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Functional Medicine > Approach towards the Matrix > Flashcards

Approach towards the Matrix Flashcards

1
Q

What is the mindset of functional medicine?

A

1) In a fire, be the detective finding the source of the fire, not just the fireman putting out the fire.
2) There is a continuum of health and wellness, where is this person on that continuum?
3) Is there imbalance?
4) Biochemical individuality. Genes and their expression differ from person to person.
5) Personalized approach (look upstream and personally tailor the approach). This is risk assessment, not diagnostic. Evaluate and treat EARLY biochemical imbalance.
6) Interconnection-the systems are all interconnected, like a web. What affects one system affects the others.

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2
Q

How many biological systems are there in FM?

A

7

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3
Q

What is the point of the MSQ?

A

To find out where the patient on the continuum of health and wellness paradigm? Are they on the left, middle or right? Do they just need a little intervention or a lot?

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4
Q

What are the 7 biological systems in the Matrix?

A

1) Assimilation
2) Structural Imbalance
3) Communication
4) Transportation
5) Biotransformation
6) Energy Regulation
7) Defense & Repair

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5
Q

What is the acronym used for the systemic approach used in Functional Medicine? What does it mean?

A 
GOTOIT.
Gather: Collect MYSELF, and all the information (MSQ, etc).
Organize.
ReTell.
Initiate:
Order:
Track:
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6
Q

What does the MSQ tell you? How do you use it?

A 
Gives an indication of overall health.
Gives a good indication of the toxic load of the body.
Ideal score: <10
Score: 30-50 (need for concern)
Score: 50-100 (needs definite attention)
Score: >100 (major medical problems)
Able to predict increases in inflammation, immune dysregulation, oxidative stress
Use it monthly.
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7
Q

What is the physical examination in functional medicine?

A
  1. What is the person’s body shape? What is their body composition? Ex-pear shape, apple shape. Above or below waistline-where is the fat?
  2. Waist circumference?
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8
Q

What does the pear shaped body tell you?

A

More gut dysfunction, hormonal issues. May not be eating as much as apple shape.

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9
Q

What does the apple shaped body tell you?

A

More towards insulin resistance, inflammation. May eat more. Digestive system almost soothes the hormonal imbalances.

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10
Q

What are antecedents?

A

Factors that PREDISPOSE a person to illness, (whether genetic or acquired).

  • Ask about family history (parents, grandparents, siblings, etc).
  • Preconception, prenatal and birth info.

Ex:
Trauma, sexual abuse, toxicity, intrauterine history, intestinal permeability

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11
Q

What are triggers?

A

Factors that PROVOKE the signs and symptoms of illness.

  • Usually major events that happen through life.
  • Triggering events spiral our lives downwards.
  • Empower people so they know what to do when those triggering events occur, so they stay closer to health.
-Ex. Physical or psychic trauma.
Memories
Stressful events
Microbes
Toxins
Surgeries
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12
Q

What are mediators?

A

Factors that CONTRIBUTE to the pathological changes and dysfunctional responses, whether biochemical or psychosocial.
-Factors on a daily basis or regularly that are contributing to pathological changes.

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13
Q

What are the 3 components of the assimilation system?

A

1) GI system-Digestion, gut microbiota
2) Skin
3) Lungs

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14
Q

What is the acronym used to describe the key functional roles and aspects of the gut?
What does each acronym letter stand for?

A

DIGIN

Digestion and assimilation
Intestinal permeability
Gut Microbiota/Dysbiosis
Immune modulation/ Inflammation
Nervous system
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15
Q

What are the consequences of gut dysregulation?

A

1) Immune systems sends out inflammatory responses.
2) The mucosa is not intact.
3) Portal circulation gets flooded with too many antigens and causes detoxification stress.
4) More immune complexes are formed and immune cascades are made.
5) Chronic inflammation (systemic or local) can affect the HPA axis.

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16
Q

What are the components of the Defense and repair system?

A

1 of the 3 finite processes that the other systems go through, it is a funnel to the signs and symptoms. It is connected to all other systems. It touches many components of the MSQ.
-It is about NON-resolution of inflammation.

  • Immune
  • Inflammation (if chronic-> failure of resolution?)
  • Oxidative stress
    (ex. watery itchy eyes, chronic coughing, frequent illness, etc).
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17
Q

What is the cycle of chronic inflammation?

A

1) Signal in bloodstream cause adhesive cells to blood vessel epithelium, which attracts PMNs to the extracellular tissue.
2) Neutrophils (PMNs) engulfs whatever the signal indicates, then starts apoptosis, which starts another signal.
3) The monocytes are called by the signal into the extracellular tissue, which calls the MACROPHAGES. The macrophages engulf the neutrophils which are apoptotic to contain the contents. Then they turn into REITER cells, which go into the lymphatic system and are resolved.
If the macrophages do not do this, then the neutrophil contents (lysosymal enzymes) creates necrosis and inflammation of the tissues. This creates more signaling to the immune system, causes increased oxidation and starts the process over again.

Defense and repair problems can lead to auto-immune problems.

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18
Q

What process works hand in hand with genetics?

A

Methylation.

Methylation quenches oxidative stress! More oxidative stress leads to more inflammation.

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19
Q

What are the 5 genes that are related to methylation?

A 
MTHFR
MTR
MTRR
CBS
COMT
20
Q

Mine:

What is methylation?

A

Methylation is a simple biochemical process – it is the transfer of four atoms - one carbon atom and three hydrogen atoms (CH3) – from one substance to another.

21
Q

Why is methylation important?

A

The body is a very complex machine, with various gears and switches that need to be all functioning properly to operate optimally. Think of methylation, and the opposite action, demethylation, as the mechanism that allows the gears to turn, and turns biological switches on and off for a host of systems in the body.

https://www.thorne.com/take-5-daily/article/what-is-methylation-and-why-should-you-care-about-it

22
Q

How does methylation happen?

A

HOW DOES METHYLATION HAPPEN?

CH3 is provided to the body through a universal methyl donor known as SAMe (S-adenosylmethionine). SAMe readily gives away its methyl group to other substances in the body, which enables the cardiovascular, neurological, reproductive, and detoxification systems to perform their functions.

Unfortunately, the system that produces SAMe is reliant on one switch being turned on by a critical B vitamin, 5-MTHF (also known as active folate or methylfolate).

23
Q

What would cause inadequate 5-MTHR?

A

the system that produces SAMe is reliant on one switch being turned on by a critical B vitamin, 5-MTHF (also known as active folate or methylfolate).

Simply put, if enough 5-MTHF is present, the methylation cycle will work efficiently.

Folic acid from the diet or supplements must be converted to this active form, 5-MTHF, before it can be used in the body in the methylation cycle.

Unfortunately, approximately 60% of people in the United States have a genetic mutation that makes it challenging for their bodies to create enough 5-MTHF.

24
Q

What is energy linked to?

A

Mitochondrial function (produces energy). Quenches oxidative stress?

On the MSQ- the energy, mind and emotions are linked to mitochondrial function/energy.

When mitochondria don’t function- the defense and repair, and communication/hormones don’t function as well.

25
Q

What do the organic acids tell you?

A

Linked to the mitochondria? Citric acid cycle?

26
Q

What do you do with the MSQ score?

A

Write it on the Matrix.

27
Q

How do you detox?

A

1) Sweating is a primary means of elimination.

Sedentary lifestyle is dangerous, builds toxins.

28
Q

What is glyphosate linked to?

A

Cancer.

29
Q

What is related to structural integrity?

A

Omega-3’s.

Blood spot test- checks RBC membranes

30
Q

What are SCFAs?

A

Short chain fatty acids are the end products of bacterial fermentation of dietary fiber in the gut.

31
Q

Name some types of SCFAs.

A

1) Acetate
2) Propionate
3) Butyrate
4) Valerate

32
Q

What is the most common or abundant type of SCFA? What does it do?

A

Butyrate- is main fuel for the cells in the large intestine. Want to have high levels of this. Gut uses 70% of the butyrate and 30% is absorbed, used as brain fuel.

33
Q

How do you get butyrate?

A

From butter. Also a supplement-but smells like rotten eggs.

34
Q

What about propionate?

A

Too much is not good. Studies in rats showed autistic behavior when fed too much propionate.

35
Q

How do you balance the levels of SCFAs?

A

Optimize gut flora so the bacteria ferment in a good way.

36
Q

What is the intestinal permeability assay test? Name the 5 sugar molecules used for testing.

A

IPA tests the small intestine. Sugar solution (5 different sugar molecules) are mixed with water and ingested before bed. Urine collected in 8 hrs the next morning, sent to lab.

1) Mannitol
2) Cellobiose
3) Sucrose
4) Raffinose
5) Lactose

37
Q

Significance of mannitol urine test?

A

1) Indicates absorption capacity- Mannitol (very small molecule), should be absorbed and should be in urine. In damaged intestines, will not be in urine, not absorbing nutrients.

38
Q

Significance of cellobiose urine test?

A

Cellobiose- is a marker of intestinal permeability. This is a large sugar molecule (2 glucose molecules). Too big to pass usually through the enterocytes, unless there is leaking in the tight junctions and damage. Should not see much of this in the urine.

39
Q

Significance of sucrose urine test?

A

Sucrose- marker of gastric permeability. Disaccharide. This is table sugar. This is hydrolyzed by sucrase in the duodenum. This should not be absorbed in the stomach, does not usually cross the stomach lining unless the lining is damaged. High sucrose/raffinose ratio means sucrase deficiency.

40
Q

Raffinose/ mannitol ratio significance?

A

Is a marker of intestinal damage? Raffinose is an indigestible trisaccharide. High ratio means some damage.

41
Q

Lactase significance in urine test?

A

Lactose intolerance. Is a disaccharide found in milk. High ratios of lactose/raffinose indicates lactose intolerance.

42
Q

Food or supplement?

A

Better to give foods than a supplement.

43
Q

Top 5 supplements used for gut healing?

A

1) Broad spectrum probiotic, at least 100 billion.
2) Saccharomyces-if sIGa is low. Crowds out yeast.
3) If inflammation- fish oil, curcumin, ginger. Licorice. Zinc for healing?.
Do you think it is oxidative stress? Or Inflammation?

44
Q

Top 5 supplements used for gut healing?

A

1) Broad spectrum probiotic, at least 100 billion.
2) Saccharomyces-if sIGa is low. Crowds out yeast.
3) If inflammation- fish oil, curcumin, ginger. 4) Licorice. 5) Zinc for healing?.
Do you think it is oxidative stress? Or Inflammation?

45
Q

When do you refer out?

A

Results positive for occult blood, low markers for pancreas/bile, infections requiring treatment? Calprotectin? Can say-I will treat what I can treat, but I will refer you back to your own doctor also.
IBS dx-not given until you rule out other serious conditions behind it.

Functional Medicine (24 decks)

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