Myth and Truth about the Thyroid and Adrenal Glands ... · Serum toxins can be quite misleading. Much more extensive panels exist but are quite expensive.) ... Motivated Molly –

Welcome!

This presentation is copyrighted by Purpose Inc. with all rights reserved, available for student reuse strictly subject to the terms outlined in the student program agreement.

Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

Online Q&A bulletin board within this course is available to you for follow-up at any time on questions specific to this course content. Make use of this tool to expand your (and others’) learning. Please understand we cannot accommodate detailed client case reviews on the Q&A boards.

Take lots of notes! The more often you see these connections, the more readily you will be able to recall them.

Plan to review this course material again, at least once more – preferably twice more. Remember: Repetition breeds Retention.

If you ever have any technical trouble with your SAFM membership or site access, please don't hesitate to contact our team at [email protected]

SAFM Semester: Anchoring Essentials2

Labwork 202

This presentation is copyrighted by Purpose Inc. with all rights reserved, available for student reuse strictly subject to the terms outlined in the SAFM student program agreement.

Today’s Agenda

A Few Quick Reminders Labwork Pearls Pulling it All Together

Vivacious Theresa Frustrated Romeo Motivated Molly More on Marsha

4

MaximizePut in what’s needed for this unique personRaw materials your body needs to function and heal Oxygen, Water, Vitamins, Minerals, Antioxidants, Protein, Healthy FatsBelief that the therapy one is choosing is effective and safe.

MinimizeTake out what’s harmful for this unique personToxins, Infections, Allergens, Stress, TraumaLimiting beliefs, fear, negative expectations

PrioritizeCreate an environment for healing for this unique personSleep, Rest, Laughter, Stress ReductionExercise, Stretching, BreathingMeaningful RelationshipsPositive visualizations and associations

And then the body will heal itself – will naturally seek wellness.

Simplifying the face of health can

be very calming and inspiring to your clients

and patients.

Of course, we are not very good at doing these three things consistently. The result? Chronic Dis-ease in the body. This is Why Your Clients Need You!

Optimal Health is Not Complicated5 Spectracell,

RBC Zinc, Fatty acids panel

Stool test(pathogens),Autoimmune antibodies,

blocked Phase 2 detox pathway

DUTCH, LDL, CRP, HbA1c, Fasting insulin

Oxygen Intake and Spiritual Mindset

Stress and Stress Management

Toxins and Detoxification Ability

Sensitivities and Allergies and Immune Health

Energy Generation and Circulation

Nourishment and Absorption Ability

Genetic Predispositions and Infections

Expectation, Association, History, Belief

All Things are Interconnected6

In this course, we step away from individual marker interpretationand expand into the richer, more complex challenge of compiling

data from multiple sources to support our patients and clients optimally.

7

Labwork Pearls

8

First Principles

A client's own self-awareness and intuition is the most important tool you have, as a team, in getting to the bottom of how to best support their wellness.

“It's not a database with a face; it's a wonderfully unique, complex, and dynamic person...somebody's Mom or Dad or Best friend”

● One-time piece of information

● Just a few puzzle pieces of the entire picture

● Each one is unique

● There are no “hard and fast” rules

9

Common Labwork Misconceptions & Myths

• As long as a lab value is within the reference range, it's “okay” and doesn't merit treatment, investigation or attention. MCV of 98 and fasting blood sugar of 98 are both BIG issues and opportunities!

• Average = Normal. The ideal place for every patient to be – all the time - is in the middle of the reference range. CRP (C-reactive protein) RR is 1.0-3.0mg/L, yet ideal is less than 1.0

• Devil in the detail. Timing and circumstances can influence greatly the interpretation and the reliability of the data measured.

• First morning vs. later afternoon cortisol or Progesterone on Day 8 vs. Day 21 of a menstrual cycle. Both examples will (and should!) differ significantly. Timing matters greatly.

• You're fine! As long as a lab value is within the reference range, the patient doesn't need to know the details.

• Encourage your clients always to ask for actual copies of their labwork data and Keep up with the Trend. Include past 2 years of data as part of your initial health history review.

• It's IN there! Using only serum measurements to assess sufficiency in vitamins and minerals.

• Cellular markers (e.g. RBC zinc) or Functional markers (e.g. OAT) for vitamins and minerals can distinguish between gut absorption vs. cellular absorption or sufficiency.

• Looking at only a single marker vs. the whole picture where symptoms seem inconsistent with initial test results. See the Forest AND the Trees.

10

Labwork Pearls

Always remember that Labwork is a frustrating, time-consuming, expensive(and potentially confusing and fearful too) step for your clients.

Run your own salivary, stool, & urine tests, so you have empathy and awareness.

The goal: uncover clues you don’t already know. Not bolster your confidence.

Your clients expect significant discoveries in exchange for their investments. WS tip: Set their expectations appropriately and in advance.

Don’t use labs you aren’t well-educated in how to interpret and in what the values mean. 6 case minimum. Would you want to be the recipient of your novice, insecure efforts?

Many labs are highly influenced by what happened that morning on the way to the lab.

When patients approach their physicians well educated on why they want specific Labwork, they are much more likely to have it done.

If a Labwork list is too long, your client’s PCP may choose to run none of it – including obvious, more conventional markers.

11

Labwork Pearls - 2

PlanSTRESS reduction!100% elimination of coffee and black tea; green tea first AM and early a'noonSleep support (primarily through sleep hygiene but also 5-HTP and taurine)Thorne Adrenal Cortex (3x/day)Gaia Energy-Vitality (first-AM, noon)Life-flow ProgestaCare (at night, days 14-28 of her cycle)100% elimination of sensitivitiesDaily kelp capsules (for iodine)

Make it easy. Have all labs drawn in a first morning, fasting state.

Your clients do not consistently interpret the instructions to be “fasting”. But I only had coffee? I skipped dinner to be sure it was long enough. Is 11am good ???

Spell out clearly in your communications something like this “You will want to be having your blood drawn as soon as possible in the morning after you awaken, where you have fasted 10-12 hours with no intake but water, on a typical day. Try to plan in advance to avoid stressful circumstances or rushing on the way to the lab, as this an significantly affect many lab markers.”

Recommend your patients stop taking all supplements a full two days before the blood draw (unless you believe there is a risk of instability as a result) except digestive support that has been in ongoing use.

Always consider the entire set of information you know. Be cautious about hyper focus on the numbers. Labs do make errors. Most markers are a single point in time. One point is not a “trend”. There are one-time flukes.

12

Labwork Pearls - 3


Always consider the timing of any Labwork (fasting?, stressed?, menstrual period?, “white coat” effects?, post-vacation abnormal circumstances?)

Generally, benign experiments are a much better use of your client’s time and money if the information you have points strongly in a specific direction (e.g. dairy elimination, HCl challenge, magnesium supplement).

There are always multiple reasons why a lab marker can be awry. Always. There is no such thing as a black-and-white lab marker.

If someone’s diet is very low in nutrients, it may be wise to focus on diet fully for awhile before testing. I.e. If it’s pretty clear they are malnourished from what they eat, you don’t need labwork to confirm the obvious.

13

A few Specific Labwork Strategies


Food sensitivity or stool test? Assess if their symptoms are persistent. Happen every day? Wake up with them?

Most minor gut issues do not require an expensive stool test. Address the basics first: poor eating hygiene, stress, lack of sleep, sluggish thyroid, poor diet, food sensitivities.

No food sensitivity test is comprehensive. Tell Your Clients This In Advance. All antibody (IgG, IgG4, IgA) tests require the food is being consumed.

Wait 6+ weeks after completion of steroid medication use before relying on any data assessing immune system reaction/strength (e.g. food sensitivity test, WBC data, Globulin, fecal sIgA).

It may take months for a gut microbial population to be restabilizedafter a course of antibiotics. Be willing to changeyour plan (and not test?) when the unexpected happens.

Always consider the entire set of information you know. Be cautious about hyper focus on the numbers. Labs do make errors. Most markers are a single point in time. One point is not a “trend”. There are one-time flukes.

14

Common Functional Medicine Labs

Annual Physical blood work (major pearls within the reference ranges!) Comprehensive stool tests (to assess microbial balance/pathogens, digestive function, and

inflammatory markers e.g. Genova’s GI Effects or Doctor’s Data for most comprehensive or GI Map for pathogenic microbe focus)

SIBO Breath test (to assess both hydrogen and methane gas over time in a multi-sample collections after ingesting a sugary beverage)

Organic Acids test (aka OAT, to assess byproducts of various biochemical processes in the urine as reflection of functional nutrient deficiencies and impaired/overloaded pathways e.g. Genova’s Organix or NutrEval or Great Plains Laboratory’s OAT)

SpectaCell Micronutrient Test (to assess which nutrients can be increased that would lead to healthier lymphocytes; essentially a combination of functional and cellular testing)

Hormone test (to assess a variety of hormone and hormone metabolite levels and balance e.g. cortisol, DHEA, estrogens, melatonin; I highly recommend dried urine testing only e.g. DUTCH unless assessing overt gland failure/disease)

Food Allergy/Sensitivity tests (to assess immune system reactions to food; NONE are fully comprehensive e.g IgG, IgE, IgA, IgG4, innate immune response. I highly recommend KBMO or Cyrexpanels.)

Heavy Metal Toxicity (to assess representative evidence of impaired detoxification and stored toxins; NONE are quantitatively accurate. I highly recommend chelated urinary challenge test e.g. DMSA, but in US at present, this requires prescription. Instead, Genova’s Urine Toxic Elements (RBC). Serum toxins can be quite misleading. Much more extensive panels exist but are quite expensive.)

Up-and-coming! 8-OHdG, Zonulin, Glyphosate, Reverse T3, Cyrex AI panel, QuikSilver Mercury Tri-T

15

Labwork 202

Putting it All Together– Vivacious Theresa

– Frustrated Romeo

– Motivated Molly

– More on Marsha

16

Vivacious Young Woman!

●Theresa, 38 y/o, 5'7”, 147 lbs, very healthy in presentation● I wrote in my notes “Wow – so vibrant!”● Great energy, Positive outlook, No noticeable ongoing stress

●Wrestling with stubborn 10-12 lbs of excess weight●Active (exercises 4-5x/week, mix of aerobic and weight-bearing exercise)●Complains of intermittent stomach ache/spasm (not acute) and believes it's

associated with specific foods; unsure which ones●Occasional indigestion/belching●Whole body warmth but cold toes and fingertips year-round●Takes B-complex, fish oil, Vitamin D, and probiotic daily●Eats low-glycemic, whole foods, Paleo-like diet●Nearly obese as a child●Childhood history of chronic ear infections●Fasting blood sugar 88; HbA1c = 5.0

What interconnectedness

do you see?

17


18


●Began taking 1-2 capsules HCl Betaine with Pepsin during protein-containing meals. Well-tolerated!

●Very rapidly, indigestion episodes went away. ●Continue daily B-complex●After 3 months retest: MCV = 90, MMA = 2.0 (RR: 0-4.7 µg/dl, blood).

●Still feel cold fingers and toes.

19

Genova IgG4 Food Sensitivity Panel (96 foods)

20


●Began taking 1-2 capsules HCl Betaine with Pepsin during protein-containing meals. Well-tolerated!

●Very rapidly, indigestion episodes went away. ●Continue daily B-complex●After 3 months, retest: MCV = 90. MMA = 2.0 (RR: 0-4.7 µg/dL).●Still feel cold fingers and toes.●Eliminated dairy foods, eggs, and almonds 100% for 4 months.●Upon reintroduction, eggs and almonds well received. Dairy foods

caused stomach pain/cramp, so continued elimination. ●4 lb. rapid weight loss sustained. ●Still feel cold fingers and toes.●Began eating 4-5 brazil nuts daily (for selenium)●After 3 months, retest Free T3 = 2.62 (still suppressed!)●What’s Next???

21

More Food Testing....

and an Adrenal Connection?

22


Use Beginner's Mind – every time. Every body is unique. Everything is interconnected!

●Continuing Dairy foods elimination.●Also eliminating all Severe and Moderate ALCAT foods for 3 mos.●12lbs more lost with no other change in diet.●All remaining GI distress disappeared. ●Continuing to eat Gluten-free long-term.●Cold fingers and toes greatly improved. ●After 6 months retest: Free T3 = 2.95●Planning to retest MCV and MMA in future to see if food sensitivities

were also causing malabsorption of Vitamin B12.

23

Urinary Organic Acids

●Functional markers of metabolic effects of a situation in the body●Many measurable including markers of nutrient deficiency, toxic exposure,

neurotransmitter activity, intestinal microbial activity.●MMA and FIGlu are functional markers of B vitamins. Excellent to check

when impaired methylation is suspected. Organic acids are typically expelled in urine (best measure); excessive amounts will also spill over into blood.

●Methylmalonic Acid (MMA)● Functional marker of B12 insufficiency● In the process of breaking down certain amino acids,

the body produces MMA which requires B12 to be further converted into succinic acid for inclusion in the Citric Acid Cycle for energy generation.

●Formiminoglutamic Acid (FIGlu)● Functional markers of Folate insufficiency● In the process of breaking down the amino acid histidine,

the body produces FIGlu which requires Folate to be further converted to the glutamic acid.

24

ALCAT/MRT

* http://nowleap.com/

● ALCAT - Antigen Leukocyte Cellular Antibody Test

● We have two components of our immune system: Innate and Adaptive.

● ALCAT is for food sensitivity/intolerance by the innate immune system.

● Specifically measures number and size of all white blood cells in response to a particular food. Does not require prior exposure! Sensitive to amount of food as well. Very common.

● Multi-vial blood test. Requires phlebotomist but can be done in-home with some online ordering companies.

● The next generation version of ALCAT is MRT testing (which I prefer) which has been shown to be less vulnerable to false positive results (~95% specificity). *

● Different from IgE food allergy and IgG food sensitivity reactions, a marker of an adaptive immune system reaction (which requires some exposure to “prime” the reaction)

● As with the IgG and related tests, highly disputed within the conventional medical community. Clinical study on both shows mixed results. I never recommend this type of food sensitivity testing as a first option.

● There is seldom correlation between these types of “sensitivity” reactions and true “allergies” (typically measured with IgE blood test or skin RAST test).

25

Frustrated Romeo

What interconnectedness

do you see?

●Ted, 48 y/o, 190 lbs, 5' 11”

●Corporate America middle management

●Very happy with job now but acknowledges many prior years of very high-stress roles.

●Divorced from high-stress marriage 5 yrs ago.

●Wrestles now with low energy, low motivation, low libido – all of which has been “brewing” for several years. “Wanting to take a nap is embarrassing!” Wants to date but lack of “get up and go”.

●Wants to work out more regularly (used to) but often feels not enough energy now.

●No insomnia, but doesn’t feel refreshed in the morning.

●Trying to self-medicate here and there with caffeine & refined carbohydrates but knows it's a bad idea.

●HbA1c = 5.3, healthy blood pressure

26

●Hormones, Hormones, Hormones!

●Ted opted to order his own labwork from www.MyMedLab.com to avoid having to make an appointment with his doctor – and also anticipating pushback on his requests.

●Salivary Cortisol & DHEA

●Serum Total & Free testosterone

●Today, I would recommend aDUTCH Complete.

http://www.mymedlab.com/

27

Frustrated Romeo

* No longer manufactured; Thorne’s Adrenal Cortex would be a good substitute.

●Went to his PCP (with data!) to get prescription for testosterone cream. But No Go!

●DHEA 25mg/day. Isocort* 3 tablets first-morning.

●600mg phosphatidylserine (PS) before bed (not PS “complex”)

●Coached on need to avoid refined carbohydrates to avoid converting testosterone into estrogen. Cruciferous vegetables intake to ensure healthy estrogen metabolism. (DUTCH testing would have shown if he had tendency to this.)

●Retested in 2 months & showed almost no change in testosterone. Dosage was doubled to 50mg/day. Check RBC Zinc (was clinically low); added 30mg 2x/day OptiZinc, which is zinc paired with copper. (Today, I would check fasting insulin!)

●Retested in 2 more months. Substantial improvement (below). Ted started working out again (& dating!). Stopped cortisol support after 3 mos; zinc to 1x/day.

28

Elevated Cortisol (Hyper-stimulated Stress Axis)

Depressed Cortisol (Under-stimulated Stress Axis)

HypervigilantOverly alert, doom'n'gloom preoccupation Insomnia (racing mind) Poor digestion, “irritable” gutHypertensionRacing heartDepressed immune system (may get sick easily) Anxiety (often along with Depression) “Wired and Tired”Here you will find many patients with T2

Diabetes, Metabolic Syndrome Consider: Sympathetic Dominance Perhaps higher sodium/chloride, lower

potassium

Exhaustion, perhaps debilitating fatigue (not recoverable with short-term increase in sleep)

Lethargy, MalaiseWeakness, myalgia, painDepressionHypotension, dizziness upon standingHypoglycemia Low pulse rate Low motivationHere you will find many patients with

allergy/asthma, autoimmune disorders, pain syndromes (CFS, Fibro), postpartum depression

Consider: Parasympathetic Dominance Perhaps higher potassium, low sodium.

Typical Symptoms of Extremes

Unabated Stress*

Fatigue, Mood swings, Poor sleep, Hypothyroid function

* Likely via reduced CRH receptor sensitivity. https://www.ncbi.nlm.nih.gov/pubmed/19269917 , https://www.ncbi.nlm.nih.gov/pubmed/12377295

* As purposeful, regulatory, self-preserving action IN THE BRAIN, not intrinsic adrenal dysfunction!

https://www.ncbi.nlm.nih.gov/pubmed/19269917

https://www.ncbi.nlm.nih.gov/pubmed/12377295

29

The body has a coordinated stress response! Ongoing stress often suppresses DHEA synthesis and increases SHBG.

Other sex hormone production can fall off as well (e.g. progesterone). The body is prioritizing survival over thriving (and libido/fertility).

Can be a major cause of low libido and weight gain especially in middle-aged men and women.

30

Motivated Molly

● Molly, 70 y/o female, 5'5”, 152 lbs● Diagnosed just over a year before with Graves' Disease,

the auto-immune form of hyperthyroidism. TSH = 0.08 (RR 0.3 – 5MIU/L). Free T4 = 1.9 (RR 0.8-1.7ng/dL).

● Treated one year with methimazole which blocks thyroid peroxidase (TPO), inhibiting thyroid hormone formation.

● Medication makes a person hypothyroid (by design). Stopped for her when TSH = 4.5, Free T4 = 0.9, Total T3 = 92 (TRR 80-200ng/dL).

● Motivated client! Sought help from me on why she experienced autoimmune illness and what she needed to do to address root cause and avoid another AI issue.

● She brought me her “typical” labs from prior 5 years.

31

Motivated Molly What possible interconnectedness

do you see? What testing would you

now recommend?● MCV = 91 fl consistently

● WBC = typically 4.8

● Family history of cardiovascular disease

● Historically low Vitamin D (less than 30 ng/mL)

● Two years prior, serum calcium plummeted to 8.0 (RR 8.4 – 10.3 mg/dL). Other years high-normal.

● Three years prior, neutrophils highly elevated 89% (TRR 50-70). Had tooth infection (abscess, eventually extracted), treated with long course antibiotics.

● Four years prior, experienced mildly elevated liver enzymes in two lab sets. ALT 49-57 (RR 5-40 IU/L) . Other years mid-normal.

● Chronically constipated past several years. Intermittent stomach pain. Chronic knee pain (arthritis). Occasional “weird rash”. Borderline hypertension (unwilling to take medication).

32

AutoImmune Dis-Ease

● 100+ different types

● Immune system targeting internal tissue

● Typically a “three-legged stool” of drivers: genetic component, intestinal permeability, an environmental trigger

● Activated by long-time immune system activation,typically in response to internal threat(s). Typically multiple factors:● Gluten and Intestinal permeability● Environmental allergy/threat (e.g. living in house with mold)● Food sensitivities/allergies (often to a food one loves and eats daily)● Gastrointestinal dysbiosis (yeast, bacteria, parasite, or mixture) or other chronic infection● Nutrient deficiency (especially Vitamin D, zinc)● Overt toxicity or chronic, slow storage of toxins (e.g. mercury)● Ongoing stress

● Every major, conventional treatment for autoimmune disease is suppressing the entire immune system (perhaps making true root causes worse!).

● Typical functional labwork for chronic autoimmune activation: comprehensive stool test, food sensitivity panel, organic acids test, and perhaps cortisol/thyroid testing.

33

Prior version of Genova's “GI Effects” Stool Profile

● Gluten-free, Dairy-free

● GastroMend

● ParaSmart (x2)

● GI Encap

● Therbiotic Complete

34

35

Genova's IgG Food Sensitivity Panel (with optional

Celiac/Gluten Sensitivity panel)

36

RBC Mineraland Toxic Elements

(part of Genova NutrEval or ION panels or separate

“Elemental Analysis, Packed Erythrocytes” )

Organic Acid Vitamin Markers(part of Genova NutrEval or ION or Organix

or Great Plains Lab Organic Acids)

What else do you want to know?

● Homocysteine: 15.7 (TRR 4-10 umol/L)● Glutathione: 730

( want bare minimum >700 umol/L )● C reactive protein: 3.6 (TRR 1-3 mg/L)

37

Liver detoxification pathways and supportive nutrients

Urine, Feces, Sweat,

Exhalation

Folate

38

The Mighty Methylation Cycle

●Methylation protects DNA.

●Methylation conjugates toxins (e.g. environmental estrogens, arsenic).

●Methylation reduces homocysteine (cardiovascular disease risk factor).

●Methylation makes glutathione (combats oxidative stress *and* supports detoxification)

●Methylation SNP can be measured in blood “MTHFR”

39

Now Majorly! Motivated Molly

● Very targeted supplements e.g. high-dose B-complex with emphasis on folate and P5p for B6, Vitamin D, and a Zinc/Copper combination.

● Used short-term HCl with Betaine support (1-2 caps) to ensure good absorption.

● Addressed gut healing (H Pylori first, then parasite, then yeast followed by intestinal lining repair, short-term use of digestive enzymes)

● 100% elimination of Severe and Moderate IgG foods● Two months of concentrated detoxification for heavy metals

(e.g. EcoNugenics PectaClear, Metagenics Advaclear and Ultra Clear Renew)

● Six months check: Homocysteine = 11. CRP 1.6.

● Blood pressure low-normal. Sleeping “like an infant”.

● She feels “the best I ever remember feeling –even when I was 25!”

● Thyroid function is mid-normal with low-normal TSH and no signs of return to auto-immune activation.

40

More on Marsha

What interconnectedness do you see?

What additional testing would you suggest?

● 53 y/o female

● Obese, hypertension, 5’6”, 280 lbs

● Complains of mood swings (incl. periods of rage), exhaustion, some swelling and numbness in legs, “I just don't feel right.”

● Doc says only real concern is CRP which is “just due to extra weight”.

● On three hypertension medications

41

More on Marsha

● Vitamin D 50, Vitamin A High/Normal, RBC Zinc High/Normal.

● First, I ran an IgG food sensitivity panel which showed only a few mild sensitivities AND one severe sensitivity: baker's yeast.

● Three months of combined Nystatin (Rx), antifungal herbals, probiotics, and *attempted* combination anti-yeast/yeast-free diet did not change her yeast levels or symptoms. However, six weeks of Diflucan Rx did (retest confirmed no yeast present). Followed by 3 mos of herbal antifungals, probiotics. Also Gluten-Free.

● After first three weeks on Diflucan, Marsha found it much easier to adopt low glycemic diet. Six months later, Marsha has lost ~37 lbs and her blood pressure has normalized. Marsha's mood issues stabilized (rage gone!).

42

Helping the Whole Person

The patient is one, whole, single, unique person!

Not a list of separate, unconnected symptoms or diagnoses.

Have Beginner's Mind

Everything is interconnected. Everything.

Acute care may be critical, but ultimately, the root cause needs to be addressed to bring long-term healing. The difference you can make is major – and potentially life-saving!

43

This is the Deep End of the Pool!

Entire books have been written about functional interpretation of annual physical blood work alone.

Be patient with the learning process. It will take you years to master even the basics.

Run functional panels on yourself that you want to understand.

Work with the markers you well understand and leave the rest for now.

Primary Care providers are responsible for monitoring Labwork for overt disease and treatment of clinically high/low levels.

No matter how much you think you know, Keep Beginners’ Mind. This is actually harder to do the more you learn. The ego gets in the way.

ANY help you provide with improving suboptimal markers is beneficial to the patient. You do not have to be 100.0% comprehensive. Always trying to do so is a major reason for functional medicine practitioner burnout. And after all, you can’t help anyone if you burn-out and give up.

* I highly recommend you acquire this book if you are going to work regularly with Labwork in your practice. On Amazon.

Tracy’s health counseling certification is from Columbia University for the Institute of Integrative Nutrition in New York.

She has completed ongoing training and is working on a certification in understanding the root causes of chronic illness with the Institute of Functional Medicine and on an additional Masters degree in Human Nutrition at Bridgeport University.

She holds a Masters degree in Engineering from MIT and a Masters degree in Management from The Sloan School at MIT.

Online Q&A bulletin board within this course is available to you for follow-up at any time on questions specific to this course content. Make use of this tool to expand your (and others’) learning. Please understand we cannot accommodate detailed client case reviews on the Q&A boards.

Take lots of notes! The more often you see these connections, the more readily you will be able to recall them.

Plan to review this course material again, at least once more – preferably twice more. Remember: Repetition breeds Retention.

If you ever have any technical trouble with your SAFM membership or site access, please don't hesitate to contact our team at [email protected]

SAFM Semester: Anchoring Essentials44

This presentation is copyrighted by Purpose Inc. with all rights reserved, available for student reuse strictly subject to the terms outlined in the student program agreement.

Thank You for Joining Us!

Labwork 202

Documents

Myth and Truth about the Thyroid and Adrenal Glands ... · Serum toxins can be quite misleading. Much more extensive panels exist but are quite expensive.) ... Motivated Molly –