Download Copper/Zinc metabolism and resting metabolic rate in Chronic

Nutritional & Environmental
Medicine: Putting all the pieces
together.
Blake Graham, B.Sc (Honours), AACNEM
Clinical Nutritionist
www.nutritional-healing.com.au
(08) 9381 4112
February 16th 2008
What causes disease?
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Genetics.
Gastrointestinal abnormalities.
Nutrient imbalances/diet.
Environmental. (e.g. heavy metals)
Allergies/intolerances.
Chemical imbalances. (e.g. hormones)
Disordered sleep.
Psycho-social factors.
Lifestyle factors.
Multi-factorial model.
All disease is
multi-factorial!
Web of inter-relationships and vicious cycles.
Ripple effect.
Spectrums.
Self healing.
Complex corrective mechanisms.
 Identify and remove:
 Causes.
 Impediments to healing.
 Reduce burden of stressors on the body
below the threshold which the body can
restore balance.
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Disease treatment models.
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Treat symptoms:
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Nausea = anti-nausea medication
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High cholesterol = cholesterol lowering medication
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Dry skin = moisturizer
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Insomnia = sedatives
Address underlying causes:
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e.g. nausea caused by gastrointestinal infection
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e.g. high cholesterol caused by poor diet
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e.g. dry skin caused by fatty acid deficiency
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e.g. insomnia caused by anxiety
Disease treatment models.
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Disease centred diagnosis.
 Irritable bowel syndrome.
 Chronic Fatigue Syndrome.
 Migraines.
 Depression.
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Person centred diagnosis.
 Nutrient deficiencies.
 Sleep deprivation.
 Food intolerances.
 Intestinal infection.
Genetics.
Genetics.
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Inter-relationship between
genetics and environment.
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Environment influences genetic
expression.
Genetics influence reaction to
environment.
Genetics.
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Specific links of interest:
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Environmental chemical metabolism.
Nutrient imbalances.
Gastrointestinal health.
Allergies/intolerances.
Chemical imbalances. (e.g. hormones)
Immune integrity.
Genetics.
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Family history:
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Eczema/asthma/hay fever/hives  Allergies
Depression/anxiety/OCD  Neurotransmitters
Crohn's Disease  Increased intestinal
permeability
ADD/ADHD  Abnormal zinc metabolism
Genetic testing.
Huge genetic
variation!
Reference: www.genovations.com/
Gastrointestinal health.
Gastrointestinal imbalances.
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Imbalanced gastrointestinal flora ('dysbiosis').
Gastrointestinal infections (bacteria, parasitic, yeast).
Increased intestinal permeability ('leaky gut').
Maldigestion/malabsorption.
 Stomach acid deficiency (hypochlorhydria).
 Pancreatic enzyme insufficiency.
 Bile acid deficiency.
Intestinal flora.
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Functions of healthy flora:
 Produce short chain fatty acids which are needed by the intestinal mucosa
for energy
 Produce biofilm (mucus barrier) to protect intestinal mucosa
 Interact with the gut associated lymphoid tissue (GALT) – 70% of
immune system, e.g.
 Improves antibody formation
 Reduce allergies (eczema and asthma)
 Regulate cytokine levels / inflammation modulation
 Synthesize nutrients (certain amino acids and vitamins)
 Improve digestion/absorption
 Inhibit the overgrowth of harmful bacteria, yeast, viruses and parasites
 Improve intestinal motility and stool formation
 Influence genetic expression
 Assist the detoxification of various substances and convert some toxins
into less toxic forms :
 Mercury
 Hormones (e.g. estrogen)
 Potentially carcinogenic chemicals
 Drugs
 Lipids (e.g. cholesterol)
Harmful bacteria.
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Produce toxic chemicals as metabolic by-products which have
systemic effects, e.g.
 Ammonia  Hyperammonemia
 D-lactic acid  D-lactic acidosis
Decrease production of short chain fatty acids
Produce antigens which disrupt immune function
Reduce levels of healthy flora
Impair nutrient digestion/absorption
Degradation/consumption of nutrients
Damage intestinal wall
Intestinal flora testing.
Gastrointestinal health: Yeast.
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Opportunistic/secondary.
Great exacerbating factor.
Releases harmful chemicals.
Lab tests are notoriously unreliable.
Yeast symptoms/signs.
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Genital thrush
Vaginal itching or redness, vaginitis or 'jock itch' – often scratching/itching at genital
area
White or grayish-white coating on your tongue or inner cheeks, or white patches in
the mouth
Nasal congestion or stuffiness, swelling of the nasal membranes or sinusitis
Previously noticed a decline in your health following antibiotics or antibiotics
exacerbate your current health problem
Fungus infections of the skin (e.g. athletes foot) or nails
Psoriasis, eczema or hives
Puffiness/bloating/swelling in the hands, face and feet
Sugar cravings
Eating sugar make you feel worse/worsens certain symptoms
Negative reaction to certain dietary yeasts/molds
Very high fondness for yeasty foods
Chemical sensitivities (e.g. car exhaust, petrol, cigarette smoke, perfumes, etc.)
Multiple food sensitivities
Lower abdominal bloating
Gas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stools
Itchy rectal/anal area or red ring immediately around the anus
Attention problems
Feel ‘spaced out’ &/or ‘brain fogged’
Yeast testing.
Gastrointestinal health: Parasites.
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Remarkably common.
Under-diagnosed due to:
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Lack of consideration.
Inadequate laboratory
techniques.
Giardia intestinalis
Intestinal parasite symptoms/signs.
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Current illness began with diarrhea/food poisoning
Frequent diarrhea
Loose/unformed stools
Abdominal bloating
Abdominal pain/discomfort
Excessive flatulence
Visible mucus or pus in stools
Itchy anal/rectal area
Foul smelling stools
Frequent constipation
Frequent nausea and/or vomiting
Food allergies/intolerances
Teeth grinding (bruxism) while sleeping
Skin conditions (bluish cast around lips, hives, psoriasis, eczema, skin ulcers)
Fatigue/weakness
Forgetfulness or unclear thinking
Nervousness, apathy, depressed, anxious or headaches
Dizziness
Parasite testing.
Maldigestion/malabsorption.
Stomach acid deficiency (hypochlorhydria).
 Pancreatic enzyme insufficiency.
 Bile acid deficiency.
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Digestive function testing.
Hypochlorhydria symptoms/signs.
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Undigested food in stool
Trouble digesting red meat
Food or water ‘sits in stomach’
Poor appetite or feel overly full easily
Stomach aching/pain/discomfort or bloating after meals
Reflux &/or heartburn
High fat foods cause nausea/stomach upset
Nausea/reflux after supplements (e.g. fish oil)
Feel unwell/fatigued right after meals
Lemon juice improves digestion
Low iron levels
Heidelberg pH Diagnostic System.
Reference: www.phcapsule.com/
Gastrointestinal treatments.
Probiotics/prebiotics.
 Anti-microbials.
 Dietary changes.
 Digestive enzymes.
 Stomach acid supplement (Betaine HCl).
 Bile acids.
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Nutrients.
Nutrient status continuum.
Nutrient status continuum.
Nutrition: Nutritional status.
I.
Intake:
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Food choices
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Soil levels, food storage, food processing
II. Digestion/assimilation
III. Genetics
IV. Synthesis (vitamins K & D)
V. Other factors (hormone imbalances, toxic
chemicals, infections, other nutrient levels,
medications, oxidative stress, emotional stress,
activity levels, kidney/liver problems, etc.)
Nutrient supplementation uses.
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Optimizing levels.
Therapeutic value.
Fatty acid deficiency symptoms/signs.
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Dry skin (e.g. feet/face/general)
Scaly or flaky skin (e.g. legs)
Cracking/peeling fingertips & skin (e.g. heels)
Lackluster skin
Small bumps on back of upper arms
Patchy dullness &/or color variation of skin
Irregular quilted appearance of skin (e.g. legs)
Thick or cracked calluses
Dandruff or cradle cap
Dry, lackluster, brittle or unruly hair
Soft, fraying, splitting or brittle fingernails
Dull nails - lack of surface shine
Slow growing fingernails
Dry eyes
Menstrual cramps or premenstrual breast pain/tenderness
Excessive ear wax
Excessive thirst
Allergic (e.g. eczema/asthma/hay fever/hives)
Crave fats/fatty foods
Stiff or painful joints
Magnesium deficiency symptoms/signs.
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Muscle cramps, spasms or pain (e.g. back ache, neck ache, leg/foot
cramps)
Muscle tension
Muscle twitches, tics or jerks
Muscle weakness
Muscle tremors
Restless legs
Fatigue / sighing
Breathlessness / chest tightness
Heart palpitations / arrhythmias
Numbness or tingling of skin or “creepy-crawly” feeling under skin
Sensitivity to loud noises or sudden bright light
Menstrual cramps
Headaches / migraines
Frequent constipation or anal spasms
Difficulty falling asleep and/or restless sleep
Irritable, depressed, anxious, nervous or panic attacks
Hair mineral analysis.
Reference: www.doctorsdata.com/
RBC fatty acid analysis.
Reference: www.metametrix.com/
Plasma amino acids.
Reference: www.doctorsdata.com/
Nutrient imbalance treatments.
Nutrient supplementation.
 Dietary changes.
 Correct absorption problems.
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Nutrient supplementation case study.
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Symptoms:
 Frequent urination
 Night time urination
 Night thirst
 Blurred vision after heavy exercise
Mineral supplementation:
 “From one day to the next at least 90% of my
symptoms vanished. These are symptoms I
have lived with and have worsened for more
than 10 years. Quite amazing.”
Toxic chemicals.
Increased toxic chemical exposure.
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Lead levels of human bones are
~1000 times higher than preindustrial bones.
Cadmium 500 times higher.
Heavy metal sources:
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Food:
 Soil
 Pesticides
 Cooking items
Water
Air
Medical:
 Amalgam fillings
 Vaccines
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Direct contact with heavy
metal containing or
contaminated substances
 Paints
 Cigarettes
 Household chemicals
 Body products
 Many many others!
Autism – mercury Study 1.
221 children with ASD vs. 18 controls
 Post-DMSA urine levels
 Mercury was 3.15 times higher!!
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Jeff Bradstreet, M.D. David Geier, B.A. Jerold Kartzinel, M.D. James Adams, Ph.D. Mark Geier, M.D.,Ph.D. A Case-Control Study of Mercury
Burden in Children with Autistic Spectrum Disorders. Journal of American Physicians and Surgeons Volume 8 Number 3 Fall 2003
Autism – mercury Study 2.
14 children with Autism vs. 11 controls
 Mercury was 3 times higher in baby teeth!!
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Adams JB. A Review of the Autism-Mercury Connection. Conference Proceedings of the Annual. Meeting of the Autism Society of America, July
2004.
Toxic chemical treatments.
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Chemical avoidance.
Chelation agents.
Supportive
nutrients/herbs.
Far infrared (FIR)
saunas.
Other environmental influences.
Electromagnetic radiation (EMR).
EMR testing.
Toxic mould.
Mould testing.
Sick building syndrome symptoms/signs.
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Ongoing or frequent coughing / dry throat or mouth
Irritated, stinging or burning sensation of throat or mouth
Throat hoarseness / changed voice (e.g. raspy)
Metallic taste in mouth
Wheezing, irritated lungs or bronchitis
Shortness of breath / chest tightness
Irritated, sore or burning eyes
Red or watery/tearing eyes
Sensitivity to bright light / blurred vision
Nasal congestion / running or stuffy nose / sneezing / nose bleeds
Irritated, stinging or burning nose or nasal passage / nasal itching
Sinusitis / sinus congestion or pressure
Stinging, burning or itchy skin / skin sensitivity to light touch
Skin rash or reddening of skin
Dizziness / vertigo
Headaches
Fatigue / weakness
Allergies/intolerances.
Food reactivity.
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Many reasons why a person may react negatively to specific foods.
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Allergy
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Intolerance
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e.g. lactose intolerance or fructose malabsorption
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e.g. impaired ability to metabolize salicylates, etc.
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e.g. gut flora/leaky gut mediated
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e.g. pharmacologic properties of the food - aspartame
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e.g. toxins in foods
 No one lab test for diagnosis of all negative reactions.
Food intolerance or allergy symptoms/signs.
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Itchy, tingly, irritated or burning tongue/lips/palate/throat during or after meals
Swollen lips/mouth or recurrent mouth ulcers
Frequent hives - generally or around mouth/lips (e.g. rash or ring around mouth )
Increased mucus production in throat / regularly clearing throat
Excess drooling / excess saliva production / spitting during speech
Irregular patches on tongue (geographic map-like) or mottled tongue
Puffiness or ‘bags’ below eyes; or puffy or swollen nose/face
Dark circles under eyes (‘allergic shiners’)
Inner corners of eyes itch or whole eyes itch / eye rubbing or scratching
Watery, glassy or glazed eyes; or red eyes
Itchy nose / nose rubbing or scratching (‘nasal salute’)
Nasal or sinus congestion / sinusitis / runny or snuffly nose / sneezing
Postnasal drip (nasal mucus draining down the back of the throat)
Abnormally red and/or flushed appearance of cheeks or nose (e.g. red tip nose)
Red ears / hot or ‘burning’ earlobes
Eczema or wool intolerance / psoriasis
Itchy arms, ear canals, hands, legs or skin in general
Puffy or swollen hands/knuckles/feet
Asthma or recurrent wheezy bronchitis / infection or exercise induced wheezing
Abdominal pain, bloating or vomiting
Increased frequency of stools / unformed bowel movements / frequent constipation
Feel best when don’t eat or skip meals
Feel worse (energy, mood, concentration, etc.) or look pale/red after some meals
Strong particular food cravings and dislikes / fussy eater
Recurrent ear infections and/or recurrent glue ear
Headaches/migraines
Elimination/provocation testing.
GRAINS - Whole grain rice
 MEAT - 100% unrefined lamb
 VEGETABLES - Cabbage, kale, carrots,
cauliflower, squash, broccoli & sweet potatoes
 FRUIT – Pears
 OILS/SEASONINGS - Olive oil & sea salt
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Inhalant allergies.
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Dust.
Cats/dogs.
Pollen.
Grass.
Food intolerance case study.
Fibromyalgia.
 Elimination diet  50% drop in symptoms.
 Lactose intolerance.
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Chemical imbalances.
Neurotransmitter & hormone imbalances.
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Neurotransmitters:
 Serotonin
 Dopamine
 Noradrenaline
 GABA
 Acetylcholine
 Endorphins
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Hormones:
 Adrenal hormones
 Thyroid hormones
 Sex hormones
 Growth hormone
Biochemical continuum.
Serotonin deficiency signs/symptoms.
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Depressed
Nervous/anxious
Worrier
Fears/phobias
Negative/pessimistic
Irritable/impatient/edgy
Obsessive compulsive tendency
Think about the same things over & over again
Self destructive or suicidal thoughts/plans
Low self esteem/confidence
Rage/anger/explosive behavior/assaultive
Sleep problems/light sleeper
Crave sugar/carbohydrates/alcohol/marijuana
 Use these substances to improve mood & relax
Feel worse in & dislike dark weather
Chronic pain (e.g. headaches, backaches, fibromyalgia)
Serotonin pathway.
Reference: Bioconcepts. [www.bioconcepts.com.au/]
Adrenal Rhythm.
Reference: www.diagnostechs.com/
Mild adrenal insufficiency signs/symptoms.
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Fatigue/lethargy not relieved by sleep
Trouble getting up in the morning
Crave salt or salty food
Low blood pressure
Light-headed or dizzy when getting up to stand from laying or sitting
Feel unwell during/after emotional stress, e.g. exhausted, shaky or confused
Decreased ability to handle stress/pressure
Tendency for low blood sugar
Intolerance to cold / frequently feel cold
Unstable body temperature
Light sensitivity
Increased frequency/severity of allergies
Dark brown spots on face/neck/shoulders
Poor exercise tolerance
Increased time to recover from infection
Thin, can't gain weight or weight loss
Insomnia / sleep disturbance
Anxious or panic attacks
Saliva Adrenal Stress Profile.
Reference: www.gdx.net/
Adrenal hormone case study.
“I am feeling so much better than when we first consulted
over 6 months ago… for the last month I have been doing
about 500 metres of swimming + 2 kms of walking about 5
times a week. This compares to just barely struggling to do
the weekly shopping! The feelings of exhaustion are not very
common anymore. Depression and anxiety totally under
control. Sleeping is much better. Overall, I am beginning to
feel like a completely different person.”
Sleep.
Sleep.
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Inadequate sleep quantity and quality are
extremely common.
Sleep.
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Functions of sleep:
 Rejuvenation/Repair
 Growth
 Detoxification
 Memory storage
 Energy conservation
Reference: Dr. Reza Samvat, www.sleep4health.com.au/
Sleep – treatment.
Remove causes.
 Supportive lifestyle, environment and sleep
routine.
 Dietary changes.
 Herbal/nutritional supplements.
 Relaxation techniques.
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See: www.nutritional-healing.com.au  ‘Articles’ for more info.
Stress.
Psycho-social stress.
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Universal disease exacerbator.
Known effects:
 Impairs immune function.
 Increase nutrient requirements (e.g.
magnesium).
 Impair digestion.
 Impair sleep.
 Impair neurotransmitter balance.
 Impair hormone (e.g. cortisol, DHEA, thyroid
hormones, sex hormones) balance.
Psycho-social stress – Management.
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Treatment options:
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Eckhart Tolle [www.eckharttolle.com/].
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Emotional Freedom Techniques (EFT).
[www.integrative-clearing.com.au/]
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Breathing/muscle relaxation exercises.
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Biochemical.
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Exercise.
Lifestyle.
Lifestyle factors.
Smoking.
 Alcohol.
 Drug use.
 Exercise.
 Rest.
 Fun.
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How to put it all together.
1.
Optimize basics:
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General diet.
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Sleep.
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Stress.
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Lifestyle.
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Healthy environment.
How to put it all together.
1.
2.
Optimize basics:
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General diet.
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Sleep.
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Stress.
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Lifestyle.
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Healthy environment.
Identify contributing factors:
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Gastrointestinal issues.
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Nutrient imbalances.
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Environmental.
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Allergies/intolerances.
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Neurotransmitters & hormone imbalances.
Questionnaire.
Nutritional & Environmental
Medicine: Putting all the pieces
together.
Blake Graham, B.Sc (Honours), AACNEM
Clinical Nutritionist
(08) 9381 4112
February 16th 2008
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