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Certainly! Here's your blog article  professionally formatted for web publishing—without any graphics, emojis, or bullet clutter. The layout is clean and ready for posting. Functional Medicine Approaches to Optimize Dopamine Dopamine is a powerful neurotransmitter that drives motivation, pleasure, attention, and movement. It plays a central role in our sense of reward and is implicated in conditions such as ADHD, depression, fatigue, and Parkinson’s disease. While conventional treatments often rely on medications that manipulate dopamine levels, functional medicine focuses on identifying and addressing the root causes of dopamine dysregulation through personalized, holistic strategies. Below are five evidence-informed functional medicine approaches to support optimal dopamine levels. 1. Nutrition to Fuel Dopamine Production Dopamine is synthesized from the amino acid tyrosine, which is abundant in protein-rich foods. Several nutritional cofactors are also required for efficient production and function of dopamine. Key nutrients include: Tyrosine:  Found in eggs, dairy, soy, turkey, fish, and legumes; also available as a supplement. Vitamin B6:  Required for the conversion of L-DOPA to dopamine. Folate and Vitamin B12:  Support methylation pathways critical for neurotransmitter synthesis. Iron and Zinc:  Cofactors for tyrosine hydroxylase, the enzyme that catalyzes dopamine synthesis. Vitamin C:  Assists in the conversion of dopamine to norepinephrine. Clinical evidence: Iron deficiency has been associated with reduced dopamine transporter function and worsening symptoms in conditions such as ADHD and restless legs syndrome (Youdim et al., 2004; Konofal et al., 2008). A 2014 randomized controlled trial demonstrated that iron supplementation improved symptoms in children with ADHD and low ferritin levels. Citation: Konofal, E., et al. (2014). Iron supplementation in children with attention deficit hyperactivity disorder and low ferritin levels: A randomized controlled trial. Archives of Medical Research , 45(8), 650–656. https://doi.org/10.1016/j.arcmed.2014.11.001 For a broader review on botanical and nutritional approaches, see:Dutta T. et al. (2022). Phytotherapy for attention deficit hyperactivity disorder (ADHD): A systematic review and meta-analysis. Frontiers in Pharmacology , 13, 827411. 2. Sleep Optimization: Regulating the Dopamine Clock Dopamine activity follows a circadian rhythm, peaking during the day to support alertness and falling at night to allow restful sleep. Chronic sleep deprivation can blunt dopamine receptor sensitivity and impair both mood and cognition. Functional strategies to support dopamine through sleep: Maintain consistent sleep-wake cycles. Limit screen exposure and blue light in the evening. Supplement as needed with melatonin, magnesium glycinate, or L-theanine. Increase exposure to natural daylight, particularly in the morning. Clinical evidence: Volkow et al. (2012) demonstrated that sleep deprivation reduces dopamine D2/D3 receptor availability in the striatum. A 2019 meta-analysis by Masi et al. showed that melatonin supplementation improves sleep onset and duration in children with ADHD, indirectly enhancing attention. Citations: Volkow, N. D., et al. (2012). Evidence that sleep deprivation downregulates dopamine D2R in ventral striatum in the human brain. Journal of Neuroscience , 32(19), 6711–6717. https://doi.org/10.1523/JNEUROSCI.0031-12.2012 Masi , G., et al. (2019). Melatonin for sleep disturbances in children with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Journal of Child and Adolescent Psychopharmacology , 29(6), 427–436. https://doi.org/10.1089/cap.2019.0012 3. Exercise: Movement as Dopaminergic Medicine Physical activity is one of the most accessible ways to boost dopamine levels and receptor sensitivity, especially in the prefrontal cortex—where attention, motivation, and impulse control are regulated. Recommended approaches: Engage in 30 to 45 minutes of aerobic exercise most days of the week. Include movement forms that are enjoyable or novel to activate the brain’s reward pathways. Clinical evidence: Aerobic exercise increases dopamine receptor availability and enhances cognitive control (Robertson et al., 2016). A 2015 randomized trial found that children who participated in 30 minutes of daily structured physical activity experienced significant improvements in attention and behavior. Citation: Hoza, B., et al. (2015). A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children. Journal of Abnormal Child Psychology , 43(4), 655–667. https://doi.org/10.1007/s10802-014-9929-y 4. Stress Management and Mind-Body Therapies Chronic stress can deplete dopamine, reduce receptor sensitivity, and raise cortisol levels—all of which disrupt dopamine's normal functioning in the brain. Functional stress-reduction practices include: Mindfulness meditation:  Shown to increase gray matter density in areas rich in dopamine receptors. Yoga and breathwork:  Support autonomic nervous system balance and lower cortisol. Cold exposure:  Brief cold showers have been shown to increase dopamine levels by up to 250%. Vagal stimulation and gratitude practices:  Improve parasympathetic tone and emotional regulation. Clinical evidence: A 2018 meta-analysis by Evans et al. found that mindfulness-based interventions significantly improved symptoms of inattention and impulsivity in ADHD. Shevchuk (2008) showed that cold exposure stimulates dopaminergic activity through hypothalamic activation. Citations: Evans, S., et al. (2018). Mindfulness-based interventions for youth with ADHD: A systematic review and meta-analysis. Journal of Attention Disorders , 22(9), 873–884. https://doi.org/10.1177/1087054717710767 Shevchuk , N. A. (2008). Adapted cold shower as a potential treatment for depression. Medical Hypotheses , 70(5), 995–1001. https://doi.org/10.1016/j.mehy.2007.04.052 5. Removing Dopamine Disruptors Functional medicine recognizes that healing requires not only adding supportive elements but also removing harmful ones. Several lifestyle and environmental factors can impair dopamine production and receptor function. Common dopamine disruptors: Chronic inflammation from food sensitivities (e.g., gluten, dairy). Heavy metals such as lead and mercury, which damage dopamine neurons. Overstimulation from social media, processed foods, or excessive screen time. Mold or biotoxins that impair the hypothalamic-pituitary-adrenal (HPA) axis. Functional medicine providers often utilize environmental medicine labs and detoxification protocols—such as sauna therapy, antioxidant support, or binders—to evaluate and address these disruptors when clinically indicated. Final Thoughts Dopamine is central to motivation, focus, mood, and resilience. Functional medicine offers a systems-based, individualized approach to dopamine optimization that goes beyond pharmaceuticals. By focusing on root causes and lifestyle interventions—nutrition, sleep, exercise, stress regulation, and environmental detox—this approach supports the body’s innate capacity to regulate neurotransmitters naturally. If you're experiencing low motivation, poor focus, or emotional instability, consider working with a functional or integrative practitioner to assess your dopamine pathways and personalize your care plan.

Here's a formatted version of your content as a professional, citation-rich blog article: Functional Medicine Approaches to ADHD: A Whole-Person Strategy Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental condition traditionally managed with stimulant medications. While these can be effective, functional medicine offers a complementary or alternative approach—aiming to identify and treat the root causes of ADHD symptoms through a personalized, systems-based lens. Functional medicine emphasizes nutrition, gut health, sleep hygiene, physical activity, stress management, and environmental detoxification as foundational interventions. This article explores evidence-based functional medicine strategies for ADHD, referencing clinical trials and systematic reviews where available. 1. Nutritional Interventions Elimination Diets and Food Sensitivities Food sensitivities and allergies may trigger neuroinflammation, contributing to hyperactivity and inattention. Elimination diets have shown promising results in identifying and removing problematic foods. A landmark randomized controlled trial known as the INCA study found that 64% of children following a restricted elimination diet experienced significant improvement in ADHD symptoms compared to controls. The diet removed potential allergens like dairy, wheat, and artificial additives. Citation : Pelsser, L. M., et al. (2011). The Lancet , 377(9764), 494–503. DOI: 10.1016/S0140-6736(10)62227-1 Nutrient Supplementation Several nutrients support neurological health and have been associated with symptom reduction in ADHD: Omega-3 Fatty Acids : A 2017 meta-analysis of 16 RCTs concluded that omega-3 supplementation (particularly EPA) significantly improved attention in children with ADHD. Citation : Chang, J. P., et al. (2017). Neuropsychopharmacology , 43(3), 534–545. DOI: 10.1038/npp.2017.160 Zinc, Magnesium, and Vitamin D : A 2016 review highlighted modest but meaningful improvements in ADHD symptoms with supplementation, particularly in individuals with documented deficiencies. Citation : Saul, A., et al. (2016). Current Psychiatry Reports , 18(12), 112. DOI: 10.1007/s11920-016-0748-2 Low-Sugar, Whole-Food Diets Whole-food, anti-inflammatory diets may protect against ADHD, while diets high in refined sugar and processed foods may worsen symptoms. A 2019 meta-analysis found that nutrient-poor, high-sugar diets increased ADHD risk, while Mediterranean-style diets had a protective effect. Citation : Del-Ponte, B., et al. (2019). Journal of Affective Disorders , 252, 160–173. DOI: 10.1016/j.jad.2019.04.061 2. Gut Health and the Gut-Brain Axis Emerging research highlights the microbiome’s influence on brain function and behavior, including neurotransmitter production and inflammation modulation. Probiotics and Microbiota Support A randomized trial found that early-life supplementation with Lactobacillus rhamnosus GG  reduced the risk of ADHD and other neurodevelopmental disorders. Citation : Pärtty, A., et al. (2020). Pediatric Research , 87(4), 677–683. DOI: 10.1038/s41390-019-0609-6 Gut Healing Protocols Functional approaches often involve identifying food intolerances and supporting gut barrier integrity using nutrients like L-glutamine and prebiotics. While direct trials in ADHD are limited, these strategies are increasingly used in integrative care settings. 3. Sleep Optimization Poor sleep exacerbates ADHD symptoms. Functional medicine promotes both behavioral and nutritional strategies for improving sleep. Melatonin for Sleep Regulation A 2019 meta-analysis found melatonin supplementation improved sleep onset and duration in children with ADHD, indirectly supporting better daytime behavior. Citation : Masi, G., et al. (2019). Journal of Child and Adolescent Psychopharmacology , 29(6), 427–436. DOI: 10.1089/cap.2019.0012 Functional interventions may include melatonin, blue-light reduction, consistent routines, and magnesium-rich foods. 4. Physical Activity and Exercise Exercise boosts dopamine and norepinephrine levels, improving attention and executive function. A 2015 RCT demonstrated that 30 minutes of aerobic exercise five days a week significantly improved attention and impulse control in children with ADHD. Citation : Hoza, B., et al. (2015). Journal of Abnormal Child Psychology , 43(4), 655–667. DOI: 10.1007/s10802-014-9929-y Functional medicine encourages consistent movement tailored to individual preference—whether running, martial arts, or dance. 5. Stress Reduction and Mind-Body Therapies Chronic stress and dysregulated cortisol may worsen ADHD symptoms. Mind-body techniques can help regulate arousal and support emotional control. A 2018 review found mindfulness-based interventions had moderate effects in reducing inattention and hyperactivity in children and adolescents. Citation : Evans, S., et al. (2018). Journal of Attention Disorders , 22(9), 873–884. DOI: 10.1177/1087054717710767 Yoga, breathwork, meditation, and cognitive behavioral strategies are frequently integrated into functional treatment plans. 6. Environmental Toxin Reduction Exposure to neurotoxicants like lead, mercury, and pesticides has been linked to ADHD, especially in genetically vulnerable individuals. A 2016 review connected environmental toxin exposure with increased ADHD risk, suggesting that reducing these exposures may improve outcomes. Citation : Nigg, J. T., et al. (2016). Journal of Child Psychology and Psychiatry , 57(3), 231–233. DOI: 10.1111/jcpp.12511 Practical strategies include using organic produce, filtered water, and minimizing plastics and household chemicals. 7. Personalized Testing and Biomarkers Functional practitioners often use lab testing to assess nutrient levels, metabolic markers, and genetics. One example is ferritin: Low iron stores are associated with worsened ADHD symptoms, and a 2014 RCT found symptom improvement with iron supplementation in children with low ferritin. Citation : Konofal, E., et al. (2014). Archives of Medical Research , 45(8), 650–656. DOI: 10.1016/j.arcmed.2014.11.001 Other commonly evaluated markers include vitamin D, methylation factors (like MTHFR), and heavy metal burden. Limitations and Clinical Considerations While several strategies (e.g., omega-3s, exercise, melatonin) are backed by solid evidence, others (like detoxification protocols or leaky gut interventions) need more robust clinical trials. Functional medicine emphasizes individualization. What works for one child may not work for another. These strategies are often best used alongside , not in place of, conventional treatments—especially when symptoms are severe. Conclusion Functional medicine offers a holistic framework for ADHD care that goes beyond symptom suppression. By targeting nutrition, gut health, sleep, physical activity, stress, and environmental triggers, functional interventions may complement traditional therapies and improve quality of life. A growing body of evidence supports this integrative approach, though personalization and professional guidance remain essential.

Serotonin vs. Dopamine: Understanding Two Powerful Brain Chemicals When it comes to mental health, motivation, and mood, two neurotransmitters stand out: serotonin  and dopamine . Though they often interact, their roles in the brain—and the body—are distinct. Serotonin Role : Promotes mood stability and overall well-being. Functions : Regulates mood, sleep cycles, appetite, digestion, and social behavior. Associated Issues : Low levels : Depression, anxiety, irritability. High levels : Risk of serotonin syndrome (especially with certain medications). Key Brain Regions : Prefrontal cortex, amygdala, hippocampus. Dopamine Role : Drives motivation, reward, and movement. Functions : Reinforces pleasure, attention, goal-seeking behavior, and fine motor control. Associated Issues : Low levels : Parkinson’s disease, attention-deficit/hyperactivity disorder (ADHD). High levels : Linked to addiction, schizophrenia, impulsivity. Key Brain Regions : Substantia nigra, ventral tegmental area (VTA), prefrontal cortex. Key Differences Mood vs. Drive : Serotonin fosters calm and satisfaction; dopamine energizes and activates. Physical Impact : Serotonin influences the gut and sleep, while dopamine controls movement and reward-seeking. Neurochemical Balance : Serotonin helps regulate impulsivity; dopamine boosts motivation. A healthy mind depends on a delicate balance between the two. Can Serotonin/Norepinephrine modulation help with ADHD? Duloxetine and venlafaxine can be administered to treat symptoms of ADHD while being well tolerated. It seems that duloxetine is more potent in reducing ADHD symptoms. It can also be concluded that venlafaxine is more effective in females, and is more effective on inattentive symptoms of ADHD rather than hyperactive symptoms. Dezfouli RA, Hosseinpour A, Ketabforoush S, Daneshzad E. Efficacy, safety, and tolerability of serotonin-norepinephrine reuptake inhibitors in controlling ADHD symptoms: a systematic review and meta-analysis. Middle East Current Psychiatry. 2024 Jan 31;31(1):8. Dopamine vs. Endorphins: Motivation Meets Euphoria Our brains run on complex chemistry, and two of the most influential molecules behind how we feel and act are dopamine  and endorphins . Though both are tied to pleasure and well-being, their roles, triggers, and effects differ significantly. Dopamine Role : A neurotransmitter that powers motivation, reward, and movement. Core Functions : Fuels pleasure, motivation, and goal-directed behavior. Regulates movement through the basal ganglia. Enhances focus, learning, and anticipation of rewards. Key Effects : Produces short bursts of pleasure when we pursue or achieve something meaningful—whether it’s food, praise, or accomplishment. Associated Issues : Low levels : Parkinson’s disease, ADHD, anhedonia (inability to feel pleasure). High levels : Linked to schizophrenia, risk-taking behavior, and addiction. Primary Brain Regions : Substantia nigra, ventral tegmental area (VTA), and prefrontal cortex. Endorphins Role : Natural opioids—neuropeptides that ease pain and boost mood. Core Functions : Reduce pain and stress, often creating a euphoric state (the classic “runner’s high”). Promote feelings of relaxation and well-being. Support stress regulation and modulate immune response. Key Effects : Released during exercise, laughter, sex, or pain, helping the body cope with stress and discomfort. Associated Issues : Dysregulation isn’t fully understood, but low levels  may worsen mood disorders or pain sensitivity. Primary Action Sites : Throughout the brain and body, especially in pathways regulating pain and stress. Key Differences Between Dopamine and Endorphins Aspect Dopamine Endorphins Function Drives motivation and reward anticipation Acts as a natural painkiller and mood stabilizer Trigger Released in response to rewards or goal achievement Triggered by pain, stress, or physical activity Effect Duration Short bursts tied to goal-oriented behavior Longer-lasting calming or euphoric effects Pleasure Type Energizing and motivating Soothing and relieving

Part II: ADHD and Dopamine/Norepinephrine modulation - Ritalin and Wellbutrin Ritalin  and Wellbutrin —two medications that affect brain chemicals like dopamine  and norepinephrine , but in very different ways. 🧠 How They Work Ritalin Wellbutrin Type Stimulant Antidepressant (NDRI) Dopamine Boost Strong Moderate Norepinephrine Boost Moderate Moderate Onset Fast (30–60 min) Slow (1–2 weeks) Serotonin None Minimal What They're Used For Ritalin  is FDA-approved for ADHD  and works quickly to improve attention and reduce impulsivity. Wellbutrin  is approved for depression  and smoking cessation , and used off-label for ADHD , especially with coexisting low mood. Pros and Cons Ritalin Pros: ✅ Fast, potent focus aid✅ Proven ADHD treatment Ritalin Cons: ❌ May cause insomnia, anxiety, appetite loss❌ Controlled substance Wellbutrin Pros: ✅ Non-stimulant, less abuse risk✅ Helps with energy, mood, and smoking cessation Wellbutrin Cons: ❌ Slower onset❌ Can worsen anxiety or raise seizure risk Which Should You Choose? Need quick, strong ADHD relief ? → Ritalin Battling focus + depression/fatigue ? → Wellbutrin Concerned about stimulants or addiction risk ? → Wellbutrin Bottom Line Ritalin  is best for classic ADHD symptoms. Wellbutrin  is great when low motivation, mood, or energy are also in the mix. Reasearch: Can Wellbutrin (bupropion) treat ADHD as well as Ritalin (methylphenidate)? Results A total of 146 subjects in four RCTs comparing bupropion with methylphenidate in the treatment of ADHD were included. The pooled mean changed scores of the Iowa–Conner’s Abbreviated Parent and Teacher Questionnaires and the ADHD Rating Scale‐IV for parents and teachers of children and adolescents with ADHD in the bupropion‐ and methylphenidate‐treated groups were not significantly different. Additionally, the pooled mean changed score in adult ADHD between the two groups, measured by the ADHD Rating Scale‐IV and the Adult ADHD Rating Scale, was also not significantly different. The pooled rates of response, overall discontinuation, and discontinuation due to adverse events between the two groups were not significantly different. Maneeton N, Maneeton B, Intaprasert S, Woottiluk P. A systematic review of randomized controlled trials of bupropion versus methylphenidate in the treatment of attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment. 2014 Aug 1:1439-49.

PART 1 - RITALIN & DOPAMINE/NOREPINEPHRINE How Ritalin Boosts Dopamine to Help Manage ADHD: Understanding Root Causes May Allow Functional Medicine to Explore Alternative Ritalin by focusing on Dopamine Norepinephrine: Ritalin (methylphenidate) is one of the most widely prescribed medications for attention deficit hyperactivity disorder (ADHD). While it’s often associated with improving focus and reducing hyperactivity, the key to how it works lies in its effect on a powerful brain chemical: dopamine . Dopamine plays a central role in attention, motivation, impulse control, and reward processing. Research shows that individuals with ADHD often have dysregulated dopamine activity, especially in brain regions responsible for executive functioning. Ritalin helps correct that imbalance. How Ritalin Works: Dopamine in Action Blocks Dopamine Reuptake - Ritalin attaches to dopamine (and norepinephrine) transporters in the brain, blocking their reabsorption into neurons. This causes dopamine to remain longer in the synaptic cleft—the space between brain cells—enhancing its activity. The prefrontal cortex and striatum, both crucial for focus and self-regulation, are particularly affected. Increases Dopamine Release - Ritalin also promotes the release of dopamine from neurons, further increasing its availability. This dual action provides a stronger and more sustained dopamine signal, helping the brain filter distractions and stay on task. Improves Brain Function in ADHD By increasing dopamine and norepinephrine, Ritalin strengthens the connections between neurons involved in planning, attention, and impulse control. In people with ADHD, this leads to better focus, reduced impulsivity, and improved emotional regulation. What to Expect: Timing and Effects Onset : For immediate-release formulations, effects typically begin within 30 to 60 minutes. Duration : The benefits usually last 3 to 6 hours for short-acting Ritalin and up to 12 hours for extended-release versions (like Concerta). Metabolism : Ritalin is broken down in the liver and excreted through the urine. Potential Side Effects While many find Ritalin effective, it's not without risks. Common side effects include: Insomnia Reduced appetite Increased heart rate or blood pressure Anxiety or restlessness Because of its stimulant properties and potential for misuse, Ritalin is classified as a Schedule II controlled substance  in the U.S. Ritalin Is a Tool—Not a Cure Ritalin doesn’t cure ADHD—it helps manage the symptoms by supporting the brain’s natural chemistry. Its effectiveness can vary between individuals and is often optimized when paired with behavioral therapy, coaching, or lifestyle interventions. Part II will explore further dopamine/norepinephrine hypothesis Part III will explore serotonin and endorphine Part IV Functional Medicine and ADHD In summary, understanding the root causes of how Ritalin (methylphenidate) works may allow functional medicine to explore alternative by focusing on Dopamine/Norepinephrine modulation. Part II will explore ADHD and dopamine/norepinephrine modulation by comparing Ritalin (methylphenidate) to Wellbutrin (bupropion)

A novel combination of drugs—an immune checkpoint inhibitor and the anti-parasitic medication ivermectin —has shown powerful results in preclinical research against triple-negative breast cancer, according to a City of Hope study published in npj Breast Cancer . Triple-negative breast cancer is notoriously hard to treat because it lacks three key proteins (estrogen, progesterone, and HER2 receptors) that are typically targeted by existing therapies. But researchers, led by Dr. Peter P. Lee, discovered that combining anti-PD1 monoclonal antibodies with ivermectin dramatically improved outcomes. Here’s how it works: Ivermectin turns "cold tumors" (lacking immune cells) into "hot tumors" by triggering immunogenic cell death , which attracts cancer-fighting T cells. Once tumors are "hot," checkpoint inhibitors (anti-PD1) can effectively activate the immune system to destroy the cancer. Individually, these drugs had little effect—but together, they had a powerful, synergistic  impact. In animal models, 40–60% of treated subjects completely eradicated their tumors and  resisted reintroduction of the cancer. “This is the first time we can show that by adding an inexpensive, existing drug, we can make breast cancer treatable with immune checkpoint therapy,” said Dr. Lee. “It’s the combination that’s the magic.” Why this matters: Anti-PD1 therapies can cost ~$15,000 per dose. Ivermectin? About $30 per dose. Both drugs are already FDA-approved and have established safety profiles. The research also found the combo worked in a wide range of scenarios: before and after tumor surgery, and even against metastatic cancer. Next step: Testing optimal dosing in preparation for a first-in-human clinical trial.

How Can Integrative and Functional Medicine Help Solve Complex Conditions? Integrative and functional medicine are uniquely suited to addressing complex medical conditions. Integrative medicine considers the full spectrum of a person's well-being—mind, body, emotions, and spirit—acknowledging how each aspect contributes to overall health. Functional medicine complements this by expanding the investigative scope, allowing for a deeper understanding of the root causes of illness. Take a seemingly straightforward thyroid condition, for example. What appears simple may actually be quite complex. Functional medicine enables a comprehensive evaluation by utilizing advanced diagnostic tools and extensive lab testing. This includes not only TSH, but also free T3, free T4, reverse T3, anti-thyroglobulin antibodies, and thyroid peroxidase antibodies—just to name a few. There are numerous other tests available to provide a more complete picture. The strength of this approach lies in its ability to both zoom out—viewing the body as a whole system through an integrative lens—and zoom in—using functional tools to explore specific biochemical imbalances at a microscopic level. This dual perspective allows practitioners to uncover underlying causes that might otherwise go undetected, offering truly personalized and effective care.

For those exploring integrative oncology options: Most major centers—such as MD Anderson, Memorial Sloan Kettering (MSK), and City of Hope—offer services under the Society for Integrative Oncology (SIO) framework. In my opinion, SIO can be somewhat dated and conservative in its approach. For our integrative oncology patients, I often recommend a metabolic approach to cancer —specifically therapeutic ketosis—combined with low-dose naltrexone (LDN) . I encourage you to look into the work of Berkson  on this topic (search: "Berkson + LDN + Cancer"). This combination has yielded the most consistent clinical benefits in my practice, particularly for symptom management and quality of life during active treatment or in advanced disease stages. The original Berkson protocol also incorporates IV alpha-lipoic acid. Another helpful resource is Jane McLelland’s book , which outlines the Care Oncology Clinic protocol  using generic medications. While I have not adopted that specific protocol at this time, I do see its value. In fact, a recent patient of mine chose the Care Oncology route and declined the ketogenic approach; unfortunately, they later developed brain metastases. While anecdotal (n=1), it highlighted for me the potential neuroprotective advantages of ketosis. Instead of pharmaceutical protocols, my practice focuses on matching medicinal mushrooms to cancer types , alongside an acupuncture protocol  developed by a late Korean master. This protocol addresses energy balance, physical discomfort, and emotional well-being. Herbal support is customized based on each patient’s symptoms. Most importantly, I always recommend patients read Bernie Siegel, MD’s work , especially Love, Medicine and Miracles , and begin cultivating a mindset of becoming an “exceptional cancer patient.” Mental health and resilience are vital—working with a therapist or counselor can be transformative. During my time at the University of Kansas Integrative Medicine program , I participated in research on high-dose intravenous vitamin C. While it was found to be safe and supportive of quality of life, it did not improve survival outcomes. Currently, I lead the Integrative Oncology program at the Memorial Institute of Health & Healing in Carthage, IL , where we accept most insurance plans, including Medicare and Illinois Medicaid. Learn more here: Memorial Institute of Health & Healing . I also have a telemedicine private practice  serving Texas, Florida, and Georgia for those who cannot travel to Illinois. For those located elsewhere: California : I highly recommend Dr. Myrto Ashe  for a functional medicine approach and Dr. Donald Abrams (UCSF)  for a more conservative integrative oncology perspective. New York City : MSK is a strong starting point. Advanced cancer patients : I urge you to consider a second opinion at MD Anderson (Houston, TX) . They tend to take the most aggressive approach, and I’ve seen them help patients outlive prognoses after other institutions had given up. Finally, I encourage all patients to explore clinical trials  and empower themselves with knowledge. As Bernie Siegel emphasized, the empowered patient often becomes the exceptional one. Yoon Hang Kim MD MPH www.directintegrativecare.com www.yoonhangkim.com

I recently saw a patient with neuropathy of the feet unable to walk barefoot without pain. Patient came seeking relief from the pain. After using anti-inflammatory protocol, patient feels pain has improved more than 60%. Patient is now able to walk barefoot without pain. Patient also was able to lower medication Lyrica from 75 mg BID to 50 mg BID. Functional medicine offers a personalized and holistic approach to neuropathy by focusing on identifying and addressing the root causes of the condition rather than just treating the symptoms. Neuropathy, which refers to nerve damage that can lead to pain, numbness, tingling, or weakness, may result from a variety of underlying issues such as diabetes, autoimmune diseases, infections, toxin exposure, or nutritional deficiencies. Here’s how functional medicine may approach the treatment of neuropathy: Root Cause Analysis The first step is to identify the underlying cause(s) of the neuropathy, which may include: Diabetes Inflammation Toxin Exposure Nutritional deficiencies Personalized Diet and Nutrition Anti-inflammatory diet Specific nutrient supplementation: Based on testing, supplements like alpha-lipoic acid, B vitamins, acetyl-L-carnitine, curcumin, and omega-3 fatty acids may be recommended to support nerve repair and function. Gut health optimization: Since the gut plays a key role in inflammation and nutrient absorption, gut health is often a focus. This may involve addressing dysbiosis, leaky gut, or food sensitivities Integrative Therapies Acupuncture: Can help reduce pain and improve nerve function. By focusing on the individual’s unique biology and addressing all possible underlying causes, functional medicine aims to not only alleviate neuropathy symptoms but also restore optimal nerve function and overall health.

I recently saw a type 2 diabetes patient who has been treated with conventional medical approach. In conventional medicine, management of diabetes often relies on medications like Metformin.  While initial treatments can be successful, most people require higher dose and eventually other medication(s).    Patient wanted a functional medicine approach or root cause treatment approach to reverse diabetes.  Because root cause of type 2 diabetes often involves elevated blood sugars as a natural consequence of underlying metabolic dysfunction, patient was given a specific diet aimed at reversing the metabolic dysfunction.   In one month, patient lost about 10 pounds of weight –also a contributor to metabolic dysfunction – and resulted in reduced Hemoglobin A1c level by 10 to 8.  More significantly, patient’s fasting blood sugar has dropped to 90’s which is normal level.   Because Hemoglobin A1 level reflects long-term blood sugar levels, further improvements in Hemoglobin A1c is very likely.   I feel grateful to see these improvements through services performed through Memorial Institute of Health & Healing at Memorial Hospital, Carthage, IL.  I am looking forward to continuing to support the patient and observing the improvements – which hopefully could include reversing his type II diabetes.

What is Celiac Disease? Celiac disease is an autoimmune disorder triggered by the ingestion of gluten , a protein found in wheat, barley, and rye. The pathogenesis of celiac disease involves both genetic and environmental factors. Individuals with specific genetic markers, such as HLA-DQ2 and HLA-DQ8, are predisposed to developing the disease. When these individuals consume gluten, their immune system mounts an abnormal response. Gluten fragments, particularly gliadin , are modified by the enzyme tissue transglutaminase (tTG) in the small intestine. This modified gliadin is then presented by antigen-presenting cells to CD4+ T cells, triggering an inflammatory immune response. The resulting inflammation damages the intestinal villi, leading to malabsorption, nutrient deficiencies, and gastrointestinal symptoms. In addition to the immune response, other factors such as changes in the gut microbiome and increased intestinal permeability (often referred to as "leaky gut") contribute to the pathogenesis of celiac disease. In some cases, environmental triggers like infections may also influence the onset of the disease. Over time, the chronic inflammation caused by repeated gluten exposure can lead to more severe complications, including an increased risk for certain cancers and other autoimmune disorders. The only effective treatment for celiac disease is a strict, lifelong gluten-free diet, which helps prevent further immune activation and allows the intestinal lining to heal. What is Gluten Sensitivity? Gluten sensitivity, also known as non-celiac gluten sensitivity (NCGS), is a condition in which individuals experience symptoms related to gluten consumption, despite not having celiac disease or a wheat allergy. People with NCGS may experience gastrointestinal symptoms such as bloating, diarrhea, and abdominal pain, as well as extra-intestinal symptoms like headaches, fatigue, joint pain, and brain fog. Unlike celiac disease, gluten sensitivity does not involve an autoimmune response or damage to the intestinal lining. The exact mechanism of NCGS is not well understood. Diagnosis is typically made after ruling out celiac disease and wheat allergy, and symptoms usually improve on a gluten-free diet, although some may tolerate small amounts of gluten. How to test for this? Functional medicine offers many tools that can help to explore GI function, intestinal permeability, as well as IgE, IgG, IgG4, and complement reaction.

I recently saw a patient who came to me with hives. A functional medicine approach to treating hives (also known as urticaria) aims to address the root cause of the condition rather than merely managing symptoms. Functional medicine considers a variety of factors including diet, lifestyle, environment, and underlying health conditions that could be contributing to the hives. 1. Identifying Triggers and Root Causes Functional medicine looks for what might be driving the hives, such as: Food Sensitivities: I usually perform a food allergy test to include IgE (food allergy) and IgG, IgG4, and complement. Allergies: Because environmental allergens (dust, pollen, mold, pet dander) may trigger hives, I usually recommend patients to consider respiratory allergy tests. Gut Health Imbalance: Because conditions like leaky gut or dysbiosis (imbalance of gut bacteria) can result in food particle (molecules) to cross over, it can trigger hives. Chronic Infections: Underlying infections (such as candida, H. pylori, or viral infections) can sometimes provoke an immune response resulting in hives. Toxin Exposure: Chemicals, heavy metals, or other environmental toxins might play a role in immune dysregulation. Stress and Hormonal Imbalances: Stress or conditions like adrenal fatigue, thyroid issues, or hormonal fluctuations can trigger hives. 2. Testing and Diagnostics For this patient, below tests were chosen to start with: Comprehensive Stool Testing to check gut health Food Allergen test 3. Dietary Interventions Elimination Diet: Removing common allergens and inflammatory foods like gluten, dairy, soy, and sugar, then gradually reintroducing them to identify any triggers. Anti-inflammatory Diet - low carbohydrate diet promoting ketosis consistent with Duke Keto Diet developed by Eric Westman MD at Duke University Results: complete resolution of hives on keto diet and elimination diet based on food allergy list