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FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. The FDM Approach to Auto-Immune Disease Rheumatoid Arthritis: Causes, Assessment and Treatment How is RA Diagnosed? The following labs make up the basics of ruling in or out RA. Citrullinated Peptide (anti-CCP) Antibodies Rheumatoid factor Erythrocyte sedimentation rate C-reactive protein White Blood Cell Count Blood tests for anemia Citrullinated Peptide (anti-CCP) Antibodies in RA Important marker for diagnosis and prognosis As sensitive and more specific than IgM Rheumatoid Factors Marker of erosive disease May be detected in healthy individuals years before clinical onset of RA © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Allopathic Approach to RA The primary objective of traditional medicine is temporary relief of pain and dysfunction via pharmaceutical agents: Disease modifying anti-rheumatic drugs (methotrexate, gold, sulfasalazine etc.) Corticosteroids The Logical Approach Patient Centered The Downside of Accepted Medical Protocols Disease Specific May change based on clinical studies The concept of Good Medicine © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. The Possible Causes of RA The following should be considered as potential causes of RA: Compromised Cortisol/DHEA/S IgA Increased Intestinal Permeability Bacterial, Parasitic Infections (mycoplasma) Hormonal Imbalance Fatty Acid Imbalance Nutritional and Amino Acid Co-factor Deficiencies Oxidative Stress Cortisol/Inflammation Connection Eicosanoid Modulation CHO Metabolism •Immune Regulation •Inflammation control •Cell Energetics •Glycemic Control Musculoskeletal Health •Bone Turnover •Muscle Integrity •Collagen Turnover Metabolism Fats & Proteins •Weight Gain •Protein Turnover •Mucosal Integrity Cortisol/ DHEA Ratio Detox Capacity •Free Radical Removal •Heavy Metal Removal Neural Tissue Health •Neuronal Connectivity •Memory & Learning •Sleep & Mood Endocrine Function •Thyroid Function •Pancreas - Insulin •Ovarian Function © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Intestinal Hypermeability © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Patient Specific Treatments for RA Treat the Underlying Cause of RA Restore cortisol/DHEA ratio Restore s IgA levels Treat the GI: The 6 “R” Approach Restore hormonal balance Replace EFAs Treat nutritional and amino acid deficiencies Reduce oxidative stress Put the fire out: treat the pain © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Restoring Cortisol/DHEA Ratio Treat Low Cortisol Lifestyle changes Stress reduction: chronic stress can fatigue the adrenals, rest, exercise, prayer, meditation, relaxation exercises Dietary changes: Balance blood sugar: Lower calorie, high protein, high complex carbohydrate and high fiber diet Nutritional supplements: High-grade multivitamin and mineral. Additional Vitamin C, Vitamin B5, Vitamin B6, and zinc, as indicated Herbal Support: Adaptogenic" herbs: American or Korean ginseng (Panax spp.), Siberian ginseng (Eleuthrococcus senticosus), Withania (Withania somnifera) Miscellaneous herbs: Licorice (Glycyrrhiza glabra) to prolong the half-life of cortisol, Sarsaparilla (Smilax spp.) is a cortisol precursor Glandular Support Hormone replacement therapy Cortisol, DHEA, pregnenolone, as indicated Treat High Cortisol Lifestyle changes: Stress reduction: rest & relaxation, prayer, meditation, regular exercise, blood sugar stabilization, sufficient sleep, elimination of food allergies and restoration of normal bowel function Nutritional supplements: High-grade multi-vitamin/mineral. Additional Vitamin C, Vitamin B5, Vitamin B6 and zinc, as indicated. Phosphatidyl serine may resensitize the hypothalamus and pituitary to cortisol negative feed back. Herbal Support: Nervine and "calmative" herbs: St. John's Wort (Hypericum), Passionflower (Passiflora), Valerian (Valariana), Skullcap (Scutellaria), and Hops (Humulus lupulus) Low dose adaptogens: Siberian ginseng (Eleuthrococcus senticosus) Withania (Withania somnifera) © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Treat DHEA Imbalances Low DHEA: Consider lifestyle, dietary, and herbal options outlined under high cortisol. DHEA or pregnenolone supplementation may be warranted Consider measuring testosterone and/or estradiol levels and intervene if necessary High DHEA: Consider lifestyle, dietary and herbal options under low cortisol Consider measuring testosterone and/or estradiol levels and intervene if necessary Treating The GI – The 6 “R” Approach Remove mucosal Irritants Reduce: sugar. Restore proper bowel transit time Replace digestive supporting nutrients Re-inoculate with friendly flora Repair mucosal lining Rheumatoid Arthritis Case Review © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. History 38 year old Caucasian woman Primary Symptoms Significant joint swelling and pain Previous Diagnoses Rheumatoid Arthritis (onset 2004) Digestion problems (2006) Traditional medical providers: Primary physician Rheumatologist X 2 Medical Record Review May 2005 – Mobic Elevated CRP (15) Positive Rheumatoid Factor (50) Citrullinated Peptide Antibodies (70) June 2005 – Methotrexate August 2005 – Ultracet October 2006 – Saw Dr. Grisanti for 1st time November 2006 – Saw another rheumatologist – Mobic prescribed again Sxs on Questionnaire Dry, flaky skin Dandruff Feels clogged up in GI after fatty meal Craves chips (all the time) Severe life stressors Diarrhea and abdominal discomfort Dark rings under the eyes Cannot handle any stress Frequently upset and overwhelmed Sensitive to loud noises, jumpy © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Initial Report Suspected Dysfunctions: Fatty acid imbalance Compromised Secretory IgA with possible dysbiosis Stress related issues compromising secretory IgA Tests Ordered: Adrenal Stress Index Fatty Acid Test CDSA Fatty Acid Test CDSA © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com FDM Training: FDM Approach to Auto-Immune Disease Dicken Weatherby, N.D. & Ron Grisanti, D.C. Secretory IgA from the ASI Personalized Treatment Plan Natural Medicine products 30 Mins before break-fast Oxygenic B Inflazyme-Forte Breakfast 1 Before Lunch Lunch 1 Before Dinner Dinner Before Bed 1 3 3 Licorice plus 2 Support adrenal 2 2 Support minerals Coconut oil 1 tsp 1 tsp Natural antiinflammatory modulator Summary © Sequoia Education Systems, Inc http://www.FunctionalMedicineUniversity.com
