Case Study – Weight Loss
Pain, Fatigue, and High Blood Pressure
Jamie learned of Brain Based Functional Medicine while attending a seminar I taught. I could tell that he saw the self evident big ideas that I was teaching. He was visibly excited, and made an appointment for the next week.
In our interview, I learned that Jaime had been suffering for five years with back, neck, and feet pain. He was disabled so greatly by this pain, that walking had become a challenge, and working was a virtual impossibility. He was unemployed, with a bleak outlook (no wonder he was so excited…finally some hope!)
He had surgery on his back three years prior, which didn’t provide any relief to his back pain. He also experienced heartburn, fatigue, insomnia, sinus allergies, acne, food cravings and weight gain. At the time of examination, he weighed 320 pounds.
Jamie also struggled with high blood pressure, for which he was medicated with Lisinopril, although at the time of examination his blood pressure read 188/128. Lisinopril is an Angiotensin Converting Enzyme (ACE) inhibitor that prevents your body from producing an adrenal hormone called aldosterone. Aldosterone signals the body to preserve sodium, and sodium travels with water, water increases the total volume of blood, thereby increasing the pressure in the arteries.
His doctors didn’t even check his aldosterone levels to see if it was high. They failed to ask why his body adaptively chose to increase blood pressure. They chose to suppress and regulate, unsuccessfully.
He had been to several physicians including a foot specialist, all of which resulted in the high blood pressure medication, Motrin for pain, shoe inserts, and the failed back surgery. He was scheduled to get a second prescription for the high blood pressure, as they were determined to regulate the one thing they could put their finger on.
I performed a full physical, neurological, and metabolic evaluation to assess the condition we were starting from. I will save you the details and present only the highlights that led to his recovery.
Jaime’s Functional Diagnosis:
When I looked at Jaime’s lab tests, three separate but intertwined processes jumped out at me.
First of all, his triglycerides were 242, and his HDL, the good cholesterol, was 39. The ratio of triglycerides to HDL cholesterol is a good indication of a process called insulin resistance. The number should be close to 1. Ideally triglycerides of 80, and HDL of 80, or in that neighborhood. He also had high fasting glucose, which builds the case for this process being present.
This is a process where his cells actually do not respond efficiently to the hormone insulin. A hormone must interact with a cell to create an effect, which in the case of insulin, is to allow the blood glucose (sugar) to enter the cell culminating in the creation of ATP or energy. His cells were refusing to accept the insulin, and his nervous system had “down regulated” his insulin receptors, which means literally that his brain had ordered a reduction of receptors for insulin.
This is the process that leads to the diagnosis of diabetes, and Jaime was well on his way to becoming a diabetic.
The second process was identified with one simple blood test, the high sensitivity C-Reactive Protein (CRP). This is a marker for systemic inflammation. Ideally, this number should be below one…Jaime’s was 17. Above 3 puts you at high risk for sudden cardiac death.
CRP does not indicate where the inflammation is coming from, but one possibility is the elevation of a hormone called prostaglandins. Prostaglandins are the specific chemical that is blocked when using aspirin and ibuprofen. They are a product of fat metabolism, so the types of fats you eat can affect prostaglandin levels, as well as high insulin, which was evident from the triglyceride and HDL readings.
The third process was found in performing a test called the Adrenal Stress Index. This test measures cortisol throughout the day, along with another adrenal hormone called DHEA. The reason for multiple cortisol measurements throughout the day is because the adrenal glands have a daily rhythm, so any one measurement doesn’t provide the whole picture.
The adrenal glands activate in stressful situations, and help to regulate blood sugar by releasing cortisol when blood sugar falls between meals. Cortisol pulls glycogen from muscles and the liver, and converts it into usable glucose. This process allows us to sleep for seven or eight hours without eating and maintain a healthy blood sugar so our cells can make energy and create new cells, sustaining life.
At bed time, your cortisol should be at a daily low level, and through the night it increases gradually to maintain blood sugar levels, and peaks in the morning right about wake up time. If the adrenals fail to produce cortisol through the night, your blood sugar drops, and you wake up at 2 AM. You don’t realize that the waking your system has done is to protect you from dangerous blood sugar lows, so you curse the insomnia rather than listen to its message.
Assuming the cortisol does rise, you wake refreshed, eat a healthy breakfast, and the cortisol gradually declines throughout the day, preparing your system to once again sleep and repair come bed time.
Jaime’s cortisol did not rise through the night, or any time through the day. His adrenal rhythm was abnormal, affecting his sleep, and his adrenal output was low, further complicating his blood sugar woes.
Jamie was suffering with pain, high blood pressure, fatigue, and insomnia. Those were the consequences of the functional processes of insulin resistance, adrenal fatigue, and inflammation. As a result of these processes, his testing also showed kidney failure (protein and ketones in his urine), he wasn’t digesting his proteins adequately (elevated serum globulin), his liver was damaged (elevated ALT), and his mineral balance was affected (low potassium, low calcium) (this will affect muscle tightness, and can lead to muscle spasms and cramping).
Jaime’s Functional Protocol:
The main stress that slowly led to his presenting circumstances was his diet and lifestyle. He had eaten himself into a cycle of stress, insulin resistance and pain. His body had failed him because he ate junk food and sugar. He knew he was not treating his body well, but he was stuck in a cycle of sugar cravings as a result of his unstable blood sugar.
It wasn’t until I explained how this cycle affected his ability to heal and repair tissues, and that this cycle was directly responsible for his pain and disability, that he agreed to make some major changes in his diet.
It wasn’t easy for him, but he was motivated to live well again and get rid of this pain. I supported him with nutritionals to stabilize blood sugar and support his adrenal gland function so the physiological sugar cravings would let up. I coached him on his diet, and on many occasions “busted” him on eating junk food.
At one point, he declared, “Man, I can’t get anything past you. If I eat anything, my body tells on me.” During our visits, we were “asking” his body what its needs were using kinesiology. We originally tested all muscles and muscle groups to identify his structural weaknesses. Those weaknesses reappeared now and again, at which point I asked him what he ate. Eventually I “showed” him that he doesn’t even need to tell me. I would put Crisco, or pure sugar, or MSG in his mouth, and sure enough, the weaknesses would instantly return. It helped him “get it” and stick to his diet.
Taste is a sensory experience, which is neurological…because of the connections in our nervous system, anything can impact anything. If his taste receptors “pick up” a signal that something stressful is coming, it can shift the entire nervous system instantly, including his stress hormone, digestive function and the muscle test. His reality in real life was that every time a Little Debbie touched his lips, his entire nervous system was cringing!
When it is one’s lifestyle that is ultimately the trigger for the neurological cycle they find themselves on, one big challenge is getting them to change. Change is always difficult, and requires five distinct neurological processes.
They have to see the bigger picture of what they really want. They have to be motivated. They have to have exact action steps. They have to have a system to check in and notice their results. And they have to be accountable to someone.
All of these processes were met in Jaime’s program. He wanted his ability to live life back, he was motivated by achieving this and the pain he was experiencing, I gave specific diet recommendations or actions, including what to eat and not to eat, we followed his progress closely using his neurological findings, weight, blood sugar, and how he felt, and we “busted” him regularly, refocusing his efforts on what he truly wanted.
As a result, he was successful.
Six months after starting his program, Jamie’s blood pressure was 112/65, and his weight was 274 (total loss of 46 pounds). On retesting, his triglycerides were 113, and high sensitivity C-Reactive Protein was 1.12.
In his own words:
“I’d tried every diet known…my doctor put me on blood pressure medication, I had surgery on my back, and saw a podiatrist for my feet. All this failed, and pain ruled my body and my blood pressure was 189/129 (on meds), and my weight was 335 pounds.
At this point, I’m a new man. I’ve not felt this good in 12 years. I feel better about my future. I’ve lost about 55 pounds and my blood pressure is 129/75 with NO MEDS! My feet and neck are almost PAIN FREE!.
All of my friends have noticed how good I’m getting along, and I tell them that I thank God for Dr. Stone!”