Printer Friendly

Clinical treatment protocol emphasis on nutrition - A to Z - part four of a collectible series.

Human Papilloma Virus (HPV)

History

* Most common sexually transmitted disease

** Rarely transmitted from mother to infant

* Commonly associated with genital warts

** Although warts can also appear on hands, feet, around the mouth and upper respiratory tract (rare, recurrent respiratory palillomatosis)

* Some strains of the virus have the potential to cause vulva, vagina, penis, anus, tongue, tonsil, or throat cancer

** Persistent infections are more likely to cause cancer

** High risk strains are 16 and 18

** Abnormal bleeding, heavy menstrual flow or bleeding between menstrual periods are considered potential signs of cancer

* 90% of cases are resolved by the body's immune system within 2 years of exposure

* Manifest as small papules or a group of papules in the genital or in other regions

** Papules can be large and elevated or remain flat or cauliflower shaped

* High risk activities include having multiple sex partners, having sex at a young age, and immune-compromised individuals

Evaluation

* Vinegar solution test

** Turns HPV-infected genital areas white

* Pap test

** Removal of sample cells from the cervix and vagina

* DNA test

** Detect the DNA of high risk strains

Treatment Overview

* Diet and supplementation

* Botanicals

* Surgical removal of warts

Step #1

Diet and Nutrition

1. Increase fiber

2. Increase chicken and cold water fish

3. Increase fruits and vegetables

4. Avoid alcohol, caffeine and smoking

5. Increase olive oil

Step #2

Supplements

1. Antioxidants

a. Vitamin A 10,000 I.U.q.d.

b. Vitamin C 1,000 mgq.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mgq.d.

e. Selenium 100 meg q.d.

2. Lactobacillus rhamnosus and reuteri 4 to 8 billion per capsule q.d.

3. Digestive enzymes, amylase, lipase and protease 25 units of each with meals t.i.d.

4. Omega 3 fatty acids 1,500-3,000 mg q.d.

Step #3

Botanicals

1. Garlic (Allicin) 1,000 meg q.d.

2. Echinacea 150 mg q.d.

3. Goldenseal 120 mg q.d.

4. Reishi mushrooms (Lentinan) 12 mg q.d.

5. Oil of Oregano 300 mg q.d.

6. Passion flower 100 mg q.d.

7. Kava 150 mg q.d.

8. Valerian 120 mg q.d.

9. Astragalus 200 mg q.d.

10. Siberian ginseng 150 mg q.d.

11. Asian ginseng 150 mg q.d.

Hyperlipoproteinemia (High cholesterol)

History

* Large number of lipids or cholesterol in the blood stream

** May result in a build up of fatty deposits on vessel walls

* Genetic and dietary components

* Associated with obesity, diabetic, hypothyroid, sedentary lifestyle, menopause and increasing age

* Precursor to atherosclerosis and eventually coronary artery disease

* Reduced blood flow can result in angina and shortness of breath

* Can eventually lead to a myocardial infarction

Evaluation

* Lipid panel

* CPK isoenzymes test

* Electrocardiogram

* Echocardiogram

* Stress Test

* Coronary catheterization

* CT or MRI

Treatment Overview

* Diet and supplementation

* Botanicals

* Quit smoking

* Exercise

* Stress reduction

Step #1

Diet and Nutrition

1. Avoid saturated and trans fats

2. Increase fiber

3. Reduce simple sugars

4. Avoid fatty meat

5. Increase chicken and cold water fish

6. Increase olive oil

7. Reduce dairy products

8. Increase legumes, nuts, seeds and flaxseed oil

9. Increase fruits and vegetables

Step #2

Supplements

1. Vitamin B3 100 mg t.i.d.

2. Vitamin B5 500 mg q.d.

3. Vitamin C 1,000 mg q.d.

4. Magnesium citrate 750 mg q.d.

5. B-100 complex q.d.

6. Omega 3 fatty acids 1,500 mg q.d.

7. Selenium 100 mcg q.d.

8. Vitamin E 600-800 I.U. q.d.

9. L-Taurine 500 mg q.d.

10. CoQ10 100 mg q.d.

11. Chromium 200 mcg q.d.

12. Zinc 100 mg q.d.

Step #3

Botanicals

1. Garlic (Allicin) 1,000 mcg q.d.

2. Guggul lipid 400 mg q.d.

3. Red Yeast Rice 120 mg q.d.

4. Ginger 200-250 mg q.d.

5. Grape seed extract 100 mg q.d.

6. Policosonol 150 mg q.d.

7. Dandelion 1,000-2,000 mg q.d.

8. Hawthorne 200-300 mg q.d.

9. Flax seed oil 1 tbsp q.d.

Hypertension

History

* High blood pressure

* Increases the risk of damaged arteries, heart attack, aneurysm, metabolic syndrome, memory problems, or stroke

* Primary hypertension

** Develops over the years

** No identifiable cause

** Affects most people

* Secondary hypertension

** Caused by kidney abnormalities, tumors of the adrenal gland, congenital heart defects, medication (birth control, cold remedies, decongestants, OTC pain relievers and certain prescription drugs), and illicit drugs

* Risk factors for development include: age, gender (men), race (African American), family history, obesity, sedentary lifestyle, smoking, high sodium diet, low potassium and vitamin D diet, alcohol, stress, chronic diseases, and pregnancy

Evaluation

* Blood pressure

** Normal: below 120/80 mm Hg

** Prehypertension: between 120-139/80-89 mm Hg

** Stage 1 hypertension: between 140-159/90-99 mm Hg

** Stage 2 hypertension: over 160/100 mm Hg

Treatment Overview

* Diet and supplementation

* Botanicals

* Exercise

* Chiropractic Manipulation Therapy (CMT)

* Acupuncture

* Relaxation and stress management

* Weight management

* Lifestyle changes

** Increase sun exposure to optimize levels of vitamin D

Step #1

Diet and Nutrition

1. Avoid alcohol, caffeine and smoking

2. Reduce refined foods and simple sugar

3. Decrease saturated and trans fats

4. Reduce sodium

5. Avoid food allergens

6. Increase fiber

7. Increase fruits and vegetables

8. Decrease fatty meats

9. Increase olive oil

10. Increase chicken and cold water fish

Step #2

Supplements

1. Omega 3 fatty acids 1,000-2,000 mg q.d.

2. Magnesium citrate 750-1,000 mg q.d.

3. Zinc 50 mg q.d

4. CoQ10 10 mg q.d.

5. B-100 complex q.d.

6. Vitamin B6 100 mg q.d.

7. Vitamin B12 400 mcg q.d.

8. Folic acid 800 mcg q.d.

9. L-Taurine 1,000 mg q.d.

10. Calcium citrate 1,200 mg q.d.

11. Selenium 100 mcg q.d.

12. L-Carnitine 1,000-2,000 mg q.d.

Step #3

Botanicals

1. Hawthorn 250-300 mg q.d.

2. Dandelion 1,000-2,000 g q.d.

3. Passion Flower 100 mg q.d.

4. Kava 175 mg q.d.

5. Valerian 120 mg q.d.

6. Chamomile tea 2 cups b.i.d.

7. Garlic (Allicin) 1,000 mcg q.d.

Hyperthyroidism

History

* Aka Thyrotoxicosis or Grave's disease

* Autoimmune disease

** Antibodies against thyroid stimulating hormone

** Onset typically follows emotional stress or shock such as the death of a close relative, divorce or difficult separation

** Human leukocyte antigen (HLA) gene commonly present

** Associated with dyslexia

* Typically found in women between the ages 20-40

* Hallmark sign is a nonpainful, diffuse goiter and exophthalmos

* Elevated levels of T3, T4, free T4 and T4 index

* Clinical symptoms are weakness, sweating, weight loss, palpitations, nervousness, loose stools, heat intolerance, irritability, insomnia and fatigue Skin may be warm, moist and thin

* Tachycardia with increased perspiration

* Staring spells and tremor may occur

* Pretibial myxedema, acropachy, alopecia, onycholysis and sometimes paralysis

* Smoking is a risk factor

* Incidence increases with supplementation of iodine in individuals with sufficient iodine levels

* Exposure to mercury and cadmium cause immediate onset of the disease

* Low doses of iodine and administration of amiodarone in the elderly increases risk of development

Evaluation

* Physical examination

** Smooth, diffuse, nontender goiter

** Tachycaria with a systolic murmur

** Mild proptosis, lid retraction, lid lag and tremor

* Lab tests

** Suppression of TSH

** Elevation of T3, T4, thyroid resin uptake and free thyroxine

** High serum antibody levels

* Thyroid scan

* Rule out cancer

Treatment Overview

* Diet and supplementation

** Some protocols suggest supplementing with high levels of iodine

** Large amounts of iodine can suppress the thyroid gland and cause it to normalize or it can trigger hyperthyroidism in a subclinical thyroid patient

** Supplementation with large amounts of iodine is considered unpredictable and potentially dangerous and should be avoided

* Botanicals

* Small frequent meals

* Stress management is the most important treatment

** Chiropractic, acupuncture, relaxation techniques, yoga or massage

** Hydrotherpay, cold compress over throat and adequate sleep

Step #1

Diet and Nutrition

1. Avoid alcohol, caffeine and smoking

2. Increase total calories

3. Increase cold water fish

4. Maintain proper hydration

5. Increase natural goitrogens

a. Turnips, cabbage, rutabaga, mustard, soybeans, pine nuts and millet

b. Must be eaten raw-aldente (Cooking inactivates goitrogenic components)

Step #2

Supplements

1. Antioxidants

a. Vitamin A 50,000 I.U.q.d.

b. Vitamin C 2,000 mg b.i.d.

c. Vitamin E 600-800 I

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

2. Calcium citrate 1,200 mg q.d.

3. L-Carnitine 1,000-4,000 mg q.d.

4. CoQ10 10 mg q.d.

Step #3

Botanicals

1. Melissa 100 mg q.d.

2. Lycopus virginicus 1 g q.d.

3. Gooseberry 250 mg q.d.

4. Valerian 120 mg q.d.

5. Skullcap 500 mg q.d.

Hypothyroidism

History

* Underactive thyroid gland (not producing enough hormones)

* Women over 50 are at risk

* Gradual onset of symptoms

** Weight gain, fatigue, sluggishness, intolerance cold, constipation, elevated cholesterol levels, muscle aches, joint pain, infertility, and depression

* Signs include: low body temperature, facial edema, orthostatic hypotension, and loss of lateral 1/3 of eye brow

* Long-term and untreated can result in myxedema

** Life-threatening

** Symptoms are drowsiness, intense cold intolerance, lethargy, and loss of consciousness resulting in a coma

* Goiter formation may occur causing dysphagia and discomfort

* Associated with heart problems due to high level of LDLs

* Caused by autoimmune disease (Hashimoto thyroiditis, most common), radiation therapy, radioactive iodine or anti-thyroid medications for hyperthyroidism, thyroid surgery, pituitary disorder, congenital defect, pregnancy, or iodine deficiency

* Risk of disease increases with age and family history

* Can result in birth defect if mother is pregnant

Evaluation

* Thyroid panel

* Iodine load test

** Be aware of any possible allergy to iodine and if autoimmune issue is a factor

* Serum blood test

** Vitamin D3 levels

Treatment Overview

* Diet and supplementation

** Anti-cholesterol approach

* Botanicals

* Clear the liver through detoxification (about 60% of T4 to T3 conversion happens here)

* Support the adrenals and their function

* Exercise, prescribe as appropriate

Step #1

Diet and Nutrition

1. Decrease cabbage, broccoli, rutabaga and cauliflower

2. Increase organically grown foods

3. Increase Atlantic Sea kelp

4. Reduce fluoride, bromine and chlorine in the diet

a. Fluoride found in fruit juice, soft drinks, tap water and some toothpastes

b. Bromine found in bread and bread products and soft drinks

c. Chlorine found in barley, wheat and other grains and tap water

5. Increase chicken and cold water fish

6. Reduce simple sugars

7. Avoid saturated and trans fats

8. Reduce sodium

Step #2

Supplements

1. Thyroid extract (containing large amounts of tyrosine and iodine) q.d.

2. Tyrosine 100-200 mg q.d.

3. Antioxidants

a. Vitamin A 10,000 I.U. q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

4. B-150 complex q.d.

5. Copper 5 mg q.d. 6. CoQIO lOOmgq.d. 7. Iodine therapy

a. Dose dependant on patient following iodine load test

8. Vitamin D3

a. Dose dependent following serum blood test

b. Mild to moderate depletion is 5,000 I.U. q.d. for 3 months, then retest

c. Moderate to severe depletion is 10,000 I.U. for 2 months, then retest

Step #3

Botanicals

1. Coleus forskolii 150 mg q.d.

2. Ginkgo biloba 40-80 mg q.d.

Immune System (Up-Regulation)

Step #1

Diet and Nutrition

1. Decrease food allergens

2. Reduce simple sugars

3. Avoid alcohol, caffeine and smoking

4. Reduce fatty red meats

5. Reduce saturated and trans fats

6. Increase chicken and cold water fish

7. Increase fruits and vegetables

8. Reduce sodium

Step #2

Supplements

1. Antioxidants

a. Vitamins A 10,000 I.U. q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 mg q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

2. B-100 complex q.d.

3. CoQIO lOOmgq.d.

4. Mannose 250 mg q.d.

5. N-Acetylglucosamine 500 mg q.d.

6. N-Acetylnuramic acid 500 mg q.d.

7. Fucose 500 mg q.d.

8. N-Galactoseamine 500 mg

9. Spleen 120 mg q.d.

10. Thymus extract 120 mg q.d.

Step #3

Botanicals

1. Echinacea 150 mg q.d.

2. Astragalus 200 mg q.d.

3. Goldenseal 120 mg q.d.

4. Bioflavonoid mixtures 1,000 mg q.d.

5. Pycnogynol 50 mg q.d.

6. Aloe (Acemannon, glyconutrients) 200 mg q.d.

Immune System (Infections)

(In Addition to Previous Protocol)

Influenza

Step #1

Diet and Nutrition

1. Increase glyconutrients

Step #2

Supplements

1. Polysaccharide K 1-4 g q.d.

Step #3

Botanicals

1. Aloe (Acemannon, glyconutrients) 200 mg q.d.

Bacterial Fungal and Parasitic Infections

Step #1

Diet and Nutrition

1. Increase rice, oats and barley

Step #2

Supplements

1. Polysaccharide K 1-4 g q.d.

2. Beta-glucan 500 mg q.d.

Step #3

Botanicals

1. Aloe (Acemannon, glyconutrients) 500 mg q.d.

2. Arabinogalactans 500 mg q.d.

2. Reishi mushroom (Lentinan)12 mg q.d.

3. Cordycepts 1-3 g q.d.

4. Pumpkin seed extract 80 mg q.d.

Inflammatory Bowel Disease(Crohn's Disease and Ulcerative Colitis)

History

* Triggered by a germ or an immune system problem

* Family history

* Characterized by inflammation or ulceration of the bowels

* Ulcerative colitis and Crohn's disease

* UC

** Inflammation and ulcers in the lining of the colon and rectum

** Diarrhea with blood and mucus, abdominal pain and cramping, tenesmus and unintended weight loss

** Occurs in continuous stretches of the colon

** Defined depending on the location

*** Ulcerative proctitis inflammation confined to rectum

*** Proctosigmoiditis inflammation of the sigmoid colon

*** Pancolitis inflammation of the entire colon

*** Fulminant inflammation of the entire colon

**** Rare and life threatening

**** Severe pain, diarrhea, dehydration, and shock

**** Toxic megacolon

**** Rupture of the colon

** Believed to be triggered by virus or bacteria or hereditary

** Affects people in their 30s

** Caucasians of Jewish descent are at highest risk

** Possibly due to medications (Isotretinoin and NSAIDs)

*** Exacerbate symptoms

** Complications include: anemia, osteoporosis, arthritis, inflammation of the skin and eyes, severe dehydration, liver disease, and increased risk of liver disease

* Crohn's

** Inflammation of the lining of the GI tract

** Clinically manifests as diarrhea, abdominal pain and cramping, blood in the stool, ulceration of the intestines, reduced appetite and weight loss

** Other symptoms include: fever, fatigue, arthritis, inflammation of the eye, liver or bile ducts, skin disorders, and delayed growth or sexual development

** Believed to be triggered by bacteria or a virus inducing an autoimmune response

** Most commonly found in Caucasian or Ashkenazi Jewish decent

** Onset is usually between 20-30 years of age

** Smoking, family history, living in highly industrialized areas, and use of Isotretinoin (Accutane) or NSAIDs are risk factors of developing Crohn's

** Possible complications are bowel obstruction, fistula formation, anal fissure, malnutrition, enteropathic arthritis, kidney or gallstones, and osteoporosis

** Increases the risk of developing colon cancer

** Cobblestone appearance of the bowels

** Narrowing of the GI lumen

Evaluation

* CBC for anemia or infection

* Stool sample is checked for WBC signifying inflammation

* Biopsy of tissue

* Visualization of the colon

** Colonoscopy

** Flexible sigmoidoscopy

* Imaging

** Barium enema creates a silhouette of the colon

** X-ray

** CT scan

Treatment Overview

* Diet and supplementation

* Botanicals

* Exercise

* Chiropractic

* Acupuncture

* Biofeedback

* Stress management and relaxation techniques

* Surgery

Step #1

Diet and Nutrition

1. Elemental diet

2. Elimination diet

3. Increase fiber

4. Avoid food allergens

5. Increase short chain and medium chain fatty acids

6. Reduce saturated and trans fats

Step #2

Supplements

1. Antioxidants

a. Vitamin A 10,000 I.U.q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

2. Magnesium citrate 750 mg q.d.

3. B-100 complex q.d.

4. Iron 50-200 mg q.d.

5. Calcium citrate 1,200 mg q.d.

6. Potassium citrate 100 mg q.d.

7. Vitamin D 5,000 I.U. q.d.

8. Vitamin K 2 mg q.d.

9. Vitamin B12 200-400 mcg q.d.

10. Folic Acid 200-400 mcg q.d.

11. High-potency vitamin-mineral q.d.

12. Digestive enzymes, amylase, lipase and protease 25

units of each with meals t.i.d.

13. Lacobacillus acidophilus 4 to 8 billion per mil q.d.

14. L-Glutamine 500 mg q.d.

Step #3

Botanicals

1. Quercetin 200 mg q.d.

2. Roberts/Bastyr formula (combination of botanicals)

3. Chamomile tea 2 cups b.i.d

4. Ginger 250-500 mg q.d.

Inflammatory Conditions (General)

History

* Caused by trauma, allergies, food allergies, autoimmune disease, bacteria, and viruses

* Red, hot, swollen pain and loss of function

* May present as flu-like symptoms

** Fever, chills, loss of appetite or fatigue

* Can affect organs, joints,or soft tissue

Evaluation

* History and physical to determine cause

* Determination of allergies or food allergies

* Lab tests

** Antinuclear antibodies

** Rheumatic factor

** CBC, CMP, urinalyasis

Treatment Overview

* Diet and supplementation

* Botanicals

* Functional medicine approach to decrease the malabsorption, aid digestion and increase metabolism associated with inflammation

** Detoxification of the liver and Gastrointestinal tract

** Liver (Balance the Phase I, P-450 metabolism system and Phase II conjugation of intermediate metabolites making them water soluble)

** Maximize function of the gastrointestinal Tract

Step #1

Diet and Nutrition

1. Avoid food allergens

2. Decrease saturated and trans fats

3. Avoid alcohol, caffeine and smoking

4. Avoid fatty meat

5. Increase chicken and cold water fish

6. Increase olive

7. Vegetarian or vegan diet

8. Increase fiber

Step #2

Supplements

1. Vitamin B12 200 mcg q.d. (intramuscular injection or sublingual Q or oral if intrinsic factor is intact may be required)

2. B-150 complex q.d. (Additional vitamin B6 150 mg q.d and vitamin Bl 150 mg q.d. is recommended)

3. Acetyl myristoliate, CLA or Alpha Lipoic acid 1,000-2,000 mg q.d.

4. Antioxidants

a. Vitamin A 10,000 I.U. q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mg q.d

e. Selenium 100 mcg q.d.

5. Copper 1 mg q.d.

6. Omega 3 fatty acids 1,500 mg q.d.

7. Digestive enzymes, amylase, lipase and protease 25 units of each with meals t.i.d.

8. Betaine HC1 100 q.d. and bile acid 200 mg q.d.

9. Tryptophan 500 mg q.d.

10. L-Glutamine 500 mg q.d.

11. Glutathione 200 mg q.d.

12. Vitamin K 2 mg q.d.

13. L-Methionine 1,000 mg q.d.

14. Lactobacillus rhamnosus and reuteri 4 to 8 billion per ml q.d,

15. Tyrosine 100-200 mg q.d.

16. Lysine 200 mg q.d.

Step #3

Botanicals

1. Quercetin 200 mg q.d.

2. Bromelain 500 mg t.i.d.

a. 2,000-2,500 mcu or gdu

3. Curcumin 400 mg t.i.d.

4. Devil's Claw 150 mg q.d.

5. Licorice (DGL) 150 mg q.d.

6. Chamomile tea 2 cups t.i.d.

7. Evening primrose oil 500 mg q.d.

8. Aloe (Acemannon, glyconutrients) 200 mg q.d.

9. Melissa 100 mg q.d.

10. Ginger 200-250 mg q.d

11. Valerian 120 mg q.d.

12. Kava 175 mg q.d.

13. Holy Basil 50 mg q.d.

14. Capsaicin oil topical application PRN

Interstitial Cystitis (Chronic UTI)

History

* Uncomfortable bladder pressure or pain

* Ranges from a mild burning to severe pain

* Women most commonly affected

* Frequent urgent urination

* Small volume of urine produced

* Dyspareunia

* Chronic pelvic pain

* Possible causes: autoimmune reaction, allergy, congenital or infection

* Risk factors include age, sex and chronic diseases

Evaluation

* Bladder diary consisting of water intake vs. urine excreted

* Complete pelvic exam

* Urinalysis

* Potassium sensitivity test

** More pain with potassium than with water is a positive test

* Cystoscopy

* Biopsy

Treatment Overview

* Diet and supplementation

* Botanicals

* Increase the integrity of the interstitium along with the lining of the bladder wall

* Prevent further oxidative damage to interstitium

* Enhance the Immune system (Prevent infection if common or treat if present)

* Bladder training

* Dietary changes

* Supplementation

Step #1

Diet and Nutrition

1. Increase fruits and vegetables

2. Decrease simple sugars

3. Avoid food allergens

4. Maintain proper hydration

5. Decrease fatty meat

6. Avoid carbonated beverages and caffeine

Step #2

Supplements

1. Antioxidants

a. Vitamin C 10000 mg q.d.

b. Vitamin E 600 I.U. q.d.

c. Vitamin A 10,000 IU or Beta Carotine 250,000 I.U. q.d.

d. Zinc 50-100 mg q.d.

e. Selenium 100 mcg q.d.

Step #3

Botanicals

1. Gotu kola 400-500 mg q.d.

2. Uva Ursi 150-250 mg q.d.

3. Goldenseal 250-500 mg q.d.

4. Quercetin 200-250 mg q.d.

5. Curcumin 200-250 mg q.d.

Irritable Bowel Syndrome (IBS)

History

* Family history

* Occurs more often in women

* Commonly occurs in women under the age of 35

* Sensitive to certain foods and stress

* Characterized by constipation and diarrhea

* Other symptoms are bloating, abdominal pain and cramping

* IBS may lead to or aggravate hemorrhoids

* Symptoms may disrupt social, professional or sex life

Evaluation

* Used to rule out other conditions

** Stool sample testing

** Blood test

** X-rays

** Sigmoidoscopy or colonoscopy

Treatment Overview

* Diet and supplementation

* Botanicals

* Counseling

* Diet

* Adjunct therapy to reduce stress

** Chiropractic, acupuncture, yoga and massage

Step #1

Diet and Nutrition

1. Avoid food allergens

2. Increase fiber

3. Increase fruits and vegetables

4. Avoid alcohol, caffeine and smoking

5. Reduce saturated and trans fats

6. Reduce fatty meat

7. Eliminate foods known to induce flatulence

a. Carbonated beverages, salads, cabbage, broccoli, and cauliflower

8. Maintain proper hydration

9. Reduce simple sugar

Step #2

Supplements

1. Magnesium citrate 750 mg q.d.

2. B-100 complex q.d.

3. Digestive enzymes, amylase, lipase and protease 25 units of each with meals t.i.d.

4. Folic acid 200-400 mcg q.d.

5. Vitamin C 1,000 mg q.d.

6. Vitamin B12 200-400 mcg q.d. .

7. Lacobacillus acidophilus 4 to 8 billion per mil q.d.

Step #3

Botanicals

1. Ginger 250-500 mg q.d.

2. Chamomile 2 tea cups b.i.d.

3. Peppermint 50-75 mg q.d.

4. Valerian 120 mg q.d.

5. Cascara sagrada (Constipation) 50 mg q.d.

6. Senna (Constipation) 50 mg q.d.

Macular Degeneration (Age Related)

History

* Chronic disease resulting in deterioration of the macula

** Responsible for central vision

** Located on the inside back wall of the eye

* Blurs vision or causes blind spots

* Affects adults over age 50

* Condition develops gradually and painlessly

* Signs of macular degeneration

** Need bright light when reading or performing close work

** Difficulty adapting to poorly lit areas

** Decrease in intensity or brightness of colors

** Difficulty recognizing faces

** Reduced visual acuity

** Hallucinations

*** Charles Bonnet Syndrome

* Early stage is characterized by many small and a few medium sized drusen bodies unilaterally or bilaterally

** No loss of vision has occurred

* Intermediate stage demonstrates many medium sized drusen bodies with one or more large drusen bodies

** Vision begins to blur and extra lighting is needed for reading

* Advanced stage shows several large drusen bodies with degeneration of light sensitive cells in the macula

** Well-defined blurring of central vision

* Associated with family history

* More common in Caucasians

* More common in women due to longer life expectancy

* Smoking, obesity, exposure to sunlight, hypertension, coronary artery disease, previous history of stroke or myocardial infarction and insufficient intake of zinc and vitamin A, C and E increase the risk of developing macular degeneration

Evaluation

* Eye examination

** Amsler grid

*** Assess central vision

* Degeneration represented by faded, broken or distortion of the grid

** Opthalmoscopic exam

*** Reveal drusen bodies or mottled pigmentation of macula

* Angiography

* Optical coherence tomography

** Identifies areas of the retina that have thicken or thinned

** Identifies abnormal fluid retention in retina

Treatment Overview

* Diet and supplementation

* Botanicals

* Exercise

* Laser treatment

** May scar the retina

* Medications

* Photodynamic therapy

* Surgery

* Construct a support network

* Create a hazard free environment at home

* Prescription glasses

* Outdoors wear sunglasses, a hat and/or visor to protect eyes

* Stress management

* Sleep in the dark

Step #1

Diet and Nutrition

1. Increase fruits and vegetables

a. Especially carrots, sweet potatoes, spinach, blueberries and grapes

2. Increase cold water fish

3. Avoid fried or grilled foods and aspartame

4. Reduce simple sugars and sodium in diet

5. Avoid alcohol, caffeine and smoking

Step #2

Supplements

1. Antioxidants

a. Vitamin A 15,000-40,000 q.d.

b. Vitamin C 1,000 mg t.i.d.

c. Vitamin E 600-800 IU q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

3. Vitamin D 5,000 IU q.d.

4. Beta-carotene 150,000 IU q.d.

5. Lutein 5 mg q.d

6. Shark cartilage (Condroitin Sulfate 1,500 mg q.d)

Step #3

Botanicals

1. Ginkgo biloba 40-80 mg t.i.d

2. Bilberry 40-80 mg t.i.d.

3. Rose hips 200 mg t.i.d.

Menopause (Post menopausal symptoms)

History

* Permanent end of menstruation and fertility

* Occurs 12 months after the last menstrual period

* Usually occurs at age 51

* Reduction of hormonal levels

** In late 30s there is a decline in the production of estrogen and progesterone

** Ovaries stop producing eggs

* Manifests as vaginal dryness, hot flashes, sleep disturbances, mood swings, thinning hair, loss of breast fullness, and weight gain

* Menopause is induced prematurely by a total hysterectomy (leaving the ovaries and removing the uterus does not cause menopause)

* Chemo and radiation therapy can also induce menopause prematurely

* Primary ovarian insufficiency can induce menopause prior to age 40

** Insufficient hormone production

** Hereditary or autoimmune disease

* Perimenopause

** Signs and symptoms appear

** Menstruation still occurs

** Can occur up to 5 years prior to menopause

** Still possible to become pregnant

* Postmenopause

** Infertile

** One year after last menses

** Significant reduction in estrogen and progesterone

* Increased risk of cardiovascular disease, urinary incontinence, and osteoporosis

Evaluation

* Blood test

** Assess follicle-stimulating hormone and estrogen levels

* Thyroid panel

Treatment Overview

* Diet and supplementation

* Botanicals

* Hormone therapy

** Risks include: thromboembolic events, gallstone formation, and breast and endometrial cancer

** Suspected estrogen-dependent cancer, breast cancer, undiagnosed genitourinary bleeding, liver disease, and suspected pregnancy are contraindicated with this treatment

* Medications (anti-depressants or bisphosphonates)

** Conjugated equine estrogens (Premarin) is most common drug

** Contraindicated in patients that smoke and are obese or hypersensitive

** Can cause metabolic changes in the liver

** May eliminate the risk of uterine cancer

* Exercise

** Kegels

* Adjunct therapy

** Acupuncture, chiropractic, massage, yoga, and stress management

Step #1

Diet and Nutrition

1. Increase soy

2. Increase chicken and cold water fish

3. Reduce saturated and trans fats

4. Increase lignins, flax seed, psyllium and legumes

5. Avoid alcohol, caffeine and smoking

6. Increase fruits and vegetables

Step #2

Supplements

1. Vitamin E 600-800 I.U. q.d.

2. Vitamin C 1,000 mg q.d.

3. Calcium citrate 1,200 mg q.d.

4. Hesperidin 900 mg q.d.

5. Vitamin B6 100 mg q.d.

6. Vitamin B5 100 mg q.d.

7. Boron 3 mg q.d.

8. B-100 complex

9. Magnesium citrate 750 mg q.d.

10. Para amino benzoic acid 300 mg q.d.

11. Glyconutrients (bioflavonoids) 400 mg q.d.

12. Progesterone creams (Wild Mexican yam) topical application PRN

Step #3

Botanicals

1. Black cohosh 200-500 mg q.d.

2. Chaste tree 200-500 mg q.d.

3. Angelica 200-500 mg q.d.

4. Licorice (DGL) 250-500 mg q.d.

5. Ginkgo biloba 40-80 mg q.d.

6. St. John's Wort 250 mg q.d.

7. Siberian ginseng 150 mg q.d.

8. Cramp bark 200 mg b.i.d.

9. Bupleurum root 300 mg q.d.

10. Dongquai 100-200 mg q.d.

11. Rehmannia 250 mg q.d.

12. Chinese gentian root 1 g q.d.

13. Asian ginseng 150mgq.d.

14. Valerian 120mgq.d.

15. Ginger 250-500 mg q.d.

16. Wild Mexican yam 150 mg b.i.d.

17. Motherswort 100-500 mg q.d.

18. Flax seed oil 1 tbsp b.i.d.

Multiple Sclerosis (MS)

History

* Autoimmune disease that targets the myelin sheath of nerves

* Disrupts signaling pathways between the brain and nerves

* Eventually results in deterioration of the nerves

* Onset is between ages 20-40

* Found more commonly in women

* Caucasians from northern Europe are affected most often

* Symptoms depend on location

** Numbness or weakness on one side or the lower half of the body

** Partial or complete vision loss in one eye with optic neuritis

** Double vision or blurring of vision

** Tingling or pain

** Radiating pain with head movements

** Tremor, lack of coordination, or loss of balance

** Fatigue or dizziness

** Symptoms are intensified by an increase in body temperature

* Family history increases the risk of developing

* Development is associated with thyroid disease, type 1 diabetes, inflammatory bowel disease, and the Epstein-Barr virus

* Individuals from northern climates are at increased risk

* Complications are partial paralysis, incontinence, sexual dysfunction, memory loss, depression, and epilepsy

Evaluation

* Blood test

* Lumbar puncture

** Abnormalities in WBC or protein levels

* MRI

** Degeneration of brain, nerves, or spinal cord

* Evoked potential test

** Uses visual or electrical stimuli to test brains response

Treatment Overview

* Diet and supplementation

* Botanicals

* Physical or occupational therapy

* Chiropractic

* Acupuncture

* Exercise

* Regulating sleep schedules

* Chelation or detoxification

Step #1

Diet and Nutrition

1. Decrease saturated and trans fats

2. Decrease alcohol, caffeine and smoking

3. Elimination or elemental diet

4. Increase olive oil

5. Avoid food allergens

6. Increase chicken and cold water fish

7. Reduce fatty meats

8. Reduce simple sugars

Step #2

Supplements

1. Omega 3 fatty acids 1,500 mg q.d.

2. Omega 6 fatty acids 1,000 mg q.d.

3. CoQ10 100 mg q.d.

4. Selenium 100 mcg q.d.

5. B-100 complex q.d.

6. Vitamin B12 200-400 mcg q.d.

7. Folic acid 200-400 mcg q.d.

8. Digestive enzymes, amylase, lipase and protease 25 units of each with meals t.i.d.

9. Lacobacillus acidophilus 4 to 8 billion per mil q.d.

Step #3

Botanicals

1. Quercetin 200 mg q.d.

2. Bromelain 500 mg q.d.

a. 2,000-2,500 mcu or gdu

3. Aloe (Acemannon, glyconutrients) 200 mg q.d.

4. Astragalus 200 mg q.d.

5. Evening primrose oil 500 mg q.d.

6. Flax seed oil 1 tbsp q.d.

Muscular Dystrophy (MD)

History

* Group of genetically inherited muscle diseases

** Characterized by the deficiency in protein dystrophin

** Duchenne's muscular dystrophy is the most severe form

*** Onset around 2-3 years of age

*** Results in weakness of the lower legs, enlarged calf muscles, frequent falls, difficulty getting up from a sitting or standing position, and waddling gait

*** Some cases may result in mental retardation

*** Mortality occurs between ages 20-30 from respiratory or cardiac complications

* Becker's muscular dystrophy is milder

*** Onset between ages 11 and 30

*** Progresses gradually over several decades

*** Symptoms similar to Duchenne's

* Myotonic dystrophy

*** Onset in adulthood

*** Rarely affects children

*** Congenital myotonic dystrophy

*** Myotonia with the inability to relax muscles

*** Begins in the hands, feet, lower leg or forearms, and progresses up

*** Allopecia, mild diabetes, and cataracts are all complications that may occur

*** Weakness eventually affects head, face, cardiorespiratory, renal, and central nervous systems

** Regional muscular dystrophy

*** Facioscapulohumeral,limb-girdle, oculopharyngeal, distal, and myofibrilla

* Muscle fibers are damaged resulting in muscular weakness, lack of coordination, or contracture formation around joints reducing mobility

* Late stages characterized by the replacement of muscle tissue with fat and connective tissue

Evaluation

* Blood tests

*** Elevated levels of creatine kinase

* Electromyography

*** Identifies changes in muscle activity

** Ultrasonography

** Muscle biopsy

** Genetic testing

**** Identify deletions or duplications of dystrophin gene

Treatment Overview

* Diet and supplementation

* Botanicals

* Exercise

* Adjunct therapy

** Chiropractic, acupuncture, physical and occupational therapy

** Surgery

* Lifestyle changes

* Several small meals a day

Step#l

Diet and Nutrition

1. Increase fruits and vegetables

2. Increase fiber

3. Increase chicken and cold water fish

4. Reduce saturated and trans fats

5. Reduce fatty meats

6. Avoid food allergens

7. Avoid alcohol, caffeine and smoking

8. Maintain proper hydration

Step #2

Supplements

1. Calcium citrate 1,500 mg q.d.

2. Magnesium citrate 750 mg q.d.

3. L-Carnitine 1,000-2,000 mg q.d.

4. CoQ10 100 mg q.d.

5. B-150 complex q.d.

6. Glyconutrients (bioflavonoids) 1,000 mg mixture

7. Omega 3 fatty acids 1,500 mg q.d.

Step #3

Botanicals

1. Ginkgo biloba 40-80 mg q.d.

Obesity (Weight Management)

History

* Metabolic issues (diabetes, thyroid, adrenal)

** Chronic fatigue

** Fibromyalgia

* Gastrointestinal

** Elimination

** Any history of disease (IBS, Crohn's, diverticulitis, etc.)

** GERD

** Gallbladder issues

* Stress

** Physical

** Emotional

* Other chronic problems that can be an indicator or contributing factor to nutrient deficiencies such as skin issues, reproductive issues, apparent allergies, medication use, etc..

* Family History (does anyone else in the family have any of the above?)

Evaluation

* Food diary: preferably one week's worth, but can start with 24 hour recall.

* Labs (dependant on health history and what needs to be ruled in or out)

* Lifestyle (includes evaluation of stress factors/psycho-social)

Treatment Overview

* Diet and supplementation

** Dependent on all of the above, primarily look at making sure patient is eating within a reasonable means (appropriate amount from a caloric stand point- estimate needs and prescribe accordingly)

** Make sure quality of foods is as high as possible

** Make sure patient is eating at least 3 times per day to help with metabolic regulation

** Distribute foods evenly throughout the meals.

* Botanicals

* Exercise

* Treat any associated conditions

** Cardiovascular, thyroid, diabetes, cholesterol and depression

Step #1

Diet and Nutrition

1. Increase fruits and vegetables

2. Increase chicken and cold water fish

3. Reduce simple sugars

4. Reduce sodium

5. Reduce saturated and trans fats

6. Reduce fatty meats

Step #2

Supplements

1. B-150 complex q.d.

2. Antioxidants

a. Vitamin A 10,000 I.U. q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

3. 5-HTP 150 mg q.d.

4. Omega 3 fatty acids 1,500 mg q.d.

5. Chromium 200 mcg q.d.

6. CoQ10 100 mg q.d.

Step #3

Botanicals

1. Green tea 2 cups b.i.d.

2. Guggul lipid 200-400 mg q.d.

3. Aloe (Acemannon, glyconutrients) 200 mg q.d.

4. Fenugreek 5 g q.d.

5. Ephedra 50 mg q.d. (If available)

Osteoarthritis (Degenerative Joint Disease)

History

* Degenerative joint disease

* Due to the breakdown articular cartilage and periarticular bone remodeling of one or more joints

* Predominately found in the small joints of the hand and large weight bearing joints

* Affects males and females equally

* Attributed to aging, previous trauma or stress, family history, muscular weakness, and obesity

* Mechanism

** Physical or chemical trauma alters chondrocyte activity resulting in a loss of chondroitin sulfate

** Alters integrity of the cartilage reducing joint space causing subchondral sclerosis and cysts, articular deformity or synovial hypertrophy

* Manifests as reduced range of motion, stiffness of the joint, pain worse after exertion, and varies with weather patterns and loss of stability of a joint

* Inflammation of the capsule, muscular atrophy, and osteophyte formation are all signs of OA

* Hallmark sign is stiffness in the morning that gets better throughout after about an hour

* Complications are fractures, joint instability, total joint destruction, and reduced quality of life

Evaluation

* X-ray

** Non-uniform joint space narrowing

** Buttressing

** Joint deformity

** Osteophyte, subchondral bone cysts formation, and subchondral sclerosis

* Orthopedic exam

* Blood test or joint fluid analysis

** Rule out inflammatory or metabolic arthritis

Treatment Overview

* Diet and supplementation

* Botanicals

* Chiropractic

* Acupuncture

* Diet and Exercise

* Yoga, relaxation techniques and Massage

Step #1

Diet and Nutrition

1. Increase fruits and vegetables

2. Increase fiber

3. Reduce refined foods and simple sugars

4. Avoid alcohol, caffeine and smoking

5. Increase chicken and cold water fish

6. Increase complex carbohydrates and legumes

7. Avoid food allergens

Step #2

Supplements

1. Omega 3 fatty acids 1,500-3,000 mg q.d.

2. Antioxidants

a. Vitamin A 10,000 I.U. q.d.

b. Vitamin C 1,000 mg q.d.

c. Vitamin E 600-800 I.U. q.d.

d. Zinc 100 mg q.d.

e. Selenium 100 mcg q.d.

3. Glucosamine sulfate with MSM 500 mg t.i.d.

4. SAMe 400 mg q.d.

5. Boron 3 mg q.d.

6. Chondroitin sulfate 500 mg t.i.d.

7. Hyaluronic acid 100 mg q.d.

Step #3

Botanicals

1. Hawthorn 250-500 mg q.d.

2. Quercetin 200-250 mg q.d.

3. Bromelain 500 mg q.d.

a. 2,000-2,500 mcu or gdu

4. Ginger 250 mg q.d.

5. Boswelia 500 mg q.d.

6. Curcumin 200-250 mg q.d.

7. Devil's claw 250 mg q.d.

8. Capsaicin topical application PRN

References * Title: Principles and Practice of Phototherapy, Author: Mills and Bone, 2000, Edition: Churchill Livingston ISBN # 0-443-06016-9 2009

* Title: The ABC, Clinical Guide to Herbs Author: Mark Blumenthal, The American Botanical Council Edition: Thieme Pubs, ISBN 1-558890-157-2 2010

* Title: Encyclopedia of Natural Medicine Author: Murray and Pizzorno Edition: Prima Publishing, ISBN 1-55958-091-7 1998

* Title: Herbs That Heal Author: Michael A. Weiner, PhD Edition: Quantum Books, ISBN 9-912845-11-2 1995

* Title: A-Z Guide to Drug-Herb-Vitamin Interactions Author: Alan R. Gaby, M.D. Edition: 2nd Edition, Three Rivers Press -ISBN-13:978-0-307-33664-4 2006

* Title: Stockley's Herbal Medicines Interactions Author: Williamson, Driver and Baxter Edition: Pharmaceutical Press, RPS Publishing ISBN 978 0 85369 760 2 2009

* Title: The Healing Power of Herbs Author: Michael urray, N.D. Edition: 2nd Edition Prima Publishing, ISBN 1-55958-700-8 1995

* Title: Herb, Nutrient, and Drug Interactions- Clinical Implications and Therapeutic Strategies Author: Stargrove, Treasure, McKee Edition: Mosby ISBN: 978-0-323-02964-3 2008

* Title: PDR for Herbal Medicines Author: Thomson Edition: 2nd Edition ISBN: 1-56363-361-2 2010

* Title: American Herbal Products Associations-Botanical Safety Handbook Author: McGuffin, Hobbs, Upton, Goldberg Edition: CRC Press ISBN: 0-8493-1675-8 2009

* Title: Quick Access Professional Guide to Conditions, Herbs & Supplements Author: Integrative Medicine Edition: First Edition, ISBN: 0-9670772-5-7 2000

* Title: The Clinician's Handbook of Natural Medicine Author: Pizzorno, Murray, Joiner-Bey Edition: 2nd Edition ISBN:978-0-443-06723-5 2008

* Title: Herb-Drug Interaction Handbook Author: Sharon M. Herr, RD, CDN Edition: 2nd Edition ISBN: 0-9678773-1-8 2010

* Title: Harrison's Principles of Internal Medicine, McGraw Hill Author: Fauci. Et. Al. Edition: 16 ISBN 0-07-021530-8 1998

* The pH Balance Health and Diet Guide for GI SystemAuthor: Smith, Hannah and Richardson Edition ISBN: 978-0-7788-0492-5 2014

by: Anna Jurik, DC, RD, LDN, Daniel Richardson, MSc, PhD, CNC, Brett Martin, DC
TSH Level           Free T4  Free T3  Likely Dx

High                Low      Low      Primary hypothyroidism
High                OK       OK       Subclinical hypothyroidism
(>10 [micro]U/mL)                     at high risk
High                OK       OK       Subclinical hypothyroidism
(6-10 [micro]U/ML)                    at low risk
High                High     Low      Congenital absence of
                                      T4-T3-converting enzyme
High                High     High     Peripheral thyroid hormone
                                      resistance
Low                 Low      Low      Pituitary thyroid deficiency or
                                      recent withdrawal of thyroxine
                                      after replacement therapy
COPYRIGHT 2016 Original Internist, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2016 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:treating human papillomavirus infections; hyperlipoproteinemia; and hypertension
Author:Jurik, Anna; Richardson, Daniel; Martin, Brett
Publication:Original Internist
Article Type:Disease/Disorder overview
Date:Mar 1, 2016
Words:6416
Previous Article:Comparison between chiropractic and acupuncture for low back and pelvic pain during pregnancy using prospective, retrospective and randomized...
Next Article:DMSA chelation the gentle detox for heavy metal exposure.
Topics:

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters