by Amanda Malachesky | Apr 15, 2019 | Digestion, Functional Medicine and Coaching, Functional Nutrition, IBS, Stress, Uncategorized
Today’s blog post is a guest post by Ben and Rupali Brown, owners of Pali Yoga in Eureka, CA. I reached out to them to help you learn about the most useful and valuable yoga poses to support your digestive health, particularly symptoms of bloating and IBS. Ben and Rupali are a husband and wife yoga team, and offer a wide range of Vinyasa flow classes, restorative classes, barre yoga, and more. If you happen to live on the NorthCoast, check out their studio.
Whatever the cause of belly bloating, simple yoga poses can go along way towards helping to relieve the symptoms of belly bloating.
By practicing a range of asanas, we get our bodies moving, which increases blood flow and aids in the expulsion of gas and excessive fluid retention.
There are both physical and mental results of these poses that will positively effect belly bloating. Simple inversions calm the nervous system and give gas an easy pathway out of the body. Twisting stimulates your internal organs and helps you move internal stagnation, while forward folds can also put direct pressure on the abdomen to squeeze gas out.
Additionally, breathing in a way that encourages abdominal contraction on the exhales and dilation on the inhales will increase peristaltic (digestive) motion.
Lastly the benefits of calming the nervous system and reducing anxiety will have perhaps the greatest impact on the healthy functioning of our digestive system, discouraging the over-production of gases in the first place.
While practicing these poses for bloating, focus on contracting the abdominal muscles during exhales, and relaxing and dilating the belly during inhales. We recommend a range of asanas, or poses, from twists to inversions, that will help increase blood flow and stimulate the digestive tract to remove gases and fluids that have become trapped.
We recommend a sequence that begins reclining on the back, to allow the nervous system time to relax, which will create the correct conditions for the physical poses to help. Here are the poses we feel are most likely to reduce bloating and improve digestion.
Apanasana (knees to chest pose)
Draw knees tightly into chest, without creating tension in the shoulders and neck. If range of motion allows, interlace hands to elbows around the shins and hold for approximately thirty seconds. A simple modification is to practice holding only one knee at a time.
Supta Matsyendrasana (reclined twist)
Twisting sometimes offers nearly immediate relief for significant bouts of abdominal distress, and also offers the benefits of stretching tight spinal muscles and stimulating the internal organs.
Lying on your back, bend both knees and place your feet firmly on the ground. Move your hips a few inches to one side and drop your knees towards the other. Make micro-adjustments to your upper body so that both shoulders can rest easily and evenly on the ground.
If needed place a blanket under the raised shoulder to allow it to rest. Make sure to switch sides, and hold for 30 seconds at least.
Setubandhasna (Bridge Pose)
Inversions like Bridge Pose help calm the nervous system, stimulate the circulatory system, and encourage the expulsion of gas from the abdomen. Of course this can reduce bloating!
Lying on your back, bring your feet to the floor and knees to the sky, taking a moment to bring your heels in fairly close to your pelvis. Engage your thighs towards each other, press evenly through the feet and lift your hips off the floor.
Pause for a moment and bring your hands, elbows and shoulder blades closer towards each other, and then press your hips and abdomen up as high as you can while maintaining even, easy breathing.
Marjariasana Pose (Cat Pose)
Toning the front compartment of your abdomen will stimulate peristaltic motion, allowing your body to bring itself back to equilibrium, and relieve bloating.
Coming to your hands and knees, with your hands under your shoulders and your knees under your hips, press the ground away actively with your hands, broaden your shoulder blades, “tuck your tailbone”, and arch your back strongly to the sky. Focus on contracting our abdominal muscles especially with exhales and softly releasing them on the inhales.
This pose can be held, or it can be practiced in conjunction with “Cow” pose. Alternatively you can come back to neutral spine with the inhales and repeated 10-15 times with each exhale.
Malasana: (Yogic Squat)
This asana simulates the correct body position for elimination, and massages the end of the digestive tract including the colon. This can help eliminate gas and move the bowels, relieving bloating.
In a standing position, turn your toes out slightly, with heels approximately the width of your hips. Squat down between your heels. Lift the crown of your head upwards as you drop your pelvis downwards, using these two opposite forces to lengthen your spine. Use your elbows to press the thighs apart and make Anjali Mudra (prayer hands). Squeeze the thighs in against the elbows.
If it is uncomfortable or impossible to keep the heels down, prop them up. If there is too much strain in the knees place a block or a bolster under the sit bones.
Uttanasana (standing forward fold) with a pillow
Uttanasana offers the benefits of inversion, and is also a great tonic for an over-stressed nervous system. If your bloating is made worse by stress, this may help. The pressure from the pillow may also help expel gas.
Standing with your feet hip-width apart, place a firm pillow at the top of your thighs. Hinge forward from the hips and let your hands fall towards the ground. Bend your knees slightly especially if you tend towards discomfort in your lower back.
Find the ground, or yoga blocks, or your ankles, with your hands, and fold deeply, relaxing your head to gravity. Allow the pillow to exert light extra pressure to your abdomen.
Balasana (Childs Pose)
Begin on your hands and knees with toes stretched out. Shift your hips back to sit on the heels and rest your abdomen onto your thighs and your forehead onto the floor. Either extend your arms out ahead or behind you. If there is discomfort in knees place a folded blanket in between the feet and hips and/or place a bolster under the forehead. Hold for a minunte or longer.
We encourage practicing these poses and holding each for approximately thirty seconds, and repeating as needed.
Need help integrating relaxation practices AND nutrition and digestive support? Please grab your Free copy of Roadmap to Gut Recovery to learn more. You can also schedule a free 30-minute Assessment Session with me. Together, we’ll identify where your best, most efficient action towards healing can be directed. I look forward to meeting you!
by Amanda Malachesky | Feb 4, 2019 | Digestion, Food Intolerance, Functional Medicine and Coaching, Functional Nutrition, Testing
If you’ve been diagnosed with IBS, or another digestive illness, you may have been told there’s not much you can do, other than change your diet. And while diet changes are foundational for success with your IBS, there is a lot of useful information to be gained by gut microbiome testing using functional labs.
As many as 80% of IBS sufferers may in fact have SIBO, or Small Intestinal Bacterial Overgrowth as a primary cause of their symptoms. And other types of gut dysbiosis has been shown to be associated with IBS as well.
To create a meaningful strategy for healing from IBS and other digestive challenges, it’s important to do gut microbiome testing because choosing the right strategy requires knowing which types of organisms are overgrown.
Read on for a gut microbiome testing overview, and to learn which specific labs I use with my clients.
What is Gut Microbiome Testing?
With the recent evolution of DNA-PCR technology, it’s become easier and more affordable than ever to do DNA gut microbiome testing. Several labs have developed technology to identify the presence or absence of particular microorganisms in a sample of stool.
We all have a prolific community of miocroorganisms in and on our bodies, including bacteria, yeasts, parasites, and viruses. Some writers and researchers have said that our communities of microorganisms outnumber our individual cells! These communities are an integral part of maintaining our digestive function.
Gut microbiome testing uses DNA analysis to find out whether there are known pathogenic, or infectious, microorganisms in our digestive system. Some gut bugs are normal residents, but can cause problems if there are too many of them, while others are non-normal residents and can cause symptoms and illness.
Before DNA testing was available, most gut microbiome testing was done by culturing a stool sample for bacteria and yeast, and physically looking for evidence of parasites, such as eggs or parasite bodies, with a microscope. The huge advantage of using DNA testing is that it can detect much smaller quantities of organisms than can be visually seen. Labs claim that they can detect down to 3-5 cells worth of an organism by identifying its DNA fingerprint.
Gut Microbiome Testing for IBS and Other Digestive Problems
Because an irregular microbiome is a hallmark of chronic digestive problems, using gut microbiome testing can provide you with important direction when planning your individualized plan for healing.
The symptoms of IBS, IBD, Crohn’s Disease, SIBO, Celiac disease, and other digestive related disorders are similar, but the approach to helping you reach remission will be unique and individual to you. Likewise, symptoms of infection with parasites, bacteria, or yeasts are similar, but the best approach for each situation is different.
It’s always best to test, not guess to move forward with the most accurate and specific information possible, so you can create the most personalized plan.
Gut Microbiome Test #1: Diagnostic Solutions Laboratory GI-MAP
The GI-MAP is a stool test. Using the scoop in a little test vial with preservative solution in it, you collect stool at home, and ship it back to the lab for testing.
The GI-MAP test is my go-to gut microbiome test for these reasons:
- Thorough testing for the best normal and worst pathogenic players, including H. pylori, C. difficile, Giardia, Enterotoxigenic E. coli, Klebsiella pneumoniae, Bifidobacteria spp., Lactobacillus spp., Blastocystis hominis, Dientameoba fragilis, Candida albicans, and parasitic worms.
Includes markers for gut health, including Secretory IgA, Anti-gliadin IgA, elastase, calprotectin, and more.
- Its cost is reasonable compared to other similar tests.
- It is fairly often covered by insurance.
- It’s easy to collect your sample, doesn’t require complicated preparation like some other stool tests, and the sample doesn’t need to be mailed immediately.
Understanding particularly which types of organisms are likely contributing to your problem is essential to creating your healing strategy. For example, if parasites are present, it’s important to address them first, before working on bacteria or yeast. Or, if yeast overgrowth is the only thing that shows up, then the appropriate strategy would be different.
Gut Microbiome Test #2: SIBO 3-Hour Lactulose Breath Test by BioHealth Labs
It’s estimated that a high number of IBS patients actually have SIBO (Small Intestinal Bacterial Overgrowth), which is an overgrowth of normal bacteria that has migrated from the large intestine to the small intestine.
To take the Biohealth Labs SIBO test, you prepare a day ahead of time with a special diet, and then drink a lactulose solution. You then collect breath samples into glass tubes every 20 minutes (materials are all included in the test kit) for 3 hours. You mail these back to the lab for analysis.
If you have a bacterial overgrowth in your small intestine, levels of hydrogen and methane gas will spike during the 3-hour period.
SIBO is notoriously difficult to resolve, but knowing which type you have is critical for reaching resolution, because the healing approach for each type is different.
Gut Microbiome Test #3: Intestinal Permeability (IP) Testing by Genova Labs
The Intestinal Permeability test by Genova Diagnostics is not a specific gut microbiome test, but it can show you how leaky your gut is. When your gut is permeable, proteins that shouldn’t be able to cross into the bloodstream are able to do so. This is an acknowledged autoimmune trigger, and also can leave your gut vulnerable to infection with pathogens.
This test doesn’t have a whole lot of clinical value, because we can assume a leaky gut if certain symptoms, such as multiple food sensitivities are present, but some people want to know for certain if their gut is leaky or not. This test answers that question.
Gut Microbiome Test #4: Mediator Release Test Food Sensitivity Testing by Oxford Biomedical OR IgG Food Sensitivity Testing by US Biotek or Genova Labs
Again, food sensitivity testing is not specifically Gut Microbiome testing, but food sensitivities are often a side effect of underlying infections or gut dysbiosis. I generally recommend my clients first use Food-Symptom Diary tracking to get clear on their own particular and unique triggers. (You can download your copy of my Food-Symptom Diary with instructions on how to use it here.) But sometimes, the situation is really confusing, or people are unable or unwilling to complete the full elimination diet process.
I recommend the Mediator Release Test (MRT) from Oxford Biomedical Food or IgG Food Sensitivity Testing by Genova Labs or US Biotek. Food sensitivity testing can help shorten the food sensitivity discovery process, and provide a useful place to start the diet modification while working on healing the gut microbiome.
How to Get Gut Microbiome Testing for IBS or Other Gut Challenges
While there are some gut microbiome testing services that are available to the public, the tests I have mentioned here require working with a practitioner who has an account. Though more and more traditional doctors are becoming aware of the value of gut microbiome testing for their patients, many are still not using it. Functional medicine doctors and practitioners are generally using these tests and principles in practice, as well as many nutrition practitioners as well.
Check out the following referral links to find a practitioner near you, or one who works online or long distance:
Now that you know how important gut microbiome testing can be to finding your pathway to healing your gut or allergy symptoms, go get tested! I can provide access to all these tests I mention, in addition to others, as they may fit with your situation.
Not sure whether testing is right for you, or whether something else might be better first? I invite you to schedule a 30-minute Assessment Session with me to find whether testing is the next best step for you. I hope to meet you there.
by Amanda Malachesky | Jan 21, 2019 | Diet, Digestion, Functional Medicine and Coaching, Functional Nutrition, Nutrition, Stress, Thyroid
During my late teens and early 20s, mental and gut health challenges slowly became daily burdens in my life. The first time I experienced anxiety, I startled awake in my dorm room with my heart racing in the middle of the night, wondering if I was having a heart attack. Other times, I would sometimes experience a deep sense of foreboding, like something really bad was about to happen, and I would frantically ask my friends or partner to change plans.
By my 30s, I had frequent diarrhea and cramping attacks, which were inconvenient when I wasn’t near a bathroom. I would go through periods where I was nauseated a lot. And I couldn’t sort out why it was happening. And my worry compounded my digestive symptoms. I could see some overlap between my mental and gut health symptoms, but I didn’t really realize until later how my mental and gut health were deeply connected.
As I studied functional nutrition, it suddenly all fell into place: the health of our gut is totally connected to our mental health status.
Here are some aspects of the mental and gut health connection you may not know about that may help you understand what you are up against, and to create a plan.
1. The Gut and Mental Health -Microbiome Connection
Your gut is home to a community ecosystem of microorganisms, made up of bacteria, yeasts, and even some types of parasites. When in balance, this ecosystem helps you maintain your digestive function, create and absorb nutrients, and maintain an effective barrier against pathogens, or bad guys.
These microorganisms communicate by chemical signaling messages, which can be actually transmitted from gut to brain. In this way, your gut tells your brain if you’re feeling well, or if you’re feeling stressed. This is the source of a “gut feeling”.
Healthy microbiome residents, like certain kinds of Bacillus bacteria, are responsible for creating certain essential nutrients via fermentation in the colon, such as B vitamins, vitamin K2, vitamin A, and antioxidants. Some of these nutrients help maintain good gut barrier function, and prevent toxins from unwelcome microorganisms from getting to and affecting your brain.
If you have populations of unwelcome, pathogenic bacteria, their chemical messages and waste exhaust communicate with your brain via the vagus nerve and can contribute to anxiety and depression symptoms.
Collections of digestive symptoms are often a sign that gut infections may be present. Because the gut microbiome is so important to brain health, it’s important to address any hidden infections as a part of your plan to resolve your mental health challenges at its roots.
2. Regular Bowel Movements are Essential to Gut and Mental Health
If you aren’t pooping regularly, toxins and exhaust from bacteria can increase and affect your mood and mental health. For example, elevated methane gas from bacterial overgrowth in the small intestine can create severe brain fog, anxiety, depression, headaches, irritability, and fatigue. Moving the bowels if constipated may help reduce mental health symptoms. (See 9 Ways to Get to the Bottom of Chronic Constipation for additional help and resources).
3. The Thyroid- Gut and Mental Health Connection
Thyroid imbalances are closely related to your gut health and mental health. A majority of T4 hormone (made in the thyroid gland) is converted to T3 (the usable hormone) in the gut. In this way, emergent thyroid problems may be a digestive disturbance at the root, and can often be cleaned up with an elimination diet and adrenal support.
If your body notices too little thyroid hormone, your brain and thyroid gland may try to make up the difference by releasing more Thyroid Stimulating Hormone (TSH), leading to too much hormone. Too much thyroid hormone, and you may experience anxiety. Too little thyroid hormone, or low levels of T3 and T4, and you will likely feel depressed. Supporting your thyroid function by supporting your gut function can be a really important part of balancing any mental health concerns.
4. The Gluten- Gut and Mental Health Connection
Many authors have noted the presence of mental health symptoms with the consumption of gluten. Grain Brain by Dr. David Perlmutter, Why Isn’t My Brain Working by Dr. Datis Kharrazian, The Autoimmune Fix by Dr. Tom O’Bryan, The Paleo Diet Cure by Chris Kresser, L.Ac., Healthy Gut, Healthy You by Dr. Michael Ruscio, and many more explain how consuming gluten foods breaks down gut barrier function which allows toxins to reach your brain and affect your moods and mental well-being.
As partially digested gluten (and other) proteins make it to the brain through a leaky gut, they can cause inflammation in the brain and contribute to mental health symptoms, including anxiety, depression, brain fog, poor memory, and even schizophrenic episodes. There was some very interesting research done in state hospitals in the 1960s removing gluten from the diets of schizophrenics. The patients experienced noticeably improved symptoms, and symptoms got worse with the reintroduction of gluten.
If you are experiencing gut and mental health challenges, you might consider a gluten elimination diet. You can read more in 6 Reasons to Quit Gluten If You Have a Chronic Illness.
5. The Importance of Good Digestive Function for Gut and Mental Health
Many of our mood-supporting and regulating amino acids and neurotransmitters, like GABA or 5-HTP, or serotonin are in part made from protein foods in our diet. For your body to have access to the amino acids that build neurotransmitters, they must be chemically broken down from protein with hydrochloric acid in your stomach.
If your body is low on stomach acid, then you can become deficient in aminos important for your mood regulation. Further, even if you can break down the proteins, if your gut function is compromised by bacterial overgrowth, yeasts or parasites, you may not be adequately absorbing the aminos you need either.
Supporting your belly for robust digestive function is important for your mental health. You can read more in Have You Skipped These 9 Digestion Tips in Your Quest to Heal?
6. The Stress- Gut and Mental Health Connection
I hope by now you can begin to understand how important good digestive function is to support gut and mental health.
High stress levels work against this process, and not only decrease our mood, but deplete our ability to maintain a positive mood. Stress also decreases our digestive efficiency, by slowing down digestion.
To make matters worse, staying stressed out burns through large quantities of amino acids, which can further deplete your stores. Coupled with a compromised digestive system, you can see a self-reinforcing feedback loop worsening your mental health state.
To make sure your stress isn’t wrecking your gut and mental health, it’s imperative to focus on effective stress relief practices, such as breathing, yoga, meditation, or simply doing something you love.
7. The Importance of Fat for Gut and Mental Health
In a world that has mistakenly villianized dietary fat, our mental health has suffered. Not only does too much carbohydrate-rich food feed the bacteria and other microorganisms that can destabilize your gut and therefore your mood, your body need fats to make your hormones. Your hormones help keep your moods in check, help you feel motivated, confident, and relaxed.
As women begin to experience perimenopause, for example, levels of progesterone decrease, which can increase feelings of anxiety and stress. This process often collides with increased family and career demands, leading to a confluence of events that can precipitate a mental health crisis. If this woman also happens to be eating a low-fat diet, she will feel far worse than a woman who is consuming healthy fats.
Make sure that you are including healthy fats (olive, avocado, coconut, ghee, or butter) and are avoiding industrial seed oils (cottonseed, soy, canola, safflower oils) in your diet, and are supporting healthy fat digestion with stomach acid and enzyme support.
Conclusion: What does all this amount to?
To work on resolving anxiety or depression at its root cause, it’s important to consider what exactly is going on in the gut, the interface between your gut and your food, and to work to balance and correct it. In most cases, the gut is a significant contributor to mental health symptoms, and must be balanced. This work is done by managing stress, adjusting the diet to reduce inflammation, removing infections, and repairing the gut barrier function and leaky gut. It can take some time, but the mental health improvements, without medication, are worth the effort for those that want to avoid medication.
If you are experiencing gut and mental health symptoms, know that you are not alone and that there is a lot you can do to heal yourself from the inside out! When you’re ready for a some support and action in crafting a plan to investigate your root causes and heal, schedule a free 30-minute phone call with me here. Together, we’ll assess where you are, and what your next best steps would be. I look forward to talking with you.
by Amanda Malachesky | Aug 31, 2018 | Functional Medicine and Coaching, Functional Nutrition, Uncategorized
As a Functional Medicine Nutrition Practitioner, I am drawn to work with people who have confusing, complicated cases. I LOVE sitting down with a stack of labs, an interview, and a case history, and working to help a client connect the dots, so they can create a path out of their health-challenge-wilderness. They want a root-level solution.
Many people who are experiencing a complex health challenge WISH someone would do this for them.
This is where Functional Medicine and Functional Nutrition providers fill the gap left open by the insurance-model of health care, because not every health problem fits into the diagnose-prescribe-treat model. A 7-12 minute office visit simply isn’t sufficient to gather the information needed to create a root-cause resolution solution for complex illnesses.
While Functional providers are trained to make sense of complexity, there is no reason why YOU, as a client or patient, can’t play this game as well. You can uncover important details about your own health challenge, and be an integral player on your health team.
But how do Functional Medicine and Functional Nutrition providers do this work? What can you, a patient or client learn about your own case by doing some of your own legwork?
The Functional Nutrition Timeline and Functional Nutrition Matrix are two tools you can use to do this.
I’d like to share more about these two simple but radical health care tools, so you can play with them yourself and work to unlock your case mysteries and clarify your healing path.
The Right Functional Medicine Tools are Key for Success
Before I was introduced to these two tools by my mentor and teacher Andrea Nakayama of the Functional Nutrition Alliance, I was using a complicated spreadsheet that tallied a client’s self-reported symptoms with points.
Not only was it hard for both me and my clients to use, but the clinical value of the information was hard to glean.
The Functional Nutrition Timeline and Matrix are two user-friendly and intuitive tools that help clinicians think into a case systematically. Nakayama adapted the Functional Medicine Timeline and Matrix that The Institute for Functional Medicine teaches in its clinical training coursework for use in her Functional Nutrition clinic and training programs.
One of the most important things she noticed was needed when you are struggling with a complex health challenge is a framework to help clarify what is happening in your body and why. You need to discover where to look upstream for source problems. The Timeline and Matrix are the tools that help us do this.
The Functional Nutrition Timeline
The Functional Nutrition Timeline is essentially what it sounds like: it’s a chronological map of your health issues throughout your life, including detailed information all the way back to your parents’ and grandparents’ health.
This is often intuitive for people looking for answers about their difficult health problem. Those of us with puzzling symptoms have been known to pore over all the details, hoping to reveal a new clue to reveal answers. We think if we can note enough details, the picture will become clear.
I once interviewed a woman with Ehlers-Danlos Syndrome (EDS), a connective tissue disorder. When she presented a timeline she created of her illness to her doctor, he looked at her a little funny and said, “I had another patient do the same thing, and they were my only other EDS patient.”
In most cases, the emergence of a more chronic health problem is not something that just happens out of the blue. There is often a confluence of many events that collectively created it.
Correctly identifying these triggers can help you to understand where you need to work to resolve your issue at its most upstream location. The Functional Nutrition Timeline helps you do this.
To create a Functional Nutrition Timeline I use an extensive health history and interview with my clients. In the health history, I ask them about their background: their birth, childhood, teen years, significant life events, injuries, illnesses, travel, stresses, potential environmental threats, like indoor air quality in their place of work or in their home, and so on.
But as you live inside your own body, you can review your own situation and your own history. You know it better than anyone.
You want to note not only the health events you have experienced, but you also want to make note of what may have triggered those events. Anything that you feel is important should be noted.
You must also explore the particularities of your situation. How did your condition evolve and change over time? When did it begin? When did it get better or worse? What other conditions are contributing?
This information may be useful in and of itself, but provides a whole new perspective when collated onto the Functional Nutrition Timeline.
I am regularly surprised by the power of making connections on the timeline. For example, a client shared that they began having seizures at one point in their history. I suspected environmental toxins as a cause, and asked about them. But later, I asked whether there had been any history of car accidents.
The client had been in a significant car accident 3 months previous to the onset of seizures. The client had never made this connection, nor had the various doctors to whom they had gone trying to figure out the issue.
Understanding the specific demons we are confronting helps us craft effective solutions! In this client case, the missing connection between the seizures and a likely traumatic brain injury kept them from the most appropriate care. To best help yourself heal, you must understand the breadth and depth of what you are facing, and how it came to be.
TIMELINE ACTION STEP:
You can create your own Functional Nutrition Timeline by mapping out significant health events in your own life. Map them out in any way that makes sense to you.
Once you have things mapped out chronologically, consider what you know to be true about what might have triggered those events: Were you recently sick? Was there a recent stress event, like a change of job, sick child, divorce, money stress, or whatever else you can think of? Did the onset of symptoms correlate with another health event, like a pregnancy or surgery? Note the potential triggers on the timeline.
What can you learn about the evolution of your health challenge throughout your life? Make some notes, and consider asking your trusted health provider about this at a future visit.
The Functional Nutrition Matrix
Functional Medicine practitioners keep a holistic view, and no detail is too small to take note of. While creating the Functional Timeline helps you understand the big picture of what we’re dealing with and why it’s happening, creating the Functional Matrix helps you understand which body systems need attention, and helps you craft the skills to address them.
I like to refer to the Functional Matrix as your case map. First, it summarizes the top highlights of the Timeline on the left-hand side by noting the Antecedents (family history), Triggers, and Mediators.
In the center area, we make note of your current symptoms and relevant lab results, and mark them in the body area that is affected: Gut, Immune, Mind-Spirit-Emotions, Oxidative Stress and Fatigue, Hormones and Neurotransmitters, Structural Integrity, Environmental Inputs, and Detoxification.
Looking at your case details in this way helps you organize the complex, overlapping symptoms, and helps you prioritize your approach.
On the right hand side, we add in the all-important realm of skills, which represent the actual on-the-ground actions we will take to work on shifting the terrain of illness. This includes Sleep & Relaxation, Exercise & Movement, Nutrition & Hydration, Stress & Resilience, and Relationships & Networks.
This one sheet of paper can summarize your case history, your current situation, and what you’re already doing to help yourself, and where you want to go. It can help you see clusters of symptoms, and help them feel less random.
Having a completed Matrix can also help make the most of that short office visit with your other providers by giving them the most important context of your illness. It can save them the time of needing to work hard to discover all of this via interviewing, so they can focus on crafting care solutions.
Not only that, but I find that it helps educate clients about the physiology of what is happening inside their own body. For example, many clients don’t understand that food cravings can indicate a hormonal or neurotransmitter problem, or that fatigue can be an indicator of liver health. Understanding these connections can open the doorway to solutions that you hadn’t previously imagined.
But even more important than the Timeline and Matrix themselves are the conversations that open up between you and your providers to help connect the dots. Ultimately, the best Functional Medicine tools position you in a new relationship with your body, highlighting self-knowledge, personal empowerment, and connection to the intricate inner workings of your body and psyche.
MATRIX ACTION STEP:
Draw an 8-arm star in the center of a piece of paper (see the picture above for an example). Label them with Gut, Immune and Inflammatory, Environmental Conditions, Oxidative Stress and Energy Levels, Detoxification, Hormone and Neurotransmitters, Mind/Spirit/Emotions, and Structural Integrity.
Note your varied symptoms in each area of the Matrix. Is there a particular area (or areas) where your symptoms cluster? See if you can take an action to lessen the burden of the symptoms in that area.
To learn more about how I can help you use Functional Medicine tools like the Timeline and Matrix to help you walk your own personal Road to Recovery, grab your copy of Roadmap to Recovery here
When you’re ready to learn more about creating your own Functional Nutrition Timeline and Matrix with my support, schedule a free 30-minute Assessment Session with me. We’ll discuss how I can help you make sense of the complex details of your case, and create a plan for moving forward.
by Amanda Malachesky | May 21, 2018 | Functional Medicine and Coaching, Functional Nutrition
So what are Functional Nutrition and Functional Medicine, and how can it help you if you are chronically ill? Though it’s been around for 30-some-odd years, and it’s been growing by leaps and bounds in the last few years, the average person doesn’t know what Functional Nutrition and Functional Medicine is. Even people I would expect to be in the know are confused about what it is.
Functional Nutrition and Functional Medicine are an emerging holistic health care approach that will likely become a default part of the medical system within the next 5 years.
Functional Nutrition and Functional Medicine provide the kind of care that a growing number of chronically ill people with confusing health problems need to get better. It is also valuable for everyone else.
There are three fundamental principles of Functional Nutrition
1. Work to uncover the root causes of health challenges and address them at the source
Conventional treatment, though sometimes necessary, usually doesn’t try to uncover the why behind a symptom or diagnosis. You go to the doctor to get a diagnosis and maybe a prescription or other treatment. Though diagnoses are important, and can properly frame the problem, the challenge is that they are simply a label, and standard treatments do not necessarily lead to remission.
Functional Nutrition and Medicine practitioners help you dig through your case details to help identify the probable sources of your health distress.
Once the sources are identified, your practitioner helps you create a plan to remove the root causes, so your body can heal. In Functional Nutrition, this plan may include diet changes, shifts in sleep and exercise habits, stress reduction techniques, supplements to correct deficiencies, use of functional lab tests, and referral to additional practitioners.
If this work isn’t done, the situation that created the problem in the first place is likely to continue. You may need treatments and therapies to deal with symptoms forever, while never getting any closer to resolution. Does this sound a little like a hamster wheel?
2. Use tools and frameworks to clearly identify problems and possible solutions
There are many variables at play in your life that are affecting your health, but it can be overwhelming to organize these details, and to decide what the best path forward should be.
As my own chronic illness case unfolded, I had a file full of test results, food journals, forms I had filled out at doctor’s offices, notes from conversations I had with health providers, and more. I know many of you also have “the file”.
I also tried a lot of natural treatment protocols and diets that I thought might help, based on my symptoms. I would haphazardly add and subtract things from my life on a dime.
The trouble with this shotgun approach is that though you might get lucky, you’re mostly shooting in the dark. If you don’t have a systematic way to evaluate what you’re doing, or you don’t know how your signs and symptoms fit together in the whole, you’re truly flying blind.
In Functional Nutrition, we use tools, systems, and frameworks rather than protocols to help organize all the information that is relevant to your case. The tools show us where our efforts will be most useful, and track the metrics that matter. Using this information, we continue adapting your action plan so it fits with what works for your body.
3. Honor clients and patients as truly unique and “bioindividual” people, discover what’s true for the individual, and tailor recommendations to those people.
If ten of you have heart disease, you are likely to get very similar prescriptions for treatment. Statins. A Mediterranean diet. Maybe blood pressure medication. Quit smoking. Get exercise.
The trouble is, the root causes of the heart disease is different and unique for each of the ten people. For some it might be diet related, for others stress, and for others still, it may have to do with genetics or something else entirely.
And because we know heart disease is largely driven by lifestyle factors, resolving the root causes will require lifestyle shifts. Yet what a person is capable of changing, and how fast they can change it will be unique to each individual.
In Functional Nutrition and Functional Medicine, we acknowledge, fundamentally, that each client or patient is unique, and needs a unique and tailored prescription of care. Not only this, but whatever solutions we offer must fit with the client’s lifestyle, and be able to be sustained, or no real change will be possible.
Functional Nutrition uniquely fills a gap in conventional as well as Functional Medicine care. Certainly, we need doctors and hospitals, and they are experts at diagnosing and treating life-threatening, emergency, and pathological illnesses.
Yet there is a growing population of people who are sick, and need more high-touch, one-on-one, expert support care than doctors offer to restore their health. They need more frequent help and guidance, and help linking their behaviors and habits with the results they want to see.
And the truth is that most of these people are chronically ill with complex health conditions or overlapping and multiple diagnoses. According to the CDC, current statistics are 1 in 2 Americans has a chronic disease, while 1 in 4 has multiple chronic diseases.
If you are one of these chronically ill people with confusing health challenges, and you want root-cause resolution and restored function, then Functional Nutrition and Functional Medicine may be a good fit for you.
A Functional Nutrition Practitioner can help you do the detective work on your case to uncover YOUR root causes, and create a plan to restore your health, or manage your diagnosis long-term in the best possible way with the most quality of life.
Where to Find A Functional Nutrition or Functional Medicine Practitioner
There are several places to find a Functional Nutrition Practitioner or Functional Medicine Doctor. Many Functional practitioners work online, and may be able to help you even if you don’t live near them. Try these links to practitioner directories:
Functional Nutrition Alliance
Functional Diagnostic Nutrition
Institute for Functional Medicine
Learn about how to work with Amanda as your Functional Nutrition Coach.
Have you tried to create root-cause resolution with your own chronic illness or complex health challenge? Share about your experience below!
Want to see what it would look like to apply Functional Nutrition to your own health challenge? Grab a free copy of Roadmap to Recovery: How to Get Beyond Your Symptoms and Create A Personalized Plan to Restore Your Health. It’s got easy action steps to get started, and you’ll get my favorite tool as a bonus in one of my follow up emails.
by Amanda Malachesky | Mar 26, 2018 | Functional Medicine and Coaching
I’ve spent a lot of time during this last year hearing stories from women with chronic, long-term illnesses.
I’m not talking about colds that won’t go away. I’m talking about women who can hardly get out of bed, who can’t drive due to pain or frequent seizures, or migraine headaches, or can’t hold a job because of crippling fatigue. I’m talking about chronic illnesses that are challenging to shift in any positive direction.
I’m talking about things like Fibromyalgia, Ehlers-Danlos Syndrome, Lupus, Chronic Lyme Disease, Mast Cell Activation Syndrome (MCAS), Hashimoto’s or Graves disease, Irritable Bowel Syndrome (IBS), Crohn’s Disease, Endometriosis, Chronic Inflammatory Response Syndrome (CIRS) (mold and biotoxin illness), and often times, many of these conditions occur together.
And these women often look “ok” on the outside, so the people around them, including their doctors, don’t necessarily believe them when they explain how difficult life is, how hard they have to work just to get dressed.
And though many of these courageous women have tried everything they can think of to feel better, they only make small gains, if any.
But one woman last week told me that she wished there had been a fact sheet for her that helped her know what questions to ask her doctor, because she noticed there was a steep learning curve after her diagnosis. It took her some time to get educated about how to work with her doctor.
As a Functional Nutrition Coach, I walk the wide-open space between the diagnoses and basic instructions physicians give their patients to manage them, and the down-to-earth, day-to-day behaviors that patients need to make to support their wellness.
This is nowhere more important than with chronic illness, but most of these suffering people aren’t given an appropriate road-map to follow. And though many people can only make small gains in their case, when you are bed-bound, small gains may give you the edge you need to experience a better quality of life.
Here are 5 questions I think are useful to ask your doctor, when you have a chronic illness:
1. Will the treatments (medications or therapies) you are recommending reduce symptoms, or will they lead to remission? What are the alternatives?
Before agreeing to make use of pharmaceutical or other treatments, it’s important to give a full informed consent to your doctor, so that you fully understand the risks and rewards of the treatment. To clearly decide to invite a treatment into your body, you need to understand what each proposed treatment is aiming to do, and what the possible side-effects may do to your body. Will they reduce your symptoms at a cost of organ damage? Long-term effects? Will the side effects create a need for additional medications that may be harmful?
If your doctor doesn’t know how to answer these questions, you may want to explore the current research yourself, or ask your doctor if they would be willing to help you do this.
Remember, you get to decide whether to agree to a treatment. Be fully informed and educated about all the possible outcomes. Ask lots of questions, and work with your doctor to find treatment paths that provide the greatest benefit with the least harm.
2. Are you willing to communicate with other providers on my team, even alternative health providers? How can my other team members best connect with you?
Doctors routinely communicate with other providers that they have referred their patient to, to follow up on the results of that consultation. But some are not as willing to interface with allied health providers like nutritionists, chiropractors, acupuncturists, and so on.
But people with chronic illness often have many doctors and allied providers helping them with their care. Having a connected team provides a better outcome for patients, and allows the team to all work together in the best interest of the patient, and to better understand the full picture of their situation.
You can request a release of information form from your doctor’s office, to facilitate the conversation. Your doctor can’t legally communicate with other providers without permission from you.
3. What does the literature say about my diagnosis?
Many people with chronic illness spend time researching the medical literature about their diagnoses, and this is a good thing, because many medical doctors aren’t necessarily well-versed in your diagnosis, especially if it’s uncommon or they haven’t yet encountered it in practice. Their practices are often so busy that they don’t have time to read up on the latest research.
It’s estimated that clinical research takes an average of 7-10 years to trickle down to common medical practice.
Asking this question may encourage your physician to look into your diagnosis, better informing your care. If they are already informed, then you are now able to have a higher-level conversation about the choices available to you.
4. How do you feel about me trying alternative treatments before resorting to more intensive solutions?
This question is for readers who would like to avoid medications if possible. Because conventional treatments often come with unintended or unwanted “side” effects that can complicate the situation, when deemed safe by your provider, in some situations it makes sense to try low-cost, low-risk measures with a potential for benefit first, before resorting to bigger guns.
If you hold the worldview that you’d rather try low-impact choices first and that you’d like to be in charge of making your medical decisions, but your doctor doesn’t support this view, it may be time to find a provider who will support you in making the choices YOU determine are best for you. Remember, your doctor works for YOU, not the other way around!
5. Do you know of any specialists or other modalities who/that might be able to help me heal my diagnosis?
Your doctor may have a colleague who is known for their work with similar conditions or diagnoses, or know that certain therapies are helpful, but may not share about them if you don’t ask. Just last week, a woman told me that she had avoided physical therapy for her severe joint pain, because exercise of any kind hurt. When she mentioned this to her doctor, he said, “Oh, have you tried AquaTherapy?” She hadn’t and he wrote a referral on the spot for water physical therapy, which proved helpful. Even if you don’t make use of the services, knowing your options gives you other strategies to try if you don’t get the results you are looking for.
Ultimately, dealing with and healing a long-term, chronic illness is a long game, and requires being an educated patient or client. Make use of these questions to help create a pro-active, informed, and multi-pronged approach to getting the best care you can.
What questions have you found most useful to ask your provider?
When you’re ready to have support from a practitioner who listens deeply to every word you say, and can help you figure out how to talk with your doctor(s) about your health conditions, schedule a free Assessement Session with me, to learn more about how I can support you in your process.
