Moodle at CCNM

The purpose of this presentation is to allow the attendee a chance to “catch up” after a full day of genomic presentations and get an introduction to the day’s material. Dr. Anderson presents several case studies on patients he has managed. A “1-2-3” approach will be presented which outlines how practitioners can “troubleshoot” the treatment issues that happen when either the patient “self-treats” or has an unusual reaction to a nutrigenomic therapy.  Pharmaceuticals discussed in case presentations will include Deplin, Metanx, Buproprion, and Diphenhydramine.

How do the three phases of detoxification work? How do pharmaceuticals affect them? A common area of misunderstood reactivity is sulfite oxidation, which often is mistaken for a Type-1 histamine reaction. This session is designed to give clarity to the signs of these reactions as well as prevention and treatment strategies. Phase-2 is dominated by Glutathione and Glycine but also these “back-up” hydroxyl reduction in Phase-1. How do pharmaceuticals affect these supports, how clinically can we assess and support them and what does it look like clinically when they are overwhelmed? Additional case studies are discussed. Pharmaceuticals discussed in case presentations will include Mucomyst, Succimer, acetaminophen, codeine, ciclosporin and diazepam.

Multiple sclerosis (MS) is the most common autoimmune disorder affecting the central nervous system. MS affects approximately 400,000 people in the United States, symptoms can start anywhere from 10-80 years of age. No single test can diagnose MS and currently there is no cure. This presentation reviews MS diagnosis, FDA approved disease modifying therapies, and evidence-based natural therapies.

Research suggests that “classic” fibromyalgia (FMS) is a central pain processing disorder and does not appear to be a peripheral somatic disorder. Dr. Brady emphasizes the concept that this central-mediated disorder is strongly associated with psychological disorders, including trauma and abuse history, depression, anxiety, irritable bowel syndrome, and sleep disorder. Common mechanisms in-play regarding these concomitant issues and global pain will be fully explored and accurate differential diagnostic and comprehensive naturopathic therapeutic strategies will be discussed in-detail. The concept of “pseudo” or “false” fibromyalgia diagnostic labels are also discussed, to include various organic and functional medical conditions, as well as somatic musculoskeletal conditions, which confound the accurate diagnosis of “classic” FMS will are also presented.

A healthy immune system should be responsive to infectious disease and tolerant to self. As we gain a better understanding of how the immune system goes awry during autoimmune disease, we have discovered new mechanisms of self-tissue destruction. This presentation provides an update on three aspects of the immune system, and their role in autoimmunity. IL-17 is involved in the elimination of extra-cellular bacteria and fungi. However, IL-17 is also found in autoimmune lesions, suggesting that it can be pathogenic or beneficial depending upon the context. Likewise, while TNFalpha helps keep tumors at bay, it can be highly destructive in autoimmunity. Finally, we will examine the breadth of auto-antibodies to determine which are ubiquitous and which are truly predictive of disease. We will discuss the immunological chemicals as well as the pharmaceuticals – biologics – used to block these chemicals.

Depression, anxiety, and insomnia are common comorbidities, reaching epidemic proportions. After reviewing use and concerns associated with prescription medications for these concerns, the talk will review diet, lifestyle, and natural health product strategies that have proven safe and effective for management of these common mental health concerns. A key focus of the presentation will be to differentiate between strategies safe to combine with common mental health prescription medications versus strategies that are safe and appropriate for unmedicated individuals, yet inappropriate to combine with common prescriptions. A broad array of prescription medications will be mentioned… Over 50 common mental health prescriptions will be listed in slides… Too many to list here. Typically, specific discussion occurs regarding citalopram, fluoxetine, Effexor, pristiq, Ativan, clonazepam, lorazepam, and zoplicone

PTSD is a complex and often debilitating condition. My presentation includes overview of diagnosis, standard of care (including pharmaceutical treatment) for both children and adults, and evidence for integrative therapies including supplements, exercise, yoga, meditation, and writing and theater. There is also discussion about the most evidence based types of psychotherapy. The goal is that at the end of the presentation every person could create an individualized treatment plan for patients who have PTSD, as well as patients who do not meet criteria and are presenting with mood complaints.The pharmaceuticals I discuss include SSRI’s (Prozac, Zoloft, Lexapro, Celexa, Paxil), SNRI’s (Effexor, Cymbalta), Wellbutrin, mood stabilizers (Lamictal, Abilify, Risperidone), alpha agonists (clonidine, guanfacine, prazosin), and benzodiazepine’s (advise against their use). This presentation could be approved for pharmaceutical credits and this section could be lengthened or shortened.

Naturopathic physicians working with female cancers strive for “Enhanced survival and quality of life for people living with cancer through the integration of naturopathic oncology into cancer care” (Oncanp vision statement). Natural medicines can meld harmoniously with allopathic therapies to reduce harm and increase the potential benefits. Natural medicines can also follow conventional care to reinforce remissions, rebuild genuine health, and to change the dietary and lifestyle contributors to cancer occurrence. This presentation gives specific therapeutics that will allow any naturopathic doctor to better serve their female patients with cancer.

Small intestinal bacterial overgrowth (SIBO) is a syndrome in that it has multiple causes. Motility disorders are most often the underlying factors to predispose for the development of SIBO. Postural orthostatic tachycardia syndrome (POTS) leads to an imbalanced autonomic nervous system because excessive sympathetic activity overrides vagal tone. Peristalsis is reduced and SIBO may be promoted. Mast cell activation syndrome (MCAS) is a leading factor in 33% of POTS. It is also conceivable that MCAS could directly impact motility via one of 200 mediators that may reduce neuromuscular activity.  It is important to recognize POTS which has a prevalence of 500,000-1,000,000 in the US. Understanding this disease and the more prevalent MCAS (1 – 17% of the population) is critical to help many patients who otherwise suffer for decades without a diagnosis and/or effective therapy.Specific pharmaceutical medications to be discussed in both the overview and outline: rifaximin and naltrexone.

What are the basics of “cause” in the areas of agitation and sleep problems. What (and why) are the common pharmaceuticals used in these cases? How can a knowledge of the genomics of endogenous GABA, Glycine and other calming neurotransmitters benefit and refine your therapies?  What are the basics of “cause” in the areas of depression? What (and why) are the common pharmaceuticals used in these cases? How can a knowledge of the genomics of endogenous serotonin, dopamine and norepinephrine neurotransmitters benefit and refine your therapies?  How does the brain become inflamed and how does that affect neuropsychiatric status? What genomic and nutrigenomic factors can alter this status and restore the brain to a non-inflamed state?  Dr. Anderson discusses case studies that he has worked through in neuro-psychiatric conditions and how they played out. The goal of these cases is to illustrate how genomic assessment and nutrigenomics cross over pharmacology and how they can be implemented clinically.

In continuing the discussion of the principle of treating underlying causes of SIBO rather than simply focusing therapy on reduction of bacterial overgrowth, we cannot overlook the thyroid gland’s role in motility. Evidence has emerged for thyroid disorders as one of SIBO’s etiologies. This presentation explores SIBO’s intersections with dysthyroidsm, and points to implications in developing effective treatment plans and strategies for prevention of recurrence.  The presentation will include a brief overview of thyroid prescribing, both clinically and sub-clinically, including use of Levothyroxin, Tri-iodothyronine, dessicated Thyroid USP, and compound prescribing.

In the last decade, the understanding of clinical breath testing in the evaluation of SIBO has evolved. We have come to know that methane on breath testing is highly associated with constipation and requires a different approach to treatment. Hydrogen on the other hand is not related to any specific symptom. The missing gas has been hydrogen sulfide and this gas is of great importance to the symptom diarrhea. Not having this gas in the breath test profile leaves a missing piece of the puzzle out. In this presentation we will examine the interaction of all three gases and the importance they play in the evolving microbiome story of SIBO. Rifaximin will be discussed which is FDA approved, neomycin a drug not yet approved for SIBO and SYN-010 which is not yet approved by FDA for methane.