What is Functional Medicine?

Neurotransmitter testing refers to the assessment of neurotransmitter levels or activity in the body through various testing methods. Neurotransmitters are chemical messengers in the brain and nervous system that play a crucial role in transmitting signals between nerve cells.

• Purpose: Neurotransmitter testing aims to evaluate the levels or balance of specific neurotransmitters to gain insights into the functioning of the nervous system and potential imbalances that may contribute to certain symptoms or conditions.
• Symptoms and Conditions: Neurotransmitter imbalances have been associated with various mental health conditions, including depression, anxiety, attention deficit hyperactivity disorder (ADHD), insomnia, and others. Symptoms such as mood disturbances, cognitive issues, sleep problems, and behavioral changes may be indications for neurotransmitter testing.
• Testing Methods: There are different approaches to neurotransmitter testing, including blood tests, urine tests, and specialized tests that assess neurotransmitter metabolites. These tests can provide information about the levels or ratios of neurotransmitters, as well as their breakdown products, which may reflect their activity in the body.
• Limitations: Neurotransmitter testing has certain limitations. Neurotransmitters can fluctuate throughout the day, making it challenging to capture an accurate and representative snapshot of their levels. The correlation between neurotransmitter levels in the body and their activity in the brain is also complex. Additionally, neurotransmitter imbalances are not specific to a particular condition and can be influenced by various factors, including genetics, stress, medications, and lifestyle choices.
• Integrated Approach: Neurotransmitter testing is often used as part of a comprehensive evaluation that includes a thorough medical history, physical examination, and assessment of other factors contributing to symptoms. It should be interpreted alongside clinical information to guide treatment decisions and develop a personalized approach.
• Treatment Considerations: The treatment of neurotransmitter imbalances is multifaceted and typically involves a holistic approach. It may include lifestyle modifications (such as stress management, regular exercise, and adequate sleep), dietary changes, psychotherapy, targeted supplementation (e.g., with amino acids precursors), and, in some cases, medications. The specific treatment plan will depend on the individual's symptoms, medical history, and overall health.

It's important to note that while neurotransmitter testing can provide valuable information, it is not a standalone diagnostic tool. 

• Anxiety & Depression - Neurotransmitter imbalances are often associated with anxiety and depression, specifically Glutamate (panic attacks), PEA, Histamine, Serotonin, as well as Epinephrine & Norepinephrine. 
• Chronic Fatigue - An imbalance between excitatory and inhibitory neurotransmitters can lead to persistent fatigue.
• Impulsivity - GABA, Dopamine and Serotonin are three chemical messengers commonly linked to disorders like ADD, ADHD & OCD.
• Insomnia - Imbalances in Glutamate, Histamine, Dopamine, GABA and Serotonin are often linked to sleep disturbances and insomnia.
• PMS or PMDD - Imbalances in Serotonin, Dopamine, Norepinephrine and GABA are often involved in cases of PMDD (pre-menstrual dysphoric disorder) and severe PMS.

• Comprehensive PGx Testing - analyzes your DNA to predict how you will respond to different medications to deliver personalized medication. 
• ZRT Neurotransmitter Testing - Optimal neurotransmitter balance is required to maintain proper health.  Imbalances can cause the brain and the body to be over- or under stimulated, producing neurological or psychological symptoms. 

The American Thyroid Association estimates that as many as 60% of people with thyroid disease are not aware of it. Statistics show that women are seven times more likely than men to develop thyroid problems, facing as much as a one in five chance of developing a problem particularly during the peri-menopause years when hormones start to fluctuate.

Thyroid disease refers to various conditions that affect the function and structure of the thyroid gland, a small butterfly-shaped gland located in the neck. The thyroid gland produces hormones that regulate metabolism, growth, and development. 

Types of Thyroid Disease: Thyroid disease can manifest in different ways, including

• Hypothyroidism: This occurs when the thyroid gland does not produce enough thyroid hormones. Symptoms may include fatigue, weight gain, cold intolerance, depression, and sluggishness.
• Hyperthyroidism: This condition occurs when the thyroid gland produces an excess of thyroid hormones. Symptoms may include weight loss, rapid heartbeat, anxiety, irritability, heat intolerance, and increased sweating.
• Thyroid nodules: These are abnormal growths or lumps that form within the thyroid gland. Most thyroid nodules are benign, but some may be cancerous.
• Thyroiditis: This refers to inflammation of the thyroid gland, which can be caused by autoimmune conditions, viral infections, or other factors. It can result in temporary hyperthyroidism or hypothyroidism.

The most common cause of thyroid disease is autoimmune disorders that affect the thyroid gland. Hashimoto's thyroiditis is an autoimmune condition that leads to hypothyroidism. This condition occur when the immune system mistakenly attacks the thyroid gland, leading to inflammation and impaired hormone production.

Thyroid disease is diagnosed through a combination of medical history, physical examination, and laboratory tests. Blood tests, such as thyroid stimulating hormone (TSH), free thyroxine (FT4), and sometimes thyroid antibodies, are commonly used to assess thyroid function.

Ongoing Management: For individuals with thyroid disease, ongoing management is typically necessary to monitor thyroid hormone levels, adjust medication dosages as needed, and address any changes or complications. Regular follow-up appointments with healthcare professionals, such as endocrinologists or primary care physicians, are important to ensure optimal thyroid health.

Hypothyroidism (hashimoto's thyroiditis)

• Weight gain or inability to lose weight despite exercise and diet
• Feeling cold all the time (when others don’t)
• Low energy and stamina, especially in the evening
• Memory lapses or slow/fuzzy thinking
• Dry, thinning, itchy skin
• Dry or brittle hair and nails
• Hair loss
• Irregular bowel habits
• Menstrual irregularities

Hyperthyroidism

• Sudden or significant weight loss
• Rapid or irregular heartbeat
• Sweating
• Nervousness or irritability

Thyroid disease is diagnosed through a combination of medical history, physical examination, and laboratory tests. Blood tests, urine and saliva testing are options for testing thyroid function. 

• TSH- Produced by the pituitary gland, TSH acts on the thyroid gland to stimulate production of the thyroid hormone thyroxine (T4).
• Free T4 (Thyroxine) - The predominant hormone produced by the thyroid gland, T4 is converted to its active form, T3, within cells.
• Total T4 (Thyroxine) - Total T4 includes both free T4 and protein-bound T4, and is an indicator of the thyroid gland’s ability to synthesize, process and release T4 into the bloodstream.
• Free T3 (Triiodothyronine) - T3 is the active thyroid hormone that regulates the metabolic activity of cells.
• TPOab (Thyroid Peroxidase Antibodies) - Thyroid peroxidase is an enzyme involved in thyroid hormone production. The body produces antibodies, including TPOab, that attack the thyroid gland in autoimmune thyroiditis and Hashimoto’s. Testing TPOab levels can diagnose these conditions.
• Tgbn (Thyroglobulin) - A protein rich in tyrosine, the residues of which when bound to iodine become the building blocks of T3 and T4. If iodine levels are low, thyroglobulin accumulates, thus high levels indicate insufficient iodine for healthy thyroid function.

Comprehensive Thyroid Profile Testing 

The microbiome refers to the vast community of microorganisms, including bacteria, viruses, fungi, and other microbes, that reside in and on the human body, particularly in the gastrointestinal tract. Emerging research has highlighted the crucial role of the microbiome in maintaining overall health and its impact on various aspects of human well-being.

To support a healthy microbiome, it is recommended to consume diverse and balanced diet rich in whole foods, including a variety of fruits, vegetables, whole grains, legumes, and fermented foods. Regular physical activity, stress management, and adequate sleep also play a role in maintaining a healthy microbiome. However, it's important to note that the microbiome is a complex and individualized ecosystem, and more research is needed to fully understand its intricacies and develop targeted interventions for specific health conditions.

The microbiome interacts closely with the immune system and helps regulate its function. It plays a crucial role in training and modulating the immune response, protecting against harmful pathogens, and promoting immune tolerance to harmless substances. A healthy and diverse microbiome is essential for optimal immune system function.

The gut and brain communicate bidirectionally through what is known as the gut-brain axis. The microbiome plays a role in this communication by producing various neurotransmitters and metabolites that can influence mood, behavior, and cognitive function. Imbalances in the gut microbiome have been linked to mental health conditions such as depression, anxiety, and even neurological disorders. Functional medicine treatment is a great option for treatment. 

Emerging research suggests that the microbiome may influence the development and progression of various chronic diseases, including inflammatory bowel disease, autoimmune disorders, cardiovascular disease, and certain types of cancer. While the exact mechanisms are still being studied, disruptions in the microbiome have been associated with increased inflammation and dysregulation of immune responses, which can contribute to disease development.

A healthy microbiome can act as a protective barrier against harmful pathogens. Beneficial bacteria can compete with and inhibit the growth of pathogenic organisms, preventing them from colonizing and causing infections. This protective role is especially evident in the gut, where a diverse and balanced microbiome helps maintain intestinal barrier integrity and prevent the overgrowth of harmful bacteria.

• Food Sensitivity Testing- Genova’s antibody testing helps to identify the body’s immune response to foods and environmental triggers with a simple blood draw. Testing can help uncover these “hidden” food sensitivities.
• GI Effects- Most comprehensive stool test for clinical utility to identify intestinal inflammation, infection, malabsorption, metabolite imbalance, and dysbiosis. 
• SIBO testing- non-invasive breath test to evaluate for bacterial overgrowth in the small intestines. 
• Detox Genomic Profile
• NutraEval- a comprehensive profile for identifying nutritional deficiencies and insufficiencies. 
• Metabolomix+ is a nutritional test that is non-invasive, patient-friendly way to assess the functional need for antioxidants, B-vitamins, minerals, digestive support, fatty acids, and amino acids. 

Adrenal fatigue is a term that has been used to describe a condition characterized by chronic fatigue and other nonspecific symptoms attributed to an exhaustion or dysfunction of the adrenal glands. However, a more accurate term is HPA Axis Dysfunction. 

The adrenal glands are small glands located on top of the kidneys that produce hormones involved in regulating various bodily functions, including the stress response. One of the hormones produced by the adrenal glands is cortisol, which helps the body respond to stress.

Adrenal Fatigue Theory suggest that chronic stress overwhelms the adrenal glands, leading to inadequate cortisol production and a range of symptoms. These symptoms may include fatigue, low energy, sleep disturbances, difficulty concentrating, body aches, and more.

Proper evaluation is needed to help determine the underlying causes of your symptoms through a thorough medical history, physical examination, and appropriate laboratory tests. Treatment will depend on the identified causes and may involve addressing lifestyle factors, managing stress, improving sleep hygiene, treating underlying medical conditions, and addressing any nutritional deficiencies.

The HPA axis involves three main components: the hypothalamus (a region in the brain), the pituitary gland (located at the base of the brain), and the adrenal glands (situated on top of the kidneys). These components work together to regulate the release of stress hormones.

When the body perceives a stressor, such as physical or psychological stress, the hypothalamus releases corticotropin-releasing hormone (CRH). CRH signals the pituitary gland to release adrenocorticotropic hormone (ACTH), which then stimulates the adrenal glands to produce cortisol, a primary stress hormone.

HPA axis dysfunction refers to an altered or dysregulated response of the HPA axis. It can manifest in different ways, including:

• High Cortisol- Results in insomnia, anxiety, sugar cravings, feeling tired but wired, increased belly fat & bone loss.
• Low Cortisol- Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves.
• DHEA- Out of balance adrenals can lead to high or low DHEA.

HPA axis dysfunction is often associated with various symptoms and conditions, including:

• Chronic fatigue
• Sleep disturbances
• Mood disorders (such as anxiety and depression)
• Altered immune function.
• Hormonal imbalances
• Digestive issues
• Cognitive difficulties
• Altered pain perception.
• Conditions like adrenal insufficiency, Cushing's syndrome, and fibromyalgia may involve dysfunctions within the HPA axis.

HPA axis dysfunction can be challenging to diagnose, as symptoms can overlap with other conditions. It typically requires a comprehensive evaluation by a healthcare professional, including a thorough medical history, physical examination, and appropriate laboratory testing.

Treatment approaches may vary depending on the underlying cause and individual needs. They may include stress management techniques, lifestyle modifications (such as regular exercise and adequate sleep), dietary adjustments, psychotherapy, medication (e.g., for mood disorders), hormone replacement therapy (if indicated), and addressing any underlying medical conditions contributing to the dysfunction.

•  Adrenal Stress Test Kit & Cortisol Awakening Response -  also called CAR – reveals more detailed clues that help in assessing adrenal hormone/HPA Axis dysfunction. This testing is often useful for cases of PTSD, major depression, chronic fatigue syndrome and other severe stress conditions.