On Swallowing 57 Pills a Day

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Or, “What to Expect When You Visit a Functional Medicine Doctor.”

Well, I did it. I finally made an appointment with a local Functional Medicine Doctor (www.funcionalmedicine.org) to help me work out my persistent issues with inflammation despite almost a year on the Autoimmune Protocol.

For a long time, I’ve had a sort of fairy tale fantasy of what visiting a functional medicine doctor would be like. In my mind, the doctor would sit and listen for hours about every pain I’d ever experienced, every round of antibiotics, every digestive anomaly. They would pat me on the back for all the work I’ve been doing to heal with diet and who would provide a clear answer as to the reason I am still struggling with rheumatoid arthritis symptoms. The reality was a little different.

The Initial Appointment
I met with Dr. M to discuss my current symptoms, medical history, and lifestyle factors. He did indeed want to talk in detail about my medical history. He was quiet, yet knowledgeable and decisive about where to go from there. 

Test Results
Dr. M suggested I order two tests – one blood test for zonulin (which would tell us if I have leaky gut – read more about that here) and an organic acids test that looks for yeast/bacteria in an effort to solve my digestive mystery (which involved FedExing my pee to Kansas!). It was so helpful to be given a narrow list of tests to get, since I’ve often gotten lost down the Google rabbit-hole researching the multitude of tests I should get.

I tested positive for zonulin, indicating that I, after 9 months on a gut healing diet, STILL have a leaky gut, and I had elevated yeast presence as well. While frustrated that my gut hadn’t healed after all this time on my diet, I reasoned that I was still on hormonal birth control for 7 of those 11 months. Before that, I was on daily NSAIDS for 2 years and several rounds of Prednisone. As those medications likely contribute to leaky gut, then I can understand why it might be a problem. I can’t help but wonder if my current remaining medication, Plaquenil, is contributing as well but there is no research on it that I can find.

Diet
His recommended diet was basically exactly what I’ve been doing: healthy fats such as olive and coconut oil, pasture-raised meats and fish, and 9-12 cups of vegetables per day, with an emphasis on eating a variety of colors to ensure a variety of micronutrients. He recommended keeping carbs at 100 grams per day (to help fight yeast overgrowth), which I naturally tend to fall right around. He recommended adding back nuts and seeds (which I’ve successfully reintroduced some varieties of), and he is a big proponent of juicing and smoothies, which I incorporate occasionally. 

Supplements
Doctors prescribe medicine, functional medicine doctors prescribe further testing and LOTS of supplements. I was somewhat prepared for this, but nothing could be prepare me for being told to take 57 pills a day, plus a powder and two liquid supplements. These supplements include: herbal anti-fungals to kill off the yeast overgrowth in my gut; digestive support in the form of probiotics and digestive enzymes; gut healing supplements like L-Glutamine, MSM, and others; and key vitamins and anti-oxidants to help support my body’s ability to detoxify. The financial cost is enormous, and I can’t yet tell you how far into the future it will be financially sustainable for me. However, it helped to have someone knowledgeable about supplement quality recommend certain brands and look at my specific health history to recommend dosage. It took the guesswork out of buying and taking supplements helter-skelter.

Next Steps
The beauty of functional medicine is that you dig deep in search of the root cause of your illness. However, there seems to be no end to the depths which to dig to. One round of tests provides some answers that call for another round of tests. You can test for this gene defect (MTHFR) and these food sensitivities (IgG test) … but oh, if you have toxic levels of these heavy metals, then you’ll likely not improve even if you address those other factors. It’s really frustrating to start on the path for answers, learn which way you could take to get them, and then have to choose from a list of tests because you can’t afford all of them. Also, it’s hard to get good information about which tests are truly effective. I am still trying to research and prioritize what (if any) further testing I would like to do.

Results So Far
Though the doctor said it might take months to see real progress, since starting this supplement regimen three weeks ago, I have seen a number of improvements. My digestion has been the best it’s been since starting the AIP last August (though I have been experiencing some nausea and lack of appetite after taking my pills in the AM) and I’ve felt a surge of energy and a lightening of my mood.  My acne has calmed down.  My joint pain and inflammation has decreased quite a bit since my recent flare, and pain/stiffness is much improved.

The improvements so far are encouraging – especially that of my emotional wellbeing, which makes such a difference in the way life looks. So, though the reality of following this functional medicine plan means swallowing my weight in supplements, I’ll continue to pursue it and look forward to further improvement.

Feel free to ask me anything about this experience in the comments!

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