When stressed, whether it is physical, mental or emotional stress, the body secretes the hormone cortisol via the hypothalamic-pituitary-adrenal pathway (HPA) as part of our normal “flight or fight” stress response. Cortisol has many important neuro-endocrine functions. However, we were never created to live under constant high levels. That results in a number of adverse adaptations by the body. In addition, the adrenal just gets worn out over time and cannot continue to respond with adequate levels of hormone output. Then the body suffers from low cortisol levels while still under stress and this affects a person’s mood, emotions, appetite, weight, sleep/wake cycles, cognitive (brain) function, energy levels – just about everything. Evaluating adrenal function, including the very necessary daily circadian rhythm of secretion, and help to restore proper balance and health to a person suffering symptoms of too much or too little cortisol.

Dementia is devastating to patients and the family and friends that love them. It is rising at epidemic levels as our Baby Boomer generation ages. Modern pharmaceuticals have very little to offer. At best they might delay moving into a nursing home by a few months. At Integrity we have been selected to be part of the compassionate use program that the FDA is offering patients with Alzheimer’s to access TB6000, which is a breakthrough drug for the treatment of Alzheimer's and related dementias. Galectin-3 is a protein that is rapidly getting more and more attention within the scientific community, and for good reason. It plays a key role in inflammation at a systemic level. Focusing on the brain, a review paper from 2022 shows that elevated Galectin-3 levels are highly correlated in numerous major neurological disorders like ALS, Parkinson’s, and Huntington’s. In the case of Alzheimer’s, not only are Galectin-3 levels elevated, but those levels are even higher as Alzheimer’s progresses. There are two mechanisms of action to describe Galectin-3 contributing to Alzheimer’s disease progression. The first is that Galectin-3 can activate microglia and cause neuroinflammation which exacerbates Alzheimer’s disease. The second is that Galectin-3 directly promotes the formation of toxic oligomers by aggregating various nearby proteins such as amyloid-beta, p-tau, and ApoE4, and this toxicity takes on a pathogenic character that can lead to Alzheimer’s disease.

The drug TB006 is a monoclonal antibody that specifically targets Galectin-3. In doing so, it has the potential to prevent Galectin-3 from progressing Alzheimer’s disease through both pathways. In patients treated with TB006 the treatment not only stabilized the patients’ dementia but reversed it, resulting in a recovery of cognition. When comparing the treated group to the placebo, there was a statistically significant improvement in the score Mini Mental State Exam with the 1 month treatment, and recovery largely persisted for weeks after. One patient improved their MMSE 19 to 30 with 6 months of treatment. That is an incredible improvement. The medication is administered as a once monthly IV infusion in the office.

Babesia is a parasitic disease of the blood often transmitted by an infected tick bite. It is also known as “North American Malaria” as the single cell parasite will infect rec blood cells and leads to anemia and iron deficiency. Patients so afflicted with experience breathless ness as well as fatigue. Once diagnosed, it can be treated and eradicated from the body.

Bartonella is a group of unique bacteria that tend to take up residence inside an infected person’s cell. That helps it “hide” form the immune system and makes it difficult for the body to fight off. Two better known infections caused by Bartonella include Cat Scratch Disease caused by Bartonella henselae and trench fever caused by Bartonella quinana. However, there are many known Bartonella species that cause disease and are especially troublesome for patients with an impaired immune system. Treatment often requires multiple medications and an extended treatment time.

Chronic fatigue is not truly a diagnosis but rather a cluster of symptoms which, if a patient endorses enough of them, is said to have “chronic fatigue”. There is, however, always an underlying cause for chronic fatigue and that is where the detective work starts. Chronic infections both viral and bacterial, various toxins including mold and heavy metal, allergy, chronic inflammation, and imbalances in the gut just to name a few. At Integrity we will diligently search for the underlying causes and when treated rejoice with the improvement in energy.

Itching and hives can be a minor nuisance but when it becomes chronic and intractable it drives patients crazy. This may stem from undiscovered allergies to food, the environment, or to unstable mast cells releasing chemical mediators that release histamine and start the itch/scratch cycle. Help is available.

I am never satisfied to see diabetes partially treated allowing the complications to continue to accumulate. We want to preserve the pancreas as much as possible and prevent or postpone complications including neuropathy of the feet, decline in kidney function, vision loss, etc.

When I went to Medical School years ago the gut microbiome was not even mentioned. Who knew that is played such a critical role in both health and disease. Too few good bacteria or to many bad bacteria can both disrupt your health and may lead to outright disease. In fact, it has been said that all diseases start in the gut! At Integrity we understand the critical importance that a healthy gut plays in your overall health and will work with you to get it right.

It is not difficult to find a food allergy when your lips and throat swell up after eating shrimp of strawberries and you get hauled off to the emergency room for an anaphylactic reaction. That is an Immunoglobulin E problem. However there is a more subtle form of food allergy coming from antibodies in the Ig G family that cause a slower reaction that occurs 4 hours to 4 days after ingesting the offending substance. That can cause abdominal problems, but also systemic issues like joint pain, headache, brain fog and the like. Since there is a delay in symptoms patient often do not associate their symptoms with the provoking food. And if they consume it daily, like dairy products or wheat and they have antibodies to proteins in those foods, they never feel good and don’t know why. We will help you search for problem foods and get on a diet that is healthy for you.

Like Chronic Fatigue, this is not a “diagnosis” but rather a cluster of symptoms that cause doctors to label patients with the term when they don’t know what the underlying cause is. Often this is the result of mitochondrial dysfunction. It takes energy to relax a muscle, and if the body has difficulty producing sufficient energy, the muscle stays in a state of partial constriction. This impairs the blood flow and results in some anerobic metabolism with a buildup of waste products that cause pain in the muscles. Muscles also need adequate magnesium to relax and under stress the kidneys leak magnesium and patients become deficient. Most magnesium is inside the cells so measuring a serum magnesium will not spot the intracellular depletion that occurs. You need to measure the intracellular levels to fine the depletion.

Many things in our modern world are toxic to living creatures and humans are no exception. Recent headlines about lead poisoning in Flint Michigan and the resulting problems with learning in children have brought that back to our attention. Mercury is high on the list of toxic substances and makes it necessary to restrict how much fish one consumes to avoid getting more in that our bodies can safely handle. Some people have trouble removing heavy metals due to mutations in the DNA that specifies the enzymes and co-factors needed. Often people are depleted of critical antioxidants such as glutathione. Degrading metal fillings in teeth can also be a source of poisoning. Lead taken in during one’s early years (think lead containing gasoline and paint) and “stuffed away” in one’s bones comes back to haunt women in particular as they lose bone mass in their postmenopausal years. Heavy metals poison the respiratory complexes in the mitochondria and cause fatigue, brain fog and a host of metabolic problems. Finding and removing toxic metals can be an important part of getting your health back.

Both men and women are subject to premature loss of critical sex hormones with substantial consequences to their health. If fact low estrogen is one of the 5 reversible causes of dementia. But you must replace it with an estrogen that is identical to that which the body produces. When a woman is given horse estrogen (Premarin) it is foreign to the body and does not get metabolized the same way. Bioidentical hormones have been proven to be safe and effective at restoring the health ad vigor of both men and women.

See Adrenal fatigue. This important series of nerves and glands has important feedback loops to carefully regulate the body’s response to stress. When out of balance people do not do well. We work to restore the normal balance and healthy homeostasis needed to do well.

Some people are just sick all the time. They catch the “bug of the week” and it is twice as bad and lasts twice as long. Turns out that some of those people have an immune deficiency. IT could have been there since childhood or acquired along the way. Evaluating the immune system and working to correct deficiencies is an important step in restoring overall health and longevity.

Interstitial Cystitis: this is a chronic painful bladder condition where increased urinary frequency and urgency are observed. There are more than 3 million cases in the US per year. It is more common in women, often in their 30’s and if there is a positive family history of similar issues. It is associated with pain in the lower abomen, low back and pelvis. Patients also often complain of fatigue and depressed or anxious mood. It is felt to be associated with biofilm forming bacteria making standard treatments for a bladder infection ineffective. An advanced PCR urine test is helpful for diagnosis and follow up.

Inflammation in the gut can lead to damage to the cells lining the intestine where the process of absorbing nutrients occurs. If the resulting “holes” in the lining of the gut allow in molecules that normally would not be seen by the immune system as they are too big to pass through an intact gut, the body will make antibodies to those substances and star an immune cascade causing widespread inflammation and many systemic symptoms. The gut is where we interact with our environment the most and toxins, bacteria, virus, mold, parasites etc. can make people sick. It is important to help the gut repair itself and re-establish the protective barrier God intended it to be.

Lyme disease is caused by a bacteria called Borrelia burgdorferi. It is a spirochete and a first cousin of syphilis, but unlike syphilis is most often acquired through the bite of an infected tic. The tick may be in the newborn nymph stage and so small that one can barely see it, but it is large enough to harbor terrible disease carrying bacteria and viruses. Years ago doctors understood that syphilis could have a primary, secondary and tertiary stage but today they seem to have a hard time understanding that Lyme has that also. And disseminated disease, the tertiary stage, can have devastating consequences on a person’s health. I have spent 100’s of hours studying this disease and how to treat it, which we do very successfully. This did not include a week spent one-on-one with Dr. Richard Horowitz in New York, one of the world’s foremost experts in the diagnosis and treatment of Lyme disease. We can help you understand the various stages of the Borrelia bacteria (cell wall, cystic form, intracellular form, biofilm form and persister bacteria) and the specific treatments geared to treat each stage. This too can be a long process, but the outcome can be remarkably better.

Patients with Mast Cell Activation Disorder (MCAD) can present with a vast array of seemingly unrelated symptoms that flare for reasons patients are unaware. Anxiety, depression, severe pain, unusual neurologic symptoms, headaches, ringing in the ears, oversensitivity to light, touch, sound smells, food and electromagnetic fields just to name a few. Many patients with MCAD have been told by multiple physicians that it is “all in your head”! Mast cells are an important part of our immune system. They in fact are the connection between the immune and neurologic systems. They are found in every tissue in the body but are most abundant in tissues adjacent to our external environment (think skin, respiratory tract, GI tract, etc.). They make more than 200 different biochemical mediators that signal other cells and tissues to react in a wide variety of ways. IN MCAS the mast cells are “twitchy” and react when they should not producing a wide variety of unpleasant symptoms. Confirming a diagnosis can be tricky, but treatment is available to settle things down.

Mitochondrial Cytopathies – disorders of the energy producing organelles of the cells – are an increasingly recognized cause of human illness. Babies born with mutations affecting the mitochondrial DNA tend to present early with severe symptoms. Symptoms in Adults tend to develop over years, and it is uncommon for the correct diagnosis to be made early on. Symptoms such as fatigue, muscle pain, shortness of breath and abdominal pain can be easily mistaken for other diseases. The symptoms can affect every tissue and body system in a variety of ways.

Illness caused by exposure to mold and mycotoxins (proteins molds make to defend themselves against attack) are highly underrecognized as causes of human disease and suffering. It is estimated that 50% of the houses in the US have been affected at some point by water damage, which is highly correlated with mold growth and the subsequent problems. The mycotoxins they produce can be inhaled in through the lungs and get into the blood stream, ingested by mouth, and assimilated, and can even be absorbed directly through the skin. They are toxic to the brain, kidneys, immune system, and many are actually carcinogenic – they cause cancer! Finding and eliminating them can make a big difference in a person’s overall health.

Morgellons’s Disease is an emerging unrecognized disease with systemic and dermatologic manifestations. The defining characteristic is the presence of clear or colored “filaments” made of keratin (like fingernails) which are underneath and emerge through the skin. It is associated with Lyme Disease and other Tic borne infections but is not caused by the Borellia bacteria. Patients complain of crawling, biting and stinging sensations under the skin. There are spontaneously-appearing, slow healing skin lesions that often ulcerate and can cause significant scaring. Patients also often have etreme fatigue, body aches, joint pains, insomnia and brain fog. Standard labs are usually normal. It is often misdiagnosed. It is treatable but often takes up to two years of antimicrobial therapy.

POTS: Postural Orthostatic Tachycardia Syndrome (POTS) us a relatively new but increasingly common disease misunderstood by many including healthcare professionals. It is a form of “dysautonomia” – a dysregulation of the autonomic nervous system – that affects the flow of blood through the body. This causes dizziness when a patient stands up. Often we see an increase of 30 beats per minute in the heart rate as it tries to compensate for the drop in blood pressure. There are several types of POTS. Most common are the neurogenic and hyperadrenergic POTS and it is important to do a thorough evaluation as the treatment is different with the different types.