After all, November is Diabetes Awareness Month. But what do we mean when we say it's "disease x awareness month"? Surely we're all aware of diabetes. Hopefully we're all aware of how big of a problem diabetes is. So why do we dedicate one month a year to becoming aware of a disease we are already aware of? I think "disease x awareness month" is just a better sounding way of saying "we want an excuse to be in your face for a month and raise a lot of money". And don't get me wrong, raising money to fund research for these diseases is a good thing. But if we stop to think about it, these months aren't really for awareness at all.

I'll let the Diabetes Association have their "Diabetes Fundraising Month"- but I'm going to use the month of November to really bring awareness to Diabetes.

1. There are several types of Diabetes, all of which have their own distinct pathology, symptoms and diagnostic criteria.

• Type 1 (Juvenile) Diabetes is typically diagnosed early in life and is due to an autoimmune reaction and destruction of the cells in the pancreas that make insulin. After enough of the pancreas is destroyed, these folks need to be on insulin replacement for the rest of their lives.

        Symptoms of Type 1 Diabetes usually include excessive thirst, excessive urination and
        weight loss.

• Type 1.5 Diabetes is also called Latent Autoimmune Diabetes in Adults, or LADA. LADA is a relatively new addition to the diabetes family and many doctors and medical professionals are still unaware of it. These folks are typically misdiagnosed as a Type 2 diabetic because they are almost always caught after the age of 30, however they are skinny or normal weight. It has been estimated that anywhere from 5-20% of Type 2 Diabetics in western countries are actually misdiagnosed LADA patients. This misdiagnosis is huge- since their disease is much more similar to Type 1 it should be managed as an autoimmune patient to prevent further autoimmune destruction of other tissues.

        Characteristics that set Type 1.5 apart is that they tend to be diagnosed between the
        ages of 30 and 50, have a history of autoimmune disease, are skinny or normal weight,
        and have very high fasting blood glucose at the time of diagnosis (upwards of
        400-1000!) and progress rapidly to insulin dependance. People are shocked when these
        people say they have diabetes and they are told "but you look so healthy/skinny/fine!"

• Type 2 Diabetes is the most common form of Diabetes. Type 2 Diabetes is due to insulin resistance, a state in which the cells of the body become less and less responsive to insulin which leads to high blood sugar and high insulin levels. This can largely be managed or reversed with appropriate sugar and carbohydrate restriction and exercise.

        Type 2 Diabetes symptoms (and symptoms of insulin resistance and pre diabetes) include
        sugar and carbohydrate cravings, lack of energy "crashing" after meals, difficulty losing
        weight, and brain fog.

• Type 3 Diabetes is what researchers are now calling Alzheimer's Disease. Prolonged high amounts of blood sugar (glucose) and insulin are a potent cause for inflammation in the brain. Numerous studies have shown that your risk of getting AD increases dramatically if you have diabetes, and even more so if you need insulin. What's even more frightening is that elevations in fasting glucose above 100- well below the threshold of diabetes- have also been shown to increase your risk of AD.

• Diabetes Insipidus, while it shares the name diabetes, is a completely different disease than the rest of those listed here. Diabetes Insipidus is a relatively rare disease that effects the body's ability to retain fluids.

        Similar to Type 1 Diabetes, the symptoms of this disease are usually excessive thirst and
        excessive urination.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Insomnia and other sleep problems is an ever-growing problem in the United States. Forty eight percent of adults report at least occasional insomnia, while twenty two percent of adults report insomnia almost every night [ref].

Sleeping problems come in a variety of flavors including:

• Trouble falling asleep
• Waking up in the middle of the night
• Trouble waking up in the morning
• Not feeling well rested in the morning/ poor sleep quality

Sleep-wake patterns are controlled by the pineal gland in the brain stem, but it is important to recognize that other parts of the brain fire into that pathway and stimulate it. Therefore, Functional neurology and brain exercises can be helpful when combating sleep problems. From a functional medicine perspective, many things can be done nutritionally to support overall brain and bodily health, which will help those pathways run at their very best.

1. Basic blood work can go a long way in assessing overall body and brain health. With a basic panel, I can assess liver, blood sugar, kidney, electrolytes, red blood cells (anemia), white blood cells, and some vitamin and mineral statuses. All of these, particularly anemia and blood sugar problems, often go undiagnosed (or improperly diagnosed) and have a tremendous impact on brain health.

2. Sometimes I run salivary hormone panels to assess the patient's cortisol rhythm and look for things like adrenal fatigue. Oftentimes, such problems respond remarkably well to diet, supplements and lifestyle changes.

3. Stress is a major contributing factor in many cases of insomnia. Yoga, meditation, and relaxations techniques can go a long way in helping relieve stress.

4. Occasionally, I feel the need to treat the symptom of sleep problems with melatonin. No, melatonin isn't going to do anything to get to the root cause of the problem, but some times it is worth while to just get someone to sleep! Just as we need proper nutrition and health to sleep well, we need to sleep to heal our bodies and recover. While we work on the underlying problems sleep can help people recover and heal faster.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

Yours in health,

Poop isn't something that most of us feel comfortable discussing, and we tend to not know much about each others bowl habits. However, digestive problems are much more common than we let each other realize. When we have a headache or the flu we might tell a coworker, boy/girlfriend or a friend, but when we have diarrhea or constipation most of us keep that information to ourselves. At most we might see a TV commercial for some snazzy, new probiotic-enriched yogurt where Jamie Lee Curtis leads us to believe that some level of digestive discomfort is normal. But it's not normal. There is no such thing as a "normal" amount of constipation, diarrhea, blood in the stools, stomach discomfort, bloating, indigestion, or pain.

I think that many of us go through life trying not to think about poop. We're blissfully unaware of how important poop is in our lives, as well as what affect various parts of our lives have on our bowl habits. Before my schooling I remember being vaguely aware of the fact that poop was just the aftermath of whatever I had previously eaten, but I never really stopped to comprehend what that meant. In the same way that most of us process other vague health-related statements ("you should eat a healthy, balanced diet", "exercise is important"), I brushed off the thought that my food eventually turned into poop. It's like garbage. Why would we care about garbage? Because poop is more than just garbage, and it can tell us a lot about how our body is functioning. For that matter, the process by which your body makes poop is tremendously complex and a lot of things can interfere and cause gastric distress.

This is a brief breakdown of how I get to the root cause of what's causing digestive distress.

1. Basic blood work can help me glean a lot of information and assess many systems of the body at once. Thyroid hormone problems, anemia, detoxification (liver) problems, diabetes and blood sugar problems, infection, magnesium and vitamin D are just a few of the things I screen for in most patients- all of which can cause gastric distress. For about $140 for this type of panel, this is an incredibly effective way to start my investigation.

2. Food sensitivity testing my be run, depending on the patient's history. I find that gluten, dairy (casein), soy, corn and eggs are very common culprits that cause gastrointestinal and systemic (whole-body) distress. I generally run panels through Cyrex Labs, although I do have the ability to run other labs if the need arises. Even if you've been "tested for gluten" before, the testing was most likely sub-par and will need to be re-run. Most "gluten" panels only assess for full-blown Celiac disease and miss the vast majority of people who are sensitive to gluten. Leaky gut syndrome is something that often goes hand-in-hand with food sensitivities and should be ruled out and treated, too.

3. Stool testing (yes, you have to poop in a cup) may be necessary in cases in which I suspect a potential infection. These come in three basic varieties: bacterial, yeast, and parasitic. In my experience, chronic bacterial and yeast infections are fairly responsive to herbal treatments, however some parasitic infections may be more stubborn and require prescription medications. Either way, the first step in treatment is proper diagnosis. Stool testing also allows us to see how much good bacteria (probiotics) and enzymes you have in your system, and may guide us in finding the right supplement.

4. Antibodies causing an autoimmune reaction are often the culprit behind chronic gastrointestinal problems. Diseases that have a known autoimmune component include Celiac Disease, Crohn's Disease, Ulcerative Colitis, and Pernicious Anemia. In the event that an autoimmune disease is diagnosed, I would work-up and treat accordingly.

5. Other hormones such as estrogen and progesterone can play a role in gastrointestinal distress. In some cases salivary (spit) hormone testing needs be conducted in order to further assess those pathways. Often times, male and female hormone problems are very responsive to diet and lifestyle changes.

6. Stress can have a profound impact on our digestive systems. I personally became aware of this in graduate school when my crazy roommate stopped talking to me for a month. Not only was I subjected to her freezing cold shoulder, but the stomping around the apartment and slamming doors and cupboards made me a nervous wreck. During that month I noticed a dramatic increase in bloating, food sensitivities, and gastric distress which resolved after my other roommate and I moved and got away from our stressor. In cases like this, it's obviously best to get away from the cause of the stress. However, if escape isn't an option things like meditation and yoga can help.

As you can tell, there is a lot of things that can contribute to digestive problems- and none of them involve a Pepto bismol deficiency! The gut is an incredibly complex beast, and it is best to get a proper work-up and exam by a functional medicine doctor. There is no such thing as a "normal" amount of constipation, diarrhea, blood in the stools, stomach discomfort, bloating, indigestion, or pain.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

"Preventive medicine" almost sounds like an oxymoron if you think about it. If disease is successfully prevented you shouldn't need medicine. Nonetheless, the term "preventive medicine" persists in the conventional medical world, despite the distinct lack of preventative efforts in most conventional medical offices. But what exactly do they mean when they talk about "preventive medicine", anyway?

Let's start with some basic definitions:
Prevention. noun: 1. The action of stopping something from happening or arising
Medicine. noun: 1. The science or practice of the diagnosis, treatment, and prevention of disease (in technical use often taken to exclude surgery). 2. A compound or preparation used for the treatment or prevention of disease, esp. a drug or drugs taken by mouth.

Preventive Medicine- Four levels
Primary Prevention- Measures taken to prevent disease
Secondary Prevention- Measures taken to diagnose and treat disease in it's early stages before it causes significant morbidity
Tertiary Prevention- Methods to reduce negative impact of existent disease by restoring function and reducing disease-related complications.
Quaternary Prevention- Methods to mitigate or avoid results of unnecessary or excessive interventions in the health system

The disconnect here is because there are four distinct definitions of preventive medicine, but in most medical offices only three of them consume 99.9% of your time with the doctor. What most doctors call "preventive medicine" is actually what I would consider early detection; mammograms, colonoscopies, dental x-rays, cervical cancer screenings. Even prescribing statin drugs for high cholesterol is considered "preventive medicine"! I don't know about you, but I think the fact that someone has high cholesterol in the first place means that something wasn't prevented.

This is what prevention really is:
1. Eating right. Seriously. By "eating right" I don't mean getting diet soda or whole wheat pasta. I mean eating tons of vegetables. Veggies, good quality meats, fruit, healthy fats, nuts and seeds, and maybe some grains and legumes if you can tolerate them. Paleo is a great place to start.
2. Exercising. The key is to find something you genuinely love to do- that's the only way you'll stick with it. For me, it's rowing, running with my dogs, yoga, hiking, and TRX exercises with friends. Gyms just don't do it for me! I find them boring and usually icky.
3. Getting enough sleep. This is hugely, crazy important for far too many reasons to write about here.
4. Getting a few minutes of sunshine every day... if you're in a climate where that is possible, that is!
5. Taking time to relax. This is so, so important in today's hectic world.
6. Loving yourself, being grateful, and reflecting on all the good things in your life.
7. Getting adjusted. Regular chiropractic adjustments go a long way to keep your body in tip-top shape.
8. Addressing symptoms when they start and not waiting for full-blown disease. The caveat here is that you'll need to find a doctor who will acknowledge that your symptoms are a problem in the absence of full-blown disease and help you understand and correct them. This is harder than it sounds- in my experience most doctors will brush off symptoms until they are so blatant that a diagnosis can be made and a medication can be dispensed. Functional medicine doctors such as myself are generally more able to help in such situations.

Chose to prevent disease every day,

Diabetes Mellitus is a group of conditions that affects about 26 million Americans- just over 8% of the population. Most of those cases (90% or so) are Type 2 Diabetes (T2DM), a condition in which the cells of the body become less responsive or unresponsive to the affects of the hormone insulin. This is preceded by a process called insulin resistance (IR). Once the IR is progressed enough that the body can no longer keep fasting blood glucose (sugar) below 126 the diagnosis of T2DM is made, but make no mistake- the two are really one in the same. As the body's cells become more and more resistant to insulin two things happen. First, the pancreas needs to produce more and more insulin to have any affect. Secondly, if the cells are not able to respond to insulin and take glucose in from the bloodstream, glucose levels will rise.

Insulin has numerous roles in the human body, but some of the most notable occur in the fat cell (adipocyte). Insulin brings sugar (glucose) and triglycerides into the cell and stimulates the cell to store fat. Insulin also turns off the enzymatic pathway needed to get fat out of the fat cell. Since insulin is only really released upon ingestion of sugar and carbohydrates* this means that high-sugar, high-carbohydrate diets such as the Standard American Diet (SAD) are really high-insulin, weight-gain diets. This has had obvious and devastating consequences on our health and waistlines.
*(a very minor rise is seen with ingestion of protein)

The good news is that there is a lot that can be done to make the body more responsive to insulin.

1. Exercise, exercise, exercise! This is a real no-brainer, but exercise really is one of the absolute best ways to make your insulin receptors more sensitive to insulin (among many other amazing things it does for the body). Additionally, exercise counteracts the actions of insulin on the fat cell. Epinephrine, one of the hormones produced during strenuous exercise, stimulates the hormone (HSL) that releases fat from the fat cell.

2. Stop secreting so much insulin by drastically reducing sugar and carbohydrates in the diet. Atkins wasn't a quack- he knew his physiology. Low carb diets work magnificently for a multitude of different conditions because of one hormone: Insulin. Stop bombarding your cells with high amounts of glucose and insulin and not only will the insulin receptors become more sensitive and work better (reversing that nasty IR wind-up), but you'll likely be able to lose weight, too.

The diet I generally recommend people to start with is a low-carb, NO-sugar Paleo diet. Paleo accomplishes both of these points anyway, but for those who wish to manage or reverse their diabetes I recommend that they stay away from all deserts (even healthy paleo deserts) and make sure they don't go too wild with fruit and starchy root vegetables. Once you learn to manage your blood sugar and accomplish your weight loss goals, you may wish to play around with your carbohydrate tolerance, but this should come later. If you would like to read about people who have overcome numerous diseases using the Paleo diet, check out the Paleo Miracle Book.

3. Some supplements may help make your insulin receptors more sensitive, which can be helpful in the beginning stages of change. It is important to note that the main mechanism of action of Metformin (the most prescribed diabetes drug) is NOT the reversal of Insulin Resistance. Metformin works mostly by decreasing glucose synthesis in the liver. No drug can fully undo the damage done by lifestyle and dietary choices.


In my office I generally start patients off by doing a thorough history and exam and ordering blood work. At minimum I usually run blood work that includes things like glucose, HbA1C, lipids and cholesterol, CBC, electrolytes, liver markers, and Vitamin D. In diabetic patients I may run other tests that are more specific to their needs such as fasting insulin and GAD Antibodies. If you know anybody who was diagnosed with T2DM but is skinny or normal weight, PLEASE have them read this article about type 1.5 diabetes.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

*The paleo diet "works" really well by itself about 80% of the time. I don't care what your goals are- to loose weight, have better cognition, reverse or manage diabetes, heart disease, blood pressure, or an autoimmune disease. Paleo can and does help people achieve those goals all the time. But what is paleo, and why is it so effective? Is it just the next big fad diet?

"Paleo", or the paleolithic diet, is a diet that has gained tremendous attention in the last 5-10 years. The basic premise of paleo is that we should be eating like our ancestors did 10,000+ years ago because we simply haven't evolved quickly enough to be able to digest and cope with today's food. Evolution is a slow process, and the food which we eat has changed significantly faster than we could have ever hoped to have changed. The paleo diet consists of meat, vegetables, fruits, nuts, seeds, and fats and oils and excludes all grains and legumes. This stands in stark contrast to the USDA food pyramid that says that whole grains should be the foundation of a healthy diet. So why does a diet that is so radically different than the USDA's recommendations so effective?

1. Insulin is the hormone that is single-handedly bringing America and our healthcare system to it's knees. This hormone is secreted by the pancreas upon the consumption of carbohydrates and sugar, and functions to get sugar (glucose) out of your blood and into your cells. If the cells of the body are exposed to high levels of insulin (from a high sugar and carb diet), they will eventually stop listening to the signals- in the medical world this is called insulin resistance. This obviously has huge implications in type 2 diabetes, but what about other diseases?

Alzheimer's disease is now being called "type 3 diabetes". Cancer cells have been shown time and time again to need sugar to survive, and can be preferentially starved using a ketogenic diet. High cholesterol is the result of high sugar in the blood stream- NOT a high cholesterol diet. Importantly, Insulin stimulates the storage of fat in the adipocytes (fat cells) and stops the cells from using their current fat stores. This is why Atkins worked so well- decreasing insulin allows the body to use the fat it already has and stops it from storing more fat! Atkins wasn't a quack- he knew his basic physiology. Think of Paleo as Atkins version 2.0- same basic principals as far as hormones are concerned, but a much, much healthier diet that is maintainable in the long-run.

2. Food sensitivities are a much, much bigger issue than most people realize and have a huge impact on one's overall health. The most common food sensitivities that I see clinically are to gluten, soy, corn, dairy* and eggs**, followed by a number of different grains. Paleo eliminates three or four of the worst food allergens (dairy is considered part of the "primal" diet), which has a tremendous impact on many people's health. Even people who say that they were unresponsive to a gluten-free diet often feel drastically different on a paleo diet. This is most likely because they had other food sensitivities in addition to gluten, or that the broad inflammatory effects of the foods played some role in their health.

3. Processed food is bad for you and nobody should be eating it. We all know that is true, but most of us still don't take heed to this advice. It's nearly impossible to eat a paleo diet and eat anything processed. Perhaps paleo owes a large part of it's fame to the fact that it's a great way to get people to stop eating junk.

Paleo works pretty stinkin' well, but occasionally people need a little something more. Anemia, thyroid problems, hormone imbalances, intestinal dysbiosis, neurological imbalance, lack of anti-oxidants, and toxicity are all possible things that may require a little more TLC from a trained professional. This is where I come in as a doctor- my background in functional medicine makes me well suited to help with many of these problems, or if nothing else, get you to someone who can help. Sometimes all you need is a proper diagnosis and individualized plan or a little nudge in the right direction to set you up for stupendous success!

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Ah, the perfect diet. The holy grail of the nutrition world. Ask any health-nut at the local Whole Foods and they'll be quick to tell you which diet is the best diet. Ask any 10 health-nuts and I'd be willing to guess that you'll get no less than three completely different answers. But how can that be? Which diet should you choose?

There are diets that are purely intended for weight loss and are meant to end (calorie restriction, Jenny, medifast), and those that are usually intended as more of a lifestyle change (Paleo, vegan, vegetarian). I find that people who embark on the later tend to get really into it. We've all met the vegans who look at you like you're killing a kitten when you eat your burger, or perhaps the weird paleo people who eat nothing but bacon. But how can such vastly different diets all claim to be the best and the healthiest? Mustn't somebody be wrong here?

The long and short of it is: yes and no. There is no best diet for everyone and there never will be. Even thousands of years ago in the Paleolithic era our ancestors were eating incredibly different diets than that of their cousins on other continents. I find that the diets that claim to be the best (Paleo, vegetarian, vegan) tend to get a little carried away at times, to the point that they all get a little too dogmatic for my liking. I don't see the point in telling yourself you absolutely must follow a diet because of external forces. Sure, that book resonated with you and you found a bunch of great blogs on the topic, but is that what this journey is all about? No. Follow a diet that makes you feel good and does right by your body. Now, I'm not telling you to go buy Ho-Ho's because they make you feel good. The point is that we should be picking how we eat according to 1. Basic common sense about nutrition and 2. How our bodies feel when we eat things, and lastly 3. Everything else.

It's not rocket science to know that broccoli is healthier than cereal. Basic common sense about nutrition can go a long way if you choose to make healthier choices. If you want a quick, enjoyable read that will teach you what I consider common sense about food I recommend Food Rules by Michael Pollan.

Some people just don't feel good when they eat meat. I would argue that those people should not eat meat or limit meat intake. As much as the Paleo community wouldn't appreciate that stance, that's really what it comes down to. Granted, I have seen people say that they went vegetarian because they get indigestion from eating meat- and it turns out they don't make enough stomach acid to digest meat, which is actually quite easy to treat. But say you look at it from a "less real" angle. If you don't like the thought of eating an animal, if eating a piece of chicken conjures up images of factory farms and slaughtering of innocent birds, don't you think that will affect how your body responds to that food? The brain and emotions have a profound impact on the body in ways that we are only just starting to understand. Yes, not eating animals for the sake of not killing animals seems like a kind of wuss reason to not eat meat, but I would argue that it has just as much to do with the body as the brain. Don't want to eat meat? Don't eat meat, then.

The Paleo diet eliminates grains and legumes. Grains are a beast we will get more into in another post, but here's the thing about it. First of all, a lot of people have food sensitivities to grains- especially wheat. The other important thing about grains is that they generally contain a lot of starch/carbohydrates. And while Paleo is not the same as Atkins, both diets work marvelously for weight loss for the same reason: Insulin. Without sugar and starch you don't make as much insulin. Without insulin you simply do not store fat in the fat cells (and you start using the existing fat). If you stop storing fat and start using it you lose weight. Paleo works wonderfully for weight loss purposes, but again, it's not the end all be all. I encourage a plant-based Paleo approach as a framework for most people to start with, but I'm not so extreme that I'm not willing to alter the plan now and then. If you don't have a sensitivity to a non-gluten grain (like quinoa) and feel good when you eat it, I'm personally not opposed to incorporating it into your diet in moderation. The important thing is that you feel comfortable, happy and healthy eating.

I think in both of these cases there might be some middle ground that most people would be happy in. Most people don't just eat too much meat, but they eat cheap meat that was raised in a factory farm and loaded to the eyeballs with drugs and hormones. I think that most people would do well if they cut their meat intake by 1/3 and paid three times as much for good quality meat. This is one aspect of Paleo that I really like, although sometimes the paleo crowd gets a little too meat-happy for my liking. It is true that dietary fat and cholesterol are not the dietary evils we once thought them to be, but I do believe there is such a thing as too much meat. Animal protein is still pretty inflammatory, so if you choose to eat meat you have to balance it out with a hearty serving of veggies and fruit. Similarly, a lot of vegetarians are really grain-etarians (I was for many years) and would be better off replacing the majority of their grain dishes with vegetables.

Believe it or not, this was just the tip of the iceberg, but you get the point. Choose a diet that makes you feel good and keeps you healthy, and if you ever want to get screened for food sensitivities I'm right here in Tempe ready to help you.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

Oh, thyroid. Why do you plague us so?

Have you ever noticed that levothyroxine always seems to make it onto the top-ten most prescribed medications list? Of course, that's only one of the many thyroid hormone drugs on the market, but the popularity of thyroid hormones does demonstrate that hypothyroidism is a common problem in the US.

Here are a few things to know about our friend the thyroid gland and hypothyroidism, as well as how I work with it:

1. A bunch of different things can cause you to feel, and functionally be, hypothyroid. This may or may not be reflected in your TSH- the one and only lab test 99% of doctors look at when assessing the thyroid.

As is always the case in my practice, my first job as your doctor is to find out why you are hypothyroid. Autoimmunity, inflammation, birth control pills, and certain medications can all cause one to become hypothyroid. Once we know the cause we can (hopefully) try to identify what we can work with naturally, and refer to an MD or DO should the need arise for drugs

2. Autoimmune disease (Hashimoto's) is the number 1 cause of hypothyroidism in the USA and accounts for about 90% of hypothyroid cases. Furthermore, it has been estimated that about 8% of the US population has antibodies to their thyroid. This is tremendously important, as it should (but often does not) change the way these patients are treated and monitored. The vast majority of doctors (endocrinologists alike) simply replace the thyroid hormone that is lost without doing anything to treat the underlying issue: the immune system. For further reading on my approach to managing autoimmune conditions see my previous blog post here.

3. Many people who are getting their thyroid treated still have thyroid symptoms. This is most likely due to what I mentioned above- most of these people are autoimmune patients and their immune system has gone untreated for years. Examples of hypothyroid symptoms that hang around are constipation, skin problems, thinning hair, cold hands and feet, and fatigue and depression. To learn more about this topic, check out this book on amazon by Datis Kharrazian.

4. Iodine is almost never the problem in the United States. This is important, because almost all "holistic" and alternative medicine practitioners just give a ton of Iodine to their thyroid patients. This might be a good bet if we lived in rural Africa, but here in the United States with our love-affair with iodized salt it's virtually a non-issue in regards to the thyroid. For that matter, many autoimmune thyroid patients do worse when they are given Iodine.

5. TSH is not enough to fully assess thyroid function. Ideally, a full thyroid panel should include at least TSH, TPO antibodies, Thyroglobulin antibodies, T3 uptake, Free T3, Reverse T3, and Total T4.

6. Thyroid hormone is critical to the health and metabolism of every single cell in your body. Everything from your brain and your gut, to your skin and your immune system need proper amounts of thyroid hormones to function. If you suspect that you or someone you love is hypothyroid please get the above blood work done and interpreted by a functional medicine doctor ASAP.

7. Not everybody who works with the thyroid is trained equally. Commonly general practitioners and endocrinologists manage your thyroid hormone levels by monitoring TSH. Chiropractors, nutritionists, naturopaths, and other alternative medicine practitioners often load thyroid patients up with Iodine. Neither of these scenarios serve thyroid patients well. Functional medicine doctors are usually a good bet, but ideally you want to find somebody who has received training from Datis Kharrazian. I have had the privilege of taking all of Dr. Kharrazian's courses, including his thyroid course several times.

8. You may need thyroid hormones for the rest of your life. As a chiropractor, it is not uncommon for patients to come to me and ask if I can help them get off their medications. Don't get me wrong, I'm all in favor of living a lifestyle that does not necessitate that you rely on medications, but this is one area where even I have to say that you might just need that pill for the rest of your life. It really depends on two things: 1. What is causing you to be hypothyroid and 2. How long has it been going on.

If you're one of the numerous Hashimoto's cases out there who have been undiagnosed and/or mismanaged for years, you've probably destroyed enough of your thyroid gland that you can't make as much thyroid hormone anymore. Years of an unchecked autoimmune attack means that you've been waging war on your poor, little thyroid for a long, long time, and to my knowledge there is no amount of supplements that will ever bring it back. If, however, you are a relatively "fresh" autoimmune person and we catch you before you shred the poor little thyroid to ribbons we might be able to get you to the point where you no longer need additional hormone support. Now, that's not to say that you won't feel much better with this type of treatment- I'm just saying that we might not be able to ever get you off your pills and you need to be okay with that.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Chiropractic is like Ben and Jerry's. There's at least 1,000 flavors, all of which are delicious in their own respect... but let's face it- we all have our favorite. And sure you can respect the people who love Chubby Hubby, but those people who only eat Chunky Monkey are total weirdos. Perhaps your first experience with ol' Ben and Jerry didn't live up to the hype. Maybe you're really a Cherry Garcia girl but your first encounter was with Phish food. Doesn't mean that all their ice cream is bad- it just means that you haven't found your flavor yet. But you can and you will find your flavor because you are the determined type.

In Chiropractic there's about a million different techniques, all of which are beautiful in their own way but some are better than others at treating different conditions or different people. An easy example is that anyone with a neurological condition is best managed and treated by somebody who practices Functional Neurology (*cough*like me*cough*).

There are chiropractors who only adjust the first joint in the neck (NUCCA, HOI), and there are those of us who adjust everything including arms and legs. There are techniques that aim to uncover emotional roots to your problems (NET). There are techniques that don't "crack" at all (DNFT), and there are numerous techniques that incorporate the "cracking" (Diversified*, Gonstead, Pettibon)**. There are techniques in which the doctor uses tools to adjust the patient, rather than adjusting manually with their hands (Activator, Impulse). There are other techniques that use a very specific type of examination to determine where to adjust (Functional Neurology, AK, SOT).
*Diversified is the most commonly used chiropractic technique.
**On a side note, while most people think that the whole point of chiropractic is the crack, it is not always necessary to get the cavitation (cracking sound) when performing an adjustment.

In addition to the wide variety in chiropractic techniques, often times doctors will incorporate various non-chiropractic treatments into their office. For example, I use functional medicine, specialty lab testing, nutritional therapy, and supplements in my office. Sometimes I use K-Tape, but if you are looking for someone who is well-versed in the use of K-Tape for a particular athletic injury, I'll be the first to admit that I may not be the doctor who's best suited for your needs. Some offices do ultrasound, e-stim and PT in house, some (such as myself) do not. Sometimes finding the perfect office for you is a matter of finding the perfect combination of treatment modalities or clinicians.

Not only is there a wide variety in treatment methods, people may vibe differently with one doctor or office better than others. Let's face it, chiropractic can get pretty up close and personal, so you need to be completely comfortable with the person putting their hands on you. Listen to your gut and ditch the offices that make you feel at all uncomfortable (this applies to doctors offices, too).

However infrequently, it saddens me when people go to a chiropractor, don't enjoy their first experience, and write off the profession as a whole. As you can see there is a LOT of variety in chiropractic techniques, and probably even more variety in the types of people who perform those techniques. Perhaps those people who "tried chiropractic once" would really love another technique or another doctor if they gave it a chance.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

Sincerely,