An Introduction to Integrative and Functional Medicine ? Vulvar Disorders ?
An Introduction to Integrative and Functional Medicine ? Vulvar Disorders ? Rebecca A. Malamed M.D....
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Transcript of An Introduction to Integrative and Functional Medicine ? Vulvar Disorders ? Rebecca A. Malamed M.D....
An Introduction to Integrative and Functional Medicine
? Vulvar Disorders ?
Rebecca A. Malamed M.D. Integrative and Functional Medicine
Pain Management
What is Integrative and Functional Medicine?
• Integrative medicine
– Healing- oriented medicine – Focus on therapeutic relationship– Whole person (body, mind, and spirit) – All appropriate therapies, both conventional and
alternative
• Functional medicine– Dysfunctions of physiology and biochemistry – Chronic disease assessment, prevention and Rx
Differences in Diagnostic Approaches
• Conventional Medicine: – Disease/disorder based diagnosis – Vulvovaginitis, Vulvodynia, Lichens Scleroris, Lichen Planus,
Hyperplasia, Neoplasia – Search for “magic bullet” as Rx
• Integrative/Functional Medicine: – All symptoms in ANY system relevant – “Anything can cause anything” – Search for underlying function to Rx– Functional Medicine testing
Differences in Treatment Approach
• Conventional medicine– “Evidence-based” – Gold Standard: double-blind placebo-controlled– Pharmaceutical/intervention driven Rx
• Integrative/Functional medicine– Basic research-based– Gold Standard: Individual patient symptom resolution– Least harmful/synergistic Rx to allow body to heal
Your Genes on Twinkies
• Environment and Gene Expression account for almost all human disease (Epigenetics)
• Disease vs. Health is an expression of each patients:– Genetic predisposition: Cofactors, Detoxification,
Immunity– Physical Environment: Nutrition, toxins (heavy metals,
fungus, sucrose/fructose), sleep, exercise – Emotional milieu: Family, friends, mental health – Spiritual beliefs and practices
The 7 Organizing Systems Where Clinical Imbalances Develop
• Assimilation: Digestion, absorption, microbiota/gi, respiration
• Defense and Repair: Immune, inflammation, infection/microbiota
• Energy: Energy regulation, mitochondrial function
• Biotransformation and Elimination: Toxicity, detoxification
• Transport: Cardiovascular, lymphatic system
• Communication: Endocrine, neurotransmitters, immune messengers
• Structural Integrity: From subcellular membranes to musculoskeletal structure
Assimilation
• Complete and healthy absorption requires– Intact intestinal villi
• Food Sensitivities can damage and destroy intestinal villi – Mediated through IgA Immediate Type
Hypersensitivity Reactions
Assimilation
• Absorption– Increased intestinal permeability can lead to
symptoms or signs of ANY inflammatory condition locally or systemically
– Mediated through IgG delayed type hypersensitivity
Assimilation
• Microbiome: 100 trillion bacteria– Skin, gut, mouth, vagina
• Local antimicrobial treatment not sufficient?– Healthy microbiome (balanced flora) – Dysbiosis (opportunistic species predominate)– Vulvar-vaginosis, vulvodynia and other vulvar
disorders may have abnormal GI flora as precursor
Defense and Repair
• Decreased Immunity– Host defense vs. virulence of organism– Vulvar-vaginosis, Vulvodynia
• Excessive Immunity = Inflammation– Food sensitivities (IgG, IgA), Toxins– Autoimmunity– Vulvodynia, Lichens Scleroris, Lichen Planus,
Hyperplasia, Neoplasia
Biotransformation and Elimination
• We are what we eat? Actually…
• Want cleanest in and dirtiest out
• Limit toxicity and need for detoxification
• Vulvovaginal disorders may be caused by an accumulation of inflammatory mediators locally and total body burden of toxins
Toxicity
• Natural: Plants and microbes
• Manmade: Chemical, heavy metals etc.- 60,000 to 80,000 in common use- $1.5 trillion in 2010 sales by Census Bureau- Backlog of 10,000 never tested by EPA- US largest manufacturing sector
Diet recommendations
• Organic/Biodynamic• Non-GMO
- Corn, soybeans, canola, papaya, sugar beets
•Avoid processed food- Pesticides, dyes, additives
• Candida diet- Low glycemic, non-fermented (no alcohol, soy sauce)
• Cook and store food with stainless/glass
Elimination Diet for Food Sensitivities
•Most Common- Eggs, dairy, gluten, corn, soy
•Nightshades (Solanine)- Potatoes, eggplant, peppers , tomatoes
•Methylxanthines- Chocolate, coffee, caffeinated tea
•Any food cravings
Rx Toxins/Irritants
• Chlorine – Filtered water (drinking/bathing) – Organic cotton underwear
• Hygiene products – Organic tampons, non-toxic soaps etc.– Environmental working group (EWG)
• Heavy metals– Mercury: amalgams, predatory fish – Lead: solder in water pipes, paint, leaded gasoline– Aluminum: cookware, antiperspirant– Mineral Cosmetics, Gadolinium contrast dye
Natural Detoxification
• Sweating– Hot baths, saunas
(infrared), exercise
• Diet– STOP SUGAR– Dark leafy greens,
garlic, onions, cruciferous vegetables, seaweed
• Supplements- Glutathione, vitamin
E, glycine, taurine, NAC etc.
• Fiber- Organic oat bran,
charcoal, bentonite clay
• Deep Breathing- Exercise, meditation
Goals of Natural Antimicrobials, Immune Modulators and Detoxification
• Increase innate host resistance and immunity
• Downregulation of excessive inflammation
• Balancing of microbiome synergistically
• Prevention of microbial resistance
Natural Antimicrobials
• Prebiotics/Probiotics– Inulin, fermented vegetables– Multiple probiotic strains
• Coconut oil – (MCFA, Lauric acid, Caprylic acid)
• Essential oils– Tea Tree, Lavender, Oregano
• Herbs/Barks/Mushrooms – Pau D’Arco, Berberine, Sweet Wormwood, Reishi
Natural Anti-inflammatories
• Omega-3 & Omega-6 Essential Fatty Acids– Grass fed beef/lamb/dairy (omega-3)– Organic nuts and seeds (omega-6)– Fish oil (omega-3)– Blackcurrant seed oil (GLA,)– Sesame seed oil (omega-6)
• Antioxidants– Dark green leafy vegetables, cruciferous vegetables– Turmeric (curcumin), Red grapes (Resveratrol)
Summary
• Our genes + our environment = our health• “Anything can cause anything”• Goals: – Increase host immunity and defense– Decrease (modulate) inflammation appropriately
• Method:– Removing environmental stressors– Optimizing underlying biochemistry– Offer synergistic support of body systems
More Information• Related articles @ www.drrebecca.com
– Dysbiosis - a gut reaction – Food sensitivities and allergies– Sugar - not so sweet after all– Heavy metals– Detoxification - an essential process– Acute and chronic inflammation - more than just a pain– A balanced diet - why’s it so complicated?– Genetically modified food - what’s for dinner?– Probiotics in prebiotic– Dietary fiber - the lost nutrient
Rebecca A. Malamed MD10780 Santa Monica Blvd. #480, Los Angeles CA 90025
310-474-8111 / [email protected]