P.V. is a 55-year old female with severe menopausal symptoms.
Seen for sleep issues, weight gain, fatigue, menopause.
Self-employed with work–related stress graded as 12/10. Travels frequently for work, flying most of the time.
A mother of 3. Admits to alcohol intake of 7-10 alcoholic drinks/week.
Diagnosed with plaque buildup in the arteries and osteoporosis/osteopenia diagnosed at age 40. Used Boniva for 2 yrs. Boniva discontinued because of side effects.
Biometrics
Wt. 174ib. PBF 44.1, 8.3 lb. deficit on her lean muscle mass, LMM, and a visceral fat level 18
Labs: High cholesterol, Total 274, Triglyceride 157, FBS 103, Vitamin D 29, Estrogen, Progesterone, Testosterone, were all low. Her cortisol curve flat.
She was started on a program that included lifestyle changes, nutritional supplements and bioidentical hormone supplementation.
On follow–up 3 months later, all her menopausal symptoms had resolved, but she had not reduced much excess weight.
We discussed and started SHAPE Program Phase I: FasTrac Cleanse on 12/31/16.
At 4 weeks on the SHAPE Program, patient’s weight was 155. But LMM deficit had dropped to 4.6 lbs and visceral fat level to 12.
Total cholesterol had dropped to 233, Triglyceride was 94 and her HDL particle size increased from her first set of labs.
At 6 weeks, she had gone from a dress size 16 to a size 10.
After a second round of the SHAPE Program, she went down to a size 6, and she is one of my happiest and most grateful patients.
She has maintained her goal in spite of her continuing exhausting work and travel schedule on an intermittent Basic Cleanse Nutrition Protocol.
Though P.V. did not lose the most weight among my patients, I have chosen her case to highlight the importance of an integrative approach to our patient care. P.V. had optimal hormone supplementation, she was compliant on the nutritional recommendation given to her. She pushed herself through her exercise routine though I recommended she reduced that while we worked to improve her HPA axis. Her sleep improved but she still could not lose weight. It was obvious we were missing something in her program. Yes, this patient was missing a major pillar of her health: detoxification. Yes, her receptors needed to be activated and to do so we needed to remove toxins, reduce silent inflammation, and so activate her receptors.
I always go to the SHAPE Program to do this, and this was done for this patient and as soon as we started her on this anti-inflammatory program, her weight loss stagnation became history. Not only did her central abdominal fat dropped 33% on her first cycle of the SHAPE Program, she shed the excess weight. She gained muscle mass instead of losing it as is the case in most weight loss programs.
This may be preaching to the choir, but for all of us practicing functional/integrative/lifestyle/metabolic medicine or as one colleague named it, Juventology (cf gerontology) we should be ready and willing to use all the tools in our tool box to get the optimal results for our patients. Sometimes we may need to involve other practitioners such as an acupuncturist if you do not do the procedure yourself. As Mark Hyman, MD says, he will use whatever modality heals the patient, “exercise or exorcism.”
So, let’s do what the SHAPE Program teaches us to do: Heal our patients by optimizing their biochemistry and physiology by dealing with inflammation and toxins and giving the body the best chance to heal and flourish.
Many of the patients I see come in with the hope that I will just prescribe hormones to them. However, I make them understand that that will be very unlikely in my practice as I have rarely seen anyone male or female who just needs hormone supplementation. At this point they have a choice to address all the other issues depleting their hormones as I recommended. There are many practitioners in this group to choose from.
Submitted by Dr. Phyllis Okereke, MD – BodyLogicMD of Houston and BodyLogicMD of Austin
Dr. Todd’s Teaching Assessment
Integration. What an outstanding word. I have often NOT started with the SHAPE Program, as did Dr. Okereke. There are situations that must be addressed (sometimes before introducing the SHAPE Program) that will allow the patient greater success. To borrow from Dr. Cass, the right remedy at the right time is so important. Although the patient may be anxious to start the SHAPE Program, use your integrative medicine knowledge and background to make clinical decisions. Do you need to address leaky gut, insulin resistance, leptin issue, etc. first and then begin the SHAPE Program? My guess is this patient would not have done as well had these issues not been address prior to the SHAPE Program.
