I love a good Who-Done-It. This attraction to solving mysteries extends beyond my recreational reading. When I was introduced to functional medicine about 10 years ago, my immediate reaction was to ask why they didn’t teach that to me in Medical School!
The core belief of functional medicine is that all our maladies are from breakdowns in one or more of the basic physiological components of our body. Each of these components takes care of a part of what keeps us healthy. Here are the core domains: breakdown, absorption and assimilation of nutrients; generation of energy; protection from oxidative stress and removal of toxins; maintenance of the central processing unit (brain) and communication system (nervous system and hormones); protection from invasion (immune); and building and maintaining our locomotion system (musculoskeletal system). A person’s symptoms point us to which of these components may be responsible for a deterioration in our health and there are tests that can support or undermine a guess about the culprit.
Luke’s fatigue and severe indigestion.
I’ve been on such a hunt with one client for several years. Let’s call him Luke. When Luke came to visit me he had symptoms pointing us in several directions. His fatigue suggested energy, brain, or hormone subsystem. His diarrhea and abdominal pain suggested breakdown and assimilation of nutrient subsystem. His acute thyroiditis suggested breakdown in the immune system. Tinnitus was a general and bothersome symptom that like the muscle pain wasn’t very helpful in the finger pointing game.
The intensity of symptoms and the order of their appearance was an excellent guide.
We started with his digestion since it had been bothering him for the longest time. Working with issues of an alteration of the gut microbes and leaky gut we began to help his abdominal pain and diarrhea go away. In the process of working with his digestive system we discovered he had been malabsorbing several nutrients and after months of heroically large doses of some nutrients (his fat soluble nutrients were in the pits) we got them back to normal levels. His belly felt good for the first time in 15 years.
Next we worked to help him with some of his fatigue and sleep issues.
Tests suggested he was having trouble manufacturing enough of some of the neurotransmitters (possibly related to his malabsorption) and so we tried supplementing him with amino acid precursors and factors to support the manufacturing. Many of his energy and thinking symptoms improved.
Our hunt continues:
Testing suggested that he was having a lot of trouble managing free radicals. We supplemented him with some specific anti-oxidants and the tinnitus went away.
Then his digestive symptoms recurred. We poured on more probiotics. We tried glutamine and aloe. We used a product like colostrum that helps some people. We tried another elimination diet protocol. He got a little better. He got a little worse. Nightmares came back. We tried more amino acids. He was discouraged. So was I.
We sat down together again. I went back to the notes I took from the first time we met. I noticed he had mentioned that he had been bitten by a dog when he was three years old. I asked him about this and noted that the procedure to sew up his laceration was reported by his mother to have been rough. Turns out we had no idea how rough.
Using a technique called Somatic Experiencing developed by Peter A. Levine we discovered that this procedure was more than rough. We have reconstructed and gotten some confirmation from his mother that he was more than terrified—he thought he was going to die. He had been struggling and the medical personnel held him so the doctor could sew him. But they held him so tightly that he couldn’t breathe.
Levine believes and I have come to agree with him that in many people who have experienced trauma that the trauma lays lodged in us—unable to escape. The awesome and protective energy of fight or flight is caged and, unable to help us in our crises, struggles. This struggle hurts us to our core and has ramifications in our physiology until allowed to come out.
Sometimes the hunt to find the culprit transforms into a hunt for something very scary and mostly hidden. I have come to believe that the discovery of safe techniques for finding, befriending, and releasing these demons is at the heart of many “challenging cases” and worth our very best and most understanding work.
To your Health!