Taking it to the next level.
The Wahls Protocol uses functional medicine principles and a specific Paleo diet (The Wahls diet) to address autoimmune diseases such as multiple sclerosis. But in reality anyone can use the principles of the Wahls Protocol to address their health regardless of their diagnosis. My discussion of How to Talk to Your Doctor About The Wahls Protocol started with Part 1 of this blog. You can read it here. In Part 2 my discussion continues by addressing the Functional Medicine Timeline and the Functional Medicine Matrix. Dr. Wahls has modified these tools into what she calls The Vitality Timeline (a.k.a., The Functional Medicine Timeline) and Your DNA, Diet, Disease, & Health Behavioral Map (a.k.a., The Functional Medicine Matrix). For the purpose of our discussion I will simply refer to The Timeline and The Matrix. If you are going to use this approach you will first need to become familiar with these tools. I published a blog in June 2016 titled, “The Functional Medicine Timeline,” and you can read it here. A couple of other good resources are an October 2015 article in Experience Life Magazine online titled The Functional-Medicine Matrix and for even more detail this past July 2016 Functional Forum presented by Dr. Patrick Hanaway with The Cleveland Clinic Center for Functional Medicine, The Functional Medicine Matrix.
Laboratory testing is an important part of the “personalized” in personalized medicine. Your Timeline may tell you what things were important in your life history that lead up to your illness (antecedents), what are your triggers or triggering events, and what factors in your life story keep the disease going (mediators). But you cannot tell from these steps:
- What specific nutritional imbalances you may have?
- How well your body is managing glucose (sugar)?
- Whether you have imbalances in gut microbes?
- If you carry excess toxins, including heavy metals and chemical pollutants?
- If you have a chronic infection (mold, virus, parasite, or dangerous bacteria)?
- How well your body gets rid of waste (detoxify)?
- Whether your hormones are in balance?
- If you have food sensitivities?
- If your body can adequately manage oxidative stress?
- If you have a genetic vulnerability?
There are a few tests I would feel very comfortable asking your doctor to perform. Everyone suffering from multiple sclerosis should have their vitamin D level checked. If your doctor refuses find a new doctor.
In functional medicine we often refer to lab results as “optimal” rather than the index range (the range indicated by the laboratory company alongside your result). For the most part your doctor will not be versed in these “optimal” ranges.
Also, in our U.S. healthcare system with third party payers (i.e., insurance companies) there are rules a doctor must follow. A laboratory request, such as a fasting insulin level or a vitamin B12 level, must be paired with a diagnostic code (ICD-10). Having the diagnosis of multiple sclerosis may not be enough to convince your insurance company to pay for a homocysteine level, for example. A functional medicine doctor will understand that your homocysteine level is a good thing to know in this Wahls-styled approach. But your conventional doctor may not be willing to order this test, so you have to know your boundaries. Consider asking your doctor to write you an order for the tests you want and tell you doctor you are willing to pay cash to have the tests done – you just need a doctor’s order. In this case it would not be necessary to have the testing paired with the insurance accepted ICD-10 code. Shop around for the best price. (You will be surprised.)
There are a few companies where you can go for labs, and some will even provide the order (even if your doctor does not). Here are a few examples: Any Lab Test Now!, WellnessFX and DirectLabs (Direct Laboratory Services, LLC)
But remember, you can get the labs, but knowing what to do with them can be difficult. For this reason, you may want to consider working with an experienced functional medicine provider who knows what tests to order, and how to guide you based on the results.
Some functional medicine providers have a physical office where they meet with you and others have “virtual” practices where interaction is online, through Skype, for example. Beyond blood tests, basic urine or stool testing, or certain genetic tests the advanced functional medicine tests cannot be performed without a functional medicine professional. These might include:
- Comprehensive stool analysis
- Toxic element testing (especially provoked testing)
- Organic acid testing
- Food sensitivity testing
- Cortisol profile or advanced sex hormone testing (with metabolites)
- Plasma Methylation profile
This is not a one size fits all recommendation. You must discover what approach is right for you and know that making critical changes in lifestyle can get you very far. You can be successful without any of the advanced testing; strictly speaking advanced testing is not the kind of guidance offered in The Wahls Protocol. But remember that while food is absolutely critical to improving your health The Wahls Protocol encompasses more than just food. I tell my patients they can eat the proverbial “apple a day,” but if they don’t deal with their stuff (I use a more colorful word) it will not make a difference in the end. Stress, movement, sleep, and healthy relationships are equally important players when it comes to creating wellness and balance.