The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part Two
In Part One of this post, I explained the link between PCOS and adult acne. I also explained why PCOS is misunderstood and underdiagnosed. If you haven’t read it yet, make sure you go back and read Part One here. In Part Two, I’ll explain how I help women address adult acne and PCOS in my clinic.
How I Help Women With Adult Acne
Whether or not you have a clinical diagnosis of PCOS, adult acne is almost always related to hormone imbalance. In my clinic, I use a multi-faceted approach to treating hormone imbalances.
Step 1 is always proper testing to determine exactly what type of hormone imbalance you’re dealing with - there is no “one size fits all” treatment, so proper testing is critical to healing. Every woman I work with recieves a customized plan for healing based on her test results, symptoms, and lifestyle - but there are some general recommendations I start with for many women:
- Optimize Your Diet For Hormone Health
- Nurture Your Microbiome
- Lower Stress
- Promote Ovulation
- The Right Skin Care Routine
Optimize Your Diet For Hormone Health
You don’t need to go on a no-carb diet or severely restrict to optimize your diet for healthy hormones (in fact, that is probably the worst thing you can do!). Start with balancing your blood sugar and insulin. Almost all women with PCOS (regardless of weight) show some signs of insulin resistance.
You can counteract this and get back to healthy blood sugar by:
- Optimizing the amounts and types of carbs you eat. (It’s not about cutting carbs completely. Instead, eat more whole-food carbs, fewer processed carbs.)
- Moving more! It doesn’t have to be in the gym - walk more, hike, dance, swim, just stay active throughout the day.
- Using key supplements. The exact supplements and doses matter, so work with a pro to add in things like inositols, d-pinitol, curcumin, chromium, and berberine - if they are right for you.
Key nutrients for healing acne are:
- Vitamin A - natural sources are cod liver oil, liver, pastured egg yolks.
- Zinc - zinc has been shown to clear acne as effectively as antibiotics! It also interacts positively with Vitamin A. Dietary sources are organ meats, beef and lamb, oysters and scallops.
- Omega-3 fats - These fats are anti-inflammatory and reduce your skin’s reactivity to UV light, too. EPA and DHA are the best sources - find them in fatty fish or a high-quality supplement.
You should also consider cutting dairy from your diet. I don’t like to make blanket dietary suggestions, but for women with acne and PCOS, cutting dairy is almost always helpful.
Here’s why: there is a hormone in milk (from cows, goats, sheep, and camels) called insulin-like growth factor-1 (IGF-1) which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!).
In most people, a little dairy here and there can be well-tolerated - humans have a binding protein for IGF-1 that inactivates it. But for women with PCOS or hormonal imbalance who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too.
IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize.
Not only all of that - but IGF-1 also increases sebum production and inflammation in the skin - sebum is oil on your skin - and encourages new cell growth. As new cells grow, old ones die and are shed.This means more oil and old skin cells potentially clogging pores and causing acne.
For all of these reasons I do recommend you try cutting out dairy if you’re dealing with PCOS or acne. Grass-fed butter and ghee are OK to keep in, as they are almost entirely fat and don’t contain much, if any, IGF-1.
Nurture Your Microbiome
A healthy microbiome is critical for both hormone health and lowering overall inflammation to help calm your skin.
The right gut flora is a main player in regulating your hormones, especially your estrogen levels. If you have too much of the wrong bacteria, the result can be increased estrogens in circulation.
Eating a whole-foods-based diet and taking probiotics are obvious ways to care for your microbiome - but if you’re already doing that and still having gut issues, I highly recommend advanced stool testing. Common gut infections like Blastocystis hominis, H. pylori, candida, and staph or strep overgrowth in the gut correlate to acne in patients. There is also a huge connection between Small Intestine Bacterial Overgrowth (SIBO), candida, and acne - especially rosacea.
Endotoxins released into the bloodstream by a leaky gut (aka increased intestinal permeability) are also a major cause of inflammation in the body and can impact the skin, too.
Lower Stress
This is the advice everyone hates - but it is the MOST important step toward achieving long-term health.
The reason people hate the advice to lower their stress is because they feel like most of their stressors are outside their control (bills, deadlines, work, family drama!) - but the truth is that there are many small steps you CAN control that can help reduce the burden of stress on your body.
Some simple but powerful things you can start doing right now:
- Get quality sleep - that means going to bed with 7-8 hours before you have to wake
- Avoid blue light after sunset - get the glasses, change the settings on your phone, and dim the lights inside
- Start a daily meditation/gratitude practice - just 5-10 minutes can set the tone for your entire day
Promote Ovulation
Supplementation should always be done only after proper testing and consulting with a practitioner. That being said, there are supplements that can support and promote ovulation that I use with my patients:
- Flaxseed and DIM to address excess estrogen
- Saw palmetto, reishi, pygeum, zinc, white peony/licorice, and green tea to slow the conversion of estrogen to testosterone
- Vitex (aka chasteberry) to support Hypothalamic-Pituitary-Ovarian signalling and progesterone production.
- Adrenal and thyroid support, as needed (this is why you need proper testing!)
The Right Skin Care Routine
A pimple here or there - or a bad breakout after you use a new face wash - is potentially a topical issue. That means it has to do with what you’re putting on to your skin from the outside, externally. But most cases of adult acne are more a result of internal imbalances (like we’ve been talking about in this article).
That being said, what you put on your skin still matters. Don’t use harsh products externally on your skin. Instead, try more simple options. I love:
- Mother Dirt spray (promotes a healthy skin bacteria)
- NERD skincare system
- Homemade masks with Manuka honey, tea tree oil, turmeric powder, and apple cider vinegar
This Is A Whole-Body Issue
I hope you take away this key point from this article: acne is a whole-body issue, not just a skin thing!
Whether you have PCOS or not, if you have adult acne, it is a sign that something isn’t working right in your body. From gut issues to hormone imbalances, there are multiple overlapping, underlying causes that could be causing your skin troubles.
But, I also hope you now understand that PCOS is underdiagnosed and misunderstood - and it could be affecting you.
Once I discovered that truth, I was finally on my way to #clearskineveryday (not to mention better moods, healthy monthly cycles, & healthier hair and nails!).
I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with adult acne, I’d love for you to book a free 20-minute root cause symptom analysis consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.
The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part One
You wake up on the day of your dream-job interview, look in the mirror… and there it is, a big pimple on your chin.
You wish you could blame it on nerves, but the truth is that lately your skin is more broken out than it was when you were a teenager. You don’t know what else to try...
- You’re already spending tons of cash on facials and trips to the dermatologist
- You’ve tried every “miracle” regimen at Sephora
- You even tried cutting back on nights out with your girlfriends!
But here’s what you don’t know… what you think is just “annoying adult acne” might actually be more than that. It could be a sign you have Polycystic Ovarian Syndrome.
I know what you’re thinking - you’ve heard of PCOS and you couldn’t possibly have it! You have normal cycles (well, at least your birth control pill makes them seem normal), you’re not overweight (although you do feel like you carry a bit more weight than you should, given how active you are), and you don’t have any other symptoms (except the acne… and your hair is thinning a bit… and the need to wax your lip every month…).
Listen girl, I get it! When I found out I had PCOS, I was shocked. But it turns out, I actually had a pretty atypical case. And you might too.
Misinformation about what PCOS is and the symptoms it can cause let many women slip through the cracks and never get the diagnosis or treatment they deserve.
Adult acne isn’t normal, and it isn’t something you should have to deal with. Finding the root cause of your acne and addressing it can mean clear skin and better health (because acne is always a sign of a bigger problem). And even if you’re certain you don’t have PCOS, keep reading anyways - you may be surprised by what you learn!
What PCOS Is (And Isn’t)
The #1 misconception about PCOS is that it is simply a condition where cysts develop on the ovaries. So wrong. In fact, some women with PCOS don’t even have cystic ovaries!
PCOS is actually the most common type of hormone and metabolism imbalance. It affects 1 out of 10 women. (Yes, that number is the same as 10% - a huge amount.)
Based on the Rotterdam Criteria from 2003, there are 3 diagnostic criteria for PCOS - and to be formally diagnosed, you have to have at least 2:
- Confirmed androgen excess on labs or androgen excess symptoms
- Ovulatory dysfunction
- Multiple cysts on ovaries (PCOM) diagnosed via imaging ultrasound
If you have at least 2 of the 3 criteria above, your doctor can diagnose you with PCOS.
In 2018 PCOS diagnosis guidelines were updated by a combined counsel of the Australian National Health and Medical Research Council, European Society of Human Reproduction and Embryology, and American Society for Reproductive Medicine.
It was a HUGE step forward in the treatment and diagnosis of PCOS, since the new guidelines (finally!) took into account how different PCOS can be in different women.
Here are their new recommendations:
- Androgen excess can be diagnosed by measuring free testosterone or bioavailable total testosterone. However, elevations in the hormones Androstenedione and DHEAS can also indicate PCOS, even without elevated testosterone.
- When irregular menstrual cycles are present, a PCOS diagnosis should be considered. Irregular is defined as cycles less than 21 days, greater than 35 days, or less than 8 cycles per year. However, ovulatory dysfunction can still occur with regular cycles - this can be confirmed or ruled out with serum progesterone levels taken in the second half of the cycle.
- Ultrasound should not be used for the diagnosis of PCOS in those less than 8 years out from their first period, because many younger women have multifollicular ovaries, even without having PCOS.
The new diagnostic criteria don’t mention weight - and that’s because your weight is not part of the diagnosis for PCOS. Only 30% of people with PCOS are overweight or obese. And pain is not a symptom of PCOS, either.
What Does PCOS Do To You?
The hormone imbalance in PCOS creates problems with how the ovaries function, so the egg that should develop each month may not, or may not be released during ovulation (aka anovulation).
Some women think that if they aren’t actively trying to get pregnant, anovulation is no big deal - but regular ovulation is a sign your body is humming. Many women with PCOS also experience irregular cycles. Again - this is more than just a fertility problem (though it is that too!) A healthy period is a sign your overall health (physical & mental) is good
(Side note - if your doctor prescribed the pill to regulate your cycle, this is still a problem! More on that later, so keep reading).
But PCOS is about way more than just ovulation.
Excess Androgens Are The Real Cause of Adult Acne
Women with PCOS tend to have an excess of androgens. Androgens are male hormones, and an excess can mean high testosterone, high DHEA, or high metabolites of either.
Excess androgens are responsible for some of the most dreaded PCOS symptoms like:
- Acne (especially on the chin, jaw, and back)
- Male pattern hair loss/thinning
- Hirsutism (male-pattern hair growth, like on the face)
- Anger, irritability, mood swings
- Poor stress response
- Increased anxiety and depression
Not every woman with excess androgens has all of the above symptoms - and sometimes one symptom can be severe (like acne!) while other can be more mild (maybe just a bit more hair on your upper lip).
But pay attention here - hormones levels are complex! Many women with PCOS also have symptoms of high estrogen. It commonly happens like this: DHEA is high, but progesterone is low relative to estrogen levels. On top of that, many women have poor estrogen detox because their liver is overburdened.
How PCOS Presents in Real Women
Remember, every woman is unique - but there’s a common scenario I see in my clinic with women with PCOS. And - full disclosure - I was one of these women too!
Here’s a story I hear from a typical PCOS patient with acne in my clinic about her teenage years/early 20s:
- Her period came in her later teens (or never started naturally)….or started “on time” but then had irregular long windows between
- Acne started to develop and so did hair in places she didn’t want it --(like nipples, lip, chin, stomach)
- She may have been put on oral birth control pills to “regulate” her period and help deal with the acne
- And she might have been put on antibiotics like tetracycline or Accutane to further help control the acne
Sound familiar to you?
Then, as she aged into her 20s and 30s:
- As other women’s acne clears up, hers is getting worse than ever
- She may start to gain weight around her middle (even if she remains thin), or struggle to control her weight despite a healthy lifestyle
- Her hair might lose its luster and start to thin
- She may notice more anxiety and depression, trouble recovering from stress
And if she decides to stop taking the pill, here’s what usually happens:
- Her period takes a long time to return after stopping the pill - or it NEVER comes back
- Can’t conceive easily or without intervention
Not all of these symptoms are drastic (although some women do have very dramatic symptoms as a result of PCOS) - they can be subtle annoyances that hint at a bigger underlying problem.
What Not To Do If You Have PCOS & Acne
Most doctors - be they GPs, gynecologists, or dermatologists - only think of acne as a cosmetic issue. They often don’t make the link between acne and bigger issues like PCOS or hormone imbalance - especially if your other symptoms are mild or masked by the artificial hormones in the pill.
So, if you go see your doctor complaining about acne, you’ll probably be given one of these 3 things:
- Oral contraceptives (birth control pills)
- Antibiotics like tetracycline
- Medications like Accutane
While these meds might help short-term for some women, in the long-run they only make PCOS symptoms worse. Research has shown women with PCOS already have a less diverse microbiome than women without PCOS (and, that increasing microbiome diversity may be an essential part of treatment). The pill, Accutane, and antibiotics all only further damage the microbiome (especially when you’re taking them long term!)
Our microbiome (aka all the bacteria living in our gut) are critical for hormone biotransformation - that means they help produce and then clear out hormones. To have healthy hormones, (and clear skin) you’ve got to have a healthy gut - and taking any of these common acne meds can wreck your gut!
(It always comes back to the gut!)
Don’t Panic!
If you’re reading this and thinking you may have PCOS - or are nodding along because you were prescribed the Pill and antibiotics to treat your acne - please don’t panic!
Our bodies are so resilient, and there is a lot you can do to balance your hormones. In Part Two of this article, I’ll explain exactly what you CAN do and how I help women with acne, hormone imbalances, and PCOS in my clinic. Check out Part Two here.
Are Worms The Next Frontier of Health? Everything You Need to Know About Helminth Therapy
I talk a LOT about clearing infections and overgrowths - Small Intestine Bacterial Overgrowth (SIBO), yeast overgrowth (candida), and of course, killing parasites.
So I was shocked when I first heard about a new treatment idea for treating disease and healing damaged gut: worm therapy. Not clearing worms. Giving them to the patient, to help heal disease.
No, I’m not joking. It’s called helminth therapy - named for the type of organism used Hymenolepsis Diminuta Cysticeroids (HDCs). HDCs are the larval form of a very specific type of worm that help to restore immune tolerance and diversity to the microbiome when it’s been damaged.
I was really skeptical when I first heard about this. But then I heard a presentation given by one of my medical heros, Dr. Sidney Baker (former faculty member of Yale Medical School, founder of Defeat Autism Now! and Autism360.org, Linus Pauling Award recipient) and Dr. Yehuda Shoenfeld at the Institute for Functional Medicine conference in May 2018.
They shared the latest research and their experience using helminth therapy - and I went from skeptical to excited. I slowly introduced helminth therapy in my own practice and saw amazing results.
Here’s what I want you to do: suspend all your judgement for the next 10 minutes and read the rest of this post. I promise you’ll be surprised by what you learn - and I bet you’ll want to learn more about helminth therapy.
HDCs Aren’t Just Any Worms
HDCs are the larval form (aka an intermediate life stage between egg and worm) of a small helminth. Helminth grows naturally in grain beetles, which were a common part of our food supply up until about 100 years ago.
HDCs are not a parasite. By definition, a parasite causes harm to an organism - HDCs cause no harm. HDCs stay in the gut - they cannot breach the gut wall.
Really important: HDCs cannot colonize in humans. That means they’ll never go from larvae to worm in a human. For that same reason, HDCs can’t be passed from human to human either. They’re NOT contagious from person to person.
Using helminth therapy is completely different from something like taking a tapeworm from Mexico. It’s produced in sterile lab conditions (just like probiotics are) and carefully controlled.
How Are HDCs Produced - And How Do You Take Them?
Therapeutic HDCs are grown in sterile conditions in a lab - much the same way probiotics or yeast for brewing beer or culturing yogurt are.
First, the eggs are grown in rodents in the lab. If that makes you squeamish, keep in mind that these animals are kept in MUCH more humane & clean conditions than most farm animals! Then the eggs are taken and are bred into larvae in grain beetles which eat only oatmeal. The HDCs are harvested from the grain beetles and suspended in salt water.
HDCs are given orally (again, just like probiotics!) through the salt water solution. You’ll take a tiny vial (about the size of the tip of your pinky finger!) that holds the microscopic organisms. If you hold the vial up to the light, you can just barely see the HDCs as tiny white flecks.
Unlike probiotics - which can contain billions of CFUs per capsule - HDC are given in very precise, small amounts: most people start with 10 HDC per vial and work up to 30 HDC. Strong, therapeutic doses of up to 100 HDC every 2 weeks can be used, too.
If you do ingest HDCs, they can only stay in your body for about 2 weeks.
How Does Helminth Therapy Work?
This is the part that’s really exciting:
Helminth therapy works by promoting microbiome diversity and restoring immune tolerance.
Remember - our body isn’t sterile. Our microbiome is teeming with important bacteria and other organisms that help it function: both flora (like probiotics) and fauna (beneficial things like HDCs). When the gut microbiome doesn’t have enough diversity of both flora and fauna it can’t perform its functions properly.
Our gut microbiome teaches our immune cells how and when to function and it establishes our intestinal barrier (which keeps pathogens out of our bloodstream). Our immune cells are our body’s defense team. Immune tolerance is what our immune cells won’t react to. It’s our body’s bouncer waving something through.
Immune tolerance is a good thing! It means your body won’t wage war on the strawberries you ate, or cause you to sneeze and cough when you’re outside around pollen.
If you have decreased immune tolerance, you’re more likely to experience these conditions:
- Allergies (both seasonal and to foods)
- Eczema
- Asthma
- ALL autoimmune conditions (things like endometriosis, multiple sclerosis, lupus, rheumatoid arthritis, vitiligo, Hashimoto’s, alopecia, ulcerative colitis, Crohn’s and more)
Today, 50 million Americans have been diagnosed with an autoimmune disease. That’s up from 9 million in 1997. (Still a huge leap even when you factor in increased testing/awareness.)
Experts like Dr. Baker and Dr. Shoenfeld agree: the best way to treat ANY chronic illness is to restore immune tolerance.
What Makes Our Microbiome Diversity & Immune Tolerance Decrease?
Up until the very recent past (like the past 100 years) our microbiome diversity was supported naturally by our environment. People interacted more frequently and directly with nature: farming, foraging, etc. They also had less hygiene practice: no antibacterial soap or hand sanitizer.
Worms - both beneficial ones like HDCs and pathogenic ones - were also something more people had when we lived hunter-gatherer lifestyles. (These persist in hunter-gatherer groups like the Hadza tribe today - and they have the most robust and diverse microbiomes of anyone known on the planet… and virtually no IBS, UC, Crohn's, diabetes or other autoimmune disease!)
Other things in the modern world that damage our microbiome diversity:
- Antibiotic use (kill beneficial bacteria in the gut)
- PPIs (impair digestion and promote bacterial and fungal overgrowth)
- Birth control pills (kill beneficial bacteria in the gut and promote yeast)
- C-section births (prevent transfer of microbiome from mother to infant in the vaginal canal)
- Vitamin D deficiency (too much time indoors)
- Chronic stress (go-go-go cultural attitude)
- Contaminated/nutrient poor food (Standard American Diet!)
- Excessive hygiene practices (overuse of antibacterial cleaning agents)
How To Restore Microbiome Diversity & Immune Tolerance
Diet has the biggest influence of all factors on the health of our microbiota. Less diversity in your diet = less diverse gut bugs.
Step 1 has to be eating a nutrient-dense diverse diet with plenty of gut-nourishing foods: fiber, healthy fats, and protein.
Making changes to your lifestyle & hygiene practices is important too:
- Put down the antibacterial soap!
- Get out in nature and interact with the earth
- Get adequate sunlight or supplement with Vitamin D
- Eat fermented foods or supplement with a high quality probiotic
But if you already have all these steps dialed in and are still dealing with symptoms of decreased immune tolerance or chronic illness, helminth therapy that can increase diversity and immune tolerance may be the next step for you.
What The Research Shows About Helminth Therapy (And Results in MY Practice!)
- In the largest randomized control trial in history (!), 1 million children in India were dewormed by researchers who hypothesized it would lead to an improvement in general health. Instead, they found no significant effect on weight, death rate, or health. This drew into question the premise that all worm are always harmful…
- In a 2005 study, 29 patients with Crohn's disease (most of whom were non-responsive to pharmaceutical treatments) were treated with helminth therapy every 3 weeks for 24 weeks. At 24 weeks, 79.3% of the participants had responded favorably and 72.4% had completely reversed their Crohn’s disease!
- In this 2014 study, people with IBD (either ulcerative colitis or Celiac Disease) were treated with either helminth therapy or a placebo for 12 weeks. Although this study was too small and too short to be conclusive, 10% of those who received the helminth achieved remission (compared to 4% in the placebo group).
In my own practice, I’ve seen these results using helminth therapy:
- Normalization of thyroid labs
- Remission of Crohn’s and Ulcerative colitis (when symptoms have already been improved and other co-infections addressed)
- Improvement of GI symptoms (diarrhea, constipation, gas, bloating, etc.)
- Reduction of arthritis symptoms
- Improvement of inflammatory symptoms like skin rashes, insomnia, and mood/brain issues
- Reduction of histamine intolerance symptoms
Other practitioners have reported improvement in children with autism and people with multiple sclerosis.
Who Helminth Therapy Is (And Isn’t For)
There’s no magic potion in medicine that will cure all your problems (i’m sorry!).
If you’re not eating right, moving, finding joy, and managing your stress, helminth therapy won’t work for you.
But if you’ve already got those “core” practices in place and are still struggling (or just want to see how good you can feel!), helminth therapy could be beneficial for you.
Typically people take 6 doses of HDCS 2 weeks apart to initially evaluate if they are or are not going to have a beneficial response. Then, if no benefit is seen, they can increase the dose for. Risk is almost non-existent, and the potential benefits are huge.
(But, anyone on immunosuppressive drugs - like those used in some types of inflammatory bowel disease or other autoimmune diseases - shouldn’t take HDCs. The helminth therapy is not beneficial if your immune system is suppressed by medication.)
What Do You Think?
I am so glad you stayed with me.
I know that “worm therapy” sounds really weird at first- but the idea of taking probiotics was once weird, too! I’m a supporter of anything we can do to improve our gut health - because our gut health radiates out into every aspect of our being.
Want to learn more about helminth therapy (and potentially give it a try?) - book a free 15 minute consult with my team where we can create an action plan for you.
Want to get healthier but NOT ready to try HDCs? That’s OK too - I’d love to teach you about how else you can support your gut. Book a free 15 minute consult with my team here.
What Working With A Functional Medicine Practitioner Is Really Like (Patient Case Study)
You’ve been to the doctor. He runs some tests and he says nothing’s wrong.
But you know you’re not you right now. Maybe you’re dealing with digestive problems that have taken the fun out of eating. Every dinner out is a potential threat.
Or maybe it’s your hormones that seem off. Your once predictable cycle is suddenly erratic. You feel like you’re in puberty all over again.
Or maybe you’ve never had a happy gut or healthy hormones. The doctors have thrown up their hands. They can give you The Pill or suggest you try a fiber supplement, but that’s all they’ve got for you.
You’ve always trusted your doctor - but right now it feels like there is nothing they can do to help you.
Where do you turn?
This story is how so many women end up looking for a Functional Medicine Practitioner. I know it well, because this is my story, too.
What Is Functional Medicine?
Functional medicine is an evidence-based approach to health that focuses on finding the root cause of health problems. Functional medicine looks at the body as one system - meaning that is something is “wrong” in one area of the body, it is likely having an impact on other parts of the body, as well.
Functional medicine incorporates both Western and Eastern approaches - the latest technology and ancient wisdom.
The #1 misconception about Functional Medicine is that it denounces modern medicine in favor of healing crystals and water fasts. Not true!
Listen, I won’t knock anything until I try it - including crystals and fasting - but the majority of work I do with clients in my clinic is much different than that. You might not know that though, because you’ve never seen a FMP before!
What Is It Really Like To Work With A Functional Medicine Practitioner?
Today, I want to walk you through the process of working with a Functional Medicine Practitioner. I’ll share one of our amazing patient’s own journey (yes - including test results!) so that you can understand what it’s really like to work with a FMP.
Before anything else, I always do a free 15-20 minute prospective patient interview. This is just a chance for us to connect (without any pressure) and be certain we’re a good fit for working together. From there we’ll go to official first step: the case review appointment.
The case review is like a deep-dive interview. I want to know as much about you as possible. I might even ask some questions about your childhood! Here I’m looking for clues as to the root causes of what is troubling you now.
Next, we’ll order some testing - depending on your unique symptoms and history. I don’t want to waste your time or money, so we’ll only order the tests that are relevant for you.
Once test results are in, we’ll meet again to develop a treatment plan. You’ll implement the plan (usually diet & lifestyle changes, plus supplements) and we’ll have check-ins to see how you’re progressing and if we need to make tweaks to the plan.
Finally, we’ll re-test to check your progress. (This is the best way to know treatments are really working.)
I’m excited to share this story with you - let’s dig in!
Step 1: Marina’s Case Review
Marina met with Amelia, one of the clinicians who works in my practice, in January. At her first meeting, we learned a lot about her!
She was 22 and was working as a paramedic with her local fire department. She wanted to become a helicopter medic (how badass is that?) but was struggling with health problems that were holding her back. Digestive problems and brain fog were zapping her of the energy she needed to go back to school.
First, Marina told us about what was going on right now: serious digestive problems. She was having oily stool, undigested food in her stool, and couldn’t tolerate eating meat at all unless she took her “meat pill” - a prescription anticholinergic medication. The digestive problems were wearing her out, and she was dealing with brain fog.
Then we went back in time: when did her health problems start?
Marina told Amelia that when she was younger, she had developed a cyst on her heart. Her doctors had treated it with back-to-back rounds of antibiotics.
As a side effect of the antibiotics, she developed neuralgias (a kind of nerve pain that causes severe pain) and vertigo. The vertigo led to 3 concussions in a row and she was ultimately diagnosed with a Traumatic Brain Injury (TBI).
It was at this time that the digestive problems started, too. Bloating, nausea, food intolerances, and fat malabsorption (which was causing the oily stool).
Her doctor told her the digestive symptoms were just Irritable Bowel Syndrome (IBS) and gave her the prescription for the “meat pill.” That was all he could offer.
6 years after the cyst on her heart, and Marina was still dealing with the repercussions of it. That’s how she came to see us.
Based on her history of antibiotic use and her current symptoms, we suspected Mishana was dealing with a gut infection. We suggested she start with a GI-MAP - a comprehensive stool analysis that can test for many gut infections at once.
Step 2: The Test Results Are In
Marina agreed to the test, and a few weeks later, results were in:
Marina tested positive for:
- C. difficile
- Enteroinvasive E. coli/Shigella
- Enterotoxigenic E. coli LT/ST
- Salmonella
- Entamoeba histolytica
- Enterococcus faecalis
- Streptococcus spp.
- Candida spp.
- Chilomastix mesnelli
- With relative elevations in other markers
You might be thinking these test results are crazy - but it actually isn’t that uncommon! Even in the United States, gut infections and parasites are fairly common. And if you have used antibiotics or have a compromised microbiome for some other reason (like you’ve been eating the Standard American Diet) you are more susceptible to picking up gut infections.
Why don’t doctors test for these infections?
Some Western-medicine doctors do - but many others don’t. They either wrongly believe that gut infections are unlikely or they think they are “non-symptomatic” infections - meaning they don’t cause problems, and don’t need to be treated.
In my experience, (both personally and with my patients) clearing gut infections makes a huge difference in how you feel.
For Marina, we started treatment with a prescription anti-parasitic, alongside a natural bacterial protocol. After she completed those treatments, we used a prescription anti-fungal. Finally, we completed a re-seeding protocol with both probiotics and prebiotics (the most important step after any type of clearing treatment!).
After treatment, I always recommend re-testing to be sure that all the infections have cleared. Feeling better is a great indicator that infections have cleared - but it can’t replace seeing the results on paper!
Step 3: The Second Test Results:
As you can see from the results - Marina was able to clear all her gut infections!
(Note: She did have some low beneficial flora that we worked on next.)
The results on paper back up what Marina experienced day to day: her digestion has improved. No more bloating or food intolerances.
Not just that, but after years of brain fog, Marina is finally thinking clearly again. She was even able to pass her paramedic cardiac program and enroll in medic school.
Now that the infections are cleared, Marina is working on improving her habits - especially around eating foods that support gut health and getting enough sleep - so that the infections don’t have a chance to come back. I’ll keep working with her to make sure she keeps improving.
It’s Black, White, & Gray
I like to say that I look for “black, white & gray” results with my clients.
I want the black and white stuff - the test results that prove the treatments we’re using are working. And I know those results are important to you, too.
But I also want the “gray” - I want to hear that you’re going out to dinner with your boyfriend and you don't get sick, that you’re finally able to be back in school, that you don’t have to press snooze five times every morning before you drag yourself out of bed.
For Marina, we definitely got the black and white and the gray - and I am so thrilled to see her thriving again after years of struggle.
I hope this has helped you understand what it really is like to work with a Functional Medicine Practitioner. And if you’re ready to take the next step forward in your health, I’d be honored to work with you. You can book a free prospective patient interview anytime here.