1. Nutritional & Environmental Medicine: Putting all the pieces together. Blake Graham, B.Sc (Honours), AACNEM Clinical Nutritionist www.nutritional-healing.com.au (08) 9381 4112 February 16 th 2008

2. What causes disease? Genetics. Genetics. Gastrointestinal abnormalities. Gastrointestinal abnormalities. Nutrient imbalances/diet. Nutrient imbalances/diet. Environmental. (e.g. heavy metals) Environmental. (e.g. heavy metals) Allergies/intolerances. Allergies/intolerances. Chemical imbalances. (e.g. hormones) Chemical imbalances. (e.g. hormones) Disordered sleep. Disordered sleep. Psycho-social factors. Psycho-social factors. Lifestyle factors. Lifestyle factors.

3. Multi-factorial model. All disease is multi-factorial!

4. Web of inter-relationships and vicious cycles.

5. Ripple effect.

6. Spectrums.

7. Self healing. Complex corrective mechanisms. Complex corrective mechanisms. Identify and remove: Identify and remove:  Causes.  Impediments to healing. Reduce burden of stressors on the body below the threshold which the body can restore balance. Reduce burden of stressors on the body below the threshold which the body can restore balance.

8. Disease treatment models. 1. Treat symptoms:  Nausea = anti-nausea medication  High cholesterol = cholesterol lowering medication  Dry skin = moisturizer  Insomnia = sedatives 2. Address underlying causes: e.g. nausea caused by gastrointestinal infection e.g. nausea caused by gastrointestinal infection e.g. high cholesterol caused by poor diet e.g. high cholesterol caused by poor diet e.g. dry skin caused by fatty acid deficiency e.g. dry skin caused by fatty acid deficiency e.g. insomnia caused by anxiety e.g. insomnia caused by anxiety

9. Disease treatment models. Disease centred diagnosis. Disease centred diagnosis.  Irritable bowel syndrome.  Chronic Fatigue Syndrome.  Migraines.  Depression. Person centred diagnosis.  Nutrient deficiencies.  Sleep deprivation.  Food intolerances.  Intestinal infection.

10. Genetics.

11. Inter-relationship between genetics and environment.  Environment influences genetic expression.  Genetics influence reaction to environment.

12. Genetics. Specific links of interest: 1. Environmental chemical metabolism. 2. Nutrient imbalances. 3. Gastrointestinal health. 4. Allergies/intolerances. 5. Chemical imbalances. (e.g. hormones) 6. Immune integrity.

13. Genetics. Family history:  Eczema/asthma/hay fever/hives  Allergies  Depression/anxiety/OCD  Neurotransmitters  Crohn's Disease  Increased intestinal permeability  ADD/ADHD  Abnormal zinc metabolism

14. Genetic testing. Reference: www.genovations.com/ Huge genetic variation!

15. Gastrointestinal health.

16. Gastrointestinal imbalances. Imbalanced gastrointestinal flora ('dysbiosis'). Imbalanced gastrointestinal flora ('dysbiosis'). Gastrointestinal infections (bacteria, parasitic, yeast). Gastrointestinal infections (bacteria, parasitic, yeast). Increased intestinal permeability ('leaky gut'). Increased intestinal permeability ('leaky gut'). Maldigestion/malabsorption. Maldigestion/malabsorption.  Stomach acid deficiency (hypochlorhydria).  Pancreatic enzyme insufficiency.  Bile acid deficiency.

17. Intestinal flora. Functions of healthy flora: Functions of healthy flora:  Produce short chain fatty acids which are needed by the intestinal mucosa for energy  Produce biofilm (mucus barrier) to protect intestinal mucosa  Interact with the gut associated lymphoid tissue (GALT) – 70% of immune system, e.g.  Improves antibody formation  Reduce allergies (eczema and asthma)  Regulate cytokine levels / inflammation modulation  Synthesize nutrients (certain amino acids and vitamins)  Improve digestion/absorption  Inhibit the overgrowth of harmful bacteria, yeast, viruses and parasites  Improve intestinal motility and stool formation  Influence genetic expression  Assist the detoxification of various substances and convert some toxins into less toxic forms :  Mercury  Hormones (e.g. estrogen)  Potentially carcinogenic chemicals  Drugs  Lipids (e.g. cholesterol)

18. Harmful bacteria. Produce toxic chemicals as metabolic by-products which have systemic effects, e.g. Produce toxic chemicals as metabolic by-products which have systemic effects, e.g.  Ammonia  Hyperammonemia  D-lactic acid  D-lactic acidosis Decrease production of short chain fatty acids Decrease production of short chain fatty acids Produce antigens which disrupt immune function Produce antigens which disrupt immune function Reduce levels of healthy flora Reduce levels of healthy flora Impair nutrient digestion/absorption Impair nutrient digestion/absorption Degradation/consumption of nutrients Degradation/consumption of nutrients Damage intestinal wall Damage intestinal wall

19. Intestinal flora testing.

20. Gastrointestinal health: Yeast. Opportunistic/secondary. Opportunistic/secondary. Great exacerbating factor. Great exacerbating factor. Releases harmful chemicals. Releases harmful chemicals. Lab tests are notoriously unreliable. Lab tests are notoriously unreliable.

21. Yeast symptoms/signs. Genital thrush Genital thrush Vaginal itching or redness, vaginitis or 'jock itch' – often scratching/itching at genital area Vaginal itching or redness, vaginitis or 'jock itch' – often scratching/itching at genital area White or grayish-white coating on your tongue or inner cheeks, or white patches in the mouth White or grayish-white coating on your tongue or inner cheeks, or white patches in the mouth Nasal congestion or stuffiness, swelling of the nasal membranes or sinusitis Nasal congestion or stuffiness, swelling of the nasal membranes or sinusitis Previously noticed a decline in your health following antibiotics or antibiotics exacerbate your current health problem Previously noticed a decline in your health following antibiotics or antibiotics exacerbate your current health problem Fungus infections of the skin (e.g. athletes foot) or nails Fungus infections of the skin (e.g. athletes foot) or nails Psoriasis, eczema or hives Psoriasis, eczema or hives Puffiness/bloating/swelling in the hands, face and feet Puffiness/bloating/swelling in the hands, face and feet Sugar cravings Sugar cravings Eating sugar make you feel worse/worsens certain symptoms Eating sugar make you feel worse/worsens certain symptoms Negative reaction to certain dietary yeasts/molds Negative reaction to certain dietary yeasts/molds Very high fondness for yeasty foods Very high fondness for yeasty foods Chemical sensitivities (e.g. car exhaust, petrol, cigarette smoke, perfumes, etc.) Chemical sensitivities (e.g. car exhaust, petrol, cigarette smoke, perfumes, etc.) Multiple food sensitivities Multiple food sensitivities Lower abdominal bloating Lower abdominal bloating Gas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stools Gas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stools Itchy rectal/anal area or red ring immediately around the anus Itchy rectal/anal area or red ring immediately around the anus Attention problems Attention problems Feel ‘spaced out’ &/or ‘brain fogged’ Feel ‘spaced out’ &/or ‘brain fogged’

22. Yeast testing.

23. Gastrointestinal health: Parasites. Remarkably common. Remarkably common. Under-diagnosed due to: Under-diagnosed due to:  Lack of consideration.  Inadequate laboratory techniques. Giardia intestinalis

24. Intestinal parasite symptoms/signs. Current illness began with diarrhea/food poisoning Current illness began with diarrhea/food poisoning Frequent diarrhea Frequent diarrhea Loose/unformed stools Loose/unformed stools Abdominal bloating Abdominal bloating Abdominal pain/discomfort Abdominal pain/discomfort Excessive flatulence Excessive flatulence Visible mucus or pus in stools Visible mucus or pus in stools Itchy anal/rectal area Itchy anal/rectal area Foul smelling stools Foul smelling stools Frequent constipation Frequent constipation Frequent nausea and/or vomiting Frequent nausea and/or vomiting Food allergies/intolerances Food allergies/intolerances Teeth grinding (bruxism) while sleeping Teeth grinding (bruxism) while sleeping Skin conditions (bluish cast around lips, hives, psoriasis, eczema, skin ulcers) Skin conditions (bluish cast around lips, hives, psoriasis, eczema, skin ulcers) Fatigue/weakness Fatigue/weakness Forgetfulness or unclear thinking Forgetfulness or unclear thinking Nervousness, apathy, depressed, anxious or headaches Nervousness, apathy, depressed, anxious or headaches Dizziness Dizziness

25. Parasite testing.

26. Maldigestion/malabsorption. Stomach acid deficiency (hypochlorhydria). Stomach acid deficiency (hypochlorhydria). Pancreatic enzyme insufficiency. Pancreatic enzyme insufficiency. Bile acid deficiency. Bile acid deficiency.

27. Digestive function testing.

28. Hypochlorhydria symptoms/signs. Undigested food in stool Undigested food in stool Trouble digesting red meat Trouble digesting red meat Food or water ‘sits in stomach’ Food or water ‘sits in stomach’ Poor appetite or feel overly full easily Poor appetite or feel overly full easily Stomach aching/pain/discomfort or bloating after meals Stomach aching/pain/discomfort or bloating after meals Reflux &/or heartburn Reflux &/or heartburn High fat foods cause nausea/stomach upset High fat foods cause nausea/stomach upset Nausea/reflux after supplements (e.g. fish oil) Nausea/reflux after supplements (e.g. fish oil) Feel unwell/fatigued right after meals Feel unwell/fatigued right after meals Lemon juice improves digestion Lemon juice improves digestion Low iron levels Low iron levels

29. Heidelberg pH Diagnostic System. Reference: www.phcapsule.com/

30. Gastrointestinal treatments. Probiotics/prebiotics. Probiotics/prebiotics. Anti-microbials. Anti-microbials. Dietary changes. Dietary changes. Digestive enzymes. Digestive enzymes. Stomach acid supplement (Betaine HCl). Stomach acid supplement (Betaine HCl). Bile acids. Bile acids.

31. Nutrients.

32. Nutrient status continuum.

34. Nutrition: Nutritional status. I.Intake: Food choicesFood choices Soil levels, food storage, food processingSoil levels, food storage, food processing II.Digestion/assimilation III.Genetics IV.Synthesis (vitamins K & D) V.Other factors (hormone imbalances, toxic chemicals, infections, other nutrient levels, medications, oxidative stress, emotional stress, activity levels, kidney/liver problems, etc.)

35. Nutrient supplementation uses. 1. Optimizing levels. 2. Therapeutic value.

36. Fatty acid deficiency symptoms/signs. Dry skin (e.g. feet/face/general) Dry skin (e.g. feet/face/general) Scaly or flaky skin (e.g. legs) Scaly or flaky skin (e.g. legs) Cracking/peeling fingertips & skin (e.g. heels) Cracking/peeling fingertips & skin (e.g. heels) Lackluster skin Lackluster skin Small bumps on back of upper arms Small bumps on back of upper arms Patchy dullness &/or color variation of skin Patchy dullness &/or color variation of skin Irregular quilted appearance of skin (e.g. legs) Irregular quilted appearance of skin (e.g. legs) Thick or cracked calluses Thick or cracked calluses Dandruff or cradle cap Dandruff or cradle cap Dry, lackluster, brittle or unruly hair Dry, lackluster, brittle or unruly hair Soft, fraying, splitting or brittle fingernails Soft, fraying, splitting or brittle fingernails Dull nails - lack of surface shine Dull nails - lack of surface shine Slow growing fingernails Slow growing fingernails Dry eyes Dry eyes Menstrual cramps or premenstrual breast pain/tenderness Menstrual cramps or premenstrual breast pain/tenderness Excessive ear wax Excessive ear wax Excessive thirst Excessive thirst Allergic (e.g. eczema/asthma/hay fever/hives) Allergic (e.g. eczema/asthma/hay fever/hives) Crave fats/fatty foods Crave fats/fatty foods Stiff or painful joints Stiff or painful joints

37. Magnesium deficiency symptoms/signs. Muscle cramps, spasms or pain (e.g. back ache, neck ache, leg/foot cramps) Muscle cramps, spasms or pain (e.g. back ache, neck ache, leg/foot cramps) Muscle tension Muscle tension Muscle twitches, tics or jerks Muscle twitches, tics or jerks Muscle weakness Muscle weakness Muscle tremors Muscle tremors Restless legs Restless legs Fatigue / sighing Fatigue / sighing Breathlessness / chest tightness Breathlessness / chest tightness Heart palpitations / arrhythmias Heart palpitations / arrhythmias Numbness or tingling of skin or “creepy-crawly” feeling under skin Numbness or tingling of skin or “creepy-crawly” feeling under skin Sensitivity to loud noises or sudden bright light Sensitivity to loud noises or sudden bright light Menstrual cramps Menstrual cramps Headaches / migraines Headaches / migraines Frequent constipation or anal spasms Frequent constipation or anal spasms Difficulty falling asleep and/or restless sleep Difficulty falling asleep and/or restless sleep Irritable, depressed, anxious, nervous or panic attacks Irritable, depressed, anxious, nervous or panic attacks

38. Hair mineral analysis. Reference: www.doctorsdata.com/

39. RBC fatty acid analysis. Reference: www.metametrix.com/

40. Plasma amino acids. Reference: www.doctorsdata.com/

41. Nutrient imbalance treatments. Nutrient supplementation. Nutrient supplementation. Dietary changes. Dietary changes. Correct absorption problems. Correct absorption problems.

42. Nutrient supplementation case study. Symptoms: Symptoms:  Frequent urination  Night time urination  Night thirst  Blurred vision after heavy exercise Mineral supplementation: Mineral supplementation:  “From one day to the next at least 90% of my symptoms vanished. These are symptoms I have lived with and have worsened for more than 10 years. Quite amazing.”

43. Toxic chemicals.

44. Increased toxic chemical exposure.  Lead levels of human bones are ~1000 times higher than pre- industrial bones.  Cadmium 500 times higher.

45. Heavy metal sources: Food: Food:  Soil  Pesticides  Cooking items Water Water Air Air Medical: Medical:  Amalgam fillings  Vaccines  Direct contact with heavy metal containing or contaminated substances  Paints  Cigarettes  Household chemicals  Body products  Many many others!

46. Autism – mercury Study 1. 221 children with ASD vs. 18 controls 221 children with ASD vs. 18 controls Post-DMSA urine levels Post-DMSA urine levels Mercury was 3.15 times higher!! Mercury was 3.15 times higher!! Jeff Bradstreet, M.D. David Geier, B.A. Jerold Kartzinel, M.D. James Adams, Ph.D. Mark Geier, M.D.,Ph.D. A Case-Control Study of Mercury Burden in Children with Autistic Spectrum Disorders. Journal of American Physicians and Surgeons Volume 8 Number 3 Fall 2003

47. Autism – mercury Study 2. 14 children with Autism vs. 11 controls 14 children with Autism vs. 11 controls Mercury was 3 times higher in baby teeth!! Mercury was 3 times higher in baby teeth!! Adams JB. A Review of the Autism-Mercury Connection. Conference Proceedings of the Annual. Meeting of the Autism Society of America, July 2004.

52. Toxic chemical treatments. Chemical avoidance. Chemical avoidance. Chelation agents. Chelation agents. Supportive nutrients/herbs. Supportive nutrients/herbs. Far infrared (FIR) saunas. Far infrared (FIR) saunas.

53. Other environmental influences.

54. Electromagnetic radiation (EMR).

55. EMR testing.

56. Toxic mould.

57. Mould testing.

58. Sick building syndrome symptoms/signs. Ongoing or frequent coughing / dry throat or mouth Ongoing or frequent coughing / dry throat or mouth Irritated, stinging or burning sensation of throat or mouth Irritated, stinging or burning sensation of throat or mouth Throat hoarseness / changed voice (e.g. raspy) Throat hoarseness / changed voice (e.g. raspy) Metallic taste in mouth Metallic taste in mouth Wheezing, irritated lungs or bronchitis Wheezing, irritated lungs or bronchitis Shortness of breath / chest tightness Shortness of breath / chest tightness Irritated, sore or burning eyes Irritated, sore or burning eyes Red or watery/tearing eyes Red or watery/tearing eyes Sensitivity to bright light / blurred vision Sensitivity to bright light / blurred vision Nasal congestion / running or stuffy nose / sneezing / nose bleeds Nasal congestion / running or stuffy nose / sneezing / nose bleeds Irritated, stinging or burning nose or nasal passage / nasal itching Irritated, stinging or burning nose or nasal passage / nasal itching Sinusitis / sinus congestion or pressure Sinusitis / sinus congestion or pressure Stinging, burning or itchy skin / skin sensitivity to light touch Stinging, burning or itchy skin / skin sensitivity to light touch Skin rash or reddening of skin Skin rash or reddening of skin Dizziness / vertigo Dizziness / vertigo Headaches Headaches Fatigue / weakness Fatigue / weakness

59. Allergies/intolerances.

60. Food reactivity. Many reasons why a person may react negatively to specific foods. Many reasons why a person may react negatively to specific foods.  Allergy  Intolerance  e.g. lactose intolerance or fructose malabsorption  e.g. impaired ability to metabolize salicylates, etc.  e.g. gut flora/leaky gut mediated  e.g. pharmacologic properties of the food - aspartame  e.g. toxins in foods  No one lab test for diagnosis of all negative reactions.  No one lab test for diagnosis of all negative reactions.

61. Food intolerance or allergy symptoms/signs. Itchy, tingly, irritated or burning tongue/lips/palate/throat during or after meals Itchy, tingly, irritated or burning tongue/lips/palate/throat during or after meals Swollen lips/mouth or recurrent mouth ulcers Swollen lips/mouth or recurrent mouth ulcers Frequent hives - generally or around mouth/lips (e.g. rash or ring around mouth ) Frequent hives - generally or around mouth/lips (e.g. rash or ring around mouth ) Increased mucus production in throat / regularly clearing throat Increased mucus production in throat / regularly clearing throat Excess drooling / excess saliva production / spitting during speech Excess drooling / excess saliva production / spitting during speech Irregular patches on tongue (geographic map-like) or mottled tongue Irregular patches on tongue (geographic map-like) or mottled tongue Puffiness or ‘bags’ below eyes; or puffy or swollen nose/face Puffiness or ‘bags’ below eyes; or puffy or swollen nose/face Dark circles under eyes (‘allergic shiners’) Dark circles under eyes (‘allergic shiners’) Inner corners of eyes itch or whole eyes itch / eye rubbing or scratching Inner corners of eyes itch or whole eyes itch / eye rubbing or scratching Watery, glassy or glazed eyes; or red eyes Watery, glassy or glazed eyes; or red eyes Itchy nose / nose rubbing or scratching (‘nasal salute’) Itchy nose / nose rubbing or scratching (‘nasal salute’) Nasal or sinus congestion / sinusitis / runny or snuffly nose / sneezing Nasal or sinus congestion / sinusitis / runny or snuffly nose / sneezing Postnasal drip (nasal mucus draining down the back of the throat) Postnasal drip (nasal mucus draining down the back of the throat) Abnormally red and/or flushed appearance of cheeks or nose (e.g. red tip nose) Abnormally red and/or flushed appearance of cheeks or nose (e.g. red tip nose) Red ears / hot or ‘burning’ earlobes Red ears / hot or ‘burning’ earlobes Eczema or wool intolerance / psoriasis Eczema or wool intolerance / psoriasis Itchy arms, ear canals, hands, legs or skin in general Itchy arms, ear canals, hands, legs or skin in general Puffy or swollen hands/knuckles/feet Puffy or swollen hands/knuckles/feet Asthma or recurrent wheezy bronchitis / infection or exercise induced wheezing Asthma or recurrent wheezy bronchitis / infection or exercise induced wheezing Abdominal pain, bloating or vomiting Abdominal pain, bloating or vomiting Increased frequency of stools / unformed bowel movements / frequent constipation Increased frequency of stools / unformed bowel movements / frequent constipation Feel best when don’t eat or skip meals Feel best when don’t eat or skip meals Feel worse (energy, mood, concentration, etc.) or look pale/red after some meals Feel worse (energy, mood, concentration, etc.) or look pale/red after some meals Strong particular food cravings and dislikes / fussy eater Strong particular food cravings and dislikes / fussy eater Recurrent ear infections and/or recurrent glue ear Recurrent ear infections and/or recurrent glue ear Headaches/migraines Headaches/migraines

62. Elimination/provocation testing. GRAINS - Whole grain rice GRAINS - Whole grain rice MEAT - 100% unrefined lamb MEAT - 100% unrefined lamb VEGETABLES - Cabbage, kale, carrots, cauliflower, squash, broccoli & sweet potatoes VEGETABLES - Cabbage, kale, carrots, cauliflower, squash, broccoli & sweet potatoes FRUIT – Pears FRUIT – Pears OILS/SEASONINGS - Olive oil & sea salt OILS/SEASONINGS - Olive oil & sea salt

63. Inhalant allergies. Dust. Dust. Cats/dogs. Cats/dogs. Pollen. Pollen. Grass. Grass.

64. Food intolerance case study. Fibromyalgia. Fibromyalgia. Elimination diet  50% drop in symptoms. Elimination diet  50% drop in symptoms.  Lactose intolerance.

65. Chemical imbalances.

66. Neurotransmitter & hormone imbalances. Neurotransmitters: Neurotransmitters:  Serotonin  Dopamine  Noradrenaline  GABA  Acetylcholine  Endorphins Hormones: Hormones:  Adrenal hormones  Thyroid hormones  Sex hormones  Growth hormone

67. Biochemical continuum.

68. Serotonin deficiency signs/symptoms. Depressed Depressed Nervous/anxious Nervous/anxious Worrier Worrier Fears/phobias Fears/phobias Negative/pessimistic Negative/pessimistic Irritable/impatient/edgy Irritable/impatient/edgy Obsessive compulsive tendency Obsessive compulsive tendency Think about the same things over & over again Think about the same things over & over again Self destructive or suicidal thoughts/plans Self destructive or suicidal thoughts/plans Low self esteem/confidence Low self esteem/confidence Rage/anger/explosive behavior/assaultive Rage/anger/explosive behavior/assaultive Sleep problems/light sleeper Sleep problems/light sleeper Crave sugar/carbohydrates/alcohol/marijuana Crave sugar/carbohydrates/alcohol/marijuana  Use these substances to improve mood & relax Feel worse in & dislike dark weather Feel worse in & dislike dark weather Chronic pain (e.g. headaches, backaches, fibromyalgia) Chronic pain (e.g. headaches, backaches, fibromyalgia)

69. Reference: Bioconcepts. [www.bioconcepts.com.au/] Serotonin pathway.

70. Adrenal Rhythm. Reference: www.diagnostechs.com/

71. Mild adrenal insufficiency signs/symptoms. Fatigue/lethargy not relieved by sleep Fatigue/lethargy not relieved by sleep Trouble getting up in the morning Trouble getting up in the morning Crave salt or salty food Crave salt or salty food Low blood pressure Low blood pressure Light-headed or dizzy when getting up to stand from laying or sitting Light-headed or dizzy when getting up to stand from laying or sitting Feel unwell during/after emotional stress, e.g. exhausted, shaky or confused Feel unwell during/after emotional stress, e.g. exhausted, shaky or confused Decreased ability to handle stress/pressure Decreased ability to handle stress/pressure Tendency for low blood sugar Tendency for low blood sugar Intolerance to cold / frequently feel cold Intolerance to cold / frequently feel cold Unstable body temperature Unstable body temperature Light sensitivity Light sensitivity Increased frequency/severity of allergies Increased frequency/severity of allergies Dark brown spots on face/neck/shoulders Dark brown spots on face/neck/shoulders Poor exercise tolerance Poor exercise tolerance Increased time to recover from infection Increased time to recover from infection Thin, can't gain weight or weight loss Thin, can't gain weight or weight loss Insomnia / sleep disturbance Insomnia / sleep disturbance Anxious or panic attacks Anxious or panic attacks

72. Saliva Adrenal Stress Profile. Reference: www.gdx.net/

73. Adrenal hormone case study. “I am feeling so much better than when we first consulted over 6 months ago… for the last month I have been doing about 500 metres of swimming + 2 kms of walking about 5 times a week. This compares to just barely struggling to do the weekly shopping! The feelings of exhaustion are not very common anymore. Depression and anxiety totally under control. Sleeping is much better. Overall, I am beginning to feel like a completely different person.”

74. Sleep.

75. Inadequate sleep quantity and quality are extremely common. Inadequate sleep quantity and quality are extremely common.

76. Sleep. Functions of sleep: Functions of sleep:  Rejuvenation/Repair  Growth  Detoxification  Memory storage  Energy conservation Reference: Dr. Reza Samvat, www.sleep4health.com.au/

77. Sleep – treatment. Remove causes. Remove causes. Supportive lifestyle, environment and sleep routine. Supportive lifestyle, environment and sleep routine. Dietary changes. Dietary changes. Herbal/nutritional supplements. Herbal/nutritional supplements. Relaxation techniques. Relaxation techniques. See: www.nutritional-healing.com.au  ‘Articles’ for more info.www.nutritional-healing.com.au

78. Stress.

79. Psycho-social stress. Universal disease exacerbator. Universal disease exacerbator. Known effects: Known effects:  Impairs immune function.  Increase nutrient requirements (e.g. magnesium).  Impair digestion.  Impair sleep.  Impair neurotransmitter balance.  Impair hormone (e.g. cortisol, DHEA, thyroid hormones, sex hormones) balance.

80. Psycho-social stress – Management. Treatment options: Treatment options: Eckhart Tolle [www.eckharttolle.com/]. Eckhart Tolle [www.eckharttolle.com/]. Emotional Freedom Techniques (EFT). [www.integrative-clearing.com.au/] Emotional Freedom Techniques (EFT). [www.integrative-clearing.com.au/] Breathing/muscle relaxation exercises. Breathing/muscle relaxation exercises. Biochemical. Biochemical. Exercise. Exercise.

81. Lifestyle.

82. Lifestyle factors. Smoking. Smoking. Alcohol. Alcohol. Drug use. Drug use. Exercise. Exercise. Rest. Rest. Fun. Fun.

83. How to put it all together. 1. Optimize basics:  General diet.  Sleep.  Stress.  Lifestyle.  Healthy environment.

84. How to put it all together. 1. Optimize basics:  General diet.  Sleep.  Stress.  Lifestyle.  Healthy environment. 2. Identify contributing factors: Gastrointestinal issues. Gastrointestinal issues. Nutrient imbalances. Nutrient imbalances. Environmental. Environmental. Allergies/intolerances. Allergies/intolerances. Neurotransmitters & hormone imbalances. Neurotransmitters & hormone imbalances.

85. Questionnaire.

86. Nutritional & Environmental Medicine: Putting all the pieces together. Blake Graham, B.Sc (Honours), AACNEM Clinical Nutritionist (08) 9381 4112 February 16 th 2008 *Join our FREE email newsletter at www.nutritional-healing.com.au  ‘Newsletter’.www.nutritional-healing.com.au