When you’re starting on a new health journey, knowing what to eat can seem confusing. For starters, there is a ton of conflicting advice out there, with proponents of each diet insisting their diet is the healthiest.

The truth is, the best diet depends on which one works best for you. Factors that determine this include your individual food sensitivities, digestive health, blood sugar handling, and stress handling.

In functional medicine we follow general guidelines that focus on whole foods, removing foods to which you are intolerant, and stabilizing blood sugar. Beyond that, your history, lab tests, and current condition serve as guides in customizing your diet.

A custom diet plan starts with real food

With customization tips in mind, one basic rule still applies across the board: Eat whole foods.

When you eliminate foods that have been through processing (like breakfast cereal or chips), foods with artificial colorings, additives, and preservatives, and foods laden with industrialized fats and too much sugar, you are already on solid ground nutritionally.

This means sticking largely to the produce, meat, and nut sections in the grocery store. Use healthy, natural fats such as coconut oil and olive oil. Avoid vegetable oils, which are unstable and become inflammatory free radicals in your body.

Avoid hydrogenated oil as it has been shown to damage brain cells and raise heart disease risk.

You have to develop new habits to shop for and prep vegetables, cook healthy meats, and wean yourself off sodas, pizza pockets, chips, and other quick-grab items. But you’ll start feeling so much better you won’t mind. In fact, you’ll likely feel enthusiastic about it.

When eating real food is difficult

Some people favor processed food because they have trouble digesting real foods. This is a red flag digestion is seriously compromised.

For instance, if your stomach feels heavy after eating meat, as if it just sits there and does not digest, your stomach may be low in hydrochloric acid (HCl). HCl is necessary to digest meats and it’s a common deficiency.

In functional medicine, we know that a diet that consists primarily of produce is very beneficial. However, the dramatic increase in fiber from eating more fresh fruits and vegetables causes digestive problems in some people.

Factors that make eating produce difficult include an overgrowth of the wrong bacteria  low HCl, insufficient output of pancreatic enzymes, inflammation of the gut lining, and other digestive issues.

These people need to work on restoring gut health and slowly ease into eating more vegetables.

Blood sugar and stress handling

Most Americans eat too many carbohydrates and sugars, which contributes significantly to inflammation and chronic disease. At the same time, not everyone fares well on a very low-carb diet.

People with chronically low blood sugar and adrenal fatigue need to eat smaller meals more frequently to protect their brain health, whereas others find eating three meals per day optimal.

Some people feel great on a very low-carb, or ketogenic, diet, while others develop anxiety and insomnia. Finding the right amount of carbohydrates to eat so that you keep blood sugar stable and lower inflammation, yet function optimally, can take some tweaking. Then, as blood sugar and stress handling improve, you may be able to readjust.

For some women, their monthly period is no big deal. For others, it’s a grueling journey through depression, anxiety, irritability, pain, and more. If you think premenstrual syndrome (PMS) is too awful to be natural, you’re right — PMS is a symptom of a hormone imbalance often caused by too much stress.

Although a variety of factors can cause hormonal imbalances and PMS, one of the more common is low progesterone caused by long term chronic stress.

Low progesterone symptoms:

• Depression
• Mood swings
• Changes in weight or appetite
• Insomnia
• Anxiety
• Crying easily
• Irritability
• Poor focus and concentration
• Fatigue
• Frequent or irregular menstruation
• Low sex drive
• Migraines

How stress lowers progesterone

Chronic stress causes pregnenolone steal, a situation that causes progesterone deficiency and hormonal imbalances. Pregnenolone is a precursor hormone used to make progesterone and the stress hormone cortisol.

The body can only make so much pregnenolone. This means that if stress is always high, it “steals” pregnenolone from progesterone to make cortisol in order to meet the demands of stress. This causes an imbalance between progesterone and estrogen.

Factors that cause pregnenolone steal

Progesterone cream use can further skew hormones. It’s better to address the causes of low progesterone, which is typically stress-induced pregnenolone steal. Causes of pregnenolone steal and PMS include:

• Sugar and sweeteners, excess processed carbs — rice, pasta, bread, pastries, etc.
• Excess caffeine
• Food intolerances — gluten, dairy, eggs, soy, corn, nuts, grains, etc.
• Digestive issues — bloating, indigestion, diarrhea, constipation, leaky gut, pain, etc.
• Lack of sleep
• Inflammation — joint pain, chronic pain, skin rashes, brain fog, fatigue, etc.
• Autoimmune disease (such as Hashimoto’s)
• Overdoing it; over exercising
• Feeling constantly overwhelmed
• Poor nutrition
• Reverse pregnenolone steal to soothe PMS

Ways to reduce pregnenolone steal include an anti-inflammatory diet, restoring gut health, and managing autoimmunity.

A variety of compounds can help soothe PMS, such as omega 3 fatty acids and gamma-linoleic acid (GLA—evening primrose oil, borage oil, or black currant oil.

Supporting serotonin, a brain chemical that promotes well-being, may help with PMS mood symptoms — tryptophan, 5-HTP, St. John’s Wort, and SAMe.

This is a broad overview. Ask my office for more advice on using natural therapies to alleviate PMS and support healthy hormones.

Lab testing is foundational to functional medicine, and for good reason. It can show you what is causing your symptoms, if you are headed toward a disease (even if you don’t have symptoms), track the progress of your protocol, and motivate you to stick with your protocol.

Lab testing includes many different tests. Some examples of testing used in functional medicine include:

Food sensitivity testing. If a food you eat regularly causes inflammation, this contributes to chronic health disorders.

Gut testing. Gut problems contribute to chronic health issues. Tests can screen for leaky gut, gut function, parasites, bacterial overgrowth, and autoimmune reactions.

Blood chemistry panel. This is an excellent starting point in functional medicine testing and includes the use of functional medicine ranges (versus lab ranges). Blood testing screens for some diseases and can catch a trend toward a disease while there’s still time to reverse it.

Chemical and metal sensitivity testing. As with foods, an immune reaction to chemicals or metals can trigger chronic inflammatory health disorders.

Adrenal testing. Adrenal testing reveals the relationship between your health and stress handling. The most important test is the second one because it shows if your protocol is working. If not, you need to dig deeper.

Hormone testing. Hormone imbalances profoundly affect health. Testing screens for excesses, deficiencies, feedback loops, and how well you metabolize hormones.

DNA genetic testing. Genetic testing delivers insight into disease risk and genetic metabolic variations that affect health. An example is the MTHFR variance.

These are just a few examples of the types of testing used in functional medicine. What type of testing you need depends on your symptoms and health history.

Why lab testing is important in functional medicine

Functional medicine is based on peer-reviewed science and finds the root cause of your symptoms. There are a variety of factors that can lead to depression, fatigue, chronic pain, poor function, and other chronic health disorders.

Functional lab testing shows a trend toward disease

In conventional medicine, doctors use labs to screen for disease. Once a condition has become a disease, such as diabetes or autoimmune disease, the damage is significant.

Functional medicine uses lab testing to catch a health trend that is on the way to disease but that can still be slowed, halted, or reversed. For instance, lab markers that show elevated blood sugar, inflammation, and poor liver function allow you to easily reverse the march towards diabetes.

Another example is autoimmunity. A significant amount of tissue must be destroyed before conventional medicine can diagnose autoimmune disease. However, by testing for antibodies against tissue, the autoimmune progression can be slowed or stopped in its early stages.

Functional lab testing tracks progress

Although the first test is important for identifying health problems, subsequent testing is also crucial to let you know whether your protocol is working. If there is no improvement, it means you have not hit on the right protocol or discovered all the underlying causes.

Lab testing improves compliance and social support

Seeing the results of a lab test makes it easier to stick with a protocol. It also can encourage a disbelieving spouse, family member, or friend to support you. Many people think gluten sensitivity is just a fad, or that your symptoms aren’t real and you simply complain too much. Your lab results validate your symptoms and can help others be more supportive.

Ask my office about functional lab testing to help you get to the bottom of your chronic health condition.

Does stuff really leak out of your intestines when you have leaky gut? The truth is, contents of the small intestine escape through the wall into the bloodstream. This can trigger many different inflammatory disorders and autoimmune disease, a disease in which the immune system attacks and destroys body tissue.

Leaky gut is associated with symptoms including:

• Skin problems (eczema, psoriasis, rosacea, acne, etc.)
• Chronic pain
• Autoimmune disease
• Puffiness
• Fatigue
• Brain fog
• Depression
• Anxiety disorders
• Poor memory
• Asthma
• Food allergies and sensitivities
• Seasonal allergies
• Fungal infections
• Migraines
• Arthritis
• PMS and other hormonal issues

Leaky gut, referred to as intestinal permeability in the research, means the lining of the small intestine has become inflamed, damaged, and overly porous. This allows undigested foods, bacteria, molds, and other pathogens to enter into the sterile environment of the bloodstream. The immune system attacks these compounds, triggering inflammation that, when constant, turns into chronic health disorders.

Leaky gut now on the research radar

Conventional medicine once believed leaky gut wasn’t a valid concept, but researchers now validate it as linked with many chronic disorders, including inflammatory bowel disorders, gluten sensitivity and celiac disease, Crohn’s disease, type 1 diabetes, depression, and more.

How to repair leaky gut

If you have a chronic health condition — even if it’s not digestive — addressing leaky gut is vital to improving your health. The bulk of this work is done through diet. The most common causes of leaky gut are processed foods, excess sugars, lack of plant fibers, and foods that trigger an immune reaction (as in gluten sensitivity).

Excess alcohol, NSAID use, and antibiotics are other common culprits.

A leaky gut diet, also known as an autoimmune diet, helps many people repair leaky gut. Stabilizing blood sugar is also key.

If you have Hashimoto’s hypothyroidism you are not managing correctly, or if your liver is not detoxifying properly, you will likely have problems with leaky gut. Nutrients that can help support liver detoxification include milk thistle, dandelion root, and schizandra.

In addition to diet, many nutrients can help support gut healing. Some of these include probiotics, enzymes, l-glutamine, deglycyrrhizinated licorice root, collagen, hydrochloric acid, and anti-fungal herbs.

Targeted nutrients can help stabilize blood sugar, manage stress, tame inflammation, and support a healthy balance of gut bacteria. All these factors help repair leaky gut. If you have an autoimmune condition, managing leaky gut can be a lifelong process as autoimmune flares can inflame the gut.

Ask me for advice about a leaky gut diet and protocol.

The placebo effect is a target of ridicule but studies show it has become increasingly effective in recent years, particularly in the United States, where drugs for pain, depression, anxiety sometimes barely outmatch placebos.

Fortunately, researchers have decided to study how and why the placebo effect works.

By embracing the mystery of the placebo effect, you can harness its powers to enhance your health protocol or better cope with your ailment.

What is the placebo effect?

Researchers give one group of subjects a new drug or procedure and a different group a sham, then compare the results. Neither group knows which treatment they received. In some studies, the placebo treatment works as well or even better than the real treatment.

1: Use belief to enhance placebo effect

A person’s beliefs and expectations play a profound role in how their body will respond to something. When subjects are told their pain will drop before receiving a placebo, it does. Likewise, when they are told they will experience more pain, they do, even though pain delivery was not increased.

Scans during these experiments show brain activity corresponds with the expected outcome, even though neither pain relief nor increased pain was delivered.

Scientists have also learned that positive expectations release endorphins and dopamine, the “reward” brain chemical. Endorphins dampen inflammation and both endorphins and dopamine help relieve pain.

Spend some time every day reaffirming why you’re on your health journey and the positive things you expect to gain from it. Visualize feeling and functioning better.

2: Receive care and attention to enhance placebo

Increased attention, concern, and care are also believed to be why the placebo effect has become much stronger in recent years. When people take part in these studies, they receive an increased level of interaction and care that positively impacts their health.

Seek out supportive care and nurturing during your health journey. This can be from a practitioner you work with, through body work appointments, or in the company of a support group or class. Include plenty of in-person social time as it is better for you than online socializing.

3: Develop a positivity and gratitude practice

Negativity is stressful and inflammatory. Doctors report that patients who are angry, don’t believe their treatment will work, or who are not supported by their friends and family in their healing journey may not experience optimal results.

However, the person who expects the best from their protocol, learns about their new diet and supplements, and enjoys working with their practitioner experiences less stress and inflammation and better results.

Take some time each day to think positive thoughts about your health journey and what it involves. Keep a daily or weekly gratitude journal and make sure to note your progress. These tips really do help your health!

Remember, it’s the placebo effect and not superstition

Although we’ve all heard miracle healing stories, it’s best not to pin your hopes on one. The placebo effect alone is estimated to work between 18 to 80 percent of the time, which is a wide spread to bank on.

Functional medicine is about creating new lifelong habits as much as it is about restoring function. By injecting the best the placebo effect has to offer into your daily diet and protocol, you are laying the groundwork for a lifetime of more positive outcomes.