Updated: Mar 30, 2021
By Dr. Shawna Darou, ND
I have spent the past 25 years carefully observing health-care trends, staying on top of the latest in naturopathic, integrative and functional medicine, and can honestly say that it’s time to evolve how we look at human health and wellness. The issues we have been facing have intensified over the past year due to significantly higher stress levels, reduction in physical activity, dietary trends with more bread, sugar and alcohol, higher toxin exposure (cleaning chemicals!), and of course the introduction of a new pathogen.
In my own practice, patients I work with come in with much more complex conditions. It is no longer simply gluten-intolerance, high cortisol and yeast issues, as were so many cases in the beginning of my practice. Health issues have become much more complex and multi-layered. We cannot treat just one system and expect a positive outcome. For example, only addressing hormones will not resolve infertility. We often need to address inflammation, mitochondria function, detox pathways and nervous system regulation.
We now look at how systems interact and interconnect – how gut health impacts global inflammation; how stealth infections affect the ability to cope with milder illness; how hormones are impacted by any other system imbalance; and how only treating the symptoms with a targeted medication will never result in a cure for a chronic condition. There is so much misconception about naturopathic, integrative and functional medicine: in reality we spend hours each week researching and studying medical journals. This is ‘evidence-based’, even if it is not the current standard of care.
Finding the underlying causes of illness:
The top areas I look for when working with chronic illness such as autoimmune disease, chronic fatigue, chronic digestive conditions, infertility, Alzheimer’s disease, POTS, post-viral fatigue, and more have changed significantly over time. This is my current list, and I anticipate that it will continue to change and evolve over the next decade.
The gut microbiome has the most evidence behind it, but now we also consider the bladder microbiome, vaginal microbiome, uterine microbiome, skin microbiome and more. Microbiome imbalance in the gut is often the main driver of systemic inflammation through the presence of bacterial “LPS” (lipopolysaccharides) that first cause inflammation in the gut lining, and then impact inflammation in any other system. Our microbiomes have been affected by changes our food supply, several generations of routine antibiotic use, cleaning chemicals and sanitizers, use of glyphosate, lack of nutrients, medications and stress. Whenever there is inflammation, regardless of overt digestive symptoms we need to think of the microbiome.
Our toxic load has increased with each generation too, and some chemicals, heavy metals, medications, and environmental toxins like mold can have a profound impact on our health, especially neurological system. Our ability to clear toxins has a lot to do with our overall toxic load, and even more with our genetics making us more susceptibility to toxicity illness.
3) Stealth infections:
Many of us live with chronic infections that can either continue low-grade causing daily body and immune stress, or can reactivate into a renewed acute state. Infections include Lyme disease, Epstein Barr virus, Streptococcus bacteria, dental infections (gingivitis or deeper infections associated root canals or implants), herpes viruses, SIBO (small intestine bacteria overgrowth), H. pylori and more. Addressing the infection, and also how the immune system is responding to infection can start to resolve fatigue, autoimmunity, inflammation and ability to handle other infections.
4) Nervous system regulation and chronic high stress:
I’ve written many times about nervous system regulation and the impact on health. This is extremely important, because to put it very simply, the body can only heal in a state of rest. If you are constantly living in a high stress, sympathetic nervous system-dominant state, your body is not healing and repairing. High pace of life, financial stress, unreasonable workloads, countless hours in front of a screen, PTSD, increased exposure to EMF’s, and recently lack of social contact put many of us in a chronically dysregulated state. On top of that, many infections and toxins also turn on the stress-response with limbic system activation. Learning tools and finding support for stress is often the first place to start in the healing process, to allow the other steps to make a difference.
5) Insulin resistance:
Issues with blood sugar regulation, and especially insulin resistance deserves its own discussion as it is enormously prevalent right now, and occurring at younger and younger ages. Insulin resistance refers to the body’s overproduction of insulin in response to carbohydrates intake in the diet. This is often due to over-consumption of high carbohydrate foods, sugar and alcohol, but can also be impacted by hormones (high androgens as in PCOS), mitochondria disfunction, sleep issues, genetics, and prenatal exposure in utero. Insulin resistance is associated with diabetes, obesity, cardiovascular disease, metabolic syndrome, and also with an increased risk of several cancers and Alzheimer’s disease (referred to as ‘type 3 diabetes’). It is important to note that insulin resistance is REVERSIBLE.
6) Nutrient deficiencies and depletion:
Even with a fairly balanced diet, nutrient deficiencies can arise from nutrient depletion in the soil causing the food itself to be less nutrient-dense. Many of us still don’t eat enough vegetables, fruits and whole foods, and it’s very common to have genetics that predispose to issues with cellular absorption of B-vitamins, omega-3’s, zinc, vitamin D and more. In addition, many common medications deplete nutrients – for example hormonal contraceptives deplete vitamins B6, B12, folate, zinc and magnesium; Metformin depletes vitamin B12 significantly, and statin drugs (used for cholesterol) deplete coenzyme Q10. We can assess many of these nutrients with bloodwork, or more advanced testing and then replenish with foods and supplements. Nutrient deficiencies are most significant with fatigue and mental health issues.
7) Mitochondria dysfunction:
The word mitochondria has become very central in functional medicine discussions especially, and is looked at anytime there is an issue with energy, pain or cognition/ brain fog. Mitochondria are the energy centres or ‘batteries’ of your cells, and they are easily damaged by environmental toxins, chronic high stress or infections. Mitochondria function is also significant for overall hormone balance, especially cortisol production. If you have issues with energy, brain fog, cognition, fibromyalgia or migraines.
The road to recovery – starting with a health timeline
I am a big fan of mapping out your health timeline. This is often where we can see the layers building up. Did health issues start after a period of very high stress? After renovation project in your home? or with travel? Have you been on many rounds of antibiotics for ear infections, acne or chronic UTI’s? Where are the toxins coming from? Have you had extensive dental work, especially root canals or implants? Have you always had allergies, eczema, and food intolerances and now there are multiple autoimmune conditions? Has stress been chronically high for many years and now you’re having trouble sleeping and focusing? The more details that you can add, the more we can see the layers and know where to begin.
Lab testing and assessment
Coming from a scientific background (first as an Engineer), I really like data and lab tests where possible. Some of the things mentioned above are harder to test for, but we can certainly look at:
bloodwork for nutrients, insulin, hormones, inflammation
comprehensive digestive stool analysis for microbiome, gut pathogens and intestinal permeability
organic acid test for markers of microbiome imbalance, mold exposure, toxin exposure, mitochondria function, nutrient absorption and more.
devices that measure heart rate variability or track your sleep to check for issues with nervous system regulation
personal genetics to look at methylation pathways, detox pathways, susceptibility to inflammation, and literally personalize your treatment plan
testing for infections is often more difficult, especially if they are chronic or reactivated, but there are tests available where needed
Putting it all together with a treatment plan
Once we have mapped out the timeline and systems impacted, we begin with a treatment plan that always starts with the foundations: balanced nutrition, good quality sleep, stress reduction and daily movement.
These days especially, all health-care plans need to address nervous system regulation, since we’re all under increasing levels of mental and physiological stress, and remember that the body only heals in a state of rest.
From here we use labs and your health timeline to guide us – replacing nutrients, supporting gut function and the microbiome, assisting detoxification pathways to remove toxins, repairing mitochondria function, reversing insulin resistance, and targeting infections. In some cases these are addressed together (especially with cognitive decline), and in other cases we address them one layer at a time.
I wrote this article after contemplating how different my practice is now compared to when I started. Health is more complex right now, and we are always learning about new ways to get to the root of illness and understand the impact of toxins, infections, nutrition and stress on our health. What you need ultimately is a doctor with curiosity, willingness to learn, and to continuously asking WHY.