Sample treatment outline

When I had a layover thursday on the way to the ACAM convention, I ran into a woman who’s had multiple medical issues and was walking around with a backpack full of medications. She’s been going to a variety of specialists and overall her problems have been dealt with using a variety of medications. As we got to talking, she shared some of her diagnoses with me and I mentioned some other avenues she may want to investigate.
Now, I will probably never see her again, but she stayed on my mind as she’s a complex medical case. With the variety of problems, most doctors get frustrated and throw up their arms in frustration or try the couple therapies they have at their disposal then reject the patient if they don’t work. This doesn’t help the patient.
So, perhaps she will have a chance to read this and be able to take advantage of some of these therapies (I’m only including the diagnoses and avoiding any personal details so she’ll be the only one who can identify herself from this information). For everyone else, you’ll get a chance to see the approach that I take.
Her problem list includes (I wasn’t taking notes, so this relies on my memory and may have some errors): thyroid cancer in the past (eventually had entire thyroid removed) but doing well until last winter when she had sudden onset of attacks or episodes of (I don’t remember the details) fatigue and palpitations. Since then she has been diagnosed with multiple sclerosis (can only tolerate one MS drug), bone loss, massive iron deficiency anemia, massive vitamin D deficiency (I think she said she needed 60,000iu weekly just to bring her to perceptible levels, Ehlers-Dahnlos (not type 4), autonomic dysfunction, mast cell instability, hypoglycemia, orthostatic hypotension, some muscle/tendon shortening from limited use, and probably a few other things. She has tried an elimination diet in the past, eating nearly exclusively chicken and rice and felt weaker and lost weight during that time.

In terms of going after some of her current diagnoses directly, here are some things that she could try (you’ll notice some things come up more than once):
History of thyroid cancer and now completely without a thyroid: with her other problems, she may not be converting T4 (in synthroid, what is usually prescribed) to T3 (the active thyroid hormone), sometimes lab tests can help but sometimes you just have to do a trial of the different forms (Armour thyroid, cytomel, or compounded thyroid hormones) and see where the patient feels the best.
For her MS: Estriol (one of the estrogens, this is the weakest estrogen and least inflammatory) ~6 mg daily (this is the estrogen that is most elevated in pregnancy which is one time women with MS have fewer symptoms, a trial of estriol showed reduced white matter lesions in women with MS on estriol) applied transmucosally (this avoids the first pass liver metabolism that gives more metabolites from taking pills); vitamin D, enough to get her blood levels up to 60 ng/ml (plenty of data showing a connection between low vitamin D and MS); low dose naltrexone 3-4.5 mg before bed (learn more about it from
this website); it’d be good to check her stomach acid production as it’s typically low in people with MS (I had a patient the other day who took nearly 2 hours to reacidify her stomach, normal should be under a half hour, so this means food isn’t getting digested).
Bone loss: she’s already taking calcium and magnesium, but extra magnesium may be warranted and the form of calcium certainly matters in someone who’s likely low in stomach acid (and another reason to check her stomach acid); enough vitamin D is essential for calcium metabolism so we’ll make sure she’s over 60 ng/ml;
estrogen can help keep her bones strong and we already have another indication for using estriol and progesterone can help to encourage growth of the bones while testosterone (bringing back up to normal levels only) is also important for keeping bones strong; weight bearing exercise; maybe some additional supplements to support her bones.
Iron deficiency anemia: she can’t tolerate regular iron (ferrous sulfate), so while some IV iron may get her levels up right away, she should take a more gentle iron like bis-glycinate or some other chelated iron and take it with vitamin C to increase absorption; also, resistant iron deficiency anemia is a red flag for gluten intolerance or helicobacter pylori infection, so those need to be ruled out.
Ehlers-dahnlos: this is a connective tissue disorder that is typically genetic, so without knowing what the genes in her situation are coding for (they code for enzymes and other proteins so knowing where the defect it you can sometimes get around it) I would at least recommend a decent amount of vitamin C since it is essential for collagen formation and making strong tissues.
Mast cell instability: quercetin is a bioflavanoid that stabilizes mast cells and may be more effective than the cromolyn that she’s taking now (see
this book).
Orthostatic hypotension: licorice can help retain sodium and may help her get her blood pressure up, though she may well have adrenal problems so a thorough evaluation of them would be warranted.
Autonomic dysfunction: once again, adrenal problems here, too, though this is a shoe-in for the environmental illness work-up below.
Hypoglycemia: small frequent meals is the mainstay of treatment here, but using more protein and fat can stabilize things a bit; sometimes food allergies can be an issue here.

More global solutions (we’re trying to find the root cause so she doesn’t need to be taking all this stuff) since when someone has all these problems there’s often something behind it:
More thorough allergy evaluation and repair of the gut may be warranted, perhaps she’s allergic to chicken and that’s whey she did so poorly.
Heavy metal testing: sometimes heavy metals can trigger all these weird symptoms, and remember that chicken is often loaded with arsenic.
Environmental illness: toxic mold (were there some water leakage problems in her house?) or some other environmental stressor can lead to this seemingly hopeless array of problems, so a work-up by
someone who knows about environmental medicine is warranted.
Yeast: sometimes candida can become systemic and cause lots of weird symptoms, but I don’t recall her having much of an antibiotic history so it depends on the history and presentation.
Other infectious cause: lyme disease can sometimes cause a host of strange problems, and conventional testing isn’t fantastic, so even a trial of therapy could be warranted.

So, perhaps this short list of possible approaches just off the top of my head (I’m away at a conference on integrative treatment of cancer right now so don’t have access to my references) will be helpful for people to understand how I approach things and perhaps they will help this person if she happens upon my website.