Functional Medicine vs Chronic health issues

"...stroke syndromes are collections of signs and symptoms resulting from Strokes in different regions of the brain or central nervous system in this video we will cover the stroke syndrome associated with Strokes in the territory of the and IT Supplies the medial and Superior frontal and parietal lobes as well as some other structures such as parts of the corpus callosum and basal ganglia it is made up of segments first arise connects both the left and right hemispheres this segment also gives off the medial lenticular striae arteries that Supply part of the caudate nucleus and the internal capsule the a to new segment extends from the anterior communicating artery up essentially segment A3 A4 and A5 at the proximal middle and distal segments of the pericoloso artery in and the findings very most commonly there is a contralateral weakness of the leg more so than the arm or the face this is due to the arrangement of the cortical neurons known as the motor homunculus which shows that the anterior cerebral artery supplies neurons involved mostly in the motor control of the contralateral leg sensory deficits are less common but when present are generally contralateral other findings can include abulia which is the absence of willpower or the inability to act decisively speech disturbances may also be present specifically another type is transcortical mixed Aphasia meaning there are severe deficits in speaking and comprehension but repetition is preserved as the anterior cerebral artery supplies the area of the brain associated with voluntary bladder control lesions here can result in urinary incontinence A syndrome of ipsilateral ataxia and contralateral lower limb paresis being described as a result of an anterior cerebral artery in fact if both anterior cerebral arteries are involved then they may be buying and frontal disinhibition symptoms which may include the presence of primitive reflexes such as grasping and sucking reflexes that are normally inhibited by amateur frontal lobe another example is personality changes..."

Approach to Hyponatremia - Hyponatremia Diagnostic Algorithm

"...hypoalbuminemia is defined as a low level of albumin in the blood and the normal range is around 3.5 to five point five grams per deciliter I'll is the most abundant protein in human blood making up around half of all serum protein it plays a key role in maintaining oncotic pressure in the blood and since its hide therefore soluble in water albumin can transport lipophilic compounds such as hormones fatty acids and unconjugated bilirubin through the blood albumin also has in acting as a pH buffer Scavenging reactive oxygen species as well as binding some drugs and calcium hypoalbuminemia can be caused by an impact this is within the liver increased utilization by tissues problems in distribution or an increase in the loss of albumin this occurs in liver disease such as cirrhosis or chronic hepatitis weather is it decrease in the production of albumin as well as a distribution problem we're more album in leaks from the capillaries into the extracellular space kidney disease is another cause hypoalbuminemia is one of the features of nephrotic syndrome where patients are losing more than 3 grams per day of protein we take this few seconds off to inform you are valued loyal listener about the best from The Nest pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems classic functional medicine Back to Basics health tips and special as doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly health and fitness Corner also check out nasty boy CC the truest story never told Fiction podcast for that real-life on-the-go experience with the 27 year old Golden Boy Who made our guest invite number one list he tells us about his story it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week as we continue to provide you the best of health and fitness enjoy the show it can also occur in chronic kidney disease with a protein is not as quick but over a long period of time small consistent losses will lead to hypoalbuminemia malnutrition or malabsorption at other causes severe malnutrition can lead to conditions such as kwashiorkor syndrome but even mild malnutrition as is often seen in the elderly can also cause from anemia conditions affecting the absorption such as ulcerative colitis Crohn's disease and celiacs disease may also end up causing hypoalbuminemia out itself is a negative phase reactant meaning its level decreases with information cytokines like il-6 and tnf cause increased leakage from the capillaries increased and less Gene transcription of the album and Gene meaning less synthesis conditions like sepsis and septic shock particularly favorite the clinical findings are often known Civic and I linked it to the underlying cause the more common findings include weakness peripheral edema and swelling all the way up to a site he's thin hair and if they have an underlying liver disease in terms of the diagnosis when albumin levels are found to be low tests are performed to identify the cause which include liver function tests assessing for liver disease urine Vermin and protein levels to assess for nephrotic syndrome and to assess for a protein losing enteropathy we could look at levels of alpha-1 antitrypsin in the stool which if l suggest a protein leakage or increased permeability of the intestinal mucosa treatment focuses on finding and managing the underlying causes while infusions of a itself a performed in some situations such as major surgery rapidly progressing hepatorenal syndrome and certain cases of nephrotic syndrome..."

"...the ascending track to the spinal cord carries sensory information from the body up towards the central nervous system they are grossly divided into tracts that carry conscious sensation and unconscious Sensation will start with a conscious sensation the first that we will cover is the anterolateral system which is made up mostly by the anterior and lateral spinothalamic tract but it also features the spinal reticular and spinal technical tracks the anterior spinal thalamic tract is responsible for crude touch and pressure sensation while the lateral spinothalamic tract is responsible for pain and temperature generally the ascending Pathways have three neurons in the path compared to only two neurons in the descending Pathways the first order neuron in the anterolateral system comes from The receptors in the periphery and signups is with the second order neuron that has its cell body in the also Horn of the gray matter note that the first order neuron can Ascend one to two levels before sign up Ting on to the second order new run the second or the neuron then deficits to the other side of the spinal cord and it is at this point that they form the separate tracts the anterior and lateral spinothalamic tract these second-order neurons will carry the information up the spinal cord to the thalamus where they synapse to the third order on really they are located on the ventral posterolateral nucleus of the thalamus and from there the fibers will travel to the somatosensory cortex of the postcentral gyrus passing through the internal capsule note that the third order neurons do not decussate they travel to the ipsilateral cortex we said that the anterolateral system is made up mostly by the spinothalamic tract but there are also two others the spine reticular which is involved in the automatic response to pain and the spine a technical track which is involved in orienting the head and eyes to stimuli the other system involved in conscious sensation is the dorsal column medial lemniscus pathway named due to the fibers traveling in the dorsal column of the spinal cord and passing through the medial lemniscus in the brainstem the dorsal column medial lemniscus pathway is responsible for transmitting sensations of fine touch to touch discrimination vibration and proprioception slightly we take this few seconds our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems class..."

"...Serotonin syndrome also known as serotonin toxicity is a potentially life-threatening condition due to excessive serotonin levels in the body this can come from using the medication as a therapy due to drug interactions recreational drug use or even intentional overdoses the end result is an increased in the amount of serotonin in the synaptic cleft able to bind serotonin receptors, for example, selective serotonin reuptake Inhibitors like Citalopram inhibit the reuptake of Serotonin into the presynaptic neuron meaning more is available to bind the postsynaptic receptors monoamine oxidase Inhibitors likes alleged lean prevent the breakdown of Serotonin so more is available SSRIs tend to be the most common cause was because of their widespread use while monoamine oxidase Inhibitors tend to produce the more severe cases other medications include serotonin noradrenaline reuptake it is tricyclic antidepressants serotonin modulators and tryptophan supplementation as it is converted and leads to serotonin formation opioids amphetamines and cocaine also increase serotonin release serotonin is found mostly in the gastrointestinal system it is carried by platelets and also exerts a acts on the central nervous system within the CNS it has rules in attention mood sleep cognition and thermoregulation in the other systems it is involved in vasoconstriction gastrointestinal motility uterine contraction and..."

ADHD

"...Bulls could be often overlooking details or making careless mistakes difficulty maintaining focus on tasks or during a conversation even when there's no obvious others are failing to follow instructions complete tasks organize tasks losing items and forgetfulness females tend to display more symptoms of inattention and distractibility then hyperactivity and impulsivity the hyperactive-impulsive features include trouble sitting still fidgeting talking constantly including others or even being unable to wait turns such as Inner Line as patients get older the symptoms become less evident poor handwriting and dyslexia have also been found to be more prevalent in patients with ADHD additionally emotional dysregulation..."

Major Depressive Disorder

"depression is a mental state of low mood there are several subtypes of depression but the major depressive disorder is the one that is usually intended it is expected to be the number one cause of disease burden worldwide by 2030 the term major depressive disorder was first used in the 1970s and the disorder was added to the diagnostic and statistical Manual of mental disorders known as the DSM in the in 80s today we have the DSM-5 which lays out nine criteria on which the diagnosis is based they include a low mood most of the day on most days and anhedonia which means a loss of pleasure or interest in previously enjoyable activities these two are considered core symptoms and one of them must be present for a diagnosis of major depressive disorder the other criteria include significant weight loss or weight gain insomnia or hypersomnia meaning not sleeping enough or sleeping too much fatigue or a loss of energy nearly every day psychomotor retardation which means ass going down of thoughts and physical movements that is noticed by others then there is inappropriate guilt or feeling worthless a reduction in the ability tea to concentrate and it recurrent thoughts of death a total of five or more over a period of at least two weeks leading to significant clinical distress or impaired functioning need to be present for the diagnosis and the symptoms cannot be the result of substance abuse or another condition major depressive disorder is thought..."

"...today we're going to talk about pots and why it is becoming more common prevalent rights becoming more prevalent so we are seeing more pots aren't we're seeing more pots and I had noticed that we were seeing more pots we were giving more pots diagnosis pots postural orthostatic tachycardia syndrome we get a zillion people okay exaggeration we so many people that come in here with heart palpitations and I bend over and I get lightheaded and by the time people most people get here with those symptoms they've usually been evaluated for like trans ischemic attacks and and and pretty much give it a clean bill of and we see it a lot because we see we see a lot of thyroid problems that can heart palpitations we see a lot of stress responses that can cause tachycardia like issues like like more than that walks in the door but pots rear its ugly head in here every now and then and it's got a lot more unique to get some more unique features to it that it's diagnosis and dr. Gates is going to talk with you about that because spoiler alert the reason they were seeing it in a number of patients is that it's getting diagnosed more Amy's reason you're seeing it be diagnosed now you're seeing people will have it and so on and so forth it's being diagnosed more and I can totally understand that from the from what's actually causing pots and and and the fact that even though people have been..."

Health FAQS with Dr Gates On microbiomes and fibroid

 So today we're going to talk about the microbiome and thyroid and so this is a subject that has been dear to our hearts for at least eight years you've been here and before then you know that was a part of where it started to go back in my mentors days dr. cross and who I believe was the first person that really got how much thyroid affected everything so anyway the point is that when we first started doing these videos years ago a lot of people complain that we talk too much about the gut so we're going to talk about the God again today and new data on the guy and the microbiome and how it's so interesting now from why do you talk about the gut and how stupid are you how could the gut affect anything and how could diet affect autoimmunity and how could it be how could eating a right diet ever helped me and we were we were doing this in...most days and it was kind of interesting now it's kind of like people come in and educate me on the diet and it's kind of fun so diet and thyroid thyroid is like the canary in the coal mine the thyroid is connected to everything and everything seems to be connected to the the diet and and the microbiome and when people come in here for their thyroid which people still do we get a lot of people coming here for their thyroid the first thing I have to try to help them to understand it's not about your thyroid it's about everything else and one of the big everything else is is the microbiome that we were been talking about forever so so now we're going to talk a little bit more about the microbiome more nuances over the past couple of years it's come out that that microbiome is a lot to do with autoimmunity different types of autoimmunity rheumatoid arthritis for sure probably did other different types of autoimmune diseases...

we're going to continue on now with thyroid I was thinking about this earlier I'm going to talk about how I process a thyroid in my mind again when you look in a book thyroid or maybe even some stuff you see online about functional medicine is here's the thyroid here's how you do this you give them that supplement and it's not like that for the patients who come in here anyway because the vast majority have already been everywhere and they've been there doctor they've driven them crazy their thyroid symptoms are normal or okay but their numbers are off so the education is screwed some up or vice versa the numbers are okay but they have 25 out of 25 symptoms of Hashimoto's thyroiditis and the doctor was doesn't know what to do for him and because and then gives them medication and that's

actual hypothyroid case and those are the first challenge is to figure out that right there okay but really now again but really when a person comes in here and they have hypothyroid that's usually going to be they have hypothyroid they're taking that's usually beginning to be there are their several Pathways there's like twenty-one different Pathways between your thyroid making thyroid hormone and I'll go into a little your thyroid makes thyroid hormone it is made mostly like 93 to 97 percent of what it makes is enacted Department doesn't do anything it's inactive so I can be flying around your system attached these little proteins and fly around your system all

"...and depending on how this goes we may end up doing in the first two weeks I don't know but we'll definitely do it today so I'm just going to get cut right to the chase here this seems to be a stress-related group of questions so is there a link between long-term stress of about five years and hyperthyroidism / Graves disease tell you what I'll just read this and and I'll keep my stuff out of this now I think we should turn back and forth but with Graves disease the literature does state that stress can precipitate the condition some people dispute that in the literature but overall it's pretty well accepted this stress does cause Graves disease stress is not as much identified as a trigger for Hashimoto's yet but we're anticipating that that's going to change because we hear it all the time or person goes through major stressor and then they develop Hashimoto's so just realize this is an evolving situation we don't have all the answers even here in...things are changing all the time but I just read an article this morning...and they were talking about stress as it pertains to hyperthyroidism so yes without a doubt without a doubt so next couple next to I can kind of put together how is this chronic stress response turned off and the next question is how does one stop the fight flight those are 21 in the same question so and and and if there were a simple answer to that we probably wouldn't be sitting here doing these videos very true and and half of America probably be taking anti-anxiety medications and antidepressants and benzodiazepines and and on and on the number one two and three drugs in America but go ahead so and this we're doing this because I think a lot of you want to know what that could solution is because you've been conditioned and today's internet marketing world that there is a quick solution for everything there's a leaky gut solution there's a stress solution and frankly that to work with the complexity of cases coming into us so certainly you could go and try to meditate you can try to do stress relaxation techniques we're not knocking any of those but the patients that come to us chronic states of fighter flight history of childhood trauma chronic stress where there's a hyperactivation component to the amygdala the amygdala is the fear Center in the brain the problem is that the fear Center can actually grow and take over other neurological real estate in the brain it's like me growing and saying well this is mine now well that's talked about birds but that's what the amygdala does and it grows into the memory area..."

"...first question is do you ever see patients who experience inner Tremors can you address what this might be all about and I would say yes we can address what this is all about we see a lot of patients with a variety of some Tremors and inner tremors are something that have a specific medical understanding for us yeah and the internal Tremors can be a number of things you could be anxiety it could be an autoimmune response your thyroid it could be hyperthyroidism it could be something like a pheochromocytoma which is where your adrenal gland has a tumor on it and makes to me adrenal hormones so all of those are possibilities for the internal Tremors we frequently see it with autoimmune thyroid disease but we see a lot of so that so that's kind of our take on anxiety a lot of anxiety those are two things I would go to those two things first I don't know yeah okay but yes can you have fibromyalgia this is a great question because it's kind of fiber understanding of fibromyalgia can you have fibromyalgia not have irritable bowel syndrome and not hurt when someone hugs you or touches you great question the understanding of what it fibromyalgia is evolve and and we've stayed on top of that Gates has done continued to stay on top of the research so I think this is an interesting question to answer for people who are confused yeah like me right so if I were myalgia we had the 1990 criteria by the American College of Rheumatology and that criteria set forth that if you have tenderness at a certain number of the trigger points 11 out of the 18 I know they team basically then you had fibromyalgia to produce 11 out of 18 and then you had other Associated symptoms of brain fog and fatigue whereas the new criteria the 2010 American College of Rheumatology criteria that came out and it's predicated on not having the trigger points you don't have to be able to termed a low zdenek allodynia constitutes pain with a normally non painful stimulus so like somebody giving you a hug so you don't have to have that pain response when somebody gives you a hug and you don't necessarily have to have IBS either in order to be diagnosed with fibromyalgia now it can't be another condition that's causing the pain it can be associate with other pain but you have widespread pain so pain and many areas of your body there's a way to document that you have other disabling symptoms of fatigue and brain fog and the fatigue and brain fog half of these severe enough to be above a certain score level for you to be diagnosed with fibromyalgia so it's really more predicated on widespread pain fatigue and brain fog and then it also factors in other Associated symptoms like IBS but you don't have to have IBS you don't have to have trigger points to have fun that you can have other gut problems like I have Celiac can write or you could just have non-celiac gluten sensitivity.."

"...and it's not that way so we talk about the bells we talk about large and small intestines we talked about leaky gut even though it's very difficult to Clearly say this the next thing we're going to talk about is going to be chemical sensitivities because you can't get chemical sensitivities without having a leaky gut Okay so we've already dealt with the leaky gut you almost can't have chemical sensitivities if you have a strong frontal lobe now we have not talked about that because that's separate that's that's like functional neurology but we will talk about it as time goes on you almost can't have chemical sensitivities if you're if you have enough Bluetooth ion so we're so let's talk about multiple chemical sensitivity so chemical sense since they were a patient that comes in..."

kk

blood sugar has an awful lot to do with the manufacture of estrogen down the road I'm going to be looking at adrenals stress hormones your secondary sex glands are your adrenals and your adrenals and your blood sugar work together you can look at that segment and when adrenals go up then blood sugar goes up when adrenal goes down blood goes down when your blood sugar is high and low it affects these things called sex hormone-binding globulin 's these are the things that carry your estrogen all over the place and so when you're stressed and your adrenals are flaring off and it's causing your blood sugar to be high it screws with these old taxi cabs these sex sex hormone-binding globulin now all the sudden you're not getting estrogen that where you're supposed to be and it shows up as low as sturgeon and it's actually that you're stressed that's affecting your adrenals that's affecting your blood sugar and all of that is affecting you are female hormone Cycles so again

I'm going to present you with a little different look on that there's a reason that your testosterone is low we're going to talk about there's a reason that it's being presented last and actually the way we look at problems is not that their testosterone is low but the vast majority this is usually the problem basically male problems with the exception of prostate problems which is too much testosterone because it's not getting cleared out are low testosterone problems secondary to estrogen being high and that's has a term is called andropause and when I mentioned that to my male patients they kind of look at me like like they've never heard the term before

So today we're going to talk about something that isn't going to sound very sexy but you need to manage your blood sugar period Okay I lied I'm morphing more into more education on blood sugar because over this past year are just so many of the cases just they came in here were there that their success just hung the ability of us to get their blood sugar crack and people would commonly say why don't have lecture problem I'll say well you filled out my assessment for him and there are 16 symptoms on there that would indicate that you have a blood sugar problem if you mark them down and you have all of them so then the next retort from the patient is usually but my blood tests are normal kind of like the Hashimoto's thing and I'm telling you that is so common I

kk

in a certain context of an entire frame of reference that's called functional medicine and functional medicine is no longer about chasing symptoms and that's what the medical profession has been about and then you know it's their defense they were about fixing broken legs and then having heroics surgeries and heart transplants and then making drugs that got ready to send this because nobody knew any different but when you really look at it the Health Care System the Alternative Healthcare System as a lot of it has followed that model and I look online and I look at certain well-known websites which I was looking at last night it's like magnesium here are the 12 things you can do for met that night Museum does and next thing you do is you can take that magnesium is going to work and it does for most people for just a short period of time and when I say most people I'm talking about the patients who walk in here and I'm talking about the patients who are looking online today

pt

Patients' Exam: this is going to be about the examination I want to go through the exam so you see what kind of data could be gotten from the exam and again this goes your question of why aren't you telling me what's what how to how to fix my polycystic ovarian syndrome or my blood sugar my diabetes or my fibromyalgia or whatever it is that you come in with and it's because I it's because there are a lot of moving pieces to it and that's something I explained in our initial two episodes which we talked about whack-a-mole met as functional medicine and functional neurology exam because we practice functional medicine we practice functional neurology but the exam is incredibly important and so I wear exam sheets in front of me here as a guide and I'm just going to walk through this with you and as I talked about the different areas

go as you were going through and that alters immune function and we we now know it was your mother was your mother stressed when when when you were born during oh my God she was going through well we now know stress hormones can cross the placenta and that person who has anxiety and panic attacks literally since they were born the mother says they've been that way since they were born it may actually the fact that that there are that there were stress enzymes coming from all the way back that far and Doctor Bland put was the first one I saw that put this together and every step along the way you would take the you would take the particularly pertinent information from every step along the way and you would put it on this template this chart and then you would use that to compare to the person's present-day symptoms and problems and you would start to use that to

there's a way to do it and and and and so there's a there's a way to proceed there's an organization there certain foundational things that need to be done before your supplements work we're going to answer those questions this year and we're going to do it in a very organized fashion the answer to that one is one whole presentation in and of itself and we're going to do that so what we're going to do is we're going to walk you through functional medicine and awful lot of people who do functional medicine out there don't do an exam now they're going to tell you I don't know what I'm talking about well these guys who have put it together are going to tell you you need to do an exam I just was through a seminar month ago and a doctor who was presenting it was on it was on Endocrinology it was on PC iOS and and and and polycystic ovarian syndrome and infertility and menstrual problems all

for those of you who may be tuning in for the first time I am a functional medicine practitioner I'm certified functional medicine practitioner here in Reno Nevada the best way to answer those of you who said well tell us how to get better and and and and from from my side to at least in many cases answer why we can't tell you how to get better completely and this venue okay was just a walk you through what a classic functional medicine practitioner should look like and I'm not saying that because this is what I think it should look like I have my notes in front of me here these are my notes these are the notes that I've taken from attending class with literally the guys who started functional medicine the tough some of the top functional medicine researchers in the world and the and and they teach classic functional medicine does that mean classic functional mess it means there's it