Disease 101 Flashcards
- List two, relatively common, root causes as to why someone might feel cold on a frequent basis.
Anemia - which might be microcytic, where red blood cells are too small (e.g. insufficient iron intake or absorption) or macrocytic, where red blood cells are too large (e.g. insufficient Vitamin B12 or Folate intake or absorption). Less commonly, anemia can result when the overall red blood cell count is simply too low (though size is optimal - neither too small or too large), and this most often results from poor oxygen supply (eg. sleep apnea, living at high altitude, or respiratory distress (e.g. chronic allergy/asthma, chronic smoker, emphysema).
● Insufficient thyroid hormone - especially insufficient Free T3 (realize that one’s Total T4 and Free T4 levels might be optimal, but poor conversion to the much more biologically active T3 thyroid hormone may be at play, which requires in particular zinc (Zn), iron (Fe), and selenium (Se)). Excessive cortisol may also drive a hypothyroid state (and thus this symptom) by promoting synthesis of Reverse T3 instead of T3 and/or may also increase hormone binding globulins (e.g. thyroxine binding globulin, TBG) which makes less of Total thyroid hormone available as Free and thus able to have cellular effects.
● Insufficient cortisol (an adrenal hormone) - which is required to allow T3 thyroid hormone to have optimal cellular effects. Realize that thyroid hormone blood levels might, in this scenario, be optimal, but an individual would still suffer from thypothyroid symptoms.
● Estrogen dominance - can impair thyroid hormone action within cells and thus have a similar effect as cortisol above. This is a good example of how all hormones can affect one another, despite having different points of origin and different, individual effects.
● Insufficient body fat - Moderate amounts of body fat provide many helpful benefits including thermal insulation. This is most likely the case in individuals who are underweight, as those with low body fat due to higher muscle mass tend to have faster metabolisms
- Adequate levels of a specific vitamin are necessary to avoid the development of enhanced intestinal permeability.
That vitamin is: Vitamin D
- An imbalance in Phase 1 and Phase 2 liver detoxification in the body - can cause:
large build-up of free radicals (or reactive oxygen species or oxidative stress).
This oxidative stress load can - if it overwhelms the body’s antioxidant capability - cause oxidative damage throughout the body. Thus sufficient intake of antioxidants (e.g. Vitamin C) and, more importantly, the nutrients required for the body to make endogenous antioxidants on its own (e.g. glutathione) is a key component of preventing the build-up of oxidative damage (which results from the imbalance in pro-oxidant vs.antioxidant forces).
A toxin caught mid-way between Phase 1 and phase 2 detoxification can be more hazardous to the body than it was initially. This imbalance is common because there are many modern lifestyle practices that increase the rate by which the body completes Phase 1 (and not Phase 2) e.g. smoking cigarettes, eating charred meats, caffeine. Chronic oxidative stress/damage can cause inflammation (and vice versa).
- The first two components of the HPATG hormonal axis in the body are:
the Hypothalamus and the Pituitary.
Remember that hormones are essentially “messenger” molecules. This is how the endocrine system starts with input from the brain about the status of our world and thus determines what the most appropriate response might be. A key concept for our clients to understand is that this hormonal cascade can be just as heavily influenced by our thoughts and imagination as it is by “real” circumstances as perceived through our five senses.
- Two B Vitamins which are particularly important for methylation to occur throughout the body
are?
Vitamin B9 (Folate), and Vitamin B12.
This is a bit of a trick question to stimulate your thinking. These are the two nutrients most often highlighted regarding methylation from a functional nutrition perspective, and they are indeed critical. However, if you are thinking more thoroughly, you may have also thought to include both of the following:
● Vitamin B6 which is needed to start the conversion of homocysteine into glutathione (the body’s most potent antioxidant and a necessary substance for detoxifying heavy metals so they can leave the body).
● Vitamin B2 (riboflavin) is needed to activate the MTHFR enzyme (so that folate can be made available to the methylation cycle which explains to some degree the highly variable impact that MTHFR SNPs do or don’t have on actual methylation function) and is also needed to convert Vitamin B6 to its final usable form (P5P).
- A client who struggles regularly with headache, constipation, muscle spasms, and
hypertension is likely to have insufficient levels of this key nutrient:
Magnesium
Remember that RBC Magnesium is a much more accurate lab marker for this to be assessed than serum magnesium (which is the typical/default choice that most conventional practitioners will measure). It would have also been correct to say “potassium”. Magnesium functions as a master electrolyte in order to increase cellular uptake of potassium, which is actually at these symptoms. Though not technically a “nutrient”, one could also have accurately said “water”. A good reminder not to forget critical foundational choices in a healthy lifestyle.
- Clients who discover they have several moderate or severe IgG food sensitivities to foods that they consume on a regular basis are likely to have ____ as the root cause of their sensitivities.
enhanced intestinal permeability
Many factors can contribute to intestinal permeability (e.g. stress, medications, insufficient Vitamin D, microbial imbalance, chemotherapy). In some cases, this permeability may be caused or worsened by intake of gluten (even if gluten does not appear in their list of sensitivities with high IgG antibodies) or foods which are molecularly similar to gluten (e.g. other grains) in a dynamic called cross-reactivity.
Mercury is a heavy metal toxin that has a particularly high affinity for being stored in the brain.
Tracy shared a pearl with you that tremor is a common symptom of heavy metal toxicity (not just mercury but also others e.g. lead) as it causes overt damage to neurons. You may have also mentioned mood swings, memory loss, anxiety, depression, irritability, aphasia, and other peripheral neuropathy.
- An important hormone that works synergistically in the body with estrogen is?
progesterone.
Optimal levels of this hormone are important for avoiding symptoms of estrogen dominance and, in women, are also critical for fertility and retaining a pregnancy.
Even 5-10 years prior to menopause, women can begin to make less progesterone in the ovaries. If their adrenal gland is not able to “take up the slack” in progesterone production (usually due to high demands for cortisol instead or an overall low adrenal output), then symptoms of estrogen dominance can develop (even though overt estrogen levels might be healthy or even low-normal).
- The science of how specific food choices can change specific genetic expression is called?
nutrigenomics
- List three relatively common contributors to the development of hypertension (chronically elevated blood pressure). There are many choices. Your answers should include a subset of the following:
● Insulin resistance that causes chronically elevated (even slightly elevated) blood sugar levels. Fasting blood sugar persistently above 90 mg/dl (the midpoint of the typical reference range) is likely indicative of some level of insulin resistance.
● Chronic dehydration. Hydration is critical for optimal electrolyte function in keeping osmotic balance in the body.
● Insufficient magnesium. Necessary for catalyzing many enzymes in the body which
promote relaxation, including that for blood vessels. Magnesium is required to allow optimal amounts of potassium into cells. Without sufficient magnesium, higher intake of potassium is likely to simply be excreted in urine.
● Insufficient potassium e.g. low vegetable and fruit intake.
● High intake of advanced glycation end products (AGEs) e.g. from fried foods or overly cooked (browned) foods.
● Chronic stress, by promoting higher levels of stress hormones.
● Poor methylation which can cause a build-up of homocysteine or atherosclerosis (both of these are also acceptable).
● Chronic, simmering infection that causes high levels of circulating immune cells and inflammatory signaling molecules (e.g. mouth such as gingivitis, kidneys, intestinal bacterial overgrowth, candida or other fungal infection, parasites, SIBO).
● Toxic load or Impaired detoxification. This may be due to ongoing exposure at clinically significant levels of single agents (acceptable answers include BPA and other xenoestrogens, lead, arsenic, mercury), exponential load effect of multiple agents together,
or impaired detoxification that is unable to handle the collective effect of even tiny exposures over time.
● Excessive intake of sodium chloride (NaCl) in some salt sensitive individuals.
● Kidney dysfunction or disease which can overtly impair the body’s ability to naturally keep electrolyte balance or to excrete toxins.
● Calcification or hardening of arteries (or arteriosclerosis)
● Hormone imbalance, specifically high cortisol, high adrenaline, or high estrogen.
● Sedentary lifestyle. Insufficient movement/exercise.
- There are many lifestyle choices and circumstances which can contribute to downstream dis-ease beginning in the gut. At the level of physiology in the GI tract itself, list 7 relatively common mechanisms via which dis-ease can begin in the gut that you learned in your SAFM coursework. (Do not include lifestyle choices/impact but rather the downstream mechanism of dysfunction that they promote in the gut.) Your answers should include a subset of the following
● Hypochlorhydria or Low stomach acid impairs the body’s ability to absorb key minerals (e.g. Mg, Zn, Fe), Vitamin B12, and/or key amino acids (e.g. tyrosine needed to make thyroid hormone or to produce the neurotransmitters dopamine, epinephrine, and
norepinephrine). Low stomach acid might be precipitated by many different factors (usually a combination of multiple ones) e.g. age, acid-suppressing drugs (e.g. PPIs), food
sensitivities, poor eating hygiene, H Pylori overgrowth in the stomach, chronic stress, or low thyroid function. A general statement of Maldigestion is also acceptable as one answer.
● Enhanced Intestinal permeability (or leaky gut). May be promoted by many lifestyle choices including medications (e.g. NSAIDs, oral contraceptives, antidepressants), insufficient Vitamin D, mold exposure, increased zonulin release in response to gluten, or chronic stress.
● Pancreatic insufficiency as promoted by aging, pancreatitis, or insulin resistance.
● Chronic constipation impairs detoxification and the body’s ability to rid itself of toxins prepared for excretion. These toxins may then be reabsorbed into the body via the colon.
● Hepatic-biliary congestion or biliary insufficiency/stasis or cholecystectomy or gallstones or gallbladder disease. May be promoted by hypothyroid state or high estrogen state.
● Insufficient endemic, commensal microbes. Also acceptable: repeated intake of substances that imbalance or decimate gut microbes causing immune system imbalance or chronic inflammation (e.g. pesticides, antibiotics, oral birth control pills, antidepressants e.g. SSRIs, artificial sweeteners, chlorinated municipal water). Other similar answers are acceptable as well.
● Pathogenic microbial overgrowth or infection in the gut (e.g. parasite, yeast/Candida, Klebsiella or other bacteria) can cause chronic inflammation or higher levels of endotoxins or beta glucuronidase. It is also acceptable to mention medications that can cause this
dynamic e.g. prednisone, antibiotics.
● Irregular or dysregulated motility. Perhaps as caused by hypothyroid and/or hypoadrenal function or serotonin dysfunction, medication or microbial imbalances.
● Dysbiosis or Small intestinal bacterial overgrowth (SIBO) or Enterococcus/E-coli or Archaea that drives the intestinal production of serotonin unnaturally high or low, often causing IBS-like symptoms (e.g. cramping, bloating, persistent diarrhea or constipation (or an alternating pattern of both)).
● Diarrhea or fast transit time can cause dehydration and impair key nutrient absorption (e.g. magnesium or essential fats).
● Overt gastrointestinal injury or damage or surgery that causes digestive, absorptive, or motility impairment (e.g. scar tissue or removal of part of the intestines). This may also include colonoscopy.
