Center for Integrative Medicine

[DJ]

Hi All, Has anyone visited an integrative medicine practice? What kind of advice do they provide? I very much want to continue on the path of healing and I'm wondering if an investment in care not covered by insurance will yield more than I've already learned on this site. Any thoughts? Thanks. DJ

[Gabes-Apg]

DJ
I have been quite blessed
A) my best friend is a naturopath
B) australia is very pro-active towards wholistic/functional/integrative medicine practitioners..

Like all things, they are not the same, not all are good.
Like the doctor /Gi specialist situation, if they have not treated other MC patients, their knowledge will be limited.
MC is not like other IBD's. Many will try to apply a 'stock standard' IBD protocol. Probiotics, is generally one of these. And as we know from the experience here, many Mc'ers do not tolerate probiotics.

The hard part is that you have to educate them about MC. And it's querky indivdualities. Once you get over that barrier then there can well be some benefits.

A nutritionist that I was seeing, was really good, we collaborated more so than her advising, discussions and know,edge shared here on the forum has been of great interest to her. And my approach of slow and gradual introduction of foods and supps has worked well for some of other clients that we're having issues.

My advice, don't be railroaded by them.... They have to work with you and your individual needs.
The other aspect, have realistic expectations, like our eating plan, there is a bit of trial and error, hiccups and most of all it will take time.... There is no quick fix.

[DJ]

Thanks Gabes, I'm just wondering if the experience will yield anything. The first visit is $650 and the next ones are about $250 per visit. This doesn't include the very expensive supplements they sell or the tests they will order. The only thing insurance will cover is traditional/standard tests so, I'm looking at about $2,000 out-of-pocket. It would be worth 2K to improve my health but it would be a bummer if I end up educating them and paying 2K on top of it!

[Gabes-Apg]

Mmmm that is expensive...

There are some cheaper options out there. The livewello web site has list of practitioners, some do Skype consultations so you don't have to necessarily use someone local. And some are covered by insurance.

It is free to join the livewello site and access the list.

Most of practitioners I have seen are more than happy for me to source my own supplements.
Actually, one of them told me about iHerb site, which for me has saved me 40-50 per month....

I wouldn't outlay more than $350 for initial appointment. I have seen some on livewello that are about $250.

[Grace]

Hi DJ,

I'm new to this forum. Glad I found it! Have already read Wayne's book!

I thought I'd share with you my experience with integrative healthcare. In May 2007, I was diagnosed with Celiac Disease. I began to follow a strict GF diet as soon as an endoscopy confirmed the disease. At that time the GI doc told me, "You will eat meat and potatoes the rest of your life!" That was it. A nutritionist that I began to visit suggested an integrative doctor in a nearby town about 30 min from where I live. But I had read all the books and literature that said for Celiac Disease all one needs to do is maintain a strict GF diet. By December 2007, I still was having watery diarrhea frequently. So I went back to the GI doc who this time did a colonoscopy and said I had colitis (I don't recall if he specified what type...) and wanted me to begin prednisone and Lialda. I about freaked out mainly because I had seen my mother struggle with ulcerative colitis and later collagenous colitis, taking prednisone, gaining weight, losing weight, etc. So a friend suggested that I visit the gastroenterology dept at a nearby teaching hospital. So I saw GI doc #2, the guy who was the specialist in that dept for Celiac Disease. He saw my colonoscopy results from GI doc #1, said I didn't have colitis, that rather it was a "poor bowel prep" and I had IBS, and he started me on Pentasa.

Fast forward to December 2010. The Pentasa wasn't working; I was losing a lot of weight. So GI doc #2 recommends another endoscopy and colonoscopy. At the follow-up appointment he said, "I've got some good news, and I've got some bad news. The good news is your small intestine has healed; it looks like you don't have Celiac Disease, even though you still do...the bad news is you have collagenous colitis." So he told me to stop the Pentasa, and begin Entocort, which I did at the time. He also said that unlike Celiac Disease, Collagenous Colitis isn't genetic. I remember saying to him, "Really? Because my mother has it." So I did the "Entocort Dance" from January 2011 until September 2013...take it. Diarrhea stops. I become constipated. Stop it. Diarrhea returns. Take it. Stop it. Diarrhea returns.

In September 2013, our family took a vacation to the beach where I found myself mainly in our condo the whole time in pain while my family was on the beach each day. It was miserable. When I returned I decided to heed my old nutritionist's advice and go visit this integrative medical doctor. He had attended Med school at Harvard. Had practiced as a pediatrician for a number of years before venturing into Integrative Medicine. Each hour with him is $250. My insurance doesn't cover it; he's out of network. I guess if I hit my out of pocket maximum for any year I could file the claims myself and maybe be reimbursed for something. I just haven't hit my out of pocket Max in a few years.

Visiting him is more like visiting a therapist. "Tell me how your childhood was. What were you like? Have you had any traumatic events in your life?" Stuff like that on the first visit. On the second visit, it was short. He was ready with 4-5 test kits for me to take home. Tests that ranged from a copay of $25 to tests that weren't covered by insurance that cost over $500. But I did them all. There were saliva tests, urine tests, stool tests, and blood draws to check IgG levels to certain foods. The saliva tests revealed that I had very high cortisol levels. The urine tests revealed that I had major yeast overgrowth. The stool tests revealed that I had a parasite, E. Nana, which in some old medical research is found to cause problems with collagen related diseases. Knowing that, I thought that I had found what gave me collagenous colitis, even though I think the research meant collagen related diseases like rheumatoid arthritis. Oh yeah, and the blood draw revealed that I had a slight sensitivity to dairy and shrimp.

So in January 2014, I began a course of Flagyl to eliminate Mr. E. Nana. Also I began a six month course of oral Nystatin for the yeast/fungal overgrowth. And I began some supplements to take care of the cortisol.

Once I completed the Flagyl, my diarrhea had disappeared! Gone! Nada...nothing. I thought I was cured! Until April 22, 2014, when the watery diarrhea came back. See it was such a significant thing that I remember the exact date. And it was very bad timing...our family was planning a European vacation as soon as our children were out of school in June. So the integrative doc put me on a supplement of Metagenics Glutagenics which I've read others here have taken, a mixture of Glutamine, aloe, and licorice. Didn't stop the diarrhea. Then days before we were to leave I started Flagyl again thinking that perhaps we didn't get all of Mr. E. Nana the first time. But I stopped the Flagyl a couple of days before we were to leave (I had taken it for only 5 days) and wanted it out of my system before we hit Paris so that I could drink wine, since one cannot consume alcohol while taking Flagyl. The funny thing is that as soon as I landed in Europe, my diarrhea was gone again...in a blink of an eye! And stayed gone for the whole trip which was almost 3 weeks long. And as soon as I got home, the very day, it started up again like a bad habit. Watery diarrhea every day. What happened? I don't know.

Integrative doc thought it was stress. Stress is at home and when abroad on vacation no stress. But I countered and said that the trip wasn't unstressful; we were traveling from city to city every 4 days with our two young children. We were like nomads over Europe, and that isn't necessarily relaxing. There's stress to that especially with children. So integrative doc still maintained that it had to do with stress. So I saw him on and off until November 2014. He never examined me. He only talks with me for an hour for $250. He has helped me in some ways like helping me set boundaries with my job and obligations, etc. and he did discover the parasite and the yeast overgrowth. But in dealing with my stresses, when he asked me if I wanted to visit a Shaman for my diarrhea I thought he was grasping for straws.

Then one day in November, I just stopped eating GF oatmeal and consuming dairy. And my diarrhea stopped like it was my child leaving for college, just gone. At this point, I've named my gut Fiona, because they say that your gut is your second brain, and I thought, well if it has a brain, it needs a name. So suddenly out of the blue Fiona behaved. She behaved all throughout the stressful holidays, Christmas, beginning of the year job stresses that last until mid February. She behaved all winter...until April 15. On April 15, just over a month ago the watery diarrhea returned. Integrative doc reached out to me before that in March. I told him that I was doing well, and we need to address another issue that has to do with my having vitamin B6 toxicity. The supplements to address my cortisol issue contain a total of 10mg of Vitamin B6 every day. And that's enough for my body to get very toxic...And I don't know why. And because of the toxicity I get zings down my legs throughout the day. I had read that people who have a difficult time processing B vitamins and Sulfur containing foods have a tendency to develop cardiovascular disease. Both of my parents had CVD. And my older sister has hypertension that developed when she was about my age. But by the time my appointment with integrative doc came up, my diarrhea had returned. Fiona was back. And integrative doc maintains that it's due to stress. Again I said that the holiday season and winter had been VERY stressful and no diarrhea. I remembered, "Hey! This happened last April! Maybe it has something to do with all the pollen???" Nope...he maintains that my past has been extremely stressful (it has...experiences with my ex husband would make a decent movie on Lifetime,) and he wants to try some therapy on me called Somatic Experiencing that he just went to a workshop to learn. He says he's willing to adjust his rates to 50 min for $180. He says we'd have to meet weekly. I ask, how long? He says, it's a long road. So the jury is still out on whether I will do this or not. I don't have enough money for $180/week til who knows how long. Then I reminded him that we can't ignore that I have collagenous colitis. And he said that he realized that but one of my tests back in October, a stool sample, showed very little inflammation in my gut. So he maintains that my diarrhea is stress related. It may be, idk. But I find it interesting that for the past two winters Fiona has behaved until April rolls around. So that's my story and my experience with integrative medicine.

In the meantime I'm on an elimination diet of only pork tenderloin and applesauce, oh and coconut water. That's it. My frequency isn't out of control since I'm having watery stools only twice a day. I've lost 10 pounds since my annual physical on May 7, where the topic was that I had high cholesterol for the first time in my life. My PCP focused on that, thought it was caused my stress or not sleeping well at night. For the diarrhea, when I mentioned it, he just offered a prescription for Wellbutrin or Cymbalta to which I said no thanks. And to help with sleep he gave me samples of a drug called Belsomra that affects the "waking hormone" so that one is slower to wake. I'm not taking that either. I'm just hoping that my D will improve so that I can try adding my veggies back to my diet at some point. Pork and applesauce is getting old. :-/

[Gabes-Apg]

DJ, the other thought I had, years ago one had to go to a practitioner as there was not much information available.
It is different now, like Tex has written a book about MC and another about Vit D3, there are others that have written well researched books and protocols for 'heal thyself' approach.
The books are not expensive $20-40.

A lot of them have forums/facebook groups where you can ask questions, discuss things with other people following the protocol, all for free.
Yes, it takes a bit of reading but people are making it way way easier to be well, and way more affordable.

There is a group on Facebook, gut health protocol. John Herron has written a book and provides fantastic information how to resolve sibo /candida/parasite/histamine issues in the gut. He is very pro-active about managing inflammation, Vit D3 etc....

One web site I found yesterday that had some good info, explainations and links was cheap health revolution

There are loads of books /text books about nutritional deficiencies, how to interpret mineral ratio results, using hair mineral analysis to ascertain metal overload/mineral deficiency. A nutrient textbook used by naturopaths and nutritionists has been a huge help to me... It cost me $45.

If you have access to university library, it would have shelves of textbooks with key info...

A lot of labs are making various tests available direct to the public as the demand is there...

Nancy mullans who has good info about methylation on her web site (free) holds a free phone in forum where there is group discussion....

What I have learnt in the past 12 months is that nutrient/mineral deficiency is generally the root cause of most health conditions....
If you have healthy gut and healthy cells, you will have minimal health issues...

The universe blessed me with a period of not working that I could spend the time doing the reading and research... My naturopath friend and the good nutritionist helped me along the way...
An hour session with the nutritionist cost me $40. (After insurance subsidy) otherwise it would have been $80. I posed the questions from my reading and she helped with the science and helping me with best plan of approach.

[JFR]

There was a time when I thought I just needed to find the right doctor and my medical issues would be solved. I spent a lot of money, tried a few naturopaths and a couple of integrative medicine doctors along with traditional MD's. About 5 years ago I decided that I was not throwing away any more money on seeking out the practitioner who would finally know what was wrong and what to do about it. Then my symptoms went from mild to moderate to severe where I couldn't leave the house. Instead of calling my doctor I researched on the internet, found this forum, spent money on Enterolab and things have gotten better ever since. That was 3 years ago. Although there may be some integrative doctors who might have some insight I now believe that when it comes to my health I am capable of figuring out most things myself through internet research and the reading of books. I am not so arrogant as to believe that I will never need the help of a medical professional again but for most things I do pretty well on my own. My philosophy is simple. First remove all foods that are harming me. Then add in those foods that provide essential nutrients. Supplement where it seems advisable. I try to be patient, work on my attitude (for example instead of saying "why me?" I say "why not me?" or instead of feeling deprived of bread and ice cream I try to feel grateful that I can heal myself through simple dietary means) and work on stress reduction. It's working for me.

Jean

[tex]

Hi Grace,

Welcome to our Internet family. You have a very interesting story, to say the least. While I am a firm believer that stress is a huge trigger for MC, I agree with you that classic emotional (work, travel, family, etc.)-related stresses are probably not the cause of your current flare.

I had a very illuminating experience last fall. It was almost an epiphany. In late October I had a kidney stone that caused minor discomfort, but no serious pain. It seemed to strongly affect my digestive system though, because my most noticeable symptom was constipation. But the stone passed (or dissolved) with no further symptoms. Exactly 3 weeks later I had a second kidney stone that caused even milder symptoms than the first. But surprisingly, the second stone triggered an MC flare that lasted for several days. The surprising part is that I had a colon resection about 10 years ago that left me with a disconnected stub of colon that is still attached at the bottom end, and it has never been reconnected. And yet incredibly, that stub responded to the flare. You can read the gory details at the following link, if you are interested in such unusual phenomena:

Can Kidney Stones Trigger an MC Reaction?

My guess is that the first stone caused a lot of inflammation (apparently) across my entire abdominal cavity, but it wasn't enough inflammation to trigger an MC flare. I have long believed that digestive system inflammation (based on T-cell infiltration, as is the case with MC) is very slow to decay. And it seems that mast cell-based inflammation tends to be self-perpetuating for us most of the time (if inappropriate mast cell activity is the cause of the inflammation). So when the second stone came along, most of the inflammation caused by the first stone may have still been in place, and the additional inflammation caused by the second stone pushed the inflammation level over the threshold at which an MC reaction is triggered. It was a very enlightening experience, because I never would have dreamed that an event such as the passage of a kidney stone could trigger an MC flare. There's no question that it was a genuine MC flare though, so this opens up all sorts of other possibilities for triggering MC reactions.

IMO, pollen allergies cause much more inflammation in the body than is generally recognized. Many members here experience flares during both the spring and the fall pollen seasons. And the interesting part is that some of those members don't seem to have significant pollen allergy symptoms, and yet they experience a flare of their MC symptoms. Maybe it's just coincidence, but the time is certainly a match.

The point is, the body can be stressed in many different ways, and it appears that any of those avenues can trigger an MC flare. The most effective triggers seem to be associated with inflammation, but the sources of inflammation can be widely varied, and not simply the classic type of T-cell inflammation in the lining of the colon that is associated with MC. The timing of your flare may not be simply a coincidence. There is a reason for everything.

So my question is, "Have you tried treating your MC flare with antihistamines?" Many members here find that a non-drowsy antihistamine (such as Allegra, Claritin Redi-Tab, or Zyrtec) in the morning can actually bring remission of their MC symptoms. Others find that they get better results if they also add Benadryl at bedtime. The reason why this works is because of the mast cell involvement with MC in many cases. If you want to read more about this, you can find information on how mast cell activity is associated with MC, and how this can be treated, in the short articles at the following links:

What are mast cells?

How are mast cells associated with microscopic colitis?

How do I know if mast cells are causing problems for me?

How are mast cell issues treated?

Again, welcome aboard, and please feel free to ask anything.

Tex

[dfpowell]

DJ,

Do you have a reason/goal in seeing an integrative doctor?

My experience is they are expensive, I have seen 2 different integrative MDs in the past 2 years, and my reason for going was to get a natural thyroid medication and not for them to help me with MC. But both MDs wanted to explore my gut issues and so they did the Genova nutritional and gut tests. From the first round of tests, it was suggested I take digestive enzymes and probiotics neither of which helped. Then 9 months later same tests, different doctor, it showed I had candida, but everything else looked ok. My nutritional analysis looked good which told me I must be absorbing ok.
That doctor want to try antibiotics for the Candida, which I did not want to take. I decided that I would make diet changes to help with the Candida and that seems to be working. He also suggested I do allergy test which cost about 2000 dollars, which I have also declined.
In the end the integrative MDs helped with managing my thyroid condition and not the MC.

[jcml12]

I see a Integrative doctor as well as a naturopath and the Integrative Dr is who sent me to a Naturopath specialist in the College for Naturopaths here in Portland Oregon. They have a program that you can see the specialists at there clinic with students for $25. a visit. At first I thought that might be a problem but I really didn't care at that point last year how many people I told about my watery D. They were wonderful and the specialist said even though their way is to heal naturally quite often we need help and because I had been struggling with this on and off for 7 months he put me on Budesonide. He changed my diet right away as well. I am very thankful for him because my Gastro doc just was going to put me on the Budesonide for 8 weeks and then stop and we all know it would have come back. I have been on 3mg for almost a year now and I see him again in a week and he had told me originally that he wanted me to be on for about a year. Wayne's book pretty much says it takes time so I was so thankful to have found him. Integrative docs and NP (basically the same) are just like regular as far as some are very knowledgeable and some are not and some try everything when they really don't know what they are talking about (which sounds like yours) and then some will send you to someone that specializes in stomach or MC issues as mine did. Look in your area to see if there are any teaching schools for Naturopaths. Good Luck!

[DJ]

Thank you all. My appointment is tomorrow. Being that I was required to give a $200 downpayment, I guess I'll fork over the other $450 and keep the appointment. I believe they might have been helpful years ago in teaching me that I needed to eliminate gluten but I'm afraid that they won't have any particularly helpful information. My self-analysis tells me that I might be going there because I am understanding how different my life might be if I fully understood my food problems earlier. I've had debilitating gut issues for a LONG time and I've seen every kind of doctor. I visited the Integrated Medicine Center several years ago. I stopped going because I thought the tests they recommended were very expensive and because they sell very expensive vitamins and supplements in their office. I'm frustrated because medical practices are so specialized that they treat one issue and seem unaware of a person as a whole. For example, my gastroenterologist feels I should see her every six months (or more) despite the fact that there is nothing she can do. And, it appears that MC does not lead to colon cancer. She is aware that I have a debilitating cough that produces white "battery acid" from my stomach and that my vocal cords, esophaus, and throat are continuously singed, yet she never asks me if I have followed up with an ENT in recent years for a scope. We concentrate on scoping my intestines. I don't see any of these people asking themselves what my greatest risks are. I supposed I'm with all of you on this...as Gabes said, there are books and websites that provide a lot of info. The money is spent. If somethings helpful takes place, I'll post it so all will benefit. If I spend two thousand dollars on this and a hundred people benefit, it becomes a bargain. I LOVE a bargain

[tex]

DJ,

Just divide up that two thousand dollars among the members who post here regularly and we'll all be happy campers who appreciate a good bargain.

Good luck with your appointment. I hope you get your money's worth, but it won't be easy, with the bar (the price) so high.

Tex

[DJ]

Hello All,
I had my first appointment with a Nurse Practitioner at an integrative health practice. I was strongly encouraged by the scheduler to see a Naturopath instead of the Nurse Practitioner and I was required to also have an appointment with a nutritionist. Naturopaths are not licensed in NY and I've had good luck with experienced Nurse Practitioners. By the way, the scheduler and her physician husband own the practice.
My appointment with the NP was excellent. She seems to get it. I brought all medical results from the past few years, which she reviewed, in addition to ordering extensive bloodwork and stool tests. I'll have more detail on that after my next visit.
I provided the nutritionist with a list of my sensitivities, the foods I eat, and the foods I'm working toward eating. He really had nothing to add and appeared at a bit of a loss. He said we would "split" my one hour appointment so that he would see me again after my test results arrive.
Bottom line first impression: NP seems very good. Nutritionist seems unnecessary for someone who has done a strict elimination diet and has spent nearly two years on this board.
I'll report what the NP has to say after my tests are in.

[tex]

DJ,

Thanks for the update. So far so good.

I'm impressed by the candor of your nutritionist, and by the fact that he didn't try to load you up with supplements.

Tex

[Zizzle]

I go to an integrative medicine practice. They are extremely thorough, take their time, and offer many alternative lab tests that have been so enlightening! Genova stool tests founds my daughters D Fragilis amoeba after 4 years of suffering. Celisc cross reactivity testing found several foods I react very badly to - buckwheat, amaranth, sesame and coffee. But most importantly, they prescribed Low Dose Naltrexone, which brought my autoimmune disease into remission in 3 short months and vastly improved my energy, mood and MC symptoms. My insurance pays 80% as out of network and the practice submits the claims for a $10 extra fee.