Okay, good evening. I’m Sangeeta and I’m really excited to do this webinar which we’ve been asked to do many times. So, here it is. This webinar will be posted on MD Prescriptives’ website so that you guys can look at it at anytime. I think one the most challenging visits that we do as integrative doctors is the first visit because obviously most of us have a host of interactions and interventions and diagnostic tools that we’re aware of.
Which one to test first and which symptom to prioritize first? And, which supplement or hormone to go with first? Becomes a difficult challenge because if we do everything we know, the patient gets overwhelmed and isn’t able to do almost anything. So, the pieces that I’m going to cover are briefly the:
Basis of Restorative Medicine, what to focus on in initial history taking, to know which symptoms to give priority, know which tests to order first; and, what interventions to start first before the tests are back. So, this is really what interventions do I use on the very first visit before we even have labs most of the time. So, my email is always here so that you guys know about it.
Basically, there are five steps for an initial visit and the first one is to recognize that medicine is founded on intuitive principles. So, in this first visit, we need to use this intuition. The history taking and the rating of symptoms is the second step. The third is the explanation of the restorative model and how it accounts for their symptoms and disease. This is really where I spend most of the time.
It seems to me that when a patient walks out the door, you know what their priority symptoms are and they have walked out with a proper understanding of what you think is going on and why they’re having the symptoms and disease. They become motivated and connected to the plan in a way that I cannot explain but I find this to be the most important part of the very first visit.
Then of course, the last one is the creation of a written plan; which tests to order first, which interventions in each of the five areas. We always have a clinical liaison. Take the patient after I’m done with them to go over the vitals, the prescriptions, the supplements, and the written plan. So that people leave with a double reinforcement of everything and have a chance to ask their questions.
I will be taking questions at the end but it is 6 PM EST, so get comfortable. Nobody needs to learn uncomfortable. I’ve got my shoes off and for all you know, I could be in my pajamas but I’m not. The first thing that I ask you to do is to take a deep breath while we get started. Medicine is founded on intuitive principles. None of these are new to us.
First Do No Harm. Trust the Healing Power of Nature. Discover and Treat the Cause, Not Just the Effect. The Whole Person. We’re Teachers. And, Prevention is the best “cure.” This is basic stuff. We know that the animal world is full of instinctual activities and when humans are born, natural instincts prevail. So when we’re tired, we sleep.
We know that bees’ natural instincts and intuition has been responsible for the development of medical principles for 4,000 years all the way up to the finding of salicylic acid by the Greeks. So, this is a basic tenet which we gotten away from because when we’re tired now, we will reach for coffee or energy drinks instead of a nap.
We’re well aware of at this point that naps actually have been proven in the science to improve, and this is a study done by Harvard Medical School, all of these things. So our intuition is correct. If you’re feeling tired, take a nap. Then you’re supported by this study. It turns out that based on this study actually, a lot of Fortune 500 companies actually added nap rooms to their things.
What’s happened is that we’ve gotten so far away from intuition and so deep into pharmacy and surgery that we’re spending more with a higher mortality rate. That’s precisely how the restorative approach came into play for me because my feeling was that it was a necessity to have a toolbox that was wider than just pharmacy and surgery, and included a lot of other things which you can see.
A lot of medical services and a lot of other services that we do but this is exactly the issue that happens with all of us is that we get to the point where we have all these services and all these things we can do, and all these different angles that we could use to get people well. What we’re interested in is, what is the quickest, fastest, most efficient way to prioritize the interventions so the person gets well rather rapidly?
In our clinic that we’ve seen, a lot of patients in over 10,000, were finding that medical health care providers are making up 15-20% of the people we see and people under the age of 35 are now making up over 35% of who we see. These are the kind of things that we’re treating and these are some of the first complaints that people are coming in with. Most of you know that energy, sleep, weight gain, sex drive, anxiety, and depression are going to be your top symptoms.
So, I’m giving you a synopsis today of how we evaluate these kind of patients, what we focus on and it’s really rather straightforward in the very first visit, and how we put a plan together that is then followed over time. The results on these patients has been over 90% using a model that works with correcting both the subconscious and conscious mind, which I will show you a little bit about. The physical body, the hormonal levels – optimizing them. Optimizing the nutritional levels and removing the toxins.
So, our sequence when we’re seeing patients start with an initial consult and history taking. I’m going to show you that history form. We take a lot of time to rate specifically energy, sleep, pain, and mood. We always ask about gastric symptoms because I find that if you don’t address gastric symptoms, almost anything you give causes problems. So, these are some basic things we’re always asking.
We’re always testing for hormones, nutrition, and bone density to get an idea. We always do a physical plan and give a written plan of action. We share with the patient on the very first visit that, “Look, we’re going to make a list of everything that’s bugging you. Everything you want to resolve, improve or get rid completely and when the list of your symptoms…,” and this is your list, “… is in a good place and you’re happy with your result. Then instead of following you up with short visits every 4 weeks, you can come and see us twice a year.”
That suits most people quite well. That’s actually our maintenance plan is that people come in twice a year. The first thing I want to show you here is a sample of what our medical history form looks like and that would at least give you an idea of how detailed what they’re filling out is. So, the medical history form is basic. It’s giving us you know medical, family history.
We’re asking about all these things; surgeries, hospitals, specialists, allergies, prescription meds, supplements, screening they’ve done. This is the most important part of it. This is what I’m going to show you we use because you get to the point where you can have pages and pages and pages of them rating symptoms which it doesn’t really help us in any way most of the time because there are some basic symptoms that are going to be the most important.
So for me, this particular HAP sheet for a female and this particular HAP sheet for a male is where I focus to make their plan. So this is going to be important in the cases I’m going to show you today. Obviously, additional history, we get are OBGYN, personal, and social. We do a review of systems. So that there’s things that we ask about on every system just so that we can ask about those things.
We take a food and nutritional evaluation on every patient because that gives us an idea about the nutrition because every single patient that comes into our office is automatically scheduled for their initial consult, and then a nutritional consult which follows that. So, we take a pretty good detailed nutritional history from the beginning. So, what we focus on in this is the priority symptoms. So, energy and sleep are going to be two of the priority symptoms.
What are we asking about sleep? We’re asking, how many hours do you sleep at a stretch without waking up? Without being aware that there’s a world outside your sleep? The relevance of this is that the NIH research has well-shown that 8 solid hours with five 90-minute cycles continuous is what you need to recover your adrenals, to reset your metabolism, and to recover the cardiovascular and neurovascular systems.
So obviously, this is what we’re looking for. No, we do not need less sleep as we grow older. We always ask about pain because these two are going to tell you, likely these three symptoms are going to give you a lot of about anxiety right here. The mood, a lot about the adrenals, sorry. The mood whether they’re having anxiety or depression. We always take history of the gastric system as I mentioned to you.
What happens is in the very first visit, if your interventions are focused on correcting the energy and the sleep – everything else automatically corrects. That’s what you find. So usually, after we correct energy and sleep, you know we have people coming in here for diabetes and for cholesterol and for all kinds of things. What we find is these two items is where you aim first and once you correct that, metabolism corrects, other things correct.
Then you’d be evaluated in 4-5 months and see where you need to go but these are the two priority symptoms. I can tell you so that you don’t have to get confused. My finding is that when you focus on those two – everything else corrects. I showed you the section that we’re using for women that I focus a lot on. You can see that the first few symptoms are progesterone ones. The next symptoms are Estradiol. The next ones are related to Estriol.
The next ones are related to thyroid and the bottom ones are related to testosterone. This is just very loose because as you know there is no such thing as just a symptom that’s related to one hormone. They’re related to all of them. Very similarly, we have a shape for men and what I find is that when we condensed this down to half a page, they pay a lot of attention to it. We got lots of good information from this little piece of information.
You’ll see that on the cases. It has given us and that’s what I was showing you, some idea of basically what we’re thinking about when you start to focus on that one little chart there. These, of course, are the thyroid symptoms. The first four; fatigue, memory, depression, and motivation are the four, and the weight gain are the ones that I talk to the patients about when I’m trying to explain to them that everybody’s going to have some of these symptoms – because everybody has a certain amount of decline in thyroid function as time goes on.
So, if we were seeing this case which is a typical case, my first visit would be 45-minutes. She doesn’t have labs. She’s saying that she sleeps for four hours at a time and she wakes up to pee, but we know that that’s because she’s detecting the bladder at half-empty. She’s sensitive to it because she’s sleeping in lighter sleep phase. She’s having panic attacks a couple of times a month and ending up in the emergency room.
She has very low energy. Partly from sleep and possibly partly from the adrenals because once you see this kind of panic attack and that kind of energy, especially the two out of ten. You know that you’re probably are dealing with a situation where the adrenals are involved. She’s also simultaneously having heavy menstrual period, anemia, and a history of breast cysts and ovarian cysts and has been offered a lot of different things.
The most important thing for her in this initial visit is for her to know that it’s going to be for her to know that the things she’s been offered could correct it. That basically are standard things that you can use to correct it but once we give her explanation, she’ll understand it. She’s not Xanax-deficient. She’s not Ambien-deficient. She’s actually deficient in some nutrients and hormones. So, the way we used this chart for her is she’s clearly showing progesterone deficiency symptoms and some thyroid deficiency symptoms.
So, that’s basically where I’m going to go with her. When she starts to list her symptoms, the first symptom is: four hours at a stretch and wakes; 7 out of 10; low energy; heavy periods; anemia, her crit is 32; breast and ovarian cysts that are recurrent 2-4 cm; and, stress. The thing to realize is, is that I make this list in front of the patient. On our new patient history, the very first thing we’re doing is making the list of things that’s bothering the patient.
We’re not focusing on disease. We’re focusing on what’s bothering the patient. So if the patient lists a symptom which in this case she listed symptoms, that’s fine. If she decides to list conditions like diabetes or weight gain or things like that, that would make it on the chart. When I finish that chart and finish that rating, that’s the list off of which we will work on for every single visit that she comes until these things are resolved.
Every time she’s going to see what she’s rating thing and she’s going to know if she’s getting better or she’s getting worse related to where she started. So, the most important thing in the history taking and the rating of symptoms is to understand how it happened. So, if you look back at this particular patient and she’s 40-years old. Then you look at the bottom line which says stress, 7-8 out of 10 for the past five years.
She’s had biopsies. She’s changed her job. She’s had a child. She’s gone through an ablation. When I start to explain to her why she’s having these symptoms, I’m going to take in the factor the fact that this stress has put a stressor on her cortisol system which means her progesterone has shunted to cortisol. At that point, she gets all the progesterone deficiency symptoms which are the ones listed here basically.
So that understanding of how it happened like when I’m taking a history of someone who has a big immune issue, they’re having a gastric issue and it’s long-standing. You have to ask, were you breastfed or bottle-fed? Or, what was your intestines doing when you were younger? Because these things make a difference. The next step here is the explanation of the restorative model and how it accounts for their symptoms and disease.
So, this is the step I’m about to show you in her case before we write the written plan. So, what I would have explained to her is that the most important thing that happened in her case is that the mental and physical stressors that she had, the childbirths, the job changes, and the physical stressors whether it’s a commitment, an activity, or a stressor. That it would have put a demand on her gas tank. I call the hormones and nutritions the gas tank.
So how fast the engine runs has something to do with how much gas you use. When your gas tank is full, you don’t feel it. When you get into your 40’s and you’ve had an engine running fast, you’ve had childbirth, you’ve had job changes, you’ve had a lot going on – your gas tank is going to be more empty. What I will do is explain to her that the progesterone gives us symptoms that are related to the anxiety and the sleep, and the panic attacks, and that the DHEA is going to be probably involved because of the cortisol system.
Then I explain to every single patient that in this approach basically, that it’s a restorative approach. So, the very first step after she gives me her symptoms is I tell her, “Look, we’re going to use a restorative approach to your body,” and what we’re going to assume in a restorative approach is very basic. We’re going to assume that if your body has optimal levels of hormones, optimal levels of nutrition, optimal toxicities are removed, and mind and body are clear – that the body’s going to do what it’s supposed to do and take care of you.
The two premises that we always share with the patients is that and I have a sheet that explains this is that there’s two premises in a restorative model. One, that underlying imbalances cause the symptoms and the disease whether it’s a nutritional deficiency or whether it’s a hormonal deficiency. That we don’t acquire drug deficiencies but we acquire hormonal and nutritional deficiency.
The other thing that I’m going to be explaining to her is that when we’re looking for these imbalances, we’re always looking for optimal levels, not normal. These are the two principles. The principle of imbalance and looking for optimal levels that every patient is explained because when you start to interpret their labs, they’re going to ask you why you’re telling them that they need to have a vitamin D above 70.
Or that their T3 which is in the normal range is still not in the optimal range because you’re using an outer limit of 6.8. So it becomes important for them to understand that everything you interpret is going to be interpreted into the optimal range. You would be surprised how many patients immediately light up when you tell them that because that’s exactly what they’ve been looking for.
They’ve been looking at their numbers and noticing they’re borderline forever but they’re told they’re normal. So, this piece of explaining of the restorative model is extremely important for them. So in her case where we would go is to show her that the mental and the physical stressors create beta waves which start to deplete the supply. As I was saying, of hormones and nutrition. So when a patient understands that.
I have a lot of people that come in and say, “Well, I want hormonal balance,” or, “I want to lift my nutrition.” What is important for them to understand is that balancing hormones and balancing nutrition which you can look at as the gas in the tank has something to do with balance in life. If you have too much mental stressors or too much physical stressors? And, you’re not able to say no to certain things and commitments and you can’t slow it down.
You’ll be running through all these hormones and nutrients while you’re on fast pace. So I tell them that first and ask them to devote 12 weeks to getting themselves well because what they understand of course, is when there’s mental stressors or when there’s physical pain – it’s depleting the body’s reserves. Everybody gets this no matter what age they are when you explain that to them. They get that they’re depleting.
So, we always recap this that we’re aiming for restorative levels and we’re asking you to slow down and commit yourself for 12 weeks to your plan. Then the next step is of course going to be what tests we’re going to order and if you look at the number of tests we could order. We can order Serum testing at 8 AM. We can order saliva testing. We can order 24-hour urines for the hormones. We can order Spectracell or a Quantum Reflex Analysis. We can order Nutreval.
We can figure out the pH or order any of these tests for toxins. Cognitive testing, neurofeedback testing, and these are all the things that we can order for the physical evaluation of the physical body. When I started my practice, I literally used to order a lot of these things for point cortisols, and Serums, and salvias’, and nutritional testing. What you have to put first is to go back to what we’re aiming to cure first.
I had mentioned that sleep and energy are the two to go for first. So, do I need a Thermascan? A DEXA scan or a neurofeedback, or a cognitive testing for that? Absolutely not. Do I have to know what the pH of the body is? Probably not. Or if they have heavy metals, am I going to detox them when the energy levels are too? No. So when it comes to testing, I’m going to be very narrow.
I’m going to pick something to tell me whether their adrenals and thyroid are and something, probably to tell me where their nutrition is. So when it comes to testing though and you’re choosing between saliva, Serum, and urine. We have to realize that no matter what we test, the test is missing a big part of the picture because hormone function requires not only the hormone which is in this case thyroid. It requires the receptor site to be active and all the co-factors.
So, just having the T3 there is not enough and that’s why the function is much more important. If a patient is telling you they’re tired, they can’t think, they’re having low mental clarity, and things like that. The very first thing you ought to do is make sure that they understand that there’s actually a thyroid deficiency and it’s irrelevant what the number comes back at that point.
We still we end up confused whether we should get Serum, saliva, or 24-hour urine. The first thing I can tell you is I have used all of these for testing and have eventually settled on Serum testing at before 8 AM. At this point, the results that we’re getting which I told you was a 90% result really is coming from interpreting that Serum testing well. Remember you can get good information from any of these tests. You just have to use the one that makes more sense to you.
What I have noticed is that the Serum test gives me other information and it gives me a good baseline that I can defend and speak with my colleagues with, and it’s also covered by insurance. So, the salivary kits, they’re good. There’s a lot of things that can affect the saliva collection. So, the collection of the other things becomes a little more difficult. I really found out how hard it was to do a 24-hour urine because my father had to do one.
He was appalled at the fact that he had to carry that thing around all day to collect the urine but also put it in the fridge with the food which was completely repulsive to him. So, when we think about these testings, we do have to think about what’s convenient for the patient. In our practice we’ve been using Serum testing for most cases and sometimes if I get stuck on cortisols or something like that, I’ll be getting the saliva testing.
If I’m really confused, I’ll be getting the 24-hour urine testing which in my opinion is probably one of the most accurate ways to evaluate things. But at the end of the day, if you’re getting the result with the Serum and you’re within ranges – that’s what we’re doing. This particular study is showing that salivary testosterone and Serum testosterone don’t correlate. We know that. This is a salivary test that I used and I use regularly for 4 point cortisols.
This is what we need to know about this. When we’re measuring to compare, the accepted standard… First of all, the measurements that we’re getting from Serum is circulating levels. Saliva is tissue levels and 24-hour urine is metabolites. So, they’re just measuring different things. So, you have to know what you’re looking at. The accepted standard for safety and disease protection is only established in the Serum.
So, if you show that your Serum Estradiol was under 50 or under 80, you know that you haven’t overcorrected them because that’s the accepted standard. If you say that you’re going to protect or that the male is protected 41% from cardiovascular mortality because the testosterone level is above 64 but that’s in the Serum. No safety or disease protection standards have been established in saliva or 24-hour urines.
Obviously, insurance coverage for Serum is always there but for 24- urines, it’s variable. Ease of measurement, we’ve settled on Serum because the ease of measurement is high. So that’s what we’re using right now. These are the results we’ve been getting. This is what we’re testing. It’s always before 8 AM. You know you’ll find when you’re settling on testing that you end up starting with so many tests.
That as you develop your practice, you realize that, “You know, I’m not really doing anything with that particular test so really I’m not going to use it.” So, as a perfect example with the testosterone, I should be getting a bioavailable testosterone if I wanted another free amount. Most of the women I’m testing are so low in total testosterone, it just doesn’t make a difference. They become candidates for testosterone.
So, it’s unless they’re confused, adding another hundred dollars for that extra test doesn’t make any sense. So, you pare it down to what you’re going to use. I judge their adrenals from the DHEA-S before 8 AM in the morning. If that number is under 200, you know that you’re dealing with some kind of suppression because that’s the battery charge and that’s a stable number in the morning as opposed to the cortisol.
In men, we’re getting some things that tell us that the pituitary’s working and of course, the same kind of panel that in men we do get the bioavailable regularly. We always do an exam and we usually schedule this on the next visit and for nutritional testing, we’re getting Functional Intracellular Analysis. Again, I should tell you I’m only getting those on the initial visit in patients where it makes sense. That is not where I’m going to start.
Where I’m going to start is with the hormonal testing. The patient is explained at that point that they can plan to feel better soon. Eighty-five percent of patients resolve within 12 weeks using this kind of scenario. There’s those patients who have severe adrenal situations and it takes them more like six months. Our aim is first to correct energy and sleep and this is what we tell the patient.
We suggest to them that they preserve their reserve. That they need to think about what they’re saying yes to. To reduce your commitments. We’re going to start with progesterone and thyroid. Omega and magnesium to tolerance. Multivitamin and B12. Hydration because hydration and mineral deprivation are one of the tenets of sopping energy and not protecting the adrenals, and then other things.
So, I always show them some kind of map of where it might go and that map is always on this kind of situation. So, the most important thing for this woman was going to be to un-commit herself, pamper herself, get in the tub, exercise with breath exercises, keep the heart rate under 120, and un-commit herself. The next step would have been and this is all in the first visit. So literally we give them a plan and tell them, “We’re going to give you a plan that is right on the Five-point model.”
So, the same things that explain why you got this situation is exactly where we’re going to try to correct it. So in her case, she was given 25 mg of progesterone and asked to increase it every night until sleep and anxiety were corrected. This patient on the first visit was given magnesium 600 mg but they have to slowly go up to tolerance so they don’t get loose stool. Omega at 2 g but you’re really aiming for 5 g.
If you use enteric-coated RxOmega, then you’re actually getting everything you need in 2 g because it’s two and a half times absorbed because it’s enteric-coated. Then the B vitamins which are actually in Essentials 5 in 1 which has both the active and the inactive Bs in it. Then as I was mentioning the water, the pink salt, and the lemon. So, this would be a plan for that woman that I just mentioned to you that would be laid out on the very first visit, before I have labs.
Most of the time this would resolve in a very good result by the time she comes back at 3-4 weeks. So, the tenets of it is for her to really understand that she has to commit herself to a health program and keep herself in a great place. Keep herself hydrated with hydration. Salt, coconut water, lemon, possibly Ribose. We always explain to them that the Nutritional Program will include some supplements and slowly more food, and that we’ll be measuring things.
You can always call it a sort of a “cookie cutter” approach but we recommend the breath session for her and the progesterone. I’ve told you about those two, the magnesium and the pink salt. The omega and the magnesium are critical for anxiety along with the progesterone. The need to correct the anxiety is there because anxiety burns through nutrients. So, that’s where this combination of wired and tired comes from.
If your nervous system is truly running at a very high rate like a beta wave, the best thing you can do is slow it down. Progesterone, a high dose of omega, and magnesium slow that down along with breath sessions because as soon as you slow it down, you’ll burn through less nutrients and the energy levels will start to come up. So, we always give people at least two things.
We always tell them what we’re using to choose supplements with because we recommend specific things because we know that they’re going to feel better faster and we’re looking for active doses of Bs. We’re looking for zinc at 50 and selenium at 400. So and we’re giving them enteric-coated because it’s absorbed better. So, when they understand the purpose of each thing, we find that usually these people do these things.
Here’s a list of a whole bunch of things. The most important philosophy is that knowledge is their awareness and their power to choose what’s right for them. They need to congratulate themselves for the things they do and don’t put energy into things they don’t do because this allows them to pick and choose and gives them a plan. That’s usually when you give them a written plan and then they go out and meet with the next person, they will be in a good place.
So, this is a fast-forward to three and a half months where she’s corrected on the regimen that we had already mentioned. We know the labs are corrected and I’m not going into what happened to her later but the initial part of the plan is the absolute most important part of the plan. So, another quick example, a 22-year old with polycystic ovaries and these kinds of symptoms.
So, she’s gaining weight. Her energy’s low. She’s not having periods. Her sleep is disturbed. Of course, we go through with her the explanations that six hours of sleep is not enough to reset your metabolism and re-correct that pituitary gland. So, that understanding for her makes her understand why she came in saying, “Hey, I’m 28 lbs overweight. I want to lose weight.”
I tell her, “Let’s work on your sleep and energy first because if I don’t work on your sleep and energy, your metabolism will never reset.” So, that’s where we’re going with some hormonal interventions and some nutritional interventions that are laid out exactly on this map. So, we use this map for her to understand.
In her case, she was given 12.5 mg of progesterone and 15 mg of Armour and told to type trait it. What they quickly understand is that and you can call it a “cookie cutter” approach but it’s an approach that works because basic slowing down and basic adrenal support which is what you’re seeing here, actually corrects most cases of PCOS. We’ve seen that over and over in our patients.
Again, another simple example of somebody who was given the same kind of thing. I want to show you one more case before I start taking questions today. So this is a 57-year old who’s coming in complaining of low sex drive, low motivation, depression, weight gain, energy, and high cholesterol. He doesn’t have any complaints about sleep. He’s sleeping eight hours but his energy situation is severe.
Anxiety and nervousness, remember what we talked about if your brain waves are running fast, you’re burning through your nutrients and you’re going to be tired. So, the first thing we have to do is work on that anxiety and then of course, sex drive and other things that this gentleman’s complaining of. We got the Serum panel on him, which came back low for his testosterone and his adrenals, and his thyroid according to what we would look for. This is the first visit.
This man came in actually with labs. So this is a little different scenario from the one you saw in the first case because this person came in with labs. Again, his motivation was sex drive and weight gain. So, we are still going to say, “Let’s go and correct your energy and then see where everything else goes.” So, he gets a full explanation of how the imbalances underneath create the issue.
That we are making a list of every symptom that’s bugging him and we’re going to be following that all the way through and that those imbalances causes symptoms, not a drug deficiency. Those same imbalances causes cholesterol to go up because we know cholesterol’s a natural consequence of imbalances in the liver, gallbladder, and bowel; and, also the thyroid and testosterone.
The second concept that’s important for him to understand as we talked about is we’re going to go for optimal not normal. So we expect the morning DHEA-S not to be a hundred and some like his is, but to be above 300 in a male like it should be. So, people understand that concept of optimal versus normal range. I use it because that’s how they understand. So, I explain to them I’m aiming for a testosterone level above 800 and the literature well supports a level of 600 and above.
That’s actually the data piece that supports it and I use data. I have sheets of data. Patients love the data. So, on the very first visit; first of all, we put all our articles up on our website which is at sajune.com. You guys are welcome to look at them and see them if you want. This is the library which allows them to have so much more information and understand where you’re going and what you’re doing, and why you’re doing it.
It also gives them articles to share with their own colleagues. So, this gentleman got the same explanation which is slow things down. Let’s get your reserve up. Let’s get your gas tank full. Let’s correct these beta waves so you don’t use all these nutrients and get you to a more alpha state. One of the most important things there are is magnesium. You’ll see that almost every patient, I start with some magnesium.
I found that when I do the Nutritional Analysis, the Functional Intracellular Analysis I’m using, that majority of them are magnesium deficient. I can’t tell you how much of a difference it makes to put this on first. So, you’ll notice all three cases that I’ve shown you. Magnesium, omega and Essentials 5 in 1. Those are the three staple supplements that I put everybody on. Then tell them we’ll measure whenever they’re ready so that we can know where they are.
We use them transdermal. We usually tell them to type trait up. There’ll be people who will tell us, “Well, you know I can’t tolerate more than 300 mg.” Well, then use 300 mg orally and then 20-30 sprays transdermally of a transdermal magnesium oil. We get ours from Ancient Minerals. If it itches, add olive oil to it. The main thing is we need to have a lot of magnesium onboard to correct beta waves and to correct the energy level because you cannot correct the energy level, if you don’t correct the anxiety first. You have to slow the nervous system down.
This is just a study to show that transdermal magnesium is actually absorbed. So, a long time ago people were going to the Dead Sea where all the minerals were and that’s where they were getting their lovely doses of minerals. We recommend people, take off your shoes, take a bath, or go to the ocean. This is just a study showing what I was talking about that Omega3 lowers anxiety. Anything you do…
So, this gentleman is put on breath sessions. We can actually use progesterone in his case, if we wanted to. They’re always put on these two. They’re always put on some magnesium and some pink salt. It’s very standard but it’s a very standard little approach that works for your very first visit. In his case, I didn’t put him on progesterone in the beginning but it would have been a very reasonable thing to do with a level of anxiety that he had on his medication.
Again, the written plan that’s individualized along with a clinical liaison who goes over everything with them is very important. So, I’m just fast-forwarding. This is week 10 on this regimen and you can see that he’s moved. This is almost three months into better sex drive. He’s discontinued his antidepressant anxiety medication. He still has the weight on but his energy level’s good.
So at this point, we go into a weight and cholesterol program. We call ours The Metabolic Balance Program. You can see his labs have also improved. So, we really didn’t use that many interventions. I would say the most powerful intervention we used in his case was to tell him to slow it down. Slow it down for 12 weeks.
So, when we’ve used this system as I was showing you on these things. We’ve had good results especially getting people off of most of these medications. At this point, a lot of patients just come to us specifically to come off the medications. You can literally treat any age, any sex, any condition with this kind of a model focusing on energy and sleep first.
The basic tenets are, use your intuition. When you take a good history, you know what led to that generally. Rate the symptoms. Make sure the patient truly understands the explanation of how the Restorative Five-Point Model accounts for their symptoms and disease. They understand that and they understand the speed of the engine determines how much nutrients they use.
When you’re creating a written plan, the first test I’m ordering is hormonal testing and occasionally nutritional testing. The interventions you can see are very well laid out. Very basic interventions in each of the five areas and the clinical liaison goes over them. So, the concept of slowing down is reiterated. I always tell them, “Look, we’re doing a little bit here, little bit there, a little bit there.” That’s how we actually get the results.
I can’t reiterate how much we go over the protection of time to get well. I think we’ve gotten away from the concept that people actually need time to get well, but when we lay these kinds of programs out in front of them. Again, I’m asking them to take two capsules of RxOmega, four capsules of Essentials which are people who have intestinal things. I’m using the delayed release right now which is six things. Then magnesium at 600 mg. I’m using Pure Encapsulations 120.
You know, picked on the criteria that their vegetable capsules with no dyes and with no preservatives, and so on. Their 4-5 capsules of that. You’re already talking about 10 capsules right there. So, that along with what we end up giving for testosterone or in his case, whatever we end up doing. That’s a lot of number of things to add.
So we always make sure that they really understand why we’re recommending each thing and that they congratulate themselves for anything that they actually do get to do. I want to mention before I take the questions today that we have a very special conference coming up on September 27th. It is a workshop on hormones.
I’m going to be covering cases on PCOS, PMS, adrenal fatigue, cholesterol, diabetes, hypertension, and all kinds of other conditions. Fatigue, sleep, insomnia, anxiety, depression. So, I’ll be doing cases and applications. It’s in Orlando and it’s on September 27th. I would love to invite you guys to come if you can make it. It’s on a Saturday. It’s 7 CMEs. So, you’ll probably be getting some kind of email with some kind special that’s related to this webinar.
I hope to see you there otherwise you also have my email. So, you can email me questions if you’d like. So, it seems that we don’t seem to have any questions or somehow the questions aren’t coming through. So I think what we’re going to do is wrap this session up. I appreciate your attention today. Thank you very much for being a great audience. You have the best day ever and make sure that you devote yourself to those things in your life that count the most.
It’s more important that the patient is symptom-controlled than the level is appropriate. What I mean symptom-controlled is that if I have a patient with a level of 10 but she’s still having anxiety and sleep issues and irritability. I’m going to go ahead and continue to correct the progesterone upwards along with magnesium, along with omega until I correct that sleep issue.
Sometimes it won’t happen only with progesterone but I’m not going to inhibit myself from giving the progesterone just because of the level. As far as adrenal aid, let me go back to the slide. I have a question about the adrenal aid so let me go back to the slide. So that I can show you what the adrenal aid is.
So, adrenal aid is something that we’re using basically to support the adrenal glands and the mineralization. I use it in all of my patients that I’m looking to support the adrenals and what we’re using for adrenal aid is water or coconut water. The slides contain it and these slides will be posted. Pink salt, either half a teaspoon or all the way up to two teaspoons, whatever people tolerate.
Then we have a lemon. You can also add a little bit of Bicarbon. You can also add a little bit of Ribose to it. So, the fact of the matter is that we use this in all our athletes and we use it for anybody who’s got any kind of adrenal insufficiency. You can know that the number one deficiency in the United States is going to be minerals. Minerals cannot be produced by the body. Minerals have to come from the outside.
So, you have to give them pink salt which is what I use; 92 mineral salt which comes from Premier Research Lab. It’s in Austin, Texas. The difference between that particular pink salt and the Himalayan pink salt is Himalayan pink salt will still have a lot of minerals but it’ll be about 62-65.
The pink salt from PRL is going to have more like 92 because it comes from two different sources and has a form of clay in it. So, what we have to realize is that it’s almost like a Gatorade. That’s why I’m calling it adrenal aid but it’s much better than a Gatorade and it doesn’t have any of the junk in it.
So the next question is. How do oral contraceptives influence sleep and energy? So, oral contraceptives don’t directly have an effect on energy that I know of in the literature, or sleep. What I have found in my practice is they influence both because what we find is people on oral contraceptives generally have antagonistic effect on the progesterone receptor.
So, we see all the symptoms we would see with progesterone deficiency like anxiety, sleep disturbance, things like that. The other thing is that the oral contraceptives also interfere with the B-vitamins. So because of the B-vitamins we know that they also have lower energy and also because of the sleep. So, it affects both negatively in the clinical practice as far as I’ve seen it.
When do you start progesterone in the cycle and then take a break? So, there’s very good attempts at trying to mimic the menstrual cycle by cycling but we realize is that when people have a certain level of progesterone. They’re either cycling at a low level or they’re cycling at a high level. So, even if you keep them cycling at… You take them from a low level to a high level – they’re still going to cycle.
So, you don’t lose the cycle because you’ve used continuous progesterone. The other thing is that the compliance of people who are on any kind of cyclic regimen of anything actually drops to less than 15% within the first year. So knowing that, I generally don’t take a break because I know the body is taking a break anyway. If I’m giving somebody 50 mg of progesterone, they’re still cycling on top of that. So, that’s why we don’t change it.
The next question is, do you have them mixed, the pink salt, lemon, Ribose altogether? Yes, in the coconut water, the water. That’s their drink. We tell them to make that drink in the morning and try to drink that all day. So we have a question here. You mentioned delayed release multi. What brand do you use?
So, this delayed release is the same as Essentials 5 in 1 which is coming from MD Prescriptives. The benefit of it is a lot of people don’t tolerate the B-vitamins. We’ve been having a hard time getting that level of B vitamin because the kind of B-vitamins you have to give them is extremely high and active B-vitamins.
So, they have a delayed release form of Essentials 5 in 1 which actually I’m finding the patients are tolerating very well, especially patients with gastric complications with the other one. Then another question. How do you deal with a patient that cannot afford supplements? So, this is a really good question.
This is the benefit because in our practice what we try to do is minimize the number of interventions to maximize the effect. So when we tell a patient that, “Look, you can get on Essentials 5 in 1, Omega. You can use your own insurance for your testing so that you don’t have to pay out pocket for that, and magnesium.”
They’re going home with three bottles. Then we also tell them they get better deals if they can register on the website and get things, order them directly. So, that’s what we do but the most important thing is nobody wants to pay more than they want to or more than they have to. So, it’s very relevant to this program to reduce the price to the minimum.
That’s actually what you’re seeing. The reason why the initial visit and it’s important to prioritize and do some very basic things is partly because you’re dealing with people getting overwhelmed with too many recommendations and partly because people can’t afford all of those recommendations. So, that’s the reason why in this talk I really try to minimize it down if you look at what we use.
You know un-commit yourself. That doesn’t cost anything. Lower your heart rate. Say no to a bunch of things. For the two women, we used some progesterone, Essentials 5 in 1, omega, and magnesium; and, pink salt for their drink. That’s five things they had to end up getting and using. Really, you’re going to see that those five things would have given them the biggest result within that amount of time.
So, we have gotten to the point where we’re not going to be able to take any more questions today. I truly appreciate your attention and we are available. I’m available for questions by email if you wish. You guys will be getting a follow-up email about the Cases and Applications Workshop for Hormones on Saturday, the 27th in Orlando. You have a wonderful day!