The most common complaint I hear from patients struggling to recover their health after experiencing multiple failed attempts is "I've tried everything! Nothing works!"
They're often right that nothing they've tried up to this point has generated sustainable satisfactory results. But they may be incorrect in thinking they've tried everything.
Many patients feel frequently let down by conventional and "alternative" methods of treatment alike; feel exhausted by their own continued decline despite their best efforts to gain traction. There are reasons why failed recovery attempts occur and why the common methods employed by both conventional and alternative practitioners may lack adequate appreciation for one of the most fundamental aspects of establishing a successful recovery.
The Big Picture
When you think of metabolism, you may think of weight loss, performance enhancement, and energy. But metabolism is much, much more than this.
The metabolic system is the vast collection of ALL chemical reactions required by a living organism to maintain life. Metabolism includes the synthesis and repair of all cells, production, regulation, and degradation of hormones, neurotransmitters, and other cell-signaling compounds. It includes all of the processes that break down and remove dead cells, unwanted pathogens, xenobiotics, and waste products. It supplies the resources to adapt to stress. Collectively, it represents every highway along which the functions of life are carried out.
When the metabolic pathways themselves lack what they need in order to work and begin to fall into dysfunction, whole body systems can collapse into disease. Clinically, the picture rapidly begins to grow in complexity.
Adapting to Stress
Our stress-response system, or neuroendocrine system, is tied to the broader functioning of the metabolic superhighways. This means that our adaptive responses and survival processes, on a deep chemical level, rely upon optimally-functioning metabolic superhighways. When the neuroendocrine system falls into disrepair, patients can begin to feel as though they are "suddenly" combating multi-system breakdown. Digestive disturbances, heart palpitations, mood disturbances such as anxiety and depression, sleep disturbances, weight changes, hormonal imbalances, increased food allergies and sensitivities, chronic pain, and many more symptoms may broadly signal underlying widespread metabolic dysfunction.
The neuroendocrine system relies upon our metabolic health and as such, metabolic health informs how well we adapt to stress. Metabolic health influences the production/regulation of hormones, neurotransmitters, and countless other important cell-signaling mechanisms that contribute directly or indirectly to stress adaptation. Put simply, the illnesses you are susceptible to and how well you recover and overcome them will depend largely on what state your metabolic and neuroendocrine health is in.
Your Response is Unique
Our genes carry the blueprint for how our metabolic pathways function by encoding for the enzymes (which are proteins, themselves) that help to guide the flow of metabolites through the metabolic pathways, among other things. Many of us carry propensities to metabolize certain compounds more slowly or quickly than others. This can mean that some of us will be more prone to experiencing more severe side-effects from certain dietary patterns, medications, supplements, other environmental exposures, and general metabolic stressors. However, all of us, no matter the genetic context we are birthed from, can do much to optimize the functioning of our metabolic pathways with proper understanding of nutrition.
Our metabolic pathways require enzymes that in turn require specific vitamins, minerals, amino acids, and fatty acids to perform. Nutrition can even influence what and how genes are turned on and off. Additionally, we are learning more every day about the way other so-called non-nutritive microbes and phytonutrients, among other dietary agents, influence regulatory signaling in the pathways themselves.
Though life can not exist without these fundamental nutritional building blocks that allow metabolic pathways to operate, it's not simply enough to take a multi-vitamin, or stock up on supplements in general. In fact, improper use of supplements (and medications, for that matter) is a top contributing factor to a failed recovery. And unfortunately, one of the most common.
Choosing Treatment
All across the internet in almost every media format - and within many medical offices you may have visited in person - the healing power of supplements and prescription medications are openly and even aggressively promoted and advertised. They are often deployed as a first line of defense against almost any kind of disease or discomfort. Isolated and concentrated amounts of vitamins, minerals, amino acids, fatty acids, herbs, probiotics, and pharmaceuticals are ubiquitous in our modern medical paradigm. It is true that these are powerful influencing agents of metabolic pathways. It is also true, however, that the methods, dosages, and frequencies in which they are often prescribed may be ignorant of the broader metabolic implications of their usage. To read more about this issue, please read the next blog post entitled "Supplements: Who to Believe?"
Nutritional building blocks are required in very specific physiological doses and synergistic relationships to ensure metabolic pathways function optimally. Because each one of us possesses "biochemical individuality", or a unique biochemical make-up, we will need different kinds of nutritional and metabolic support. This is definitely not a one-size fits all protocol. Additionally, once metabolic dysfunction has been going on for years, the way out is anything but straight-forward. Many pathways must be repaired, deficiencies abound, and sensitivities are heightened. The "fire hose" approach to supplementation and medication may backfire in anyone, but those particularly susceptible are the ones in advanced stages of chronic illness.
Customized Medical Nutrition Therapy
Many supplement and medication recommendations that are commonly offered frequently begin to generate negative reactions in the very sick patient and this further impedes recovery. The metabolic machinery of a person in advanced chronic illness has often been compromised to the point where it may have trouble utilizing the metabolic pathways efficiently. It is very easy to generate and exacerbate metabolic "roadblocks" and "pile-ups" and generally overwhelm a weakened system.
Customized whole food-based individualized medical nutrition therapy within the metabolic medicine framework is one of the most clinically-effective approaches for an increasingly large group of patients with chronic illness. These programs, highly individual in nature, diverge in specific ways from some of the generalized guidelines for nutrition widely publicized. They require attention to minute details specific to each person and are aimed at limiting accumulation of unwanted metabolic wastes (often exacerbated and made worse by improper supplement and medication use), supporting repair of tissues and damaged receptor sites, decreasing inflammation, and rebuilding proper ratios of hormones and neurotransmitters, among many other things.
How do we know what to do?
Many metabolic lab tests, both conventional and functional in nature, may show "normal " results while the patients feel anything but normal. Since many symptoms present in severity yet remain sub-clinical in terms of what may show up on the laboratory range as indicative of disease, both patients and practitioner can become exhausted in an attempt to identify culprits for ongoing illness.
The good news is that, in the hands of a highly trained clinician, relying on tests appearing "abnormal" in order to treat may not be wholly necessary. Such a clinician, through in-depth assessments and advanced understanding of the metabolic and neuroendocrine system alone, may be able to interpret even the subtlest of symptoms and apply appropriate metabolic treatments that allow patients' health to improve dramatically. Another key point to keep in mind is this:
A test is only as good as the tools you have to treat the results of the test.
This means that it's always a good idea to ask your clinician how they plan to treat the results of the test, should it come back abnormal. Perhaps drugs or surgery will be necessary, but perhaps not. Depending on who you consult, the tools offered will look different. Lacking almost any training in nutritional biochemistry, medical nutrition therapy, and its attending customized nature, both traditional and alternative doctors cannot offer you the comprehensive nutritional therapy tools that skilled dietitians with advanced specialty can. Even the most well-meaning clinicians, if not trained in advanced metabolic medicine and medical nutrition therapy, may recommend grossly inappropriate nutritional supplement and dietary protocols in an honest attempt to help.
A team of healthcare practitioners is often necessary to work with you and your chronic illness. A dietitian trained in metabolic science and medical nutrition therapy for neuroendocrine disease is arguably one of the most vital members of this team. Dietitians specializing in whole food-based medical nutrition therapy for treating a variety of chronic conditions are uniquely equipped to assess and provide insight into how your particular needs and concerns may differ from general nutrition guidelines or advice offered by other practitioners.
About the Author
Heather Davis, MS, RDN, LDN, holds a master's degree in nutrition science and is accredited by the Academy of Nutrition and Dietetics as a registered dietitian nutritionist (RDN). She works as a clinical dietitian, educator, and medical writer specializing in neuroendocrine nutrition and advanced chronic disease medical nutrition therapy.