How I work
My Approach to Restoring Homeostasis
No matter what your health goals are, your gastrointestinal terrain must be re-balanced since every nutrient—with the exception of oxygen—must pass through the intestinal tract. GI health can be compromised via several mechanisms—overuse of antibiotics, over consumption of traditional meats(filled with antibiotics), chronic stress, adrenal fatigue(leading to an imbalance between cortisol and DHEA, which causes decreased sIgA), chronic NSAID use, the use of prednisone and/or hydrocortisone, food sensitivities, mold and/or lyme biotoxins(these lead to decreased alpha-MSH, a hormone that is important in maintaining the health of your mucous membranes. Randomly taking probiotics may create more of an imbalance instead of leading to a healing environment. A comprehensive GI test will show the ratios of Lactobacillus and Bifidobacteria, the levels of the “bad bugs”, parasites, yeast, pancreatic elastase levels, pH, bile acid levels, short-chain fatty acid levels, as well as what medications and supplements the bad bugs are sensitive and resistant to. This is important, since taking a supplement or a medication that an organism is resistant to will only further strengthen its’ resilience. The comprehensive GI Effects Profile from Metametrix will give all of the previously mentioned information and allow you to “fine tune” your health program. Therefore, regardless of what is ailing you, digestive health must be addressed first; however, gut health may not be 100% restored before you move on. This is due to the fact that some SNPs(single nucleotide polymorphisms) affect the health of the GI tract. MTHFR, in particular, will lead to decreased glutathione production, a molecule that’s crucial to the health of the GI epithelial lining.
Depending on a person’s current level of health, I may begin by focusing solely on the GI tract. This is particularly important is someone is only having a bowel movement every few days. One principle that I believe is important for everyone to understand is this: you want to move toxins OUT, not AROUND! Many people that do cleanses, chelation, etc., end up driving toxins deeper into tissues or moving them to a different tissue. This is why I’m not a fan of “provocation heavy metal testing”. If you have one of the MTHFR SNPs, I’m positive that you have heavy metals. If you are tested before your detox pathways are open, you run the risk of creating a “flare-up” of the person’s symptoms, as well as stirring up yeast, viruses, etc. In addition, many toxic metals live in synergy with microbes. According to Dr. Amy Yasko, mercury enjoys co-habitation with viruses and aluminum likes to “cuddle with” bacterial infections. Thus, much of a person’s heavy metal burden does not show up on even provocation testing. It’s only after the microbes are addressed, that the last remaining bit of toxic metals will begin to exit the body. This is why one of the classic signs of both heavy metal toxicity and a high viral load is to see increased BUN and/or creatinine on someone’s lab results. It is usually necessary to provide some supplemental form of kidney support when addressing viruses and bacterial infections, since a large amount of heavy metals will be leaving via the kidneys.
As you probably gathered from above, I’m not a big fan of chelation. The only case where I see it to be useful is when cardiac/coronary issues are involved. Even then, it’s important to ensure at least a basic level of GI health is achieved, along with balancing phase I and phase II detoxification in the liver. After I’m satisfied with that person’s current level of GI health, I help to guide them on how to lower their inflammatory burden. There are numerous ways to achieve this, but I typically recommend eliminating dairy and/or gluten as much as possible. In addition, I recommend either transdermal Curcumin or an oral form of Bosweilla. There are many compounds that I have used, so the previously mentioned are only two of a large group of anti-inflammatory compounds. I’m a fan of transdermal supplements, especially at this stage of healing, as it prevents from adding any additional stressors to the liver and GI tract. Not controlling inflammation is a very common mistake and leads to an increase in symptoms when beginning to open detox pathways. There is an inverse relationship between the level of inflammation and how well methylation pathways are working—the more inflammation present, the more inefficient methylation will be. Because the methylation pathways are a disposal route for heavy metals and several environmental compounds, opening these pathways leads to a temporary increase in inflammation. Think of it this way—if you injured your knee and it was swollen, you would likely ice and elevate it since controlling inflammation is the FIRST step to healing. YOU CANNOT HEAL IN AN INFLAMMED ENVIRONMENT! Keep this in mind, as I see many people, including myself at times, forgetting the basics while addressing complicated biochemistry. To summarize, I begin by addressing GI health, followed by lowering that person’s inflammatory load. Then, depending on what information/data is available, I typically move onto addressing the major SNPs that are tested via Dr. Amy Yasko’s test. However, I must also take into consideration that individual’s financial situation, past history, current goals, etc. Everyone truly is unique. In an ideal world, I would run many, many tests and have tons of data on that person. This is not practical, especially considering the current economic situation that we find ourselves in.
Because I have learned from so many practitioners, I do not always follow the exact steps that Dr. Yasko recommends. I typically follow roughly 90-95% of them, but not all. In addition, I don’t use as many supplements or as much testing—I haven’t found anyone yet who could afford that amount of testing, although it would be great data to have!! When you factor in the specialty food items that most of us need/desire, expenses can add up rather quickly. As demand grows, hopefully prices will decrease so that healthy options are available for all. Some tests that I do not prioritize are—hair tests, provocation heavy metal tests, and OATs test. With the OATs test, it’s not that I don’t think it’s important, but more that I would rather have someone allocate their funds toward the GI Effects Profile from Metametrix. Since an OATs test gives information regarding some GI issues, that portion of the OATs is no longer needed if an individual can purchase the GI panel. The other portions of the OATS—Kreb Cycle intermediates—I don’t need to see in the beginning because if someone has MTHFR, CoQ10 and carnitine will usually be low by default. This test can be important to gather information regarding mitochondrial health later on, after the GI system is working more efficiently. As discussed previously, I’m not a huge fan of provocation heavy metal testing because I’ve seen it cause an increase in symptoms in many people, likely due to a combination of yeast and viral aggravation and the re-location of toxic metals to other tissues. I don’t prioritize hair analysis because the metals that you need to be concerned with are the ones that don’t show up on the hair test—the fat-soluble metals that are not excreted through the hair. For example, the first haircuts of kids on the Autism spectrum actually show LESS heavy metals than neuro-typical kids. This is secondary to a decreased detoxification capability of these kids. Please note that this is not saying that practitioners who use the tests that I typically choose not to do not know what they are doing—they may have knowledge that I simply have yet to acquire. I often say that the answers that I give today will be very different six months from now as I continue to learn and evolve. This is the sign of a good practitioner in my opinion.
Depending on the individual’s age and other factors, having information regarding that person’s hormonal levels, a basic metabolic panel, and some other select information can be important and/or necessary. For example, when it comes to immune system health, it’s possible—and even likely—that while certain aspects of the immune system are under-active, other parts are quite over-active. Therefore, it’s more about BALANCING the immune system than it is stimulating the immune system. If someone has a positive ANA, or thyroid antibodies, it’s important to take this into consideration as increasing activity in that part of the immune system can create many side effects. While thyroid issues, particularly hypothyroidism, can lower immune activity, I typically find it necessary to address immune health before hormonal health(however, every person is very different!). Increased cytokines from the immune system have been shown through rigorous research to activate the HPA(hypothalamus-pituitary-adrenal) axis, leading a state of sympathetic dominance, also known as the fight-or-flight mode. The HPA controls the release of cortisol, as well as many of the sex hormones. Since your body CANNOT live without cortisol(you’ll die within a couple of hours), your body prioritizes the stress hormones, especially cortisol—a physiological hierarchy of needs, much like Maslow’s Hierarchy of Needs in psychology. From a practical standpoint, this means that the body will sacrifice the sex hormones in an effort to create more cortisol. Pregnenolone, the “mother hormone”, is a precursor to both cortisol and the sex hormones. Your body will preferentially steal this molecule to make cortisol—leading to a lower level of sex hormones. Therefore, “adrenal fatigue” may show up first as a decreased level of sex hormones. In the short-term, you may not notice this effect. However, the adrenal glands eventually “burn out”, leading to lower than needed cortisol levels. Even though many people refer to this axis as the HPA, it is more correctly labeled the HPAT, with the T standing for the thyroid gland. When lower than necessary cortisol levels are present, thyroid health is affected. This is why it’s so important to look at the body as an inter-connected unit, instead of individual parts. If someone with lowered adrenal output is given supplemental(prescription) thyroid, they typically develop a lot of side effects, such as heart arrthymias, nervousness, etc. This is because the adrenals are only being further stressed by the additional thyroid—they simply cannot keep up with the increased metabolic activity.
In these situations, I find it’s important to take a step back and address the adrenals. The adrenals are a very misunderstood system in that many people tend to take adaptogenic herbs, supplemental hydrocortisone, etc., without ever finding the source of stress to the adrenals. Adrenal stressors come in many, many forms: gut infections, blood sugar imbalances, systemic viral or Candida infections, poor quality diet, lack of sleep, emotional or psychological stress, lack of downtime, toxicity, etc. Therefore, the take home message is that THE ADRENALS SIMPLY DO WHAT THEY ARE TOLD BY THE BRAIN. It’s fine to provide adrenal supplements in the short term, the long term goal should ideally be to find all of the physiological and psychological stressors—easier said than done! While the physiological stressors may be possible to eliminate, the psychological stressors need to be eliminated when possible, and otherwise reduced to the lowest level possible. Optimizing magnesium levels and balancing the calming neurotransmitters can help tremendously in lowering psychological and emotional stressors. This is quite a different approach than many practitioners, who only want to add supplement after supplement. This is not integrative/functional medicine/health—it is simply an allopathic approach using supplements instead of medicines. Many times several different supplements are necessary in the short term(and possibly in the long term, depending on the situation); however, the goal should always be to get to the root cause and reduce the amount of supplementation to a minimum.
Because the MTHFR SNP is closely tied into the HPA via several mechanisms, addressing one’s MTHFR issues can definitely affects hormone levels. One mechanism by which this occurs is that inflammation is partly controlled through the methylation pathway. This means that less cortisol may need to be produced, since one of the many jobs of cortisol is to control inflammation. In addition, both serotonin and dopamine are made through the methylation pathway. Research has shown that the pituitary needs serotonin and dopamine in order to “release” the right signals. This is yet another example of how interconnected the human body is—brain chemicals can influence hormone production! One additional way that methylation can influence hormone production is through its’ production of glutathione. Glutathione, known as the “master anti-oxidant”, has numerous effects throughout the body—detoxification of heavy metals and environmental chemicals, controlling oxidative stress, as well as boosting/modulating immune function. Because significant oxidative stress/inflammation can activate the HPAT axis, having glutathione around lessens the burden on the adrenals by lowering the need for cortisol. Lastly(but not least!), T-cells are made/activated in the methylation pathway. If a person has a decreased T-cell count, they will accumulate a high viral load, as well as several other types of infections. This puts a significant strain on the adrenals, as a large amount of inflammation is created from the infections. By addressing MTHFR, T-cell counts should be normalized/optimized, leading to decreased infectious agents–one less stressor for your adrenals to handle.
I hope that you enjoy reading this document as much as I enjoyed writing it. I hope that you appreciate that it is the compilation of approximately 12 years of combined knowledge from many different doctors/practitioners, research articles, content experts, internships, courses, and many other modes of learning. I have attempted to take from each expert what I found to be the most useful and combine it into what I hope is a very practical, safe and effective approach in coaching you back to health. When I began this journey, each doctor or practitioner that I saw, addressed a very small piece of the healing puzzle. I like to think, however, that he/she did the best that they could armed with the knowledge that they possessed at that moment—exactly what I aim to do when working with someone. I urge everyone to get to what I call the “great equalizers” of your health—those things that should supercede everything else when attempting to achieve wellness. For example, everyone that I saw when I began this journey 12 years ago said I had Candida. And they were right. Then, everyone said that I had heavy metals—they were also right. The next health “issue du jour” was adrenal fatigue. I had that too. This was followed by viral infections(check), gut dysbiosis(check), omega-3 fatty acid deficiency(check), environmental toxicity(check), sub-clinical hypothyroidism(check), malabsorption(check), Vitamin D3 deficiency(check), methylation issues(check), sex-hormone imbalance(check), lyme(check), as well as a tad of mold toxicity(check). All of these people were right—and wrong. While I did have all of the previously listed issues, most of the practitioners never stopped to ask the following—“What can I do to make EVERYTHING ELSE work better?” I spent nearly $30,000 on yeast eradication alone. You won’t get rid of yeast until the heavy metals are gone. You won’t get rid of heavy metals until methylation is optimized and microbial infections are targeted. And you won’t completely get rid of infections until the immune system is balanced. And you cannot optimize the immune system until MTHFR is addressed. In addition, optimal immune function won’t be achievable until certain infections, such as lyme are handled. My goal with listing all of the above maladies is to illustrate just how inter-connected the human body is and to emphasize the importance of creating a hierarchal approach to restoring health—certain issues will take precedence over others. This will save tremendous time, money and a ton of frustration on everyone’s part. Many people write to me asking if they would benefit from X amount of Nutrient A, B, C, etc. The answer is likely yes. But start by optimizing the big “health rocks”, such as digestion, MTHFR, and the immune system. Picture your health as an open jar. To achieve wellness, I think that it’s crucial to begin with the previously mentioned “big rocks”. As the saying goes, “don’t major in minor things”. Many practitioners—both allopathic and integrative/functional—are quick to jump on the latest health bandwagon. They then label everyone as having that issue and create a sense of worry and urgency within that individual. The program to address said issue may indeed fix it, only to find it return over and over again. This should be a red flag to look elsewhere for the answers. As holistic health expert Paul Chek pointed out, we have created a nation that can land on the moon, analyze DNA, yet are unable to do basic functions—have a daily bowel movement, consume adequate water, prioritize sleep and health, decrease consumption of chemically-laden food, etc. I think that many things regarding health will fall in line once people learn to prioritize certain aspects of their healing—MTHFR(and, of course, the other SNPs), digestive health, infectious agents, and, when needed, hormone levels. Many of the other issues that we obsess over tend to resolve when these are optimized(again, there are exceptions, but this applies to the majority).
Dr. Tim Jackson, DPT