Category Archives: 4. Ask the Doc Q&A

Natural Weight Loss Alternatives: Part 2

Weight gain has been a bane of our existence in our current society.  It’s frustrating, especially when you’re trying to follow all the rules and do everything right.  Well, sometimes it’s not as simple as counting your calories or spending hours in the gym.  In the last post, I mentioned three major reasons why someone would gain extra weight.  Here are three more:

Cause #4: Gastrointestinal problems – many of us have major disruptions in our digestive system without realizing it.  More than 75% of all my patients have some kind of digestive dysfunction, whether it’s a parasite, a yeast, a bacterial infection, or a combination.  Much like a nice patch of grass that becomes infested with weeds, these “critters” take up residence along the walls of your intestines, keeping us from digesting and absorbing of many nutrients that help us burn fuel efficiently.  Without these nutrients, we end up with a scenario similar to the thyroid dysfunction, storing the unburned fuel in our fat cells.

Gastrointestinal bugs can also produce wastes that bog down the liver, causing the traffic jam I described above.  A comprehensive digestive analysis is a crucial tool that reveals a lot of information about how well you’re digesting and absorbing nutrients, as well as whether or not you have a parasite, yeast, or bacterial infection in your intestinal tract.

Cause #5: Excess Estrogen (both sexes) and/or Uterine Fibroids (women) – with all the hubbub surrounding hormone replacement therapy and its touted benefits, it may surprise you to learn that many women (and men) actually have too MUCH estrogen!  This is a condition known as Estrogen Dominance.  Estrogen in the proper amounts is normal and healthy, but too much estrogen can wreak havoc on the body.  In men, excess estrogen starts to compete with testosterone, which shifts a man’s metabolism more toward fat storage.  In women, there is less testosterone, but the outcome is similar: easier fat storage.

In addition, estrogen can promote abnormal uterine growth, called a uterine fibroid.  Uterine fibroids are benign tumors of the uterus, and with excess estrogen driving them, they can grow very large–the size of a grapefruit, or even bigger.  These can contribute toward significant (and sometimes rapid) weight gain.  This is especially true if your body has shifted toward making a more powerful form of estrogen rather than its normal, healthy mild form.  Often, a blood test for estrogen levels doesn’t go far enough; it’s good to test for the actual ratio between the milder and more powerful forms of estrogen.  This test is simple and can possibly save your life by alerting you to a possible risk of certain hormone-driven cancers such as breast cancer.

Cause #6: Excess Insulin – estrogen isn’t the only hormone that promotes fat storage.  When we eat a meal, especially one high in sugar or carbohydrates (even complex carbs), our blood sugar levels rise.  To counteract this, the pancreas will release insulin, whose job it is to take that blood sugar and bring it inside the cells for fuel.  However, if there is too much insulin over time, the cells become stuffed with blood sugar and they don’t need anymore.  So they stop responding to insulin when it comes knocking with more blood sugar in hand.  Now the blood sugar has nowhere else to go except–you guessed it–right into the fat cells.  Most doctors will test fasting glucose (a very simple and routine blood test) but may not run another very important test that measures how well your body has handled its blood sugar over the long-term, a period of about 4 months.

As you can see, there are several possible reasons why a person might gain weight, none of which have much to do with calorie-cutting or spending time on the treadmill.  When the body functions inefficiently or there’s a breakdown in body function, one of the most common ways this shows up is weight gain.  The important part is finding out which cause or causes are actually happening, because each of these causes requires a different approach in order to be effective and get results.  This is why comprehensive testing is so important.  Remember: for every test not run, the practitioner is only guessing, and you may not see the results you’d like.  It’s best to know for sure – it saves time and money in the long run.

Natural Weight Loss Alternatives: Part 1

One of the most common questions people ask is, “how do I lose weight?”  Indeed, most of us are carrying around a few extra pounds.  If you are, you’re not alone; two-thirds of the population is now officially overweight.

There is good news and bad news.  The good news is, the problem can usually be solved.  The bad news is, it’s not a simple answer.  If it were, we wouldn’t all be struggling like we do!

Weight gain is a symptom of an underlying problem, and as with any healthcare dilemma, it’s extremely important to get to the bottom of what’s causing the extra weight to accumulate.  There are lots of causes of extra weight gain, too many to explore completely in one article, but I will touch on the most common causes and perhaps write a continuation in the future.

Cause #1: Low Thyroid Function – your thyroid gland makes thyroid hormone, which is a biochemical gas pedal for your cells.  It tells your cells how fast their metabolism should be.  It keeps you going, but also eases back on the throttle when necessary so that you don’t burn out. If your cells aren’t getting enough thyroid hormone, their metabolic activity slows down.  When this happens, your cells don’t burn fuel (blood sugar, oxygen, etc) like they should and the extra fuel gets stored in the fat cells.

Now, consider this: there are literally 22 different causes that fit into 7 different categories of thyroid dysfunction.  And it may not even be an actual problem with the thyroid gland at all!  The real culprit may be coming from any one of several other body systems, and the thyroid gland could be the victim, not the suspect.  This is why it’s extremely important to have a *complete* thyroid function panel done, and to have it interpreted correctly.  There are two problems that most people encounter; one is, most conventionally-trained doctors will only run TSH and maybe T4 or if you’re lucky, they’ll add T3 Uptake. The second problem is, the lab results aren’t interpreted in a way that evaluate for proper function, so many conventional doctors miss an underlying thyroid problem.

Cause #2:  Overactive Adrenal glands – your adrenal glands are small triangular-shaped glands that sit on top of your kidneys.  Their main function is to help us deal with stress.  They produce and release cortisol, our “stress hormone” whose job it is to raise blood sugar and heart rate so that we have more energy to handle the stress we face.

The catch is this: we’re only designed to handle immediate stressors that quickly pass.  If we’re under too much stress for too long, our bodies pay the price.  If cortisol levels are consistently too high, they will promote weight gain, especially around the lower abdomen and hips.  If the problem worsens, a person’s face can become rounder and slightly more pale.  It is important to have your cortisol hormone levels checked.  The best test for this is actually not a blood test; it’s a saliva test.  The cortisol found in saliva is the amount of active hormone readily available for your body to use, so it’s a more relevant test.

Cause #3: Liver Congestion – the liver is a large organ under the right side of your rib cage that basically acts as a garbage disposal or water treatment plant.  It has more than 500 jobs, and detoxification is at the top of the list.  Every toxic chemical we breathe, eat, or drink (air pollution, food additives), and every metabolic waste product from all your cells passes through the liver to be cleansed and converted to a less- or non-toxic substance.  The result is that the wastes go to the kidneys and the circulating blood is clean.

If your liver gets bogged down with too many toxins (poor diet, polluted area, or excess hormones), then it creates a traffic jam and all the toxins waiting in line to be detoxified start to back up.  As a defense mechanism, your body will try to pick the safest spot to store the excess toxins, where they will do the least amount of damage.  That would be (drumroll, please): the fat cells.  There are excellent tests that evaluate true liver detoxification function that go much further beyond the basic blood tests your conventional doctor is familiar with.  The functional tests are usually part of a much larger panel designed to evaluate a wide variety of body functions.

Please see Part 2 for more!

How to supplement serotonin? Natural alternatives for depression

A reader writes:

Is there any way to supplement serotonin?  I used to be such a happy person; now I am very angry…irritable…depressed.  I MISS the happy-go-lucky girl that I was.

I am so sorry to hear that you’re going through such a hard time.  Unfortunately, there is no quick fix, but you do have options.

The lion’s share of the serotonin your body makes is not actually made in your brain.  Although it’s important for your brain and your brain uses quite a bit of it, it is actually produced in the intestines.  The intestinal environment is delicate and can be prone to problems.  Any one of over 10,000 different microorganisms can interfere with intestinal function, so it is very important to be screened for these organisms.  It is also important that the test be very sensitive.  Most conventional stool cultures used by family physicians and hospitals are not nearly sensitive enough and may not reveal an existing problem.  Many Functional Medicine doctors use a DNA-based test that is anywhere from 200-1000 times more sensitive.

In addition, food intolerances can create digestive inflammation, which can also interfere with proper serotonin production.  Many food allergy/sensitivity tests can be misleading as well; a positive result can almost always be trusted, but a negative result may well be a false negative.  Test panels that evaluate multiple types of immune reactions are best.

And then there’s stress.  Stress suppresses stomach acid production, which is required to break down protein.  If your body is not efficiently breaking down proteins into their building blocks (called amino acids), then it cannot make serotonin or other neurotransmitters (a fancy word for brain chemicals), because several particular amino acids are precursors to major neurotransmitters.

Next, to manufacture serotonin requires several complex biochemical reactions.  For these reactions to take place, several vitamin and mineral cofactors are needed, such as B vitamins and iron.  Many ladies are lacking in iron due to heavy monthly cycles or uterine fibroids.  Lots of people also lack iron because their bodies can’t convert it to a usable form.

Chronic stress and adrenal dysfunction often deplete B vitamins because of B-complex’s role in supporting adrenal function.  Extremely high short-term stress or even mildly high long-term stress force the adrenal glands to work harder, using up B vitamins before your body can use them in the production of serotonin.  There are excellent functional lab tests for both adrenal function and to assess cellular Vitamin B complex status.

And last but not least, if your liver isn’t functioning as efficiently as it should (usually due to toxin exposure, environmental pollution, heavy metals, hormone overload, or a diet heavy in processed foods), then it can’t fully clear your body of hormones, wastes, and toxins.  This causes a traffic jam in which these harmful substances will build up in the body, circulating in the blood and affecting sensitive brain tissue and serotonin usage.  Toxic overload is one of the most common causes of depression, and it is almost always entirely overlooked by the conventional medical system.

Note: There is no clinically reliable lab testing for serotonin or other neurotransmitters themselves yet.  There are some doctors and other practitioners who use a urine test that claims to indirectly evaluate levels of various neurotransmitters.  Current research failed to verify the validity of the claims made by the proponents of this type of testing (typically the lab company offering the test).  So, please do NOT fall for these claims!  At present, the closest we use clinically are some excellent questionnaires derived from observations in academic settings and a superb lab test panel that measures several principal biochemical pathways (including some by-products of neurotransmitter production pathways) for their efficiency and metabolic activity.

So as one can see, a LOT of variables come into play here – we’ve covered adrenal stress, gastrointestinal function, liver detoxification ability, hormone overload, environmental and heavy metal toxin exposure, and even uterine fibroids!  Truthfully, there are probably more to add to the list that are beyond the scope of this post.  Since the appropriate treatment is different for each, it is crucial to narrow down the cause to avoid lost time and money, and the progression of the underlying condition!

I certainly hope your world begins to look up for you soon!

Additional Information:

Serotonin deficiency symptoms: how and when to suspect you’re short on serotonin:

  • You seem to be more sensitive to pain than you used to
  • Your appetite is irregular
  • You experience sadness, but can’t pin down the cause – you just feel sad.
  • You sleep poorly
  • You have tinnitus, or ringing in the ears that isn’t linked to any particular event (or if it can vary every so often)
  • You’ve lost pleasure or enjoyment from activities/people/situations that you used to enjoy before.
  • Your self-esteem is low

What about Selective Serotonin Reuptake Inhibitors (SSRIs)?

Antidepressant drugs such as Zoloft, Prozac, and Paxil don’t actually produce any serotonin at all.  Instead, they attempt to concentrate the levels of existing serotonin to keep it viable for a longer period of time.  The problem with this is that brain cells have been shown to adapt to their surrounding environment; if this environment is saturated with serotonin (since pharmaceutical drugs cannot duplicate the delicate balance of normal body mechanisms and will often “overshoot” the level needed), then the cell may become desensitized to serotonin.  An in-progress study that will soon release its results has suggested that long-term use of SSRI medications may actually reduce serotonin levels, which is the last thing a person wants if they are suffering any of the symptoms above.

Dr. L. Sweeney, DC is the Director of the Functional Medicine program at San Antonio Family Alternative Medicine.  She works  with a wide variety of patients, many of whom suffer depression, insomnia, fibromyalgia, migraine headaches, gastrointestinal dysfunction, adrenal fatigue, and more.  She runs a wide variety of quality diagnostic lab testing, leaving no stone unturned.  She can be reached at (210) 340-2150 or you can visit the clinic website at

Foods or Herbs to heal stomach lining with Gastritis?

A reader writes:

“My doctor informed me that I have gastritis and prescribed me medication.  Are there foods I can eat or herbs I can take that will help heal the lining of the stomach?”

There are indeed.  Some people are going to chime in:

“Slippery elm!”

But before we get to that, a more important question to ask is, what’s causing the gastritis?  After all, everything mentioned above is just symptom relief. 

It doesn’t do anything to alleviate the real problem.

In Functional Medicine, a diagnosis is certainly helpful, but it doesn’t tell you anything about why you have the problem or what’s causing it.  For example, “gastritis” is a very nonspecific term for “an inflammation (irritation and swelling) of the lining of the stomach”.  That’s a good place to start, but what’s causing the inflammation in the first place?  (Most doctors don’t attempt to look for the cause.)  Until we know the underlying cause(s), all you can do is treat the symptoms; by getting to the “why” and the root cause, that’s how we figure out the most appropriate course of action so that the problem can be corrected from the ground up.

The reason it’s so important to identify the root cause is, a single symptom or disease can have several widely different causes, and each of those causes must be addressed differently.  In this case, gastritis has two extremely common causes, and I see these all the time in practice.

  1. Reactive intolerance to certain foods – namely gluten, but definitely not limited to gluten only!
  2. Intestinal microbes – these can include parasites (hookworms, pinworms, etc), yeasts/fungi (candida and others), and/or bacterial infections (Helicobacter pylori or opportunistic bacterial overgrowth).

Practically every single patient I see in my office has BOTH of these problems!  They are both incredibly common.  They are also both incredibly overlooked or worse, met with skepticism by most doctors if a patient attempts to bring up the subject.

In this case, there are some diagnostic tests that can be ordered to figure out why your digestive lining is inflamed.

One is a gluten intolerance/reactivity test.  This isn’t the same as some of the tests they usually run at a hospital for Celiac Disease (which usually involves an endoscopy, which often produces falsely “negative” or “normal” results).  There are several ways to test for various aspects or evidence of gluten intolerance, and there are several different lab companies that each offer their own versions of testing options.  Some offer lab testing services directly to patients and don’t require a doctor’s order!  A variety of testing methods are available, and some results can be obtained from a simple cheek swab.  Please visit my SA Gluten Free website for my free, no-strings-attached e-book on Gluten Intolerance and various testing options.

The other test I typically need to order is a digestive analysis with microbe screening.  This is actually a combination test panel that offers a whole lot of info about any microbes you might be carrying around (as mentioned above, these can be any one or combination of the following: yeast, bacteria, and/or parasites.  The average patient comes into my office with no less than 3 separate species of these microorganisms!).  In addition, the version of this test I run tells us a lot about the environment of your digestive tract and it offers some indirect evidence of how well you’re absorbing nutrients.

It’s especially important to order these tests because:

Reason #1: Everyone has these problems.  Out of hundreds of tests I’ve done, I’ve had only one single initial test come back clean, which means in my clinical experience, the incidence of these issues is extremely high.

Reason #2: Other doctors are NOT checking for these and if they are, the tests are very invasive and outdated and frankly, can give you incorrect results.  They may appear “normal” or “negative” even if something is going on.  It’s crucial that sensitive, relevant test methods are used to ensure accurate information.

Reason #3: These issues wreak havoc until they’re dealt with.  Food intolerances do not go away, and neither do intestinal microorganisms.  Intolerance reactions build with time and may become severe enough to promote destruction of your own tissues, organs, or glands.  Intestinal microbes act like squatters on your property (your intestines) until they’re forcibly evicted.

Reason #4: Treatment approaches for these issues are very different.  Many people make the innocent mistake of attempting to treat themselves using information gleaned from a Google search (I used to be That Person myself), but until we have the test results in hand, how will you know which approach to take?

If the problem lies behind Door Number 1 (the food intolerance), one must eliminate that food, identifying the infinite number of possible hidden sources, and this dietary modification is usually for life.  Some choose to forgo the testing and simply attempt to eliminate (or “cut back” on) the reactive food, but this approach is rarely successful and besides – why go through the trouble until you know for sure that you need to?

If the problem lies behind Door Number 2 (the intestinal bugs), it takes a very potent synergistic blend of herbs, nutrients, enzymes, and probiotics to manage and help eliminate intestinal imbalance, and it can take a considerable amount of time and expense.  Again, there’s no reason to spend 3 months or more (to do it properly) and spend a heavy investment if you don’t know for sure that you need to.  And more importantly, without the proper testing, there’s no way to know for sure whether or not the efforts were successful.

Maybe the problem lies behind an unforeseen Door Number 3.  In that case, even if the first 2 tests I discussed above were truly negative, the effort and investment was not wasted, because it’s good to at least have ruled out those very common ailments so that we can begin to look at other possible issues without having wasted time or energy elsewhere.

Once we know what’s going on, we can address the root cause of the problem so that we can give you a permanent solution and real, long-term RELIEF with an approach that we know is going to truly make a difference!

How do I choose the right probiotic?

A reader writes…

“How do you go about selecting the right probiotic?  I’ve heard such conflicting information.  Some say that probiotics are useless, because you’re born with what you have and there’s no way to replenish.  What are your thoughts?”

My first thought is, who on earth is telling people there’s no way to replenish good intestinal bacteria?  Whoever it is, he or she is gravely misinformed on several counts.  First, we’re not actually born with any gut bacteria; we acquire it early on–first during a regular vaginal birth and next during breastfeeding.  (Those who did neither missed out on these opportunities and may not have adequate levels of good bacteria if they didn’t acquire it from other places.)

Next, it’s important to understand that our normal gut flora (beneficial or “good” bacteria) are constantly under attack.  These attacks come from anywhere: stress, processed foods, alcohol, tap water, soil, other animals, medications (especially antibiotics and antacids), other people, and lack of stomach acid, just to scratch the surface.

Why do we need these bacteria in the first place?  They carry out an extensive array of extremely important functions.  They help fight some major disease-causing bacteria; in fact, they help form most of our immune system!  They turn vitamins into their active forms so that our body can use them.  They help you absorb nutrients, including fats, carbohydrates, protein, vitamins, minerals, and others.  There’s even a growing body of evidence that suggests these bacteria may play a role in lowering cholesterol.

So, when we don’t have enough of these bacteria, the above benefits start to evaporate; the immune system becomes weak, other “bad” bacteria (as well as yeasts, fungi, and parasites) can become opportunistic and “install” themselves, you can become seriously deficient in multiple important nutrients, and if the recent studies are correct, your cholesterol may elevate.  Does any of this sound familiar?  It should.  Why?  Because most people are indeed missing much of the good bacteria they need.

So, we turn to probiotic supplements.  I would love to sit down with someone who doesn’t believe probiotics do any good and show them the before-and-after digestive analysis tests of my patients (with names protected, of course), and show them the growth of the colonies of good bacteria between the initial test and the subsequent follow-up.  The numbers of good bacteria do improve.  This is how I know the probiotics are working.

So how does one choose a good probiotic?  There are quite a few choices out there and unfortunately, not all probiotics are created equal.  The supplement industry is largely left to police itself without a lot of regulation, which has both advantages and disadvantages.  The bad news is, there are some that don’t do squat.  The good news is, there are many that are quite effective, and these companies are free to innovate and develop superior products, which many of them have done.

So how do we separate the “men from the boys”, so to speak?  There are two fundamental qualities to look for in a probiotic: a variety of species, and high, potent doses.

At your local health food store, most of the products contain anywhere from 3 to 5 species or so.  This is okay, but it’s not quite enough.  This is because your intestinal tract is essentially a small ecosystem.  There are literally billions, even trillions of different types of bacteria happily co-existing together, each of them occupying space and keeping each other in check, ultimately creating a delicate balance.  Supplementing with a 3-species formula won’t do much.  (Most formulas available only through healthcare professionals typically have much higher quality and potency than those available to the public at health food stores and other places.) The most diverse higher-quality* formulas we have found so far (and thus, the ones we use) contain 12 different species.  While that doesn’t sound like much of an improvement in the grand scheme of things, it seems to work quite well, each additional species having a compound effect.

Next, let’s talk potency.  Potency is measured in colony-forming units, or CFUs.  One CFU, theoretically, goes on to start its own entire colony.  It’s mind-bending to consider how many billions of microorganisms there are in just a teaspoon of probiotic powder.  The storebought brands tend toward lower dosages, somewhere around 5 to 35 billion CFUs.  The highest dose medical grade supplements we found (and incidentally, the ones we use) contain 100 billion CFUs…in a single quarter teaspoon.

And last but not least, as with all supplements, it’s important to avoid supplements that contain (or come from a factory that uses) gluten fillers (wheat germ, wheat flour, wheat proteins, food starches, etc), yeast, soy, egg, milk, corn, shellfish, and MSG, just to name a few.  This is because many (if not most) people actually have immunological hypersensitivites to various common foods, in which the body’s immune system perceives that food as a toxin and launches an attack against it, creating lots of inflammation and chronic, mysterious health problems.  Many storebought supplement companies may be contaminated with these common allergens, but most medical grade supplements specifically state that they are free of all of these substances.

Since our ability to maintain good bacteria balance declines with stress, age, and lifestyle, it’s good to take a high-quality probiotic as part of a maintenance regimen.  This is especially true after finishing a round of antibiotic treatment, such as that for an infection.

*There are other formulas that may contain up to 14 different species, but these are not potent enough to be considered medical food/medical grade supplements, which have the highest quality and potency.

In health,
~Dr. L. Sweeney
Functional Medicine, Functional Endocrinology, and Functional Immunology
San Antonio Family Alternative Medicine

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