Functional Medicine Part 3: Nutrition

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Chiropractic, Diets, Functional Medicine, Functional Medicine Series, Health, Holistic Medicine, Natural Health, Nutrition, Remedies, Supplements, Wellness

Functional Medicine Doctor Explains Nutrition

Each chemical reaction which occurs in the human body requires enzymes and each one of these processes needs a coenzyme. But what are coenzymes? They are vitamins and minerals. Approximately 37 billion, billion chemical reactions occur in the human body every second.

That is why proper nutrition and a balanced diet rich in whole foods with vitamins and minerals is fundamental towards overall health and wellness. The majority of people in the United States are vitamin and/or mineral deficient. But, how do you know if you�re a part of the 90 percent of individuals with enough deficiencies to develop disease? We will discuss the tests you can utilize to find out if you�re vitamin and/or mineral deficient and what you can do about it.

What�is�Nutrition?

Hello, welcome to part three of �Taking Control of your Healthcare�. Today, we will discuss one of the fun topics of functional medicine: nutrition. Unfortunately, nutrition is one of the most essential conversations that many doctors aren�t willing to have with their patients. The average medical doctor learns about disease and malnutrition rather than learning how to use nutrition as treatment or even how to use nutritional therapies to achieve optimal health and wellness.

I personally believe that food can be utilized as a form of medicine. That it should be the foundation of medical practice, not an afterthought in medicine. There is no better treatment than proper nutrition. Approximately 90 percent of individuals in the United States aren�t getting the essential nutrients they require for healthy bodily functions. And more than that probably aren�t getting enough nutrients to prevent diseases associated with nutritional deficiencies. However, what is ultimately needed to achieve optimal well-being? More than 98 percent of Americans are deficient in omega-3, 80 percent in vitamin D, 50 percent in magnesium, and 10 percent in vitamin C. Nutrient deficiencies can also continue to cause health issues for years.

Acute diseases, such as rickets, scurvy, beriberi, or iron deficiency anemia, are often the most talked about health issues associated with nutrient deficiency, however, there�s also something known as long latency deficiency diseases. So, how much vitamin D do we need to not get rickets? Not a lot, only 30 units really. And how much do we need to not get osteoporosis? Perhaps about 3,000 to 4,000 units per day. Now, how much folate do we need to not get anemia? Also not very much. But, how much do we need to prevent heart disease, cancer, and dementia? You definitely need a lot more units per day.

Each chemical reaction which occurs in the human body requires enzymes and each one of these processes needs a coenzyme. But what are coenzymes? They are vitamins and minerals. Approximately 37 billion, billion chemical reactions occur in the human body every second.

That is why proper nutrition and a balanced diet rich in whole foods with vitamins and minerals is fundamental towards overall health and wellness. The majority of people in the United States are vitamin and/or mineral deficient. But, how do you know if you�re a part of the 90 percent of individuals with enough deficiencies to develop disease? There are only several nutrients which we are generally tested for. And for a majority of these, doctors aren�t aware of what the optimal values should be which can make correcting the nutrient deficiency so much difficult to do.

Taking Control of Your Nutrition

One of the most fundamental nutrients you need to measure is vitamin D. Although it�s referred to as a vitamin, it�s actually more like a hormone and it�s produced from cholesterol. This is yet another reason why cholesterol is essential. Approximately 80 percent of the population is deficient in vitamin D. Unless you�re in the sun 20 minutes every day between 10:00am and 2:00pm, you might need to take vitamin D supplements. In order to supplement properly, however, we need to know from what level you are starting at first. By way of instance, optimal vitamin D levels should be anywhere between 50 and 80 nanograms per milliliter of blood. The recommended amount of vitamin D we can supplement is about 2,000 to 4,000 units.

If you have lower vitamin D levels or if you have genetic problems, you may actually need to supplement with up to 10,000 units of vitamin D. That�s why it�s fundamental to work with a doctor or functional medicine practitioner who can measure and test your nutrient levels as well as help you optimize them. Most supplements contain about 400 units which is 10 times less than the amount most of us need. The optimal levels are generally just over 20. This is way too low. In one research study, women with vitamin D levels between 45 and 60 experienced reduced preterm labors by up to 60 percent. Vitamin D is also essential to help build strong bones and muscles, to improve immune system function, to prevent cancer, and ultimately, to help you live longer. It�s incredible.

Another measurement or test that�s performed by most doctors but is not always interpreted correctly is referred to as the MCV or mean corpuscular volume. The MCV measurement evaluates the size of your red blood cells in a test called CBC, or complete blood count, which is one of the most common blood panels ordered by healthcare professionals. So, if you are deficient in nutrients, your cells can either become smaller or larger. By way of instance, if your cells are too big, it could be a signs of a folate or vitamin B12 deficiency.

B vitamins are essential in numerous chemical reactions within the human body. They help us produce energy as well as help us regulate gene expression in order to create proteins that will ensure our overall health and wellness. If our B vitamins are too low, we could eventually develop an iron deficiency, anemia, or it could even cause a genetic disorder.

Optimal levels of B vitamins should be between 80 to 90. B complex vitamin supplements can help easily optimize levels of B vitamins. But, why would anyone be deficient in B vitamins? Is their diet not providing them with enough nutrients? Are they vegan? Are they taking any drugs and/or medications that prevent vitamin B12 absorption? Moreover, B vitamins are depleted during times of high stress which, as a practicing chiropractor, I can say it happens frequently to a majority of the population in the United States alone.

MCV is not the only measurement or test which evaluates a patient�s levels of B vitamins. Homocysteine is an alternative marker we will discuss in future articles which demonstrates B6, folate, and B12 levels. However, both the MCV and the homocysteine measurement or test only demonstrates that one or more of these nutrients may be deficient. It doesn�t necessarily tell us which one. Therefore, some additional, follow up evaluations may be required.

The MMA, or methylmalonic acid, measurement or test also shows vitamin B12 levels. Ultimately, vitamin B12 is essential for many processes in the human body, including energy production, gene expression, methylation, nerve function, and mood, among many other processes. Vegans have a higher chance of developing a B12 deficiency because it�s only found in animal products. Folate is another fundamental B vitamin. It can be determined directly in the blood, but, homocysteine is a more precise marker for folate levels.

In this section, we�re also going to discuss genetics because there is a measurement or test which can demonstrate a lot more regarding the status of your B vitamins and your ability to utilize them. Our genes are capable of making proteins. We have approximately 20,000 genes which are designed to create proteins. And one third of all the proteins they make are for our enzymes. Enzymes convert molecules into other molecules. These enzymes are also largely dependent on specific nutrients. One of the most fundamental genes which can be affected is known as MTHFR, or methylenetetrahydrofolate reductase. But you can just call it MTHFR.

MTHFR is essential because it helps regulate methylation, homocysteine, and folate, which are vital towards our overall health and wellness. When you have elevated levels of homocysteine, you should check your methylation status by looking for the MTHFR gene through a simple blood test.

Methylation is a key biochemical process which is fundamental towards the proper function of most of the human body�s systems. It triggers billions of times each second. And it ultimately helps control homocysteine, a substance which can damage blood vessels and has been associated with dementia, heart disease, and cancer, among other health issues. Methylation also helps repair your DNA on a regular basis as it helps recycle molecules necessary for detoxification, or getting rid of toxins. It also helps control your mood and it helps manage inflammation. Methylation is critical.

But, to make sure that methylation is active, the human body needs optimal levels of B vitamins. Without enough B vitamins, the methylation process can break down and the effects can be destructive. This is where we start seeing an increase in birth defects, such as spina bifida, down syndrome, and more miscarriages.

MTHFR is frequently abnormal in approximately 35 percent of the population. Methylation breakdown can also increase the risk of developing health issues like osteoporosis and diabetes, cervical dysplasia or cancer, including colon cancer and lung cancer, and even depression, pediatric cognitive dysfunction as well as mood and behavioral disorders, dementia, and stroke. Methylation is truly a key biochemical process.

When we discuss genetics, we have to understand that our environment can alter our genes. So, what if you have an MTHFR variation in your genes? First of all, not all mutations cause health issues. One mutation, by way of instance, known as C677T, is one version of the gene which is more significant than another version of the gene, known as A1298C. Now there�s no need to worry about these gene variations. They serve as examples to demonstrate you the quality of these mutations and how they function. People with these variations of the gene, by way of instance, might only need more folate or they might need a particular type of folate known as methylfolate. This is where a functional medicine practitioner can help their patients.

A genetic test can let you known if you have one of these gene variations. But, don�t get stressed. There�s a lot you can do to optimize your overall health and wellness. Many patients have visited my office after they find out they have these variations in their genes. And they quickly learn that they do have the option to take control of their well-being. However, what you do control is not your genes, you control your gene expression.

If you alter your healthy eating habits, you alter your nutrients. If you alter your environment, you alter which genes become active and which genes become inactive. And with these mutations, you can do just about the same thing by simply following the proper nutrition. When you find a doctor or functional medicine practitioner that�s willing to work with you, they�re going to tell you what lifestyle modifications you should follow to prevent health issues.

So, we�ve only just discussed the B vitamins. Next, we will discuss another fundamental nutrient in the human body: magnesium. Magnesium is a super essential mineral. Approximately 48 percent of people in the United States consume less than the required amount of magnesium from food. Magnesium is necessary in over 300 chemical reactions in the human body. It is also fundamental in the production of ATP, or the energy the human body utilizes as fuel.

A magnesium level blood measurement or test can help determine if you have a deficiency. Magnesium can also help reduce anxiety, calm the nervous system, and improve sleep. It is also an essential nutrient in the management of blood sugar levels. If you�ve been told by a healthcare professional that you have an average blood sugar level of over five and a half in something known as A1c, then magnesium can help.

Also, it�s very easy to know if you have a magnesium deficiency by looking at your current diet and symptoms. Do you eat enough magnesium rich foods like dark, leafy greens, beans, nuts and seeds? Or do you eat a lot of processed foods? Perhaps you also have symptoms such as anxiety, insomnia, constipation, muscle twitching, muscle cramps, PMS, and/or palpitations. If you have one or more of the symptoms I just mentioned, you may have a magnesium deficiency.

Next, we will talk about zinc, the immune-boosting and testosterone-boosting mineral in the human body. This important nutrient is in charge of maintaining your hair volume as well as repairing your gut lining. It�s also responsible for making sure your thyroid is functioning properly. Zinc can be easily measured or tested in the blood and unfortunately, it�s another nutrient we are highly deficient in, in the United States. Additionally, you can also look at your alkaline phosphatase levels, which can be calculated through a liver function evaluation on a regular blood panel. High levels of alkaline phosphatase may indicate the presence of cancer or bone problems, among other health issues, however, low levels of alkaline phosphatase may indicate a zinc deficiency, because it�s a zinc-dependent enzyme.

Finally, the last fundamental nutrient we are going to discuss is iron. Iron is frequently deficient in vegans and vegetarians, or in women in general due to menstruation. Iron is necessary for transporting oxygen throughout the human body and it�s ultimately essential for brain health and wellness. Iron is also important for hair and nails, sleep, and so many other things.

Ferritin is a stored type of iron and it�s this nutrient which helps you see your iron levels. Optimal ferritin levels should be between 50 to 150 in women and 100 to 300 in men. And many times I�ve seen women visit my office who have ferritin levels of less than 50, or worse, in the single digits. This is because pre-menopausal women lose blood every month due to their menstrual cycles and it becomes so much harder for them to maintain proper ferritin levels. Many women also eat way less than what they�re supposed to be eating every day. High levels of ferritin, on the other hand, could be a sign of inflammation, generally caused by insulin resistance to sugar, or it could be a sign of hemochromatosis or iron storage disease, a very dangerous genetic disorder.

Having decreased levels of ferritin can also make you feel tired, and it can cause hair loss, it can cause insomnia. So, even if your blood count is normal, if your ferritin levels are low or your iron levels are low, it can also cause these symptoms. That�s why if you experience symptoms of fatigue, it�s essential to measure or test your ferritin levels. And it can be easily supplemented.

Aside from ferritin, a low MCV can also determine if you have an iron deficiency. Iron deficiencies can cause red blood cells to become very small and that can be demonstrated in low MCV levels, which evaluate the size of your red blood cells. Additionally, transference saturation, serum iron, TIBC, or total iron binding capacity, and hemoglobin, can provide us with a more in depth look at your iron status to distinguish different causes of anemia. These are included on a regular iron blood panel in a lab test.

We�ve discussed several nutrients which can be ordered by a majority of healthcare professinals with access to conventional lab testing. Furthermore, there�s another test which can tell us more about which type of nutrients we need based on our genes. It�s called the DNA health test and it�s provided by a company called DNAlife. This test evaluates a variety of genetic markers associated with detoxification, lipid metabolism, and inflammation, including the MTHFR gene and other B vitamin markers. Now, DNA Health demonstrates the different genes we evaluate. And most of these are common genes, they�re those we can do something about. We analyze the genes we can change based on your nutrition and other lifestyle factors.

It shows us the MTHFR gene, other B vitamin markers, genes that control B6, folate, and B12 as well as demonstrating how they function and whether you have nutrient deficiencies. Then it tells us which nutrients you will need to supplement and how much we will need to give to you. It�s tremendously helpful.

There was an individual who had two variables of the MTHFR gene. This woman had miscarriage after miscarriage after miscarriage. She visited her doctor for an evaluation and it turns out that she had a folate-regulating mutation. So her doctor then started giving her the proper amount of folate she needed and she started having healthy babies. Sometimes, nutrition can be that powerful towards improving a patient�s overall health and wellness.

The DNA health test can help personalize your approach when optimizing your well-being based on your genetics. What we measure utilizing the DNA health test provide well-established insights about your genes as well as what you can do about them.

A micronutrient test known as the individualized optimized nutrition profile or the ION panel, are alternative test options which can also provide information about your current nutritional status. This test is by Genova. This is a robust test which measures all the essential vitamins and minerals, fatty acids, organic acids, and antioxidants you currently have. Ultimately, this test looks for imbalances, insufficiencies, or deficiencies, rather than looking for a specific disease. It looks for things that a majority of doctors never look at.

Functional medicine practitioners or doctors look at patient�s amino acid levels, mineral levels, and even toxin levels from heavy metals like mercury, lead, arsenic, and many more. We also look at your antioxidant levels, vitamin A and vitamin E levels, as well as your CoQ10 antioxidant and beta carotene status. We can determine if a person eats vegetables or not if, by way of instance, they have low levels of beta carotene. We also look at vitamin D levels, essential fatty acids, including your omega-3 fats and your omega-6 fats. We can tell if a person eats junk food. We can tell if a person is eating fish. And We can tell if a person is eating too much olive oil or saturated fats. It�s all demonstrated in these measurements and tests.

An OAT test, or organic acids test, also looks at what is known as organic acids. This test demonstrates a wide array of parameters associated with your mitochondria, which we will discuss in the next article, your B vitamins, your neurotransmitters, your gut flora, and your detoxification. It�s ultimately a comprehensive test which shows me if a patient is well or sick. It shows me where the imbalances are and where I need to recommend lifestyle modifications. It also helps provide clues about other health issues.

By way of instance, if your mitochondria aren�t functioning correctly because you have decreased levels of essential amino acids or you have increased oxidative stress or if you simply have low levels of selenium and zinc, there�s a possibility that you might have some form of toxic overload due to heavy metals. And that�s precisely what I would go looking for. Signs like these provide a lot of information about what we can do to treat a patient. And an experienced functional medicine practitioner or doctor can determine what�s really going on with a patient or they can help patients discover how to optimize their overall health and wellness.

Nutrition is the study of nutrients in food and how the human body utilizes nutrients as well as the relationship between diet, disease and overall health and wellness. Nutrients are a source of nourishment, including carbohydrates, proteins, fats, vitamins, minerals, fiber and water. Functional medicine focuses on the use of food as a form of medicine. A balanced nutrition can help prevent as well as treat a variety of health issues. Similarly, nutrition in functional medicine involves how certain diseases and conditions may be associated with dietary factors, such as poor diet or malnutrition, food allergies and food intolerances. Dr. Alex Jimenez D.C., C.C.S.T.

Understanding Your Nutrition

As good functional medicine doctors we�re often left asking ourselves, why is it that so many people in the United States are overfed but undernourished? Or, why is it that Americans eat too many calories and too few nutrients? The leading causes for the widespread nutritional deficiencies are the following: First, humans evolved from eating wild foods which contained tremendously higher levels of nutrients. Second, the soil we currently utilize to grow our crops in has become greatly depleted of nutrients. Hybridization techniques from industrial farming are yielding animals and vegetables to have decreased levels of nutrients. Third, processed foods have absolutely no nutrients, which is why they frequently have to be fortified. And last but not least, exposure to environmental toxins, lack of sunlight, chronic stress, and poor diet, including increased alcohol, caffeine, and sugar consumption, can increase our nutritional needs, much of which we�re already not getting enough from our current nutrition.

Well you might not need any vitamins, however, if you can meet certain conditions. Perhaps if you only hunted and gathered wild food and if you weren�t exposed to environmental toxins. Or maybe if you went to sleep with the sun and woke up with the sun, sleeping nine hours a night. And if you experienced absolutely no amount of chronic stress. Ultimately if you only drank pure, clean water and breathed pure, clean air. Then, you probably wouldn�t need any vitamins. But the rest of us that don�t follow these conditions, we do need them.

And with that thought, we wrap up this article. In the next article, we will talk about hormones. Hormones can affect almost every aspect of our well-being, and many healthcare professionals don�t understand what our optimal hormone levels should be or even when to test them and what to do about it once they do. Measuring and testing hormone levels should be standard practice, and many patients have never had a blood panel to look at their hormones. It�s fundamental to know as well as understand what�s going on inside your own body. And that�s why this next article is so important. You won�t want to miss our next update. See you soon.

The scope of our information is limited to chiropractic and spinal health issues as well as functional medicine topics and discussions. To further discuss the subject matter, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900�.

Curated by Dr. Alex Jimenez

Additional Topic Discussion:�Acute Back Pain

Back pain�is one of the most prevalent causes of disability and missed days at work worldwide. Back pain attributes to the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Injuries and/or aggravated conditions, such as�herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief. �

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