What prompted me to write this article was a pattern that I saw last week. On a single day, I saw an individual who had been diagnosed with Meniers disease. And then another one who had been diagnosed with Wegener’s Vasculitis. And then another one experiencing recurring Urethritis. Now although their symptoms varied, all of them were joined by a common experience; they had been around the block trying the various ‘cures’ provided to them by their doctors, but every single had got nowhere and two had reacted very badly to their treatment.
But this came as no surprise. Not a single one of them had properly discussed their sleep. Or their adrenal balance. Or their ability to absorb food. It seems that some doctors think that patients can somehow heal while they are getting only 2 hours of good sleep and while their cells are being nutritionally-starved by the chaotic mess that is their digestive tract.
This is not to say it was their fault; the opposite, in fact. Each one instinctively knew that the “find a symptoms, give it a name, then write the prescription” approach was failing big time. They knew there were some underlying issues that hadn’t been identified. And there are specific underlying issues that crop up again and again:
Digestion: if you cannot absorb food properly, your cells do not stand a chance of functioning properly. Digestion can be disturbed in a number of ways, for example low hydrochloric acid production (this itself affects protein breakdown and mineral absorption, as well as the activation of digestive enzymes and the release of bile). Dysbiosis is also a common problem; while this originates in the intestines and wreaks havoc here, this also triggers inflammation throughout the body and represents a huge stressload for the adrenals.
Sleep quality: if you are not consistent quality sleep, you will not be able to heal efficiently. There are all sort of chemicals involved in healing – various hormones, prostaglandins, cytokines and transcription factors – and all of them are affected when your sleeping becomes disturbed. Output of one of the most important hormones, growth hormone, can drop by almost 90% if you are not getting deep sleep. Getting people to sleep better always means controlling/reducing their adrenaline output (which is consistently high in people with chronic fatigue, despite their low energy).
Adrenal balance: the adrenals affect your metabolic rate, your stress response, your sleep-wake cycles, your blood sugar level balance, your blood pressure, your cellular sensitivity to thyroid hormones. They also have a huge impact on energy levels, clarity of thought and mood. Basically, everything. And, in the last 8 years, 100% of people with chronic issues have shown adrenal imbalance upon testing.
Central Nervous system: it’s called central for a reason, yet it is the organ system most overlooked. If the conditions in your central nervous system are disturbed, then your neurotransmitters will not be able to do their job effectively. This means you are never as awake as you should be in the day time and never as asleep as you should be at night. The autonomic signals that govern your digestion, immune system function and sleeping also get screwed up. Huge obstacle.
There are other imbalances that can occur but these are the Basic Four. They can be tested, both through lab tests of functional investigation, although a myriad of useful information can be yielded from a thorough screen during consultation..
In any case, it is simply pointless to start any protocol without looking at these four areas as a minimum. I will screen every individual I see in these areas, and this often means starting a program in a similar way. Does this mean that I am employing the same program for everyone? Not at all, although the recommendations made upon the first consultation can be very similar. The investigations and lab work that I order may not appear too different. The irony is that, in order to develop a personalised program, you need to start in a consistent manner. After all, you cannot spot irregular responses if you do not have a standard point to compare to.
Once you have this standard point (“the starting line”, as I often call it), you can now start to yield the next level of information. This is where things start to get quite variable. Like peeling an onion, a lot of symptoms and problems cannot even be detected properly until you have calmed the body, reduced the sky-high adrenaline and allowed the individual to leave the fight-or-flight mode that they have been unknowingly trapped in for months. For example, I don’t often measure thyroid hormones or run a test for estrogen/testosterone until we have taken steps to balance the adrenals, because any adrenal balance will ALWAYS distort the results of the others (of course, this is not a rule and there are exceptions).
This means that a multi-step approach is called for. But that’s fine. Rome was not built in a day. And, although I can get insomniacs sleeping reasonably well 70% of the time in one attempt, there are no individuals with chronic imbalance that can be fixed in one 55 minute appointment. I’m looking at getting the person feeling truly great and this can take months. The human machine, a complex structure of multiple organ systems and around 74 trillion cells, cannot be mapped out on single discussion alone. Or lab work alone. Instead, we yield an detailed picture of the individual’s internal environment from:
- the screening that occurs in the first appointment
- the lab work that is ordered on the basis of this first appointment
- the individual’s response to the intervention made following the interpretation of the lab work
- and so on
Any unusual responses shine a light on the individuals needs and allow us to run more specific tests that can be spectacularly helpful. Sometimes, the treatment is the test. Sometimes, a trial of a particular food or supplement is often quicker, easier and cheaper than running a cutting-edge test.
In any case, by the third or fourth appointment, we may have seen the individual go from a sleep-deprived, adrenaline-fuelled, symptom-rich mess to a somewhat functional being that feels “decent enough”. In other words, they’ve gone from 1/10 to 6/10 – the level most people across the Western world are at. We’ve gone from the very basics (eg. “you clearly need magnesium”) to more specific biochemical differences (eg. “the results of your steroid pathway test suggest your delta-6-desaturase enzyme function may be sub-optimal”). It’s these seemingly-small differences that take the individual from 6/10 to 9/10*.
If there’s some golden rules I can leave you with, it would be the following:
- if any of the most basic symptoms are not supported, your cells are being starved/distorted/insulted
- you cannot expect anyone to heal if they are not sleeping properly
- to test some organ systems ‘fairly’, you need to remove the distortions (eg. adrenaline)
- treat things in the right order
- small tweaks are likely to deliver nothing if applied on the first appointment (before the Basic Four have been addressed), but may deliver amazing results on the fifth
Of course, these are simply guidelines and simply cannot express the complexity found on a successful treatment protocol. Following them will not automatically see your body sitting pretty with a perfect balance, but ignoring them guarantees that it will not.
*I consider my job finished at 9/10 as it is only the stress load, life satisfaction and the passage of time that will take them to a 10/10.