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General Functional Medicine

We seem to see lots of asymptomatic UTIs.

Dr. Amy Nett: Yeah we would see a couple of asymptomatic urinary tract infections, but again we weren’t finding it...

Opinion about a 50-year-old client dealing with brain lesions. She did a lumbar puncture and it was not demyelination. So she has high blood pressure, constipation for many years, feet and legs are swollen from time to time, gaining weight in the past few years. When she came to see me she was doing a few months of colon hydrotherapy trying to help her constipation. We’re working on diet and lifestyle, and she has a very limited budget for testing. So would you start by testing her gut?

Dr. Amy Nett: Yeah, I probably would. I mean the constipation, yes, and I mean, our general approach is almost...

The time when women’s cycles start to change and there are symptoms of hot flashes and night sweats, which I’ve learned as low estrogen, is that correct?

Dr. Amy Nett: Yes, I can be. It can be due to low estrogens. I don’t know if that’s the...

Given that estrogen replacement is more controversial than progesterone, what are your favorite things to do specifically for hot flashes and night sweats besides the exposome work and the HPA gut work? Any specific supplements?

Dr. Amy Nett: Okay. So this one might be a little bit more detailed than we really want to get...

I’d like to ask what test you suggest for a 55-year-old man who had thrombosis with pulmonary consequences last month. We’re cleaning his diet. He has a lifestyle that is very balanced besides his job. He is a captain at Emirates Airlines. He is in treatment for six months and not flying but wants to go back to his passion. His doctor put him on an anticoagulant Xarelto and that was all he did. So wondering where to start the investigation.

Dr. Amy Nett: Oh, that’s a great question. I really haven’t actually come across any patients who have pulmonary embolus...

My client isn’t dealing well with the anticonvulsants prescribed for her atypical neuralgia. She has a history of low bone density, feels extremely fatigued, constipated, hormonal imbalance, and is taking a combination of pregabalin and carbamazepine. She’s been on it for over a year now and feels her health is steadily declining. Since the TMJ treatment is giving her extreme headaches and muscle cramps, she isn’t continuing it at this point in time. Since both medications have GABA relations, do you think supplementation with GABA might be helpful to calm her nerves? What about LDN? I really want her off the pills but haven’t yet found an alternative.

Dr. Amy Nett: Yeah, I don’t know that I would put her on any sort of GABA supplement though, while...

In this week’s content, Chris mentions that high serum B12 in the absence of supplementation is a sign of impaired B12 metabolism and possibly low active B12. Would you do any additional tests, and what would treatment be in the case of impaired B12 metabolism?

Dr. Amy Nett: So in the setting of high serum B12, you would also want to look at, this is...

This is sort of unrelated to our course content, but I figure that with your radiology background, you would be a person to ask. One of my patients who also sees another functional med practitioner in town mentioned that she has had so much imaging done, including several CT scans, at least one MRI, multiple radiographs this year that when she goes to the hospital or imaging center, they make her sign a waiver guaranteeing that she won’t place blame and understands how much radiation she’s getting. She said they make a big deal of how much imaging she’s done. And I Googled the approximate effective radiation dose that each of these tests incurs and I’m just wondering what you know about what’s recommended as far as maximum for an individual in a given time period. Have you seen policies where a person might be refused to test because there’s concern over how much radiation they’ve been exposed to over time?

Dr. Amy Nett: Okay, so I’m going to back up a little bit here. So when we think about it,...

I’ve read that berberine does not absorb systemically and acts primarily in the lumen of the GI, three antimicrobial actions. Is this consistent with your understanding of its mechanism of action?

Dr. Amy Nett: Yeah, I’m not sure on the mechanism of action in terms of the glucose effect, but the...

I would like your opinion on a 55-year-old client who is overweight since she had her only child at the age of 44. Had very heavy periods for years, then a hysterectomy. About four years ago she also had high blood sugar levels and high cholesterol. She feels her body is very inflamed and her legs and feet get swollen frequently. She has physical exhaustion, had her gut tested, being treated for dysbiosis with a botanical protocol, working on her diet, eating Paleo for the past month where she saw a big improvement. Also working on sleep but no energy for exercise. She’s taking boswellia and curcumin for inflammation. Finances are limited and doctors are conventional. What would I suggest as the next step to helping her?

Dr. Amy Nett: Okay so the cheap answer is lifestyle. What is she doing in terms of meditation? So because...

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