1. Contact Information David B. Wood, ND www.trinityclinic.com 425.778.LORD (5673) David B. Wood, ND Trinity Family Health Clinic, PS 19031 – 33 rd Ave. W. Ste. 301 Lynnwood, WA 98036

2. Why am I so tired? Doc, just give me a pill so I’m not so tired all the time! Or, Doc don’t you have a pill for this? First the doctor must determine the cause of the fatigue!

3. Some possible physiologic causes of FATIGUE Anemia Dysglycemia (low or high blood sugar) Thyroid hormone imbalance (low or high) Adrenal Gland insufficiency or excess Chronic food or airborne allergies Chronic infections (esp. viral) pH imbalance (usually too acid) Lack of exercise or excessive exercise

4. Anemia Borderline states often missed and go untreated! Iron deficient – microcytic hypochromic Best: ferrous glycinate Beets, Black Strap Molasses, beef B12/Folate deficient – macrocytic hypochromic Best: bioactive B12 and folate Methylcobalamin/Folinic acid Beef, liver, greens

5. Dysglycemia Balance Blood Sugar Levels: Low glycemic diet high in fiber, protein and low in sugar Exercise Nutrients such as: Chromium (polynicotinate) Vanadium (organic, aspartate) B Complex (Bioactive phosphorylated) Biotin (8,000 to 16,000 mcg per day) Botanicals such as: Gymnema, Fenugreek, Cinnamon

6. Thyroid Hormone Imbalance Serum laboratory evaluation TSH, Free T3, Free T4, possible evaluation for autoimmune thyroid dz On waking Basal Body Temperatures OR oral temperatures 3x per day (97.6 – 98.2 BBT) (98.3 – 98.9 OT) Subjective/Objective Sx: fatigue, dry skin, constipation, cold extremities, out 1/3 eyebrow thinning, pretibial edema, dry coarse hair or hair loss/thinning, depression, slow or absent reflexes. TX: Rx natural thyroid hormone (T3 + T4) Nutritional Support (iodine, L-Tyrosine, kelp)

7. Adrenal Gland Over or Underactive? Check Adrenal hormones – Cortisol and DHEA Serum or even better – Salivary hormones (4 samples – to map circadian rhythm) Cause of Adrenal imbalance – Stress (Dysglycemia, pain, over work, worry, anxiety, poor coping skills, nutrient deficiencies, infection, poor sleep quality, etc.)

8. Adrenal Gland Low Glycemic, high fiber, high protein diet high in fruits/vegetables but low in sugar, sweets, refined carbohydraes Increase: Vitamin C, Pantothenic Acid, Adrenal Cortex Extracts, Long Acting DHEA. Botanicals – Ginsengs, Rhodiola Correct blood sugar and pain issues, help improve sleep quality. Treat chronic infection(s)

9. Allergies Test for food and environmental allergies (if sx warrant) (serum, elimination diet or skin (only airborne) Avoid food allergies and rotate borderline and non allergic foods Reduce exposure to airbornes Oral desensitization for food/airborne allergies Correct “Leaking Gut”, “Gut Dysbiosis” and “Digestive Deficiences”

10. Chronic Infections Many patients with Chronic Fatigue have Chronic active Viral Infections Test for: Epstein Barr Virus Cytomegalo Virus Possible – Hepatitis B and C, HIV Tx: with naturopathic antiviral immune enhancers, targeted transfer factors (for specific virus) Echinacea, Sambucus, Vit C, Thymus, melatonin, Astragalus)

11. Conclusion Take care of your health! Be Proactive! Get thorough checkups and be a good steward of your health Why? To live a longer, healthier, more enjoyable life – to be better able to serve our LORD Take care of your health! Be Proactive! Get thorough checkups and be a good steward of your health Why? To live a longer, healthier, more enjoyable life – to be better able to serve our LORD