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Web of Dysfunction Kirti Kalidas M.D., N.D.

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  • Toxic substances can be from both external and internal sources. Food additives, chemical solvents from industrial waste, pesticides and herbicides, drugs, and alcohol are all substances that we ingest that need to be detoxified properly. These wastes do not only come from large industrial chemical factories. Many of these are the cleaners, pesticides and herbicides we use in and around our home. We also produce toxins internally from bacteria and yeasts that inhabit our gastrointestinal tract. If not handled properly, these can grow and cause imbalances that lead to disease. National Human Adipose Tissue Survey (http://www.epa.gov/chemrtk/vccep/vccepmth.htm) The National Adipose Tissue Survey (NHATS) analyzed human adipose (fatty) tissue specimens to monitor human exposure to potentially toxic chemicals. Pathologists and medical examiners from 47 metropolitan statistical areas collected tissue specimens from cadavers and surgical patients during the time period between 1970-1987. These specimens were analyzed for organochlorine pesticides, PCBs, dioxins and furans, volatile organics, semivolatile organics, and trace elements. However, not all compounds were analyzed over the complete time period from 1970 - 1987. Throughout the 1970's and early 1980's the chemical residues of primary interest where organochlorine pesticides and PCBs. During 1982, volatile and semivolatile organic compounds were included in the survey. NHATS was the primary activity of the National Human Monitoring Program (NHMP), operated by the EPA Office of Pollution Prevention and Toxics (USEPA/OPPT), until the early 1990s.
  • Toxic substances can be from both external and internal sources. Food additives, chemical solvents from industrial waste, pesticides and herbicides, drugs, and alcohol are all substances that we ingest that need to be detoxified properly. These wastes do not only come from large industrial chemical factories. Many of these are the cleaners, pesticides and herbicides we use in and around our home. We also produce toxins internally from bacteria and yeasts that inhabit our gastrointestinal tract. If not handled properly, these can grow and cause imbalances that lead to disease. National Human Adipose Tissue Survey (http://www.epa.gov/chemrtk/vccep/vccepmth.htm) The National Adipose Tissue Survey (NHATS) analyzed human adipose (fatty) tissue specimens to monitor human exposure to potentially toxic chemicals. Pathologists and medical examiners from 47 metropolitan statistical areas collected tissue specimens from cadavers and surgical patients during the time period between 1970-1987. These specimens were analyzed for organochlorine pesticides, PCBs, dioxins and furans, volatile organics, semivolatile organics, and trace elements. However, not all compounds were analyzed over the complete time period from 1970 - 1987. Throughout the 1970's and early 1980's the chemical residues of primary interest where organochlorine pesticides and PCBs. During 1982, volatile and semivolatile organic compounds were included in the survey. NHATS was the primary activity of the National Human Monitoring Program (NHMP), operated by the EPA Office of Pollution Prevention and Toxics (USEPA/OPPT), until the early 1990s.

Web of Dysfunction Kirti Kalidas M.D., N.D. Web of Dysfunction Kirti Kalidas M.D., N.D. Presentation Transcript

  • Web of Dysfunction Kirti Kalidas M.D., N.D. Board Certified Internal Medicine Licensed Naturopathic Physician Center for Natural and Integrative Medicine 407 355 9246 www.drkalidas.com
  • Web of Dysfunction
    • Background
      • Medical school in South Africa, Residency and private practice
      • Frustration and need for change
    • Naturopathy
      • Basic principles
      • Modalities
    • Balance of MD and ND
    • Web of Dysfunction
  • MD/ND Perspective Development of Paradigm
    • Broad ranged , multiple modalities-How do you apply yourself
    • Disease vs Wellness paradigm
    • Frustration of 2 years of practice: Acceptance, new patients problem resolution, percentage return visits, building inroads into the community
    • How quickly can I get to the root cause????
    • Successful Practices: Focusing on one area, modality or true integration in broad range of conditions
  •  
  • Liver, Pancreas, GB, Stomach Detox Insulin resistance Impaired digestion
  • ISD
    • Chronic Infections : viral , bacterial, Fungal, Parasitic, sites for occult low grade infections, Nanobacteria, Helicobacter, Chronic Lyme and co-infections
    • Auto immune conditions
    • Asthma, allergies, Chemical hypersensitivity
    • Neurological: MS, tics, tremor, Chronic pain, neuropathies
  • What is my Toxic burden?
    • Maternal/Transplacental transfer
    • Immunizations/ thimerosal/flu shots
    • Environmental: pesticides, solvent, heavy metals, occupational, Toys from China, arsenic in playground equipment, air pollution etc
    • Food and water sources
    • Habits: smoking, alcohol, recreational
    • EMWaves etc
  • The need for metabolic detoxification is increasing daily
    • EPA Study of toxins in human adipose tissue 1
      • 100% of sampled contained plastics, solvents and dioxins 2
      • 83% also contained PCBs
    • U.S. Pesticide use – 4 billion pounds annually
      • 8 pounds for every man, woman and child 3
      • FDA Pesticide Residue Monitoring 4
      • Pesticide residue was found in 50.5% of domestic fruits and 27.5% of domestic vegetables
    1 EPA’s Office of Prevention, Pesticides and Toxic Substances 1999 2 US EPA National Adipose Tissue Survey 1982 4 Styrene, 1,4 Dichlorobenzen, xylene, ethylphenol, and TCDD 3 FDA Pesticide Program Residue Monitoring 2002 5 Body Burden, Environmental Working Group 2005
      • Over 167 synthetic chemicals and carcinogens are now found in the average human body 5
  • The need for metabolic detoxification is increasing daily
    • Over 167 synthetic chemicals and carcinogens are now found in the average human body°
    • EPA Study of toxins in human adipose tissue ۰
      • 100% of sampled contained plastics, solvents and dioxins**
      • 83% also contained PCB’s
      • U.S. Pesticide use  4 billion pounds annually
      •  8 pounds for every man, woman and child *
    ۰ US EPA National Adipose Tissue Survey, 1982 * EPA’s Office of Prevention, Pesticides and Toxic Substances, 1999 ° Body Burden, Environmental Working Group, 2005 ** Styrene, 1,4 Dichlorobenzen, xylene, ethylphenol, and TCDD Research shows that this level of exposure to environmental toxins may lead to significant health challenges in your patients
  • J Clin Pharmacol 1997;37(7):635-48.   Interpatient variability: genetic predisposition and other genetic factors. West WL , Knight EM , Pradhan S , Hinds TS . Center for Drug Abuse Research (CDAR), Howard University, Department of Pharmacology/Center for Drug Abuse Research, College of Medicine, Howard University, Washington, DC 20059, USA. Polymorphisms and other genetic factors related to enzymes metabolizing drugs and xenobiotic chemicals are well known. This article focuses on selected molecular mechanisms and introduces some of the clinical implications arising from genetically determined interpatient variability or expression in some of these enzymes. Selected are the polymorphic enzymes of cytochromes P-450 (CYP) as examples of phase I enzymes and methyl transferases, n-acetyl transferases, and glutathione-s-transferases as examples of phase II enzymes. The polymorphism surrounding arylhydrocarbon hydroxylase induction is briefly described. Phase I enzymatic reactions are predominantly oxidative, whereas phase II reactions often couple with the byproducts of phase I. Overall, in poor metabolizers, whether phase I or phase II, there is limited metabolism in most patients unless another major metabolic pathway involving other enzymes exists. Research identifies significant genetic variation in CYP450 Phase I enzyme expression in humans. These variations have a significant impact on the patients ability to clear toxins. Even genetic factors may be contributing to your patients ability to clear toxins
  • Candida and Dysbiosis
    • Traditional MD thinking and training
    • Candida – invasive vs overgrowth
    • GI balance and wellness
    • Antibiotics in foods
    • Probiotics in Foods
  • Permeability, Food Sensitivity, Nutritional deficiency
    • What is the true nutritional status of our patients
    • Is my bag of pills working for me
    • Type of diet
    • Empiric treatment until results available-Key nutrient support and possible IV support
  • CNS and HP Dysfunction
    • History of trauma, abuse, stressors-move, job, financial, student loans, marital, relationship, toxic exposure
    • The switch/fuse box- Fatigue to Fantastic Dr Teitalbaum---THINS—Toxic, Hormonal, Infectious, Nutritional, Sleep
  • Hormonal Imbalance
    • Thyroid vs. adrenal or combined symptoms
    • Classic signs and symptoms of hypothyroidism
    • Functional hypothyroidism and testing
    • Show severity of adrenal imbalance fatigue /burnout
    • Low dose thyroid support
    • Use of bio identical hormones in women
    • Testosterone use in clinical practice
    • Melatonin, growth hormone etc
  • Test used in my practice
    • Basic core labs
      • Additional blood test, Cardiac, Rheum, Lyme
    • Salivary hormones
    • Heavy metal testing
    • Spectracell
    • Food sensitivities
    • CSA with parasites
    • Organic Acid testing
    • Neuroscience
    • Gluten /casein peptide
    • Metallotheinin/Zn and copper
    • US, CT, MRI etc
    • FFA analysis, hepatic detox pathway
    • Condition specific test
  • Case Study 1
    • 42 year dental professional with chronic GI symptoms, chronic palpitations, resting heart rate of 100-110 bpm, failed medical and 3 ablation attempts
    • Test ordered
    • Treatment and resolution of symptoms in 3 months
  • Case 2
    • 38 yr female background history myalgia, 2 auto accidents, exacerbation of RSD symptoms for 8 years. TMJ surgery x2. Chronic pain and spasm requiring massage therapy twice weekly with minimal improvement
    • Test
    • Treatment
  • Case 3
    • 51 yr old female , failed 22 MD treatment over 3 years for chronic leg pain, sensitivity, hyperparasthesia, fatigue, perimenopausal symptoms and chronic constipation.
    • Impression and test
    • Course of treatment
  • Case 4
    • 39 yr female with chronic fatigue, weight gain, hypothyroidism, 7years of stress with son with sensory integrative issues
    • Not much hope given by endocrinologist
    • Physical evaluation
    • Test
    • outcome
  • Case 5
    • 42 yr disabled wheelchair bound, 3 failed back surgeries, chronic persistent leg pain, Reactive airways Disease on Oxygen, chronic foley catheter use and scheduled bladder surgery
    • Tests
    • Treatment and outcome
  • Case 6
    • 4 year old Asian male , nonverbal , gross motor normal, poor fine motor skills , advised by pediatric neurologist to continue monitoring and bring him back if he has seizures
    • Test
    • Treatment
  • Case 7
    • 54 yr old with RA and weight gain and stress post hurricane in 2005
    • Physical
    • Test
    • Outcome
  • Case 8
    • 45 year old school teacher with Fatigue, Asthma, Anemia, fibroids, recurrent URI and bronchitis and Family history of ovarian cancer
    • Test
    • treatment
  • Case 9
    • 46 yr old female with CFS for 10 years, fibromyalgia, joint pain and severe “brain fog”. Seen by multiple physicians and alternative doctors
    • Evaluation and test
    • Treatment and outcome
  • Case 10
    • 8 yr old WM with 3 year history of abdominal pain , full GI workup, learning disorder
    • Test
    • Treatment
    • Outcome in 3-4 months
  • Take Home
    • Our health is a product of gene expression, toxic exposure, functional and hormonal imbalances and lifestyle choices
    • Integration of modalities
    • Working with MD’s and other health care providers
    • Stepwise testing and support and addressing each area
    • Optimizing health, hope and healing by addressing the root cause