Nutritional & Environmental Medicine: Putting all the pieces together. Blake Graham, B.Sc (Honours), AACNEM Clinical Nutritionist .

Nutritional & Environmental Medicine: Putting all the pieces

together.Blake Graham, B.Sc (Honours), AACNEMBlake Graham, B.Sc (Honours), AACNEM

Clinical NutritionistClinical Nutritionist

www.nutritional-healing.com.auwww.nutritional-healing.com.au

(08) 9381 4112(08) 9381 4112

February 16February 16thth 2008 2008

What causes disease?

Genetics.Genetics. Gastrointestinal abnormalities. Gastrointestinal abnormalities. Nutrient imbalances/diet. Nutrient imbalances/diet. Environmental. (e.g. heavy metals) Environmental. (e.g. heavy metals) Allergies/intolerances. Allergies/intolerances. Chemical imbalances. (e.g. hormones) Chemical imbalances. (e.g. hormones) Disordered sleep. Disordered sleep. Psycho-social factors. Psycho-social factors. Lifestyle factors.Lifestyle factors.

Multi-factorial model.

All disease is multi-factorial!

Web of inter-relationships and vicious cycles.

Ripple effect.

Spectrums.

Self healing.

Complex corrective mechanisms.Complex corrective mechanisms. Identify and remove:Identify and remove:

Causes.Causes. Impediments to healing.Impediments to healing.

Reduce burden of stressors on the body Reduce burden of stressors on the body below the threshold which the body can below the threshold which the body can restore balance.restore balance.

Disease treatment models.

1.1. Treat symptoms:Treat symptoms: Nausea = anti-nausea medicationNausea = anti-nausea medication High cholesterol = cholesterol lowering medicationHigh cholesterol = cholesterol lowering medication Dry skin = moisturizerDry skin = moisturizer Insomnia = sedativesInsomnia = sedatives

2.2. Address underlying causes:Address underlying causes: e.g. nausea caused by gastrointestinal infectione.g. nausea caused by gastrointestinal infection e.g. high cholesterol caused by poor diete.g. high cholesterol caused by poor diet e.g. dry skin caused by fatty acid deficiencye.g. dry skin caused by fatty acid deficiency e.g. insomnia caused by anxietye.g. insomnia caused by anxiety

Disease treatment models.

Disease centred diagnosis.Disease centred diagnosis. Irritable bowel syndrome.Irritable bowel syndrome. Chronic Fatigue Syndrome.Chronic Fatigue Syndrome. Migraines.Migraines. Depression.Depression.

Person centred diagnosis.Person centred diagnosis. Nutrient deficiencies.Nutrient deficiencies. Sleep deprivation.Sleep deprivation. Food intolerances.Food intolerances. Intestinal infection.Intestinal infection.

Genetics.

Genetics.

Inter-relationship between Inter-relationship between genetics and environment.genetics and environment. Environment influences genetic Environment influences genetic

expression.expression. Genetics influence reaction to Genetics influence reaction to

environment.environment.

Genetics.

Specific links of interest:Specific links of interest:1.1. Environmental chemical metabolism. Environmental chemical metabolism.

2.2. Nutrient imbalances.Nutrient imbalances.

3.3. Gastrointestinal health.Gastrointestinal health.

4.4. Allergies/intolerances. Allergies/intolerances.

5.5. Chemical imbalances. (e.g. hormones) Chemical imbalances. (e.g. hormones)

6.6. Immune integrity. Immune integrity.

Genetics.

Family history:Family history: Eczema/asthma/hay fever/hives Eczema/asthma/hay fever/hives Allergies Allergies Depression/anxiety/OCD Depression/anxiety/OCD Neurotransmitters Neurotransmitters Crohn's DiseaseCrohn's Disease Increased intestinal Increased intestinal

permeabilitypermeability ADD/ADHDADD/ADHD Abnormal zinc metabolism Abnormal zinc metabolism

Genetic testing.

Reference: www.genovations.com/

Huge geneticvariation!

Gastrointestinal health.

Gastrointestinal imbalances.

Imbalanced gastrointestinal flora ('dysbiosis'). Imbalanced gastrointestinal flora ('dysbiosis'). Gastrointestinal infections (bacteria, parasitic, yeast). Gastrointestinal infections (bacteria, parasitic, yeast). Increased intestinal permeability ('leaky gut'). Increased intestinal permeability ('leaky gut'). Maldigestion/malabsorption. Maldigestion/malabsorption.

Stomach acid deficiency (hypochlorhydria). Stomach acid deficiency (hypochlorhydria). Pancreatic enzyme insufficiency.Pancreatic enzyme insufficiency. Bile acid deficiency.Bile acid deficiency.

Intestinal flora. Functions of healthy flora:Functions of healthy flora:

Produce short chain fatty acids which are needed by the intestinal mucosa Produce short chain fatty acids which are needed by the intestinal mucosa for energyfor energy

Produce biofilm (mucus barrier) to protect intestinal mucosaProduce biofilm (mucus barrier) to protect intestinal mucosa Interact with the gut associated lymphoid tissue (GALT) – 70% of Interact with the gut associated lymphoid tissue (GALT) – 70% of

immune system, e.g.immune system, e.g. Improves antibody formationImproves antibody formation Reduce allergies (eczema and asthma)Reduce allergies (eczema and asthma) Regulate cytokine levels / inflammation modulationRegulate cytokine levels / inflammation modulation

Synthesize nutrients (certain amino acids and vitamins)Synthesize nutrients (certain amino acids and vitamins) Improve digestion/absorptionImprove digestion/absorption Inhibit the overgrowth of harmful bacteria, yeast, viruses and parasitesInhibit the overgrowth of harmful bacteria, yeast, viruses and parasites Improve intestinal motility and stool formationImprove intestinal motility and stool formation Influence genetic expressionInfluence genetic expression Assist the detoxification of various substances and convert some toxins Assist the detoxification of various substances and convert some toxins

into less toxic forms :into less toxic forms : MercuryMercury Hormones (e.g. estrogen)Hormones (e.g. estrogen) Potentially carcinogenic chemicals Potentially carcinogenic chemicals DrugsDrugs Lipids (e.g. cholesterol)Lipids (e.g. cholesterol)

Harmful bacteria. Produce toxic chemicals as metabolic by-products which have Produce toxic chemicals as metabolic by-products which have

systemic effects, e.g.systemic effects, e.g. Ammonia Ammonia Hyperammonemia Hyperammonemia D-lactic acid D-lactic acid D-lactic acidosis D-lactic acidosis

Decrease production of short chain fatty acidsDecrease production of short chain fatty acids Produce antigens which disrupt immune functionProduce antigens which disrupt immune function Reduce levels of healthy floraReduce levels of healthy flora Impair nutrient digestion/absorptionImpair nutrient digestion/absorption Degradation/consumption of nutrientsDegradation/consumption of nutrients Damage intestinal wallDamage intestinal wall

Intestinal flora testing.

Gastrointestinal health: Yeast. Opportunistic/secondary.Opportunistic/secondary. Great exacerbating factor.Great exacerbating factor. Releases harmful chemicals. Releases harmful chemicals. Lab tests are notoriously unreliable.Lab tests are notoriously unreliable.

Yeast symptoms/signs. Genital thrushGenital thrush Vaginal itching or redness, vaginitis or 'jock itch' – often scratching/itching at genital Vaginal itching or redness, vaginitis or 'jock itch' – often scratching/itching at genital

areaarea White or grayish-white coating on your tongue or inner cheeks, or white patches in White or grayish-white coating on your tongue or inner cheeks, or white patches in

the mouththe mouth Nasal congestion or stuffiness, swelling of the nasal membranes or sinusitisNasal congestion or stuffiness, swelling of the nasal membranes or sinusitis Previously noticed a decline in your health following antibiotics or antibiotics Previously noticed a decline in your health following antibiotics or antibiotics

exacerbate your current health problemexacerbate your current health problem Fungus infections of the skin (e.g. athletes foot) or nailsFungus infections of the skin (e.g. athletes foot) or nails Psoriasis, eczema or hivesPsoriasis, eczema or hives Puffiness/bloating/swelling in the hands, face and feetPuffiness/bloating/swelling in the hands, face and feet Sugar cravingsSugar cravings Eating sugar make you feel worse/worsens certain symptomsEating sugar make you feel worse/worsens certain symptoms Negative reaction to certain dietary yeasts/moldsNegative reaction to certain dietary yeasts/molds Very high fondness for yeasty foodsVery high fondness for yeasty foods Chemical sensitivities (e.g. car exhaust, petrol, cigarette smoke, perfumes, etc.)Chemical sensitivities (e.g. car exhaust, petrol, cigarette smoke, perfumes, etc.) Multiple food sensitivitiesMultiple food sensitivities Lower abdominal bloating Lower abdominal bloating Gas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stoolsGas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stools Itchy rectal/anal area or red ring immediately around the anus Itchy rectal/anal area or red ring immediately around the anus Attention problemsAttention problems Feel ‘spaced out’ &/or ‘brain fogged’Feel ‘spaced out’ &/or ‘brain fogged’

Yeast testing.

Gastrointestinal health: Parasites.

Remarkably common.Remarkably common. Under-diagnosed due to:Under-diagnosed due to:

Lack of consideration.Lack of consideration. Inadequate laboratory Inadequate laboratory

techniques.techniques.

Giardia intestinalis

Intestinal parasite symptoms/signs. Current illness began with diarrhea/food poisoningCurrent illness began with diarrhea/food poisoning Frequent diarrheaFrequent diarrhea Loose/unformed stoolsLoose/unformed stools Abdominal bloatingAbdominal bloating Abdominal pain/discomfortAbdominal pain/discomfort Excessive flatulenceExcessive flatulence Visible mucus or pus in stoolsVisible mucus or pus in stools Itchy anal/rectal areaItchy anal/rectal area Foul smelling stoolsFoul smelling stools Frequent constipationFrequent constipation Frequent nausea and/or vomitingFrequent nausea and/or vomiting Food allergies/intolerancesFood allergies/intolerances Teeth grinding (bruxism) while sleepingTeeth grinding (bruxism) while sleeping Skin conditions (bluish cast around lips, hives, psoriasis, eczema, skin ulcers)Skin conditions (bluish cast around lips, hives, psoriasis, eczema, skin ulcers) Fatigue/weaknessFatigue/weakness Forgetfulness or unclear thinkingForgetfulness or unclear thinking Nervousness, apathy, depressed, anxious or headachesNervousness, apathy, depressed, anxious or headaches DizzinessDizziness

Parasite testing.

Maldigestion/malabsorption.

Stomach acid deficiency (hypochlorhydria). Stomach acid deficiency (hypochlorhydria). Pancreatic enzyme insufficiency.Pancreatic enzyme insufficiency. Bile acid deficiency.Bile acid deficiency.

Digestive function testing.

Hypochlorhydria symptoms/signs. Undigested food in stoolUndigested food in stool Trouble digesting red meatTrouble digesting red meat Food or water ‘sits in stomach’Food or water ‘sits in stomach’ Poor appetite or feel overly full easilyPoor appetite or feel overly full easily Stomach aching/pain/discomfort or bloating after mealsStomach aching/pain/discomfort or bloating after meals Reflux &/or heartburnReflux &/or heartburn High fat foods cause nausea/stomach upsetHigh fat foods cause nausea/stomach upset Nausea/reflux after supplements (e.g. fish oil)Nausea/reflux after supplements (e.g. fish oil) Feel unwell/fatigued right after mealsFeel unwell/fatigued right after meals Lemon juice improves digestionLemon juice improves digestion Low iron levelsLow iron levels

Heidelberg pH Diagnostic System.

Reference: www.phcapsule.com/

Gastrointestinal treatments.

Probiotics/prebiotics.Probiotics/prebiotics. Anti-microbials.Anti-microbials. Dietary changes.Dietary changes. Digestive enzymes.Digestive enzymes. Stomach acid supplement (Betaine HCl).Stomach acid supplement (Betaine HCl). Bile acids.Bile acids.

Nutrients.

Nutrient status continuum.

Nutrient status continuum.

Nutrition: Nutritional status.

I.I. Intake:Intake:• Food choicesFood choices• SSoil levels, food storage, food processing oil levels, food storage, food processing

II.II. Digestion/assimilationDigestion/assimilationIII.III. GeneticsGeneticsIV.IV. Synthesis (vitSynthesis (vitaminsamins K & D) K & D)V.V. Other factors (Other factors (hormone imbalances, toxic hormone imbalances, toxic

chemicals, infections, other nutrient levels, chemicals, infections, other nutrient levels, medications, oxidative stress, emotional stress, medications, oxidative stress, emotional stress, activity levels, kidney/liver problems, etc.activity levels, kidney/liver problems, etc.))

Nutrient supplementation uses.

1.1. Optimizing levels.Optimizing levels.

2.2. Therapeutic value.Therapeutic value.

Fatty acid deficiency symptoms/signs. Dry skin (e.g. feet/face/general)Dry skin (e.g. feet/face/general) Scaly or flaky skin (e.g. legs)Scaly or flaky skin (e.g. legs) Cracking/peeling fingertips & skin (e.g. heels)Cracking/peeling fingertips & skin (e.g. heels) Lackluster skinLackluster skin Small bumps on back of upper armsSmall bumps on back of upper arms Patchy dullness &/or color variation of skinPatchy dullness &/or color variation of skin Irregular quilted appearance of skin (e.g. legs)Irregular quilted appearance of skin (e.g. legs) Thick or cracked callusesThick or cracked calluses Dandruff or cradle capDandruff or cradle cap Dry, lackluster, brittle or unruly hairDry, lackluster, brittle or unruly hair Soft, fraying, splitting or brittle fingernailsSoft, fraying, splitting or brittle fingernails Dull nails - lack of surface shineDull nails - lack of surface shine Slow growing fingernailsSlow growing fingernails Dry eyesDry eyes Menstrual cramps or premenstrual breast pain/tendernessMenstrual cramps or premenstrual breast pain/tenderness Excessive ear waxExcessive ear wax Excessive thirstExcessive thirst Allergic (e.g. eczema/asthma/hay fever/hives)Allergic (e.g. eczema/asthma/hay fever/hives) Crave fats/fatty foodsCrave fats/fatty foods Stiff or painful jointsStiff or painful joints

Magnesium deficiency symptoms/signs. Muscle cramps, spasms or pain (e.g. back ache, neck ache, leg/foot Muscle cramps, spasms or pain (e.g. back ache, neck ache, leg/foot

cramps)cramps) Muscle tensionMuscle tension Muscle twitches, tics or jerks Muscle twitches, tics or jerks Muscle weaknessMuscle weakness Muscle tremorsMuscle tremors Restless legsRestless legs Fatigue / sighingFatigue / sighing Breathlessness / chest tightnessBreathlessness / chest tightness Heart palpitations / arrhythmiasHeart palpitations / arrhythmias Numbness or tingling of skin or “creepy-crawly” feeling under skinNumbness or tingling of skin or “creepy-crawly” feeling under skin Sensitivity to loud noises or sudden bright light Sensitivity to loud noises or sudden bright light Menstrual crampsMenstrual cramps Headaches / migrainesHeadaches / migraines Frequent constipation or anal spasmsFrequent constipation or anal spasms Difficulty falling asleep and/or restless sleepDifficulty falling asleep and/or restless sleep Irritable, depressed, anxious, nervous or panic attacksIrritable, depressed, anxious, nervous or panic attacks

Hair mineral analysis.

Reference: www.doctorsdata.com/

RBC fatty acid analysis.

Reference: www.metametrix.com/

Plasma amino acids.

Reference: www.doctorsdata.com/

Nutrient imbalance treatments.

Nutrient supplementation.Nutrient supplementation. Dietary changes.Dietary changes. Correct absorption problems.Correct absorption problems.

Nutrient supplementation case study.

Symptoms:Symptoms: Frequent urinationFrequent urination Night time urinationNight time urination Night thirstNight thirst Blurred vision after heavy exerciseBlurred vision after heavy exercise

Mineral supplementation:Mineral supplementation: ““From one day to the next at least 90% of my From one day to the next at least 90% of my

symptoms vanished. These are symptoms I symptoms vanished. These are symptoms I have lived with and have worsened for more have lived with and have worsened for more than 10 years. Quite amazing.”than 10 years. Quite amazing.”

Toxic chemicals.

Increased toxic chemical exposure.

Lead levels of human bones are Lead levels of human bones are ~1000 times high~1000 times higherer than pre- than pre-industrial bones. industrial bones.

Cadmium 500 times higher. Cadmium 500 times higher.

Heavy metal sources:

Food:Food: SoilSoil PesticidesPesticides Cooking itemsCooking items

WaterWater AirAir Medical:Medical:

Amalgam fillingsAmalgam fillings VaccinesVaccines

Direct contact with heavy Direct contact with heavy metal containing or metal containing or contaminated substancescontaminated substances PaintsPaints CigarettesCigarettes Household chemicalsHousehold chemicals Body productsBody products Many many others!Many many others!

Autism – mercury Study 1. 221 children with ASD vs. 18 controls221 children with ASD vs. 18 controls Post-DMSA Post-DMSA urine levelsurine levels Mercury was 3.15 times higher!!Mercury was 3.15 times higher!!

Jeff Bradstreet, M.D. David Geier, B.A. Jerold Kartzinel, M.D. James Adams, Ph.D. Mark Geier, M.D.,Ph.D. A Case-Control Study of Mercury Burden in Children with Autistic Spectrum Disorders. Journal of American Physicians and Surgeons Volume 8 Number 3 Fall 2003

Autism – mercury Study 2.

14 children with Autism vs. 11 controls 14 children with Autism vs. 11 controls Mercury was 3 times higher in baby teethMercury was 3 times higher in baby teeth!!!!

Adams JB. A Review of the Autism-Mercury Connection. Conference Proceedings of the Annual. Meeting of the Autism Society of America, July 2004.

Toxic chemical treatments.

Chemical avoidance.Chemical avoidance. Chelation agents.Chelation agents. Supportive Supportive

nutrients/herbs.nutrients/herbs. Far infrared (FIR) Far infrared (FIR)

saunas.saunas.

Other environmental influences.

Electromagnetic radiation (EMR).

EMR testing.

Toxic mould.

Mould testing.

Sick building syndrome symptoms/signs. Ongoing or frequent coughing / dry throat or mouthOngoing or frequent coughing / dry throat or mouth Irritated, stinging or burning sensation of throat or mouthIrritated, stinging or burning sensation of throat or mouth Throat hoarseness / changed voice (e.g. raspy)Throat hoarseness / changed voice (e.g. raspy) Metallic taste in mouthMetallic taste in mouth Wheezing, irritated lungs or bronchitis Wheezing, irritated lungs or bronchitis Shortness of breath / chest tightnessShortness of breath / chest tightness Irritated, sore or burning eyes Irritated, sore or burning eyes Red or watery/tearing eyes Red or watery/tearing eyes Sensitivity to bright light / blurred visionSensitivity to bright light / blurred vision Nasal congestion / running or stuffy nose / sneezing / nose bleedsNasal congestion / running or stuffy nose / sneezing / nose bleeds Irritated, stinging or burning nose or nasal passage / nasal itchingIrritated, stinging or burning nose or nasal passage / nasal itching Sinusitis / sinus congestion or pressureSinusitis / sinus congestion or pressure Stinging, burning or itchy skin / skin sensitivity to light touchStinging, burning or itchy skin / skin sensitivity to light touch Skin rash or reddening of skinSkin rash or reddening of skin Dizziness / vertigoDizziness / vertigo HeadachesHeadaches Fatigue / weaknessFatigue / weakness

Allergies/intolerances.

Food reactivity.

Many reasons why a person may react negatively to specific foods.Many reasons why a person may react negatively to specific foods. Allergy Allergy IntoleranceIntolerance

e.g. lactose intolerance or fructose malabsorptione.g. lactose intolerance or fructose malabsorption e.g. impaired ability to metabolize salicylates, etc.e.g. impaired ability to metabolize salicylates, etc. e.g. gut flora/leaky gut mediatede.g. gut flora/leaky gut mediated e.g. pharmacologic properties of the food - aspartamee.g. pharmacologic properties of the food - aspartame e.g. toxins in foodse.g. toxins in foods

No one lab test for diagnosis of all negative reactions.No one lab test for diagnosis of all negative reactions.

Food intolerance or allergy symptoms/signs. Itchy, tingly, irritated or burning tongue/lips/palate/throat during or after mealsItchy, tingly, irritated or burning tongue/lips/palate/throat during or after meals Swollen lips/mouth or recurrent mouth ulcersSwollen lips/mouth or recurrent mouth ulcers Frequent hives - generally or around mouth/lips (e.g. rash or ring around mouth )Frequent hives - generally or around mouth/lips (e.g. rash or ring around mouth ) Increased mucus production in throat / regularly clearing throatIncreased mucus production in throat / regularly clearing throat Excess drooling / excess saliva production / spitting during speech Excess drooling / excess saliva production / spitting during speech Irregular patches on tongue (geographic map-like) or mottled tongueIrregular patches on tongue (geographic map-like) or mottled tongue Puffiness or ‘bags’ below eyes; or puffy or swollen nose/facePuffiness or ‘bags’ below eyes; or puffy or swollen nose/face Dark circles under eyes (‘allergic shiners’)Dark circles under eyes (‘allergic shiners’) Inner corners of eyes itch or whole eyes itch / eye rubbing or scratchingInner corners of eyes itch or whole eyes itch / eye rubbing or scratching Watery, glassy or glazed eyes; or red eyesWatery, glassy or glazed eyes; or red eyes Itchy nose / nose rubbing or scratching (‘nasal salute’) Itchy nose / nose rubbing or scratching (‘nasal salute’) Nasal or sinus congestion / sinusitis / runny or snuffly nose / sneezingNasal or sinus congestion / sinusitis / runny or snuffly nose / sneezing Postnasal drip (nasal mucus draining down the back of the throat)Postnasal drip (nasal mucus draining down the back of the throat) Abnormally red and/or flushed appearance of cheeks or nose (e.g. red tip nose)Abnormally red and/or flushed appearance of cheeks or nose (e.g. red tip nose) Red ears / hot or ‘burning’ earlobesRed ears / hot or ‘burning’ earlobes Eczema or wool intolerance / psoriasis Eczema or wool intolerance / psoriasis Itchy arms, ear canals, hands, legs or skin in generalItchy arms, ear canals, hands, legs or skin in general Puffy or swollen hands/knuckles/feetPuffy or swollen hands/knuckles/feet Asthma or recurrent wheezy bronchitis / infection or exercise induced wheezingAsthma or recurrent wheezy bronchitis / infection or exercise induced wheezing Abdominal pain, bloating or vomitingAbdominal pain, bloating or vomiting Increased frequency of stools / unformed bowel movements / frequent constipationIncreased frequency of stools / unformed bowel movements / frequent constipation Feel best when don’t eat or skip mealsFeel best when don’t eat or skip meals Feel worse (energy, mood, concentration, etc.) or look pale/red after some mealsFeel worse (energy, mood, concentration, etc.) or look pale/red after some meals Strong particular food cravings and dislikes / fussy eaterStrong particular food cravings and dislikes / fussy eater Recurrent ear infections and/or recurrent glue earRecurrent ear infections and/or recurrent glue ear Headaches/migrainesHeadaches/migraines

Elimination/provocation testing.

GRAINS - Whole grain riceGRAINS - Whole grain rice MEAT - 100% unrefined lambMEAT - 100% unrefined lamb VEGETABLES - Cabbage, kale, carrots, VEGETABLES - Cabbage, kale, carrots,

cauliflower, squash, broccoli & sweet potatoescauliflower, squash, broccoli & sweet potatoes FRUIT – PearsFRUIT – Pears OILS/SEASONINGS - Olive oil & sea saltOILS/SEASONINGS - Olive oil & sea salt

Inhalant allergies.

Dust.Dust. Cats/dogs.Cats/dogs. Pollen.Pollen. Grass.Grass.

Food intolerance case study.

Fibromyalgia.Fibromyalgia. Elimination diet Elimination diet 50% drop in symptoms. 50% drop in symptoms.

Lactose intolerance.Lactose intolerance.

Chemical imbalances.

Neurotransmitter & hormone imbalances.

Neurotransmitters:Neurotransmitters: SerotoninSerotonin DopamineDopamine NoradrenalineNoradrenaline GABAGABA AcetylcholineAcetylcholine EndorphinsEndorphins

Hormones:Hormones: Adrenal hormonesAdrenal hormones Thyroid hormones Thyroid hormones Sex hormonesSex hormones Growth hormoneGrowth hormone

Biochemical continuum.

Serotonin deficiency signs/symptoms. DepressedDepressed Nervous/anxiousNervous/anxious WorrierWorrier Fears/phobias Fears/phobias Negative/pessimisticNegative/pessimistic Irritable/impatient/edgy Irritable/impatient/edgy Obsessive compulsive tendencyObsessive compulsive tendency Think about the same things over & over againThink about the same things over & over again Self destructive or suicidal thoughts/plansSelf destructive or suicidal thoughts/plans Low self esteem/confidenceLow self esteem/confidence Rage/anger/explosive behavior/assaultiveRage/anger/explosive behavior/assaultive Sleep problems/light sleeperSleep problems/light sleeper Crave sugar/carbohydrates/alcohol/marijuanaCrave sugar/carbohydrates/alcohol/marijuana

Use these substances to improve mood & relaxUse these substances to improve mood & relax Feel worse in & dislike dark weatherFeel worse in & dislike dark weather Chronic pain (e.g. headaches, backaches, fibromyalgia)Chronic pain (e.g. headaches, backaches, fibromyalgia)

Reference: Bioconcepts. [www.bioconcepts.com.au/]

Serotonin pathway.

Adrenal Rhythm.

Reference: www.diagnostechs.com/

Mild adrenal insufficiency signs/symptoms. Fatigue/lethargy not relieved by sleepFatigue/lethargy not relieved by sleep Trouble getting up in the morningTrouble getting up in the morning Crave salt or salty foodCrave salt or salty food Low blood pressureLow blood pressure Light-headed or dizzy when getting up to stand from laying or sitting Light-headed or dizzy when getting up to stand from laying or sitting Feel unwell during/after emotional stress, e.g. exhausted, shaky or confusedFeel unwell during/after emotional stress, e.g. exhausted, shaky or confused Decreased ability to handle stress/pressureDecreased ability to handle stress/pressure Tendency for low blood sugarTendency for low blood sugar Intolerance to cold / frequently feel coldIntolerance to cold / frequently feel cold Unstable body temperatureUnstable body temperature Light sensitivityLight sensitivity Increased frequency/severity of allergiesIncreased frequency/severity of allergies Dark brown spots on face/neck/shouldersDark brown spots on face/neck/shoulders Poor exercise tolerancePoor exercise tolerance Increased time to recover from infectionIncreased time to recover from infection Thin, can't gain weight or weight lossThin, can't gain weight or weight loss Insomnia / sleep disturbanceInsomnia / sleep disturbance Anxious or panic attacksAnxious or panic attacks

Saliva Adrenal Stress Profile.

Reference: www.gdx.net/

Adrenal hormone case study.

“I am feeling so much better than when we first consulted over 6 months ago… for the last month I have been doing about 500 metres of swimming + 2 kms of walking about 5 times a week. This compares to just barely struggling to do the weekly shopping! The feelings of exhaustion are not very common anymore. Depression and anxiety totally under control. Sleeping is much better. Overall, I am beginning to feel like a completely different person.”

Sleep.

Sleep. Inadequate sleep quantity and quality are Inadequate sleep quantity and quality are

extremely common.extremely common.

Sleep.

Functions of sleep:Functions of sleep: Rejuvenation/RepairRejuvenation/Repair GrowthGrowth DetoxificationDetoxification Memory storageMemory storage Energy conservationEnergy conservation

Reference: Dr. Reza Samvat, www.sleep4health.com.au/

Sleep – treatment.

Remove causes.Remove causes. Supportive lifestyle, environment and sleep Supportive lifestyle, environment and sleep

routine.routine. Dietary changes.Dietary changes. Herbal/nutritional supplements.Herbal/nutritional supplements. Relaxation techniques.Relaxation techniques.

See: www.nutritional-healing.com.au ‘Articles’ for more info.

Stress.

Psycho-social stress.

Universal disease exacerbator.Universal disease exacerbator. Known effects:Known effects:

Impairs immune function.Impairs immune function. Increase nutrient requirements (e.g. Increase nutrient requirements (e.g.

magnesium).magnesium). Impair digestion.Impair digestion. Impair sleep.Impair sleep. Impair neurotransmitter balance.Impair neurotransmitter balance. Impair hormone (e.g. cortisol, DHEA, thyroid Impair hormone (e.g. cortisol, DHEA, thyroid

hormones, sex hormones) balance.hormones, sex hormones) balance.

Psycho-social stress – Management.

Treatment options:Treatment options: Eckhart Tolle [www.eckharttolle.com/].Eckhart Tolle [www.eckharttolle.com/]. Emotional Freedom Techniques (EFT). Emotional Freedom Techniques (EFT).

[www.integrative-clearing.com.au/][www.integrative-clearing.com.au/] Breathing/muscle relaxation exercises.Breathing/muscle relaxation exercises. Biochemical.Biochemical. Exercise.Exercise.

Lifestyle.

Lifestyle factors.

Smoking.Smoking. Alcohol.Alcohol. Drug use.Drug use. Exercise.Exercise. Rest.Rest. Fun.Fun.

How to put it all together.

1.1. Optimize basics:Optimize basics: General diet.General diet. Sleep.Sleep. Stress.Stress. Lifestyle.Lifestyle. Healthy environment. Healthy environment.

How to put it all together.

1.1. Optimize basics:Optimize basics: General diet.General diet. Sleep.Sleep. Stress.Stress. Lifestyle.Lifestyle. Healthy environment.Healthy environment.

2.2. Identify contributing factors:Identify contributing factors: Gastrointestinal issues.Gastrointestinal issues. Nutrient imbalances.Nutrient imbalances. Environmental. Environmental. Allergies/intolerances. Allergies/intolerances. Neurotransmitters & hormone imbalances.Neurotransmitters & hormone imbalances.

Questionnaire.

Nutritional & Environmental Medicine: Putting all the pieces

together.Blake Graham, B.Sc (Honours), AACNEMBlake Graham, B.Sc (Honours), AACNEM

Clinical NutritionistClinical Nutritionist

(08) 9381 4112(08) 9381 4112

February 16February 16thth 2008 2008

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