We have swept real health under a rug and replaced it with the cursory definition – lack of ill-health or disease. All of us deserve the right to quality health care. We deserve the right to answers. We deserve the right to leading indicators. Unfortunately, in our current climate, the only one who can do anything about this is YOU.
People feel their doctor can’t help them unless their appendix is going to blow up or they lacerated their femoral artery with a chainsaw. This is because they go to the doctor’s office and the conventional doc says, “Your labs look great! Cholesterol is a little high, so watch your fat intake.” Your insurance paid 900 dollars, for that? All this even though you are 60% of the way to diabetes, have brain fog, and feel like the carpet got pulled out from under you at 3pm. The writing is on the wall…they just can’t see it.
There is no better marriage than Athletic Performance and Functional Medicine. For some this may seem like an oxymoronic statement, but the people who I have found who are willing to take a good hard look at their physiology and what’s going on with the system, are after optimization. They aren’t happy with just getting by or using the bullshit phrase, “I’m getting older.”
For many athletes and clients, we are the gateway into the functional or integrative medicine realm. The OmegaWave is one of the best check engine lights on the market and it usually gives a loudspeaker to the voice in the back of your head that is whispering maybe things aren’t OK. Enough talk let’s take a look at a few imaginary case studies.
1. A Twenty Something Female Athlete
Let’s say she wants to optimize aerobic and anaerobic capacity, as well as strength and power. She trains 5 to 6 times a week combined with a busy job and sometimes goes out on weekends. She feels ok, but has recently felt very fatigued and has needed more and more caffeine to get going especially later in the day. She also can’t seem to get her work done as fast as before. Her coach tells her to get more sleep.
She comes into your office and you find out she is borderline anemic, so none of the tissues in her body are getting adequate oxygen. So her oxygen-depleted body is only dealing out oxygen to the most necessary areas to function. She is also deficient in vitamin D despite taking 2,000 IUs of a vitamin D supplement.
Finally, due to years of birth control use, her binding globulins are elevated so even though her thyroid hormone production is adequate to turn on every cell in the body, the signal isn’t as strong as it should be. Think this couldn’t possibly be you?
● 9-12% of Caucasian women and 20% of minority women have full-blown anemia.
● 50% of American adults and 70% of American children are vitamin D deficient.
● 62% of women of reproductive age are currently on oral contraceptives.
2. A Male Client With 2 Young Children
He wants to stay lean and look good for his wife as well as be the vibrant man he has always dreamt of for his two boys. He runs a construction company and lifts with some friends 4 to 5 times a week. He was a college athlete and has stayed in pretty good shape since then.
He thinks his diet is way better than everyone else’s’. He sleeps about 6 hours a night, but just can’t shake the fact that he doesn’t have as much energy as he used to. He forgets where his keys are regularly, and is starting to lose the hair on his legs. His doctor said he looks fantastic and that his total cholesterol is superb at 147 mg/dl, far below what he sees in most patients.
This patient comes into your office and you run some labs. You find out that his cortisol is dysregulated and very high and this is eating up his hippocampus (the portion of the brain responsible for short-term memory), as well as his supply of pregnenolone, the precursor to most steroid hormones in the body.
You also find out that his testosterone is borderline low at 364 ng/dL, although his LH comes back in the middle of the normal range meaning that his body has become acclimated to this new sup-optimal state (with testosterone this low the brain should literally be screaming to the testicles to produce more testosterone – how it screams is LH).
You know that this patient needs stress management, less exercise, and far more sleep – which is the most anabolic activity we can take part in. If levels still don’t normalize once those aspects are addressed, one may need to jump-start the pituitary gland which secretes LH and you should look deeper into why the cortisol may be deregulated.
● 92% of all Americans have some type of cortisol dysregulation per Dr. Gottfried.
● The number of men on testosterone therapy has quadrupled since the year 2000.
● 65% of Americans get 7 or less hours of sleep per night.
3. A Postmenopausal Female
Let’s say this weight loss client has been training very hard for 9 months, but can’t get results no matter what she tries or how little she makes herself eat. She is a stay at home mom with a million places to go all at once. She has 1 child in middle school and another just starting high school. She has intense sugar cravings and has trouble sleeping through the night. She has also noticed that her eyebrows are thinning. She consistently has a lot of GI discomfort and finds whenever she eats a higher carb meal she gets bloated but she doesn’t like to talk about it.
She comes into your office and tests positive for a SIBO (small intestinal bacterial overgrowth) breath test as well as H pylori. Her cortisol rhythm is highly dysregulated, and her hemoglobin A1C is elevated above the functional range. You also find a positive test for TPO antibodies against her own thyroid.
● 135 million Americans have some kind of GI infection and some estimate it to be much higher at 80-90% of the population.
● 50% over the age of 60 have H Pylori, which is a bacterial infection of the stomach that causes a reduction in acidity which can lead to the subsequent migration of bacteria from the large intestine into the small intestine.
● Over 10 million women have Hashimoto’s Thyroiditis.
● 50% of Hispanics and 33% of Caucasians will become diabetic in their lifetimes and more than 25% of Americans are currently pre-diabetic.
If you are thinking, why is he talking about me? I made every one of those examples up off the top of my head. They are common themes we see, but fictitious nonetheless. Now if you are a trainer, the crazy part is that you could be doing the most sound and evidence-based work under the sun, but without getting physiology dialed in, you are eventually going to be bashing your head against the wall and blaming your client for not following your rules – even though they are or just physiologically can’t do it.
I have constantly searched for these types of answers and a way to explain them in a way that doesn’t lay blame, but instead motivates and inspires. As strength coaches, personal trainers, people who lift and eat vegetables, whatever you want to call us, we are the professionals that touch the most people. We are the gatekeepers. Get people to the right place, get people quality labs and quality interpretation and your job will become so much easier. You are not alone. You can’t be.
Solutions
So as a member of this effed up food society, what do you do? Take a sabbatical to live in an igloo and fish with a harpoon for a month and then move to New Guinea and crush coconuts and taro root all day? Sounds like a blast, and as long as there are weights, I’m all in.
But you don’t have to fly halfway across the world to thinker. You can do it right now at your local grocery store. You can start an elimination diet and then slowly add things back in. You can get a step-by-step guide to the elimination diet here.
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