Replenish 911 Gut Health

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I’m so excited to be here with you for this client 911 Power Jam I’m Andrea nakayama if you don’t know me I’m a functional nutritionist and I am owner and founder of replenish pdx and holistic nutrition lab so what I realized over the years was that the successes I was having were a result of a number of factors first of all yes I had some good information I knew some good techniques and I understood some baseline principles for me those baseline principles had less to do with tactics of treatment and more about understanding physiology and what’s going on in there because that’ll II enabled me to think on my feet and not try to problem-solve before I saw what all the problems could be so that was the information that I really needed but as I began to grow and especially as I great began to teach in holistic nutrition lab

I realized that there were other elements that made me successful and that were contributing to my success so information understanding physiology key baseline after that I really needed to understand what some protocols and some systems were for addressing specific issues but also thinking into them so the physiology gave me the baseline systems like I teach in reframe nutrition and like I share and the done-for-you protocols in the digestive intensive those gave me next possible steps but what ultimately i think is a huge part of the success that I’ve had in practice and that’s enabled me to grow replenish so that I have a number of nutritionists on the team and we have a wait list that we can’t keep up with months out is that

I offer hope to people who don’t have so much hope anymore so understanding the physiology key helps me think on my feet understanding systems to think into a problem also next step but being able to offer transformation to people is critical so this is where I want to invite you as a practitioner to invite transformation into your own life so that you can help your clients and patients transform and that’s really really key by doing that that’s how we transcend the current state of health and medicine so like I said this is a client 900 power jam meaning we’re going for four hours reviewing client cases and these cases have been submitted by select digestive intensive graduates so let me just talk a little bit about what that means so the digestive intensive is the first module in the clinician training holistic nutrition lab and it is the only module that’s offered on its own after the digestive intensive there’s the possibility to go on or not to the nine-month program a good number do and many have to put it off till the next year

but I offer this digestive intensive as a standalone module particularly because all health starts in the gut and you know that I know that but what does it mean to address any health issue by starting at the gut even when your clients from patients are coming to you telling you that they don’t have digestive issues I have an autoimmune condition myself Hashimoto’s and I don’t experience digestive distress so that’s what the digestive intensive is all about and the digestive intensive is only open for enrollment two times a year and one of the x is right now so i want to invite you to go learn more about the digestive intensive now or later WWD jest of intensive calm and you can go learn more about all that’s included and all the benefits you’ll receive within the digestive intensive what I wanted to share with you is this is what we do on our team we have a 90-minute CRM meeting every single week and that’s a client review meeting where the nutritionists on my team bring their cases to me in a fashion that you’re seeing us do today

and I review them so I’m reading these case study forms that were submitted and the first one is from Lori Thank You Lori patients name unknown patient is female age 64 and the presenting complaint is peptic ulcers so stomach issues for the past five to six years has had five scopes top to bottom all normal so additional presenting complaints this patient 64 with peptic ulcers has Hashimoto’s and thyroid nodules but not currently treated with synthroid minor urinary frequency burning or urgency mild insomnia mild aches and weakness cold hands and feet chronic constipation moderate bloating and gas moderate fatigue throughout day irritable and uncomfortable when hungry melanoma three times severe vaginal dryness and some lab results so we have some hormones vitamin D is 149 TSH is 4.39 uh interesting so that’s interesting she’s presenting with some her free t3 is 3.1 her tea for total is 6.4 glucose is 77 cholesterol 195 triglycerides 95 LDL 111 white blood count red blood count neutrophils lymphocytes okay current protocol she’s been avoiding most gluten for a few months she feels better off gluten and recent doc visit confirmed to her that it’s good to be off gluten

I suggested she try to work harder on avoiding gluten especially in hidden sources have provided her information on where to find the hidden sources off tomato citrus and most white foods to help with ulcer I recommended she try eliminating dairy to see if that helps with reflex she craves chocolate I just sent her some info you sent yesterday about carob thank you and prior to her health concerns most days she didn’t eat breakfast or lunch she recently started making fermented whole body shakes in the morning this has seemed to help is fermented powder okay with Candida issues regularly consume sugar dairy a glass of milk with dinner uses butter a cup of coffee in the morning no particular diet plan other than gluten free type-a personality high-stress job currently not exercising much she takes calcium magnesium 10 drops lugol’s so she’s taking iodine vitamin D five drops and dr. O’Hara’s probiotics she’s on DHEA probe onyx drops okay

so main questions except good everybody have a good perspective of the case main questions for discussion I know low stomach acid is not good and may exacerbate ulcers but if a client already has an ulcer do you try to increase the stomach acid or does that cause more injury so let’s start there for a moment so this plant has a lot going on it does sound like there’s some deep autoimmune issues and I’d really want to understand what the signs and symptoms of the ulcer are so it sounds like she’s experiencing a lot of signs and symptoms her life can really be feeling that full with all those signs and symptoms that fatigue the aching joints the urinary frequency so really what I would want to do is back it up back it way up in terms of her motivating factors the factors that are keeping her from going a hundred percent with the diet we have to think about where the food meets the physiology and help the client or patient to really understand those connections and we don’t help them understand it in terms of their biochemistry or interns of an evidence-based study

we help them understand it in terms of their life and where they feel held back so with a client like this I would really want to get to know her and understand where when did she feel best in her life and what would it be like to feel like that again are there things that she really wants in her life that she’s feeling held back from and once you understand that you really seen her and you can reflect any change you’re requesting back to those issues so she really does need to clean the muddy waters and that may be a slower process than you think it is to get her off of the substances that are contributing to the ulcers and likely contributing to a number of other issues so even with the labs it’s hard to fully assess them until we’ve cleaned and cleared those muddy waters so we need to remove the most inflammatory foods that’s first and foremost so getting to gluten a hundred percent and it’s great Louise that you gave her a handout but we may want to consider what does she need to make those connections and how is that going sorry I said Louise because there is a Louise Laurie I’m so sorry so Laurie we may want to look at for her what does it mean to go a hundred percent and what are the things that she’s still consuming that contain gluten and then take it onward to look at dairy and sugar is a really important one the chocolate could be a contributing factor and the coffee so those are really contributing

so before we brought in any more to address the ulcer I’d want to clear the muddy waters and that would include removing the inflammatory foods and there’s a number of ways to do that we could do that slowly but surely so that she’s making the connections and she can really feel the difference one by one or it may be that you asked her to do an elimination protocol with you for a three-week time period where you actually remove everything that might be in the inflammatory category and you hold her through that you really support her through that but before we do that it’s very hard to see what signs and symptoms still persist after that we may be looking at what foods are inflammatory for her individual but we need to clear so that we can see what still exists and this is part of backing it up and not addressing ulcer but addressing the client herself and she says do you Lori says do you suggest working on healing the gut and Candida simultaneously or focus on one or the other first and this

I’m glad you asked that because in order to sometimes work with upper digestive issues we need to make sure we have addressed the gut and we’re working with those lower digestive issues so candida and leaky gut or gut dysbiosis you can work on those at the same time depending on how extreme the candida is and what you’ve done to diagnose that was there an organic acids test was some stool diagnosis that showed the candida overgrowth so you want to be working with that overall and the number one thing to work with that is removing the refined sugar from the diet so that’s a really good place to think about backing it up and working on those techniques to get the inflammatory foods out you can see how a number of symptoms are the result of some of the same insults or instigators so working on starting with the gut while eliminating the instigators is a perfect place and you asked about ferments I’m fine with most ferments for Candida

I know there’s some discrepancy I find them to be really beneficial and you want to work with probiotics as well as antifungals particularly I would be working in some sacrifices bolyard II if you go to our store replenish me calm that’s the yeast biotic and that’s a probiotic that’s actually a yeast culture a positive beneficial yeast culture that is good to bring in when working with Candida so that was that question and then Lori says I’m afraid to start out with too much information for a client I already gave her quite a bit of information prior to working with her as a practice client how do you determine the flow of information provided to each client is that a sense you develop after working with a few people awesome question this really does come down to the art of the practice so oftentimes I find that as clinicians we instead of meeting the client where they are we are really aiming to show that we know a lot or give all the information so a good way to do that is to maybe say i’m going to show you the pictures that i see that need to be addressed just as an o review and this is where you can pull out your anatomy and physiology book and show the whole digestive system and how it relates to other systems like I teach you to do in the digestive intensive or you can just be giving a grand scope overview and then you can say now

let’s break this down because we need to go through a process where you can make incremental change that you can stick with so that it becomes part of your lifestyle practices as opposed to a diet or a protocol and that’s where you need to make sure that you’re meeting the client where they are you’re building a bridge and you’re getting agreement on what’s possible so that’s where you might bring up there’s two different ways we can do this we can do a three week protocol where we just dive in or we can do this slowly but surely what do you think is going to work for you that you’re actually going to be able to stick with and you get their agreement in that situation so we don’t want to go too much too fast I like to introduce supplements slowly not overload somebody with something at the start and many successful practitioners would disagree with that because that’s how they make their income by selling loads of supplements at once but I really want to find what works for the individual and how to stair step that forward so they begin to feel incremental change getting better all the time and have the ability to take the next step so meet them where they are get out of your own way and find agreement there in what it means to work together and the final question from Lori and then I’m going to open it up and want to take your questions Lori says I’m assuming there’s not a set template for handing to each client because everyone is unique you got it worried what’s the best way to determine how to proceed especially if there are multiple issues which i suspect happens with most clients absolutely

I’m assuming I always want to back it up and start with the gut is diet usually the best place to start awesome questions and you nailed it on the head Lori so we definitely want to back it up look at gut function and one way to do that is by clearing the muddy waters and cleaning up the diet and then building on the supplements from there there’s some things you can do simultaneously like bringing in some probiotics along with the issues I’ll tell you my signature system for most health issues would be probiotics and I think there are going to be some questions where we have to look at how to do that slowly because of reactivity from what I peeked at quickly so probiotics B vitamins are critical again it replenished me you can find our be supreme that’s a methylated b-complex that’s really critical fish oil which you can also find it replenish me and that’s all critical to helping to build I do want to note that this person had a high vitamin D level so I would look at the form of vitamin D that was measured to take that a next step we want to look at the 25 d hydroxy vitamin D and also look at calcium levels and magnesium levels and if all those look fine and the vitamin D looks a chronically high meaning it’s always the trend has been to be high then I would take down the dosage for sure she’s taking five drops of it didn’t say how much

but we don’t want that over a hundred and also if it continues to be high looking at parathyroid function but that just becomes part of our overall scope at the same time that we’re doing that overall looking we are working with the gut and with the person clearing the muddy waters and taking it from there and before I just take Caroline those questions I do want to say that oftentimes when my nutritionist on my team bring me a case where the person is still eating an inflammatory diet I just hand it right back to them you know what to do from here and then let’s bring it back and see if there’s more digging to do now I realize that’s easier said than done because our gift in the world of functional medicine is that we work with the individual to help them make those changes in a sustainable way even when they know what to do so a lot of people know what to do or know they have to do it and they don’t know how and the way we get there is by really meeting the person where they are understanding them understanding where the blocks are and it’s less about me being helping them be accountable then helping them understand the connection between what they’re feeling and experiencing that they don’t like in their lives and what they’re consuming so that they can make that Association and take ownership of that change themselves

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