a Seven Pillar approach developed by Dr.

Stuart WhiteStuart White

The seven pillars in order of importance:The seven pillars in order of importance:hormonal/neurological, glycemic regulation, bio-hormonal/neurological, glycemic regulation, bio-

terrain, inflammation, immune system,terrain, inflammation, immune system,

circulation and digestion.circulation and digestion.

Supplements, diet change, exercise, stressSupplements, diet change, exercise, stress

modification and sleep enhancement are all partmodification and sleep enhancement are all part

of the programof the program


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Pillar 1 Endocrine/NeurologicalPillar 1 Endocrine/Neurological The most powerful and important system toThe most powerful and important system to

optimize to achieve health and vitality.optimize to achieve health and vitality.

Strengthening and balancing includes theStrengthening and balancing includes the

following:following: Correcting HPA axis Correcting HPA axis

hypothalamus/pituitary/adrenal (also ovaries,hypothalamus/pituitary/adrenal (also ovaries,

testis, prostate, thyroid, etc.)testis, prostate, thyroid, etc.)

Normalizing and balancing Hormone levelsNormalizing and balancing Hormone levels

Optimizing cellular response to hormones, thusOptimizing cellular response to hormones, thus

preventing or correcting hormone resistancepreventing or correcting hormone resistance


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Pillar 2 Glycemic ControlPillar 2 Glycemic Control

Single most stressful job of the adrenal glands isSingle most stressful job of the adrenal glands is

controlling blood sugarcontrolling blood sugar

Has become an issue due to the food we eatHas become an issue due to the food we eat Single biggest lifestyle changes required toSingle biggest lifestyle changes required to

correct this pillar. They include eating bettercorrect this pillar. They include eating better

and exercising more.and exercising more.

Tremendous change can occur in a short amountTremendous change can occur in a short amount

of time with right approach.of time with right approach.


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Pillar 3 Bio-terrainPillar 3 Bio-terrain

Term to describe the mineral content ofTerm to describe the mineral content ofthe body.the body.

Imbalances result in PH (acid/base)Imbalances result in PH (acid/base)changes in the bodychanges in the body

Deficiencies produce imbalances in theDeficiencies produce imbalances in the

seven pillars.seven pillars. Makes large symptom impact whenMakes large symptom impact when

addressed, but takes longer to stabilize.addressed, but takes longer to stabilize.


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Pillar 4 InflammationPillar 4 Inflammation

Another pillar strongly impacted by lifestyle.Another pillar strongly impacted by lifestyle.

Dependence on grain products as major sourceDependence on grain products as major source

of food is the primary driver of inflammation.of food is the primary driver of inflammation. Poor fat choices also contribute. Good fat Poor fat choices also contribute. Good fat

anti-inflammatory, bad fat pro-inflammatoryanti-inflammatory, bad fat pro-inflammatory

A major cause of disease and a majorA major cause of disease and a majordeterminant of disease progression and severity.determinant of disease progression and severity.


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Pillar 5 Immune SystemPillar 5 Immune System

70% of immunity comes from the GI tract.70% of immunity comes from the GI tract.

Imbalances can lead to allergies and/orImbalances can lead to allergies and/or

immune weakness resulting in infection,immune weakness resulting in infection,both acute and chronic.both acute and chronic.

Major player in all auto-immune diseasesMajor player in all auto-immune diseases

along with inflammation.along with inflammation. Strengthening is easy, balancing is trickyStrengthening is easy, balancing is tricky


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Pillar 6 CirculationPillar 6 Circulation

Cardiovascular disease is still the numberCardiovascular disease is still the number

one cause of death in the United States.one cause of death in the United States.

Dyslipidemia is a major precursor.Dyslipidemia is a major precursor. Inflammation is what makes dyslipidemiaInflammation is what makes dyslipidemia

dangerousdangerous

Cholesterol is not the devil.Cholesterol is not the devil.


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Pillar 7 DigestionPillar 7 Digestion

For food and supplements to make you healthy,For food and supplements to make you healthy,

you have to have optimal digestion.you have to have optimal digestion.

Poor digestion leads to poor GI tract immunity,Poor digestion leads to poor GI tract immunity,see earlier slide.see earlier slide.

Digestion and assimilation are pivotal in theDigestion and assimilation are pivotal in the

seven pillar approach.seven pillar approach.

Digestive disruption is one of the leading causesDigestive disruption is one of the leading causes

of frailty in older Americans.of frailty in older Americans.


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So what do we do?So what do we do?


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Step 1 - HistoryStep 1 - History

The first and most important step.The first and most important step. Computerized history Symptoms areComputerized history Symptoms are

grouped into major physiological systemsgrouped into major physiological systems

and a numerical score obtained. Thisand a numerical score obtained. Thisallows for the patient to easily trackallows for the patient to easily track

response over time.response over time.

Oral history Gives the patient the chanceOral history Gives the patient the chanceto fill in the blanks on what they think isto fill in the blanks on what they think is

important.important.


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Step 2 Laboratory workStep 2 Laboratory work

Functional evaluation of blood tests can beFunctional evaluation of blood tests can be

different then medical evaluation.different then medical evaluation.

Functional evaluation looks atFunctional evaluation looks atphysiological optimum levels.physiological optimum levels.

The normal ranges listed are designed toThe normal ranges listed are designed to

show disease. If it is outside of range,show disease. If it is outside of range,pathology exists.pathology exists.


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Normal vs. OptimalNormal vs. Optimal

Symptoms and other signs of dysfunctionSymptoms and other signs of dysfunction

often start before abnormal readings areoften start before abnormal readings are

obtained.obtained. Therefore, non optimal values are closelyTherefore, non optimal values are closely

evaluatedevaluated

Treatment attempts to move people intoTreatment attempts to move people intooptimal ranges.optimal ranges.


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Functional vs. Normal Lab ValuesFunctional vs. Normal Lab Values

Normal rangeNormal range of TSH ( Thyroid Stimulating Hormone)of TSH ( Thyroid Stimulating Hormone)

Normal Range 0.35 to 5.5Normal Range 0.35 to 5.5

0.350.35 5.55.5


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Functional vs. Normal Lab ValuesFunctional vs. Normal Lab Values Normal rangeNormal range andand abnormal rangesabnormal ranges of TSHof TSH

(Thyroid Stimulating Hormone)(Thyroid Stimulating Hormone)


Abnormal Range 0 to 0.35 and 5.5 or greaterAbnormal Range 0 to 0.35 and 5.5 or greater

0.0 0.350.0 0.35 5.5 or greater5.5 or greater


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Functional vs. Normal Lab ValuesFunctional vs. Normal Lab Values Normal rangeNormal range,, abnormalabnormal andand optimal rangeoptimal range, of TSH, of TSH

(Thyroid Stimulating Hormone)(Thyroid Stimulating Hormone)


Abnormal Ranges 0.0 to 0.35 or 5.5 or greaterAbnormal Ranges 0.0 to 0.35 or 5.5 or greater

Optimal Range 1.0 to 2.5Optimal Range 1.0 to 2.5

0.0 0.35 1.0 2.5 5.5 or greater0.0 0.35 1.0 2.5 5.5 or greater


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Additional Testing MeasuresAdditional Testing Measures

Hair AnalysisHair Analysis

Saliva TestingSaliva Testing

Stool TestingStool Testing


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Hair AnalysisHair Analysis

Gives us the mineral content of hairGives us the mineral content of hair

Ratios of certain minerals gives us theRatios of certain minerals gives us the

effects of certain hormones at the cellulareffects of certain hormones at the cellularlevellevel

Heavy metal toxicity can be evaluatedHeavy metal toxicity can be evaluated

Protein metabolism can be evaluatedProtein metabolism can be evaluated


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Saliva TestingSaliva Testing

Tests level of free hormones at tissue levelTests level of free hormones at tissue level

Different from protein bound blood levelsDifferent from protein bound blood levels

Cheaper, so a greater number of tests canCheaper, so a greater number of tests can

be performedbe performed

Often picks up hormone irregularitiesOften picks up hormone irregularities

before they show up on blood testingbefore they show up on blood testing

Safe and reliableSafe and reliable


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Stool TestingStool Testing

Shows problems with parasitesShows problems with parasites

Shows problems with pathological bacteriaShows problems with pathological bacteria

and fungusand fungus Shows ratios of normal healthy bacteria toShows ratios of normal healthy bacteria to

determine if dysbiosis is presentdetermine if dysbiosis is present

Reveals inflammatory markers for bothReveals inflammatory markers for both

upper and lower gastric levelsupper and lower gastric levels


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Treatment ApproachTreatment Approach When all history and testing is concluded, a physical examWhen all history and testing is concluded, a physical exam

is performedis performed Potential vitamins are selected and muscle testing is usedPotential vitamins are selected and muscle testing is used

to further select treatment protocols.to further select treatment protocols.

Lifestyle changes are suggested and encouraged at theLifestyle changes are suggested and encouraged at theappropriate time including diet, exercise, sleep and stressappropriate time including diet, exercise, sleep and stressmanagementmanagement

The patient is sent home with typically a months supply ofThe patient is sent home with typically a months supply ofsupplements and a follow up exam is scheduled.supplements and a follow up exam is scheduled.

Patients have access to the Dr. thru the month if anyPatients have access to the Dr. thru the month if anyquestions or concerns should arise.questions or concerns should arise.

The patient is given at least a monthly chiropracticThe patient is given at least a monthly chiropracticadjustment to help restore the Pillar 1,adjustment to help restore the Pillar 1,

hormonal/neurologicalhormonal/neurological


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Follow up ExamsFollow up Exams

Patients are seen on a monthly basis.Patients are seen on a monthly basis. Histories are repeated and symptom resolution isHistories are repeated and symptom resolution is

quantified and explainedquantified and explained New possible supplement protocols are identifiedNew possible supplement protocols are identified

and then selected thru muscle testing.and then selected thru muscle testing. Lifestyle changes continue to be evaluated,Lifestyle changes continue to be evaluated,

emphasized and encouraged.emphasized and encouraged. A chiropractic adjustment is performedA chiropractic adjustment is performed A new regimen is given and the patient isA new regimen is given and the patient is

scheduled again for the next month.scheduled again for the next month.


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Treatment ProgressionTreatment Progression

Monthly evaluations are performed until healthMonthly evaluations are performed until healthgoals are achievedgoals are achieved

Lab work is repeated when appropriate toLab work is repeated when appropriate todetermine objective improvementdetermine objective improvement Lifestyle changes are continually emphasizedLifestyle changes are continually emphasized

and monitoredand monitored

Once health is achieved the patient isOnce health is achieved the patient istransitioned into a maintenance program andtransitioned into a maintenance program andseen in the future on an as needed basis.seen in the future on an as needed basis.


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OutcomesOutcomes Vitality restored peace, creativity, joy Not justVitality restored peace, creativity, joy Not just

not sick.not sick. Disease manifestation is avoided or lessened inDisease manifestation is avoided or lessened in

severityseverity Symptom resolutionSymptom resolution Lab results are improvedLab results are improved Often medications can be discontinued orOften medications can be discontinued or

lowered in dosagelowered in dosage Weight loss is almost always achievedWeight loss is almost always achieved Overall physical conditioning is achievedOverall physical conditioning is achieved Pain and inflammation levels are loweredPain and inflammation levels are lowered


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Outcomes ContinuedOutcomes Continued

Mood levels are improvedMood levels are improved

Activities and hobbies are resumedActivities and hobbies are resumed

Libido is improved.Libido is improved. All in all, most people feel several decadesAll in all, most people feel several decades

younger at the end of the treatment approach.younger at the end of the treatment approach.

New healthier lifestyles are learned andNew healthier lifestyles are learned andunderstood, and habits are formed to maintainunderstood, and habits are formed to maintain

improvement long termimprovement long term


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Milton ChiropracticMilton Chiropractic

Dr. John ReesDr. John Rees113 Union Street113 Union Street

Milton, Delaware 19968Milton, Delaware 19968

302 684-1995302 684-1995302 684-1559 fax302 684-1559 fax

email:email:[email protected]@firststatehealth.com

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Functional Medicine Overview