Our Approach to Metabolic Health: A Comprehensive Framework
As we’ve discussed metabolic health is foundational to overall well-being and plays a crucial role in preventing cardiovascular disease (CVD) and improving longevity. At the heart of this approach is the recognition that blood vessels are often “innocent bystanders” in the development of CVD and metabolic dysfunction. While their responses—such as inflammation, oxidative stress, and vascular dysfunction—are initially protective, chronic insults to vessels can lead to dysregulation and eventual cardiovascular dysfunction. Addressing these underlying causes through proper assessment, prevention, and treatment is key to mitigating long-term health risks.
Comprehensive Testing and Diagnosis
Understanding the root causes of metabolic dysfunction requires a detailed and individualized assessment. It’s our goal in Functional Medicine to better understand the underlying causes of these imbalances and identify early signs of disease.
Laboratory Testing:
Micronutrient imbalances: Intracellular and extracellular testing helps identify nutrient deficiencies that may contribute to metabolic imbalances. Nutrients like magnesium, vitamin D, Omega 3:6 ratios, chromium, zinc, CoQ10, Iron, potassium and more.
Standard Panels: Assessing complete blood count (CBC) and complete metabolic panel (CMP) can help identify anemias, elevated white blood counts that may indicate low grade infection or autoimmunity and early signs of inflammation.
Metabolic and Hormonal Markers: A comprehensive panel of markers that goes beyond the basics of fasting blood glucose and A1c, includes markers like fasting C-peptide, fasting insulin, proinsulin, 2-hour glucose tolerance test (GTT), thyroid and sex hormone panels.
Advanced Cardiovascular Risk Markers: Looking beyond standard lipid panels to include lipoprotein particle number and size are crucial to getting the full picture of metabolic and CVD risk. Evaluating systemic and vascular inflammation is critical to fully understanding the risk profile of each patient. These markers include C-reactive protein (high sensitivity), fibrinogen, myeloperoxidase, Lp-PLA2, SDMA, ADMA and more.
Endothelial and Vascular Health: Sensitive tests are used to evaluate endothelial dysfunction and vascular disease. These can detect functional or structural abnormalities, even when traditional risk factors for coronary heart disease do not.
Gut Microbiome and Balance: The interactions between gut bacteria, the intestinal barrier, and host metabolism influence nutrient absorption, inflammation, and energy regulation. Imbalances in gut function or microbial diversity, known as dysbiosis, are increasingly recognized as contributing factors to metabolic dysfunction, including obesity, diabetes, and cardiovascular disease. Comprehensive gut tests for assess for dysbiosis, parasites, SIBO and other imbalances are an important foundation for establishing optimal health.
Non-Invasive Cardiovascular Testing:
A wide range of imaging and functional tests help assess cardiovascular health:
• Electrocardiogram (EKG) and treadmill stress testing
• Cardio-Ankle Vascular Pressure Wave Analysis (CAPWA)
• Endothelial dysfunction testing (ENDOPAT)
• Carotid duplex and carotid intima-media thickness (CIMT) scans
• Advanced imaging such as CT angiograms, coronary artery calcium (CAC) scoring, carotid intima media thickness (CIMT) and cardiac MRIs
Personalized Treatment Plans
Functional medicine takes a holistic, individualized approach to managing metabolic health. This involves advanced diagnostics, targeted interventions, and ongoing support to optimize overall well-being. Here’s a breakdown of the tools and strategies used to create personalized treatment plans:
Early Detection and Evaluation
Effective treatment begins with early identification of risk factors and suboptimal health indicators.
Comprehensive Diagnostics:
◦ Detailed patient history and thorough evaluations identify early risk factors for conditions like cardiovascular disease (CVD), diabetes, and other metabolic disorders.
◦ Functional medicine prioritizes addressing suboptimal lab values to mitigate risks before they progress into chronic disease states.
Advanced Testing:
◦ Includes biomarkers for inflammation, oxidative stress, insulin resistance, and gut health.
◦ Examples: Advanced lipid profiles, micronutrient testing, hormonal panels, and genetic screenings.
Nutritional and Lifestyle Support
Tailored interventions focus on correcting nutrient deficiencies, optimizing diet, and addressing lifestyle factors.
Dietary Customization:
◦ Functional medicine considers unique dietary needs, incorporating plans like low-carb paleo, Mediterranean paleo, or whole-food-based diets to support metabolic health.
◦ Therapeutic approaches correct nutrient deficiencies through diet and targeted supplementation.
Health Coaching:
◦ Functional nutritionists and health coaches guide patients to implement changes and meet them where they are in their health journey.
Stress Management:
◦ Strategies to manage stress include breathwork, meditation, and limbic system retraining, which reduce the impact of chronic stress on metabolic function.
Environmental and Genetic Insights
Addressing environmental and genetic factors helps manage inflammation and improve overall metabolic flexibility.
Environmental Toxin Reduction:
◦ Strategies focus on minimizing exposure to toxins that can contribute to inflammation and oxidative stress.
Genetic Risk Management:
◦ Interventions aim to optimize gene expression, blood sugar regulation, blood pressure, and immune function.
Gut Microbiome Optimization
Gut health is foundational to metabolic and cardiovascular health.
Microbiome Balancing:
◦ Supports beneficial bacteria, addresses infections, and restores balance in the gut ecosystem.
◦ Benefits include improved blood sugar regulation, reduced inflammation, and enhanced immune function.
Hormonal Regulation
Balancing hormones is critical for metabolic processes and cardiovascular health.
Key Hormones Targeted:
◦ Blood sugar regulation: Insulin and glucagon.
◦ Cardiovascular health: Cortisol, estrogen, testosterone, and thyroid hormones.
◦ Cholesterol metabolism and blood pressure regulation.
Pharmacological Interventions
Medications are integrated into treatment plans when necessary to manage specific conditions or imbalances.
Applications:
◦ Reducing inflammation, oxidative stress, and cholesterol levels.
◦ Managing blood sugar imbalances and optimizing hemodynamics.
Comprehensive Approach:
◦ Pharmacological therapies are used alongside lifestyle adjustments and nutritional support for a well-rounded plan.
Ongoing Monitoring and Adjustment
Functional medicine emphasizes the importance of tracking progress and adapting plans as needed.
Regular Testing:
◦ Monitoring biomarkers ensures interventions are effective and identifies areas for improvement.
Long-Term Habit Change and Education:
◦ Taking the time to educate and guide patients into long-term healthy habit change can help create a sustainable and healthy future.
Long-Term Support:
◦ Patients receive continued guidance to maintain and optimize metabolic health over time. Once we have patients fully through their treatment plan, we offer and optimize membership for ongoing support and care for health longevity.
By addressing metabolic health with this comprehensive and proactive approach, we aim to empower individuals to achieve lasting wellness and prevent the progression of chronic conditions like cardiovascular disease.