Yeast Overgrowth Syndrome

Posted on January 2, 2013 by mcminnclinic

“I never got better until they treated the yeast.” I have heard this statement many times from patients suffering from various maladies such as headaches, brain fog, depression, irritable bowel, chronic sinusitis, weight gain, and fatigue. Due to the modern day world that we live in I am seeing more and more people suffering with yeast overgrowth. Old fashioned doctors used to say that “good health starts in the gut.” I think that they were right.

Poor gut health can manifest itself in many ways. Ideally we have a perfect balance in our guts with good bacteria, bad bacteria, and yeast. It is a symbiotic relationship. We can not live without our friends the “good bacteria.” Yet the modern American lifestyle tends to promote poor gut health. The standard American diet (or SAD diet) is full of sugar, simple carbs, and processed food, which is not good for the body, but which is ideal for the overgrowth of yeast. Yeast loves to feed off of sugar. When you combine this with the overuse of antibiotics in our society, it makes for a toxic environment in our guts, and that is often the beginning of a slippery slope to worsening health.

Chronic sinusitis is a classic example. We go to the doctor with a stuffy nose, and the standard response is to start antibiotics. However, according to the Mayo Clinic “fungus (yeast) is the likely cause of nearly all of these problems.” So in the long run, if we don’t treat the yeast, the antibiotics kill the bacteria, promote more yeast overgrowth and they can actually make the problem worse.

At McMinn Clinic we have Yeast Overgrowth Syndrome on our radar screen, and when appropriate we treat yeast overgrowth with a comprehensive and robust anti-fungal protocol. We have been blessed with many testimonials from our patients with stories of recovery, often after suffering with symptoms of yeast overgrowth for many years.

Call McMinn Clinic at 868-1313 and set up your appointment for a thorough evaluation for yeast overgrowth syndrome.

Grumpy Ol’ Man Syndrome

Posted on December 12, 2012 by mcminnclinic

On a given day if you asked my wife, she might claim that they named the above medical syndrome after her own beloved husband. I must admit that I have my good days and bad days on the home front. However, I take some comfort in knowing that I’m in good company. In fact, if my women patients are right, “grumpy ol’ man syndrome” has reached epidemic proportions.

The usual scenario is that the wives drag their husbands in, kicking and screaming the whole way. Of course, the men are in complete denial and are busily hoping that Scotty will beam them up at any moment and rescue them from any event in which “feelings” are discussed. Guys need to have just the right pretense for talking about such things. It’s OK to ask “how’s the marriage” when you’re riding around in a golf cart with a good ol’ buddy, or out in the middle of a lake on a fishing boat. It’s like foreplay; the only acceptable ways to engage in such conversation is if the foreplay is centered around football, golf, beer, fishing, hunting, or NASCAR. Just to cold turkey and purposely sit down and have a talk about sensitive issues such as feelings can seem extremely unmanly and may be down right uncomfortable, even with the doctor.

Fortunately the wives are on the case big time, and they usually have the common sense to come with their strong silent types to the initial doctor’s appointment. Although I know going into it, who is going to be the communicator, I at least show the guy enough respect to address the question directly to him. “How’s it going” I say. “Fine,” or some other one worder is usually about all I get. Then the truth spews forth like an Icelandic volcano from the fairer half. “He’s grumpy, sullen, irritable, moody, depressed, and he has no sex drive. He comes home after work and just crashes into his Lazyboy. He doesn’t have any energy, and he doesn’t want to do anything. He has no interests, no get up and go, no joy in life. He’s totally disconnected. And he’s getting fat and lazy.”

On the face of it such phrases may sound like fighting words. Instead, more often than not, he agrees with her, or through his silence and lack of argument one can assume that she is not too far from the truth. Now we’re starting to get somewhere. Just like when you look up at the summer night sky and see the big dipper, it all comes into focus. He has “Grumpy ol’ Man Syndrome.” Another name for this dreaded and all too common condition is “Andropause.” At that moment, I know that I can help him.

Just like women go through menopause, men go through a similar process wherein their levels of hormones (in this case testosterone) fall to well below the acceptable range. Also just as a woman’s menopause may have dramatic affects on her health, her mood, and her behavior, so too andropause may insidiously choke the life out of even the most macho of men. They often become a shell of their former selves. The men, their wives, family, friends, and co-workers all suffer the dreaded consequences of the decline in testosterone and its accompanying symptoms.

At the risk of seeming to be biased toward men, after all I personally fall into that category, I have to stand up for the guys just a bit and let them off the hook. In many instances they can’t help it. The behavior, as I described above, is not of their choosing, but instead it is often hormonally driven. If only they had a robust and balanced hormone profile they most likely would be their usual lovable and manly selves.

True story: I had a patient in the office just recently who fit this description to a tee. His wife drug him in back about 6 months ago with the classic symptoms of “grumpy ol’ man syndrome.” He was clinically depressed, grumpy, frail, had no libido and was starting to suffer from ED (erectile dysfunction). We did all the appropriate lab testing and found that his testosterone was quite low. I put him on a program of hormone repletion, nutritional supplementation, and life style changes. WOW! He came back in for his follow-up visit and announced that he was feeling fantastic. As he put it, his energy was “through the roof.” He could hardly believe what a difference the program had made for him. The depression was gone. Energy was better. He was exercising again. He was interested once again in sex, and interested in life in general. His ED had magically disappeared, and he was thinking much more clearly. He and his wife were both ecstatic. She had her beloved husband back. He had his life back, and they had their marriage back. There is no antidepressant or any other “drug” in this world which could have achieved this outcome for this patient.

Furthermore, low testosterone and andropause can have even more dire consequences. A study published in the Archives of Internal Medicine describes an 88% increase in mortality in male veterans with low testosterone. Other published studies form reputable medical journals have linked low testosterone with poor cognitive function, Parkinson’s disease, Alzheimer’s disease, osteoporosis, hardening of the arteries, heart failure, insulin resistance, diabetes, and metabolic syndrome. Testosterone decline may also contribute to abdominal obesity, decreasing muscle mass, joint pains, loss of self confidence, fatigue, disturbed sleep, anxiety, and excessive worry. Low testosterone is not just about muscles and libido. It is about optimal health, and even mortality.

Testosterone must be respected. Like all medications it must be used properly and must not be abused or used in excess. Testosterone replacement should never be done if it is not medically indicated. Furthermore, the replacement program must be conducted properly with adequate monitoring to attain optimal levels, while paying attention to possible side effects. If done properly, it is safe and may be profoundly effective. Testosterone replacement therapy is not for everybody. However, in the presence of “grumpy ol’ man syndrome” like with my patient described above, it can make a remarkable difference in the life of the patient and his partner.

Bottom line, if you suffer from “grumpy ol’ man syndrome,” get your T checked, and get it optimized. If your loved one shows signs of this dreaded disease, drag him in and get him checked for “low T.” You’ll be glad you did.

Feeling Fat, Fatigued, and Depressed; Think Low Thyroid

Posted on November 26, 2012 by mcminnclinic

Many experts now agree that millions of Americans are falling through the cracks when it comes to the diagnosis and management of low-thyroid conditions (hypothyroidism). Unfortunately, the lack of proper attention to this issue often results in the patient living a life of fatigue, low mood, struggles with obesity, and many other problems.

Although the thyroid gland is small, it has powerful effects on the body. Thyroid hormone regulates the metabolic rate of every single cell. If thyroid function is underactive (hypothyroid) a person can have a multitude of symptoms, sometimes subtle and sometimes profound. These symptoms may include, but are not limited to: fatigue, weight gain, cold extremities, low libido, dry skin, aches and pains, fibromyalgia, constipation, hair loss, brittle nails, poor memory, low stamina, headaches, puffy face, and low body temperature. Perhaps the most common and important of the symptom being varying degrees of fatigue.

Diagnosis of low thyroid conditions, like most medical conditions, starts with listening to and examining the patient. Symptoms, as mentioned above, family history, and physical signs often point to the diagnosis of hypothyroidism. If thyroid disease is suspected, a thorough lab evaluation should also be performed to assist in the diagnosis. However, the goal is to treat the whole patient, and not just to treat the labs.

If hypothyroid disease is confirmed, then proper treatment may include thyroid medications. There are several medications on the market, which may be quite helpful in relieving low thyroid symptoms. These include Synthroid, Armour thyroid, Cytomel, compounded thyroid, and others. One patient may respond well to a particular medicine, while another patient may find that a different medication works best to alleviate his or her thyroid related symptoms. Although Synthroid is often the drug of choice for many physicians, I have found Armour thyroid to be particularly effective in many of my low-thyroid patients. For others, Cytomel may be the key to alleviating their symptoms.

In summary, thyroid dysfunction is a condition that may have a profoundly negative impact on many patients. Yet according to various experts, millions of Americans suffer from inadequate diagnosis and treatment of hypothyroidism. Proper evaluation and treatment of these patients may help tremendously in improving their symptoms, and their quality of life.

“Good Health Starts in the Gut.”

Posted on August 20, 2012 by mcminnclinic

As I reviewed the long list of initial symptoms, I was happy to hear the patient say that everything was “better, better, gone.”

Dr. McMinn: “How is the fatigue?”

Patient: “It’s much better doctor.”

Dr. McMinn: “How is the brain fog and anxiety?”

Patient: “They’re also much better.”

Dr. McMinn: “How is the diarrhea?”

Patient: “It’s gone.”

This patient had been to doctor after doctor for her various symptoms, but it wasn’t until we addressed her gut issues that she got better.

Old fashioned country doctors used to say that “good health starts in the gut,” and as I have become an older and perhaps wiser physician, I have become abundantly convinced that they were right all along.

Other organs may be “sexier” but the gut is where wellness begins. We marvel at the processing ability of the incredible human brain, and the heart amazes us with it heroic pumping marathon. We manicure our nails, and fuss over our hair. However, we take the lowly gut for granted, as if we’d rather not acknowledge, much less to glorify, a mere poop factory. Yet the oft-ignored gut frequently holds the key to good health, and likewise poor gut heath may manifest in all sorts of bodily havoc. I have seen miracle cures for many different maladies by attending to gut issues. Seemingly unrelated diseases and symptoms such as fatigue, brain fog, headaches, rashes, asthma, arthritis, autoimmune disease, fibromyalgia, ADD, autism, sinusitis and many more health problems may be linked back to poor gut health.

Let’s take a look at some of the issues affecting gut health:

*Diet: Let’s begin with what we put in our mouths. Certainly the MAD diet (Modern American Diet) has not helped the situation. It’s amazing to me that our bodies can survive the daily onslaught of junk food, processed food, transfats, sugar, and toxins as well as it does. The term “garbage in garbage out” frequently applies to computers. However, the same principle is applicable to the human body. We feed our bodies garbage, and yet we expect this to miraculously turn into healthy cells. Instead, our junk diets wreak a heavy toll on gut health, which then dominoes onto other bodily parts and functions.

*Stress: This is one of the main fundamental causes of disease. Stress can take its toll on just about any body part and the gut is no exception. Stress is often associated with issues such as Crohn’s disease, irritable bowel disease, and chronic diarrhea. Ulcers, leaky gut, cramps, poor digestion, and stomach upset.

Food Allergies and Sensitivities: The gut has the daunting challenge sifting through every single molecule we eat and of deciding what to let in, and what keep out. That’s one reason that we call the gut “the second brain.” To meet this challenge, approximately 70% of our immune system lies in the gut.

For millions of years our ancestors ate a “natural” diet of berries, fruits, vegetables, roots, and leaves. They killed critters and ate fish for lean protein. Now let’s fast forward to the modern American grocery store. Most of the food we might find in the center isles may rightfully be considered by our bodies to be like a foreign body, and thus generate an immune response. This untoward immune response may express itself in all sorts of clinical symptoms. Our food has changed drastically in a relatively short period of time, but our immune system is genetically the same as our hunter-gatherer ancestors.

Poor Digestion: Next time you find yourself at the drug store, take a moment to walk down the isles and look at the over-the- counter medications. You’ll find that by far, the number one item is the digestive and gastrointestinal aids. Year after year, Nexium and its acid blocking cousins are at the top of the charts in terms of prescriptions sold. These powerful acid blockers, as well as the seemingly benign antacids like Tums, interfere with our natural digestive ability. As such, we may not get the nutrients form our food that we need to maintain healthy cells.

Bacterial Imbalance (Dysbiosis): The human body exists in an amazing state of synergistic balance with our gut flora. Perhaps an oversimplification, but this mainly consists of “good bacteria,” “bad bacteria,” and yeast. We cannot survive without our “good bacteria.” Unfortunately, we frequently kill off the good bacteria with the antibiotics that we take. Also, with the sugar ladened diets we frequently find our guts in a miserable state of yeast overgrowth. This can result in bowel wall inflammation, and eventually “leaky gut syndrome.” A cascade of inflammatory and immune reactions then take place which can affect the far reaches of the body, including brain, bones, skin, auto-immune disease, etc.

Similarly, parasites may add another twist to the complex milieu of bacterial flora.

A simple plan for gut health recovery involves the 4R program: Remove, Repair, Restore, and Replace. This program is available in the integrative medical literature, and I have had great success by adopting it in my practice.

Step One: Remove the stressors on the gut such as the drugs, alcohol, sugar, caffeine, tobacco, and other poor food choices that we find in the modern American diet. A gut detoxification program may be helpful in this regard.

Step Two: Repair the damage with optimal nutrition, stress reduction, etc. Targeted nutritionals may help such as aloe vera juice, quercitin, licorice root, garlic, tumeric, digestive enzymes, and fish oils.

Step Three: Restore a healthy bacterial balance with high quality probiotics. Cutting out unnecessary antibiotics, treating yeast, and reducing the sugar in the diet may also help.

Step Four: Replace the deficient elements such as digestive enzymes, which can have a major impact on digestion and utilization of nutrients.

In summary, continue to ignore and abuse the gut and you will reap the unhealthy consequences. Give the gut the respect it’s due, and you will enjoy the many benefits in the years to come. Start today with the 4R program; remove, repair, restore, and replace gut health program in order to achieve optimal overall wellness.

Listening……….The Most Powerful Tool in Medicine

Posted on July 11, 2011 by mcminnclinic

A wise and experienced medical school professor once said “listen to the patient, they will tell you what is wrong with them.” As profound as his words were, it took me many years to really “get it.” We in the medical profession tend to drink from the cool-aid of high-tech tests, gadgets, and procedures. They’re hot. They’re sexy, and most importantly they pay big bucks. Listening is old school, passé’ and it’s not codable, billable, or re-imbursable. Unfortunately, the system does not respect the art of listening. It does not adequately pay for a listening physician, and in fact it punishes them. I’ve known bright, kind, caring, compassionate physicians, dearly loved by their patients, who were fired from their jobs basically for being good listeners. They took too much time with patients. They weren’t productive enough. They didn’t churn patients as fast as their colleagues, so they didn’t bring in as much revenue for the practice, and as a result they were let go. Both they and their patients paid the price for a system that devalues listening. Unfortunately this penalty for listening falls disproportionately on female providers, but that’s a story for another day.

Ninety-nine percent of doctors I have known in my twenty something years in health care have been hard working, conscientious, kind, caring, compassionate, smart, well trained, and well-meaning providers who have gone to work every day with the goal of helping and healing their patients. I have the ultimate respect for their talents, and dedication to their noble cause. However, in this day and age of industrial, big business medicine, driven by government, insurance companies, and drug companies, the average primary care physician has about seven to ten minutes per patient. What is a physician to do when a patient comes into the office and gets out their internet printout and a list of symptoms that includes weakness, fatigue, brain fog, abdominal pain, hot flashes, night sweats, low libido, and insomnia? Most likely they’ll get a few perfunctory laboratory tests and the then the doctor will get out the prescription pad. In this case it’ll probably be an antidepressant a sleeping pill, and maybe a pain pill. It’s the well-worn symptom-pill, symptom- pill revolving door, which inevitably leads to more pills to treat the side effects of the first pills.

Stop the madness! The system is broken. It’s a set-up for failure for the physician and the patient. The physician does not have the necessary time to listen to the patient. Therefore they will rarely get to and treat the root cause of the problem. They’ll only put Band-Aids on the symptoms with more pills, which is a prescription for side effects and often a lifetime of unnecessary suffering.

The power of listening is that it can be such a compelling tool in finding and treating what is at the root cause of the patient’s problems. The power of the prescription pad is that it’s the accepted tool of modern western medicine. Unfortunately, after a lifetime of conditioning, it also meets many patient’s expectations (especially with direct to consumer advertising by the drug companies). Practice managers also love it because it helps meet the ten minute deadline to get the patient out and shore up the financial bottom line.

Just yesterday I had a patient in my office who was in tears because she had been suffering for ten years with profound fatigue. She had been to many physicians. She did not feel as though her doctors had ever taken her seriously. The tests were all “within normal limits”, so it must be all in her head. After ten years of searching for an answer to her symptoms she never felt “listened to.”

In fairness to doctors, the issue of non-listening goes well beyond the medical sphere. As parents, friends, brothers, sisters, husbands, wives, politicians, teachers, and world leaders, we would all benefit from being better listeners. It seems to me to be one of the most important skills that a human being can learn. We teach reading, writing, and arithmetic to our kids but we hardly ever teach them about the art of listening.
Such a class should be a part of the curriculum at every stage of ones education. Especially in medical school, there should be an emphasis on the art of listening. It is so fundamental to what we do as healers. It is diagnostic as well as therapeutic. One might say the classes are not needed. “Listening is easy. Anyone can do it” they might claim. But then again, if good listening is so easy why is it such a rarity for a patient to find a medical provider who is a good listener?

In summary, the most powerful tool in medicine is neither a scalpel, a drug, nor an MRI scanner. It is an engaged, caring, compassionate provide, patiently and earnestly listening to the wants, needs, joys, and suffering of the patient in front of him or her, who has honored the healer by entrusting them with their heart, their soul, their mind, and their body. Let’ all strive to be better listeners.

Sleep: The Magic Elixir of Wellness

Posted on June 29, 2011 by mcminnclinic

The first domino to tumble in the insidious fall from the graces of good health is often the consistent lack of deep restorative sleep. Insomnia is one of the most common complaints I hear in my practice. If left unchecked, sleep difficulties inevitably begin a negative spiral down a path of increasingly severe health problems. Insomnia begets fatigue, weight gain, irritability, ADD, depression, brain fog, fibromyalgia, cognitive impairment, memory loss, impaired judgment, hallucinations, impaired immune function, increased type 2 diabetes, increased risk of heart disease, tremors, and many more serious health problems. Likewise, it is unusual to find a patient suffering from conditions such as fatigue or fibromyalgia who also don’t also experience a chronic lack of quality sleep.

As an ER doctor for 20 years I worked more than my share of night shifts, and I have paid my insomnia dues first-hand ever since. Bless the men and women who staff our hospitals, nursing homes, factories, and other shift work enterprises, who are going to work for their long night’s work just as we are climbing into our cozy beds for a good night’s sleep. Back during my night shift days, I must have heard it a thousand times, “Jim you look tired today.” Duh! I had a right to be tired; I had been up all night. Day shift people just don’t understand night shift people, and visa versa. Finally, after many years in denial, I realized that I was slowly taking years off my life by cheating my body of mother nature’s most potent medicine: a good night’s sleep. Shortly thereafter, I weaned my self out of the ER, into a “wellness medicine” practice, and into a wellness lifestyle. More and more, I try to practice what I preach, and now I sleep in my own bed every night. Just like an ex-smoker who becomes overly indignant about those around him who light up, I have since become a crusader for a night of deep restorative sleep.

When a patient comes in with fatigue, brain fog, or many of the other conditions of chronic disease, one of the first questions I ask them is “how are you sleeping?” More often than not the patient’s response will reflect problems with chronic insomnia. The patterns can vary. Sometimes it is difficulty getting to sleep. Many others get to sleep just fine, only to awaken at 2:00 in the morning. Often they can’t get back to sleep, which makes for a long and fatigued day at work the next day. Occasionally, I’ll find that a patient may get to sleep and sleep through the night, but may never wake up feeling rested and refreshed. Each of these patterns represents their own diagnostic challenges and therapeutic approaches.

Why do we sleep? In our busy lives, it seems like a total waste of time. We spend about a third of our lives sleeping! That adds up to about 25 years in the sack conked out. How the need for sleep evolved over time remains a hot topic of research. However, we do know this much: sleep is absolutely necessary for physical, mental, and emotional health, and even for life itself.

In the old days, sleep patterns were matched with the circadian rhythms of the earth. The sun went down, and it got dark. This triggered our melatonin to go up and our cortisol levels to go down, and thus we became sleepy. However, the electric light bulb changed the paradigm. With artificial electric light, we control our day and night light. Our eyes, brains, and bodies can’t distinguish between daylight and electric night light. Many people have totally lost touch with the rhythms of nature. Studies show that these people have more depression, more ADD, more heart attacks, more illness in general, and they die younger.

Sleep labs to the rescue! Sleep medicine has mushroomed in the past decade. Everybody’s trying to get in the game. Sleep labs are popping up all over the country. However, in my humble experience, many sleep labs have become a laundering service for the sellers of C-pap machines. Certainly sleep apnea is an important part of the equation. Without a doubt, it is under-diagnosed and undertreated. Many patients do get excellent relief from C-pap therapy. I’ve known some who claim that it has saved their life. However, it represents only a small part of the overall insomnia problem. The sleep labs often leave many important questions unanswered.

The beginning of the road back to restorative sleep begins with the understanding and practice of “sleep hygiene.” Contrary to implications from the word “hygiene” this has nothing to do with cleaning up anything. Instead it involves the consistent practice of setting the conditions optimally for a good night’s sleep. I like to tell my patients to take a “mini-vacation” before bed. Turn off the TV, and the computer. Turn on some “white noise” like a fan. Turn the lights down a bit. Do things that you find relaxing, such as reading a book. Better yet, read one of my old articles. That’s bound to put you right to sleep!

As I consider therapy, when possible I like to figure out the cause of the problem. That way I can treat the root cause. With proper testing, I often find that imbalances in estrogen, progesterone, cortisol, thyroid, and neurotransmitters are the culprit. Similarly, low melatonin, or elevated cortisol levels at night may contribute to the problem. Correcting the root cause can bring about dramatic relief in some patients.

Sometimes we must resort to empirical treatments. Finding the right sleep medication is like trying on shoes. The shoes that fit Cinderella did not fit her sisters at all. Similarly, the very supplement that helps one patient “sleep like a baby” may cause the next patient to stay up all night. I prefer to try natural supplements, such as melatonin, valerian, 5HTP, GABA, and other herbal remedies first. I find that about 75% of my patients respond well to these remedies. If these supplements are not working, then I may resort to sleep medications. In this case however, patients and providers must be careful not to choose a medication that promotes sleep, but never allows the patient to get into a Stage 4 REM deep restorative sleep.

A final category of potentially helpful therapeutic measures includes such modalities as acupuncture, hypnosis, neurofeedback, biofeedback, and CES (cranial electrical stimulation). I have found these therapies to be quite helpful for some patients.

In summary, sleep is a vital aspect of your foundation of wellness. If you are not getting a deep restorative sleep, it will eventually take its toll on your health. Work with your health care provider, and at the end of the day, adopt a “whatever it takes” policy toward getting a good night’s sleep. You cannot achieve true wellness, without getting a consistently good restorative sleep.

Total Body Funk…. A New Epidemic

Posted on June 13, 2011 by mcminnclinic

In medicine, there is a tradition of doctors naming diseases after themselves. In keeping with that time-honored tradition, I have discovered a previously unrecognized disease, which I am henceforth naming “McMinn’s Disease.” The other name for the disease is “Total Body Funk” or TBF for short.

My wife is a vet so I have heard it a hundred times, “a dog can have ticks and fleas at the same time.” And so goes for many of the patients in my practice. Patients rarely come in for one isolated problem. In fact the classic patient has profound fatigue, generalized weakness, hot flashes, night sweats, brain fog, weight gain, can’t sleep, and on top of all that she has no libido. Sometimes TBF has an insidious onset. It has a mind of its own. It can smolder for many years, and then for some unknown reason it crescendos to become unbearable. On the other hand, some patients can remember the day it suddenly started many years ago. It’s like the day JFK was shot, or for the younger generation, that tragic day of 9/11 when all of our lives changed forever. For these people TBF came over them like a San Francisco fog. It rolled in one day, but unfortunately it never left.

As a physician from the traditional medical point of view, it’s exhausting to try to wrap your mind around the matrix of all of the differential diagnoses associated with the symptoms of TBF. Not to mention the fact that most doctors have about 10 minutes per patient interaction. It’s a square peg in a round hole phenomenon. The current medical system is just not prepared to deal with multisystem severe chronic illness. Furthermore, we live in a world of specialization. We go to our cardiologist for this and our rheumatologist for that. By the end of the day, we’ve gone all over town getting fragmented care from multiple specialists who don’t always have the opportunity to look at the big picture, and who frequently are unable to communicates with each other.

One of the more common symptoms of TBF is fatigue. None of the medical professionals seem to want to take ownership of fatigue. It’s the last thing a doctor wants to hear about. It can take forever, and he’s got ten minutes, with an office manager cracking the whip over him to see more patients. It overlaps into multiple disciplines, and even spills over into areas that we doctors were never trained to deal with such as nutrition, and thought processes that seem foreign to us such as the mind body connection. Try looking up your neighborhood “fatigologist” in the yellow pages next time you get a case of TBF. You’re likely to find infinitely more plastic surgeons than you are fatigue doctors.

Einstein had a lifelong pursuit of a fascinating concept called the unified field theory. He felt that there was one underlying fundamental law of the universe that controlled all of matter and energy. Likewise in these “total body funk” patients there are often fundamental processes which have gone awry that may affect multiple systems, and in fact may have a negative impact upon every cell in the body. The challenge for the physician is to peel back the layers of the onion to get at that fundamental dysfunction that is resulting in the patient’s constellation of symptoms.

In order for the physician to properly address these patients he/she must first embrace “total body funk” like an ER doctor on a heart attack. He must dedicate himself to a focused learning process above and beyond (and perhaps a bit different) than his traditional medical training. He must open his mind to new possibilities as far causes and treatments of disease. After all, we are not a collection of body parts, but we are a heavily matrixed complex whole being. He must embrace the mind-body-spirit connection, and he must expand this toolbox to include other therapeutic modalities. He should also resist the knee jerk reach for the prescription pad to write another prescription for yet another drug to put another band-aid on another superficial symptom. To optimally benefit the patient he should reach out and expand his referral network to include new partners who can be a part of his overall patient care team, such as a trusted chiropractor, a nutritionist, an acupuncturist, a massage therapist, an herbalist, a counselor, a yoga teacher, or a biofeedback specialist just to name a few. He must recognize the power of the fundamentals of wellness such as exercise, stress reduction, optimal nutrition, and a good night’s sleep. Finally, he must know going into it that TBF takes time, and it is never a quick fix. Doctor and patient must both be patient. Gradually we must unravel the mystery, stop the downward slide, and step-by-step, turn things around to begin a process of healing.

Even in this day of high tech gadgets, I would suggest that listening to the patient is the single most important medial diagnostic tool, especially when it comes to TBF. The next most powerful tool is to have the mind of a 3 year old. Always ask the question “why?” Peel back the layers of the onion, and leave no stone unturned in order to get to the root of the problem. If you just treat the symptoms with drugs, and you don’t get to the cause of the problem, then new symptoms are going to pop up elsewhere.

In summary, judging by the patients I see in my office, McMinn’s Disease, or Total Body Funk, seems to be an emerging epidemic. Many previously robust people have succumbed to it, and for the rest of us, this frightening disease may be lurking around the corner. The best prevention is attention to the fundamentals of wellness. The best cure is a focused, enlightened, overarching and thorough evaluation with a search for and treatment of the underlying root cause of the problem.

Low Thyroid

Posted on April 20, 2011 by mcminnclinic

As much as I try to teach patients about their health concerns, in the end, I always learn more from them, than they learn from me. Case in point: many years ago while flying home from a medical conference I happened to sit next to a particularly talkative woman. This always seems to happen when I need some serious shuteye. Once she found out that I was a doctor the flood gates opened and she divulged to me her entire medical history. I remember vividly how she suffered with severe fatigue, weight gain, and brain fog for many years. After seeing many doctors she was finally diagnosed with low thyroid (hypothyroid). She was put on medicine in the form of Synthroid (levothyroxine), and she did feel somewhat better. However, it wasn’t until she went to a different doctor who changed her over to Armour thyroid that she finally felt like her old energetic self again. Her energy returned, her brain fog cleared, and she began to lose weight.

As I listened to her story, I shook my head in the affirmative, as if I knew what she was talking about. After all, I was the doctor, not her. In actuality, I had never even heard of Armour thyroid. All through medical school, residency, and after many years of medical practice, Armour thyroid had never before come across my radar screen. However, here was a teaching moment, and once again, I was the student. Somehow she tweaked my interest enough so that I looked up Armour thyroid when I got home. I learned that it is a natural product containing a balanced blend of the thyroid hormones T3 and T4. This is in contrast to the form of thyroid prescribed by most doctors called Synthroid (generic= levothyroxine), which is a synthetic product containing only T4. I also learned that contrary to popular belief in traditional medical circles, women often feel better on a combination T3/T4 product such as Armour thyroid than on Synthroid. In fact, there was a well done study published in a prestigious medical journal called The Annals of Internal Medicine in which the authors compared the combination T3/T4 regimen (similar to Armour thyroid) with the standard T4 (Synthroid) regimen used by most doctors. They measured many parameters, including quality of life and patient preference. They found that 64% of women preferred the combination T3/T4 treatment, while only 7% preferred the solo T4 (Synthroid) treatment. These results mirror the trend I have seen in my own practice, in that many patients feel better on and prefer the Armour thyroid as compared to the Synthroid.

The problem of under-active thyroid is huge, affecting approximately 10 million women in America. According to the Thyroid Foundation of America, more than half of the patients with low thyroid in America are undiagnosed. Of those who are diagnosed, many are not receiving optimal treatment.

Thyroid affects just about every part of the body. The most common symptoms of low thyroid that I see in my office are fatigue (low energy) and the inability to lose weight. Other common symptoms include constipation, depression, brain fog, anxiety, dry skin, hair loss, low body temperature, low stamina, cold intolerance, cold hands and feet, low libido, generalized aches and pains, swelling, edema, puffiness, and brittle nails. Actual diseases that may be associated with low thyroid include hardening of the arteries, generalized inflammation, cardiovascular disease, abnormal lipid levels, abnormal menstrual periods, infertility, poor pregnancy outcomes, low mood, depression, fibromyalgia, chronic fatigue syndrome, and obesity.

The standard screening test most doctors use is called a Thyroid Stimulating Hormone or TSH test. I think that it is perfectly fine to use TSH alone to screen asymptomatic patients. However, if a patient presents with a clinical picture consistent with low thyroid, such as fatigue, I feel that a more thorough evaluation is warranted. If you dig a bit deeper by getting a complete thyroid panel including a Free T3 and Reverse T3, you often find that the root cause of the symptoms is an underactive thyroid gland, even with a normal TSH. I frequently find that in such cases when the thyroid function is optimized, the patient’s symptoms improve and they feel much better. In many patients, being “low normal” is not good enough. They often get excellent relief of their symptoms, when the labs are brought up to the mid or upper range of normal. This concept is called “thyroid optimization”.

Another underutilized screening and monitoring tool is the basal body temperature. The body’s temperature often correlates with the basic metabolic rate. This is the rate at which we burn calories while at rest. One of the most important regulators of basal body temperature is thyroid function. When a person’s temperature runs low, this may be a signal that the metabolism is slow, and that the thyroid function is suboptimal.

In summary, low thyroid is an important and sometimes insidious medical problem affecting millions of Americans, especially women. The symptoms may be many and varied. Low thyroid may be associated with many disease processes, and can have a profound effect on general health and quality of life. It often goes undiagnosed and under treated. If low thyroid is suspected, a careful symptom analysis and a thorough battery of tests are needed. If indicated, the thyroid function should then be optimized. A combination medication with T3 and T4 similar Armour thyroid should be considered as a viable treatment option.

Low Thyroid

Posted on November 30, 2010 by mcminnclinic

Low thyroid (hypothyroid) is a common and potentially devastating problem in America. It affects approximately 10 million women in America, and according to the Thyroid Foundation of America, more than half of the patients with low thyroid in are undiagnosed. Of those who are diagnosed, many are not receiving optimal treatment.

Thyroid hormone affects every single cell in the body, and it is the master controller for overall metabolism. The most common symptoms of low thyroid that I see in my office are fatigue (low energy) and the inability to lose weight. Other common symptoms include constipation, fibromyalgia, depression, brain fog, anxiety, dry skin, hair loss, low body temperature, low stamina, cold intolerance, cold hands and feet, low libido, generalized aches and pains, swelling, edema, puffiness, and brittle nails. Actual diseases that may be associated with low thyroid include hardening of the arteries, generalized inflammation, cardiovascular disease, abnormal lipid (cholesterol) levels, abnormal menstrual periods, infertility, poor pregnancy outcomes, low mood, depression, fibromyalgia, chronic fatigue syndrome, and obesity.

The standard screening test most doctors use is called a Thyroid Stimulating Hormone test (TSH). TSH may certainly be helpful in diagnosing a low thyroid condition. However, if a patient presents with symptoms consistent with low thyroid, such as fatigue, I feel that a more thorough evaluation is often warranted. Often upon further evaluation, and especially with clinical correlation, the patient may be found to be hypothyroid even with a normal TSH. I frequently find that in such cases when the thyroid function is optimized, the patient’s symptoms improve dramatically.

The most common treatment for low thyroid is Synthroid. However, I have found that many patients respond better to a more natural and well rounded thyroid preparation such as Armour thyroid.

If you’re feeling fatigued, gaining weight, or having other low thyroid symptoms, call McMinn Clinic at 205-868-1313 for a thorough thyroid work evaluation.