Advanced Naturopathic Case Taking: Case Analysis: Core Clinical Imbalances

Question 1

Core clinical imbalances

Answer 1

• Seven core areas of clinical imbalance which need to be considered when deciding which systems are under stress.
• Each core area impacts overall health due to influencing multiple systems and structures. The seven core areas are:
  1. Assimilation.
  2. Structural integrity.
  3. Communication.
  4. Defense and repair.
  5. Transport and circulation.
  6. Energy: Mitochondrial health.
  7. Detoxification and elimination.

Question 2

1. Assimilation:

Answer 2

All aspects of digestion and assimilation:
* Digestive secretions: Stomach acid, pancreatic juices, bile, I.F (B12).
* Digestive motility & innervation: Vagus nerve, SNS, PSNS system, enteric N.S
* Digestive hormones: Ghrelin, gastrin, CCK.
* Absorption of nutrients: Villi, brush border enzymes.
* Microbiota balance: Parasites, bacteria, yeast, short-chain fatty acids, lactobacilli, bifidobacteria.

Question 3

2. Structural integrity:

Answer 3

Covers a range of structures in the body:
* Cell membrane health: e.g. EPA/ DHA balance.
* Mucous membrane and skin integrity: E.g. vitamin A, vitamin E (skin), glutamine.
* Bone and teeth: E.g. minerals
* Joint and cartilage: E.g. calcium, magnesium, phosphorus, vit D, vit C.

Question 4

3. Communication

Answer 4

It encompasses:
* Hormones and the endocrine system.
* Neurotransmitters and the nervous system.

Question 5

4. Defence and repair:

Answer 5

This area of health covers:
* Inflammation—acute and chronic.
* Infections —↑WBC’s, ↑ESR, ↑or↓ lymphocytes and neutrophils.
* Microbiota imbalances.
* Conditions such as allergies and autoimmune disease, indicating an imbalanced and poorly-regulated immune system.
* Lowered immune function such as reduced secretory IgA which usually protects the mucous membranes.

Question 6

5. Transport and circulation:

Answer 6

This area of health covers:
* Lymphatic structures: Tonsils, spleen, thymus, nodes.
* Vascular structures: Arteries, veins, capillaries - ↑waist circumference, ↑ BP, ↑ ferritin,
* Mobilisation of blood lipids: ↑ Triglycerides, ↑ LDL, ↓ HDL

Question 7

6. Energy: Mitochondrial health:

Answer 7

Cofactors for energy production: Zn, Mg, B6, B1, B2, B3, Fe.
* Biochemical imbalances in the energy production pathways e.g. due to aluminium, fluoride, arsenic, lead toxicity.
* Mitochondrial integrity and oxidative damage.

Question 8

7. Detoxification and elimination

Answer 8

Liver (and gallbladder) function.
* Kidney function.
* Bowel function.
* Skin and lungs.
* Biochemical imbalances in the biotransformation pathways e.g. lack of methyl donors (cysteine, methionine, choline, glutathione).

Question 9

Assimilation Imbalance: Key signs and symptoms

Answer 9

• Any possible insufficiency e.g. pallor, shortness of breath
• Dysbiosis, gas, bloating, food allergies/intolerance, heartburn, increase or decrease in bodyweight
• Illnesses such as cystic fibrosis or any that would impede absorption

Question 10

Structural Integrity Imbalance: Key signs and symptoms

Answer 10

• Any issues relating to structural pain/injury, tendons or muscles e.g. osteoarthritis.
• Skin problems e.g. acne, eczema, psoriasis
• Gut membrane integrity and autoimmune conditions
• A diet low in essential fatty acids and low exposure to sunlight (vitamin D) and low bone minerals such as Ca, Mg, Zn, B, P

Question 11

Communication Imbalance: Key signs and symptoms

Answer 11

• Any signs and symptoms related to hormonal issues from reproductive, and fatigue to stress two mood and sleep

Question 12

Defence and repair Imbalance: Key signs and symptoms

Answer 12

• Recurring infections, fatigue, poor wound healing, skin issues, autoimmune conditions, intestinal permeability
• Low vitamin D and antioxidants in the diet.
• High free radicals.

Question 13

Mitochondria health Imbalance: Key signs and symptoms

Answer 13

• Any issues affecting ATP production e.g. weakness, fatigue, CFS/MEE, Parkinson’s disease, MS, poor cognitive function, poor memory, intestinal permeability

Question 14

Transport Imbalance: Key signs and symptoms

Answer 14

• Circulatory issues such as CVD, Raynaud’s and peripheral neuropathy
• Lymphatic issues such a oedema

Question 15

Detoxification and elimination Imbalance: Key signs and symptoms

Answer 15

• Consider when clients are on any medication, poor diet and lifestyle, poor stool qualities/quantity, smoking, alcohol, exposure to chemicals, low antioxidants in the diet, poor quality / light-coloured stools, jaundice, lethargy etc.