Author Archives: Vandy Roadifer

About Vandy Roadifer

Vandy Roadifer has a M.S. in Human Nutrition and lives with complex chronic illnesses, which includes many food allergies and sensitivities. She enjoys creating and sharing great tasting recipes that fit her lifestyle, discussing food related topics, and educating people on how best to meet their individual nutritional needs from an evidence based perspective.

Current Treatment Regime

It’s taken years to get a solid treatment regime in place that addresses all my health issues and is building my health up instead of tearing it down. Besides the drugs and supplements listed below, I get allergy shots every 4 weeks, I see an Osteopathic Doctor every month for Osteopathic Manipulation Treatment (OMT) to improve the muscles in my upper chest and upper back that atrophied when I was bed/couch bound for most of 2011-2012, I see a Chiropractor as needed for lower back and neck adjustments, and I see a massage therapist as needed to work out knots in my muscles that don’t work themselves out. I’m also constantly adjusting my diet and exercise routine to fit my ever changing needs. I’ll discuss other treatments I’ve tried and discontinued in other posts. Early next year I plan to have some of the in depth nutrient and metabolic tests redone so we’ll have hard proof of improvement and see if I can lower the dosage of some of the supplements I started in 2012.

Myalgia/Sleep Disorders

  • Flexeril (cyclobenzaprine) – 10mg/day I’ve taken this muscle relaxer at night to improve my sleep quality since 1993 with only a 6 month break in 2009. I’ve taken as much as 20mg/night and as little as 5mg. For years I was on 15mg dose. I’ve also played with the timing of the dosage a lot. If I take it too late at night I wake up with a drug hangover and if I take it too early then I don’t fall asleep during its optimal effectiveness time. Currently I take it at 7pm.
  • Naltrexone, Low Dose (LDN) – 3mg/day I take this compounded drug before bed to improve my sleep quality and immune system. It helps the body produce the chemicals needed to heal itself that are usually produced during stage 4 sleep. I took it for 6 months in 2009 and didn’t see any improvement with it. I started it again in 2012 and have had great success with it. I wake up before my 8:30am alarm feeling alert and awake 98% of the time and with much fewer muscle aches and stiffness. For someone who used to spend weekends sleeping until noon and avoided morning shift work for years this is amazing.
  • Magnesium – 1000mg/day (500mg 2x a day) This helps prevent lactic acid build up in muscles which causes muscle aches & cramps. It also helps relax muscles and decreases anxiety. I do best on Magnesium Citrate but Chelated Magnesium is better absorbed by most people and has fewer side-effects.
  • Melatonin – 500mcg/day This helps sleep patterns, particularly circadian rhythms. It helps me fall asleep and stay on a regular sleep schedule. Since starting it in 2009 I’ve been able to decrease it from 3mg a night down to 1/2mg. If I take too much then I wake up feeling like I’ve been drugged.
  • Potassium Glutamate – 99mg as needed. I learned, after years of extreme muscle cramps before my period, that a woman’s body tends to demineralize at that time of month, severely decreasing levels of magnesium and potassium. Adding potassium at the first twinge of muscle cramping has kept them mild for the past 18 months and the huge knots in my leg muscles that occurred each month have disappeared. I took it twice daily for a year when I was on a grain free, modified Paleo diet since I wasn’t eating bananas or potatoes but dropped it back to as needed once I started eating potassium rich foods again.

Mitochondrial Dysautonomia & Nutrient Deficiencies

  • Alpha Lipoic Acid – 600mg/day A powerful antioxidant that helps prevent and reverse oxidative stress. It helps stabilize blood sugar and helps decrease neuropathy. It is an essential fatty acid that helps brain function and is a necessary substance in the metabolism of L-Carnitine. My levels were critically low when checked in 2012.
  • Calcium Citrate – 400mg/day Helps with bone, hair and nail health. Important for me because I don’t get calcium from very many foods due to malabsorption. My fingernails have never been this healthy. They no longer break, bend, or peel.
  • CoQ10/Ubiquinol – 400mg 2x/day A co-enzyme essential in the production of energy by the mitochondria. It improves heart function, assists in recovery from exercise, and is an antioxidant. My blood levels were in the low-normal but, because it’s needed by every cell in the body, blood levels can’t accurately show if supplementation is needed. I’ve seen a huge difference in my energy levels since taking it and I recover from activities much faster. Switching to the more bioavailable Ubiquinol means that I need less to get the same results.
  • Coenzymated B Complex – 2x/day It took me awhile to build up my B vitamin levels from where they were in early 2012 to a place where I could take a B complex without it making me more ill. Coenzymated means the vitamins are in their bioavailable form so they can be absorbed by the body without further breakdown in the gut. I still take a few B vitamins in addition to the B complex because I need them in greater quantities than what are in the B complex. I look for a complex that has lower amounts of B6 and Niacin (B3) and greater amounts of Thiamine (B1) and Riboflavin (B2) based on my 2012 deficiencies.
  • 5-MTHF Folate (B9) – 400mcg/day B vitamins are necessary for the production of red blood cells and a healthy nervous system.  I take bioavailable forms of Folate and B12 because my MTHFR gene mutations affects my ability to turn the vitamins into forms that my cells are able to utilize. My first neurologist told me to take folic acid but, since my body couldn’t turn it into a bioavailable form, my blood levels were too high and cellular levels were too low.
  • Methylcobalamin (Methyl B12) – 2000mcg/day B12 is needed for the normal functioning of the brain and nervous system, and for the creation of blood. It is involved in the metabolism of every cell in the body, esp. DNA synthesis and regulation, and also fatty acids and energy production. Methyl B12 is a bioavailable form necessary for those with MTHFR gene mutations since the body has decreased ability to turn inactive B12 vitamins or food sources into a bioavailable form. I use a sublingual (under the tongue) form so it bypasses the gut and gets directly into the blood stream.
  • Adenosylcobalamin (Adeno B12) – 10mg/day Another bioavailable form of B12. Adding Adeno B12 allowed me to wean myself the drugs used to mute neuropathy pain in the brain. I also take this as a sublingual tablet.
  • Iron – 5mg/day Iron supplementation helped decrease my muscle twitching & trembling. My previous PCP recommended it instead of putting me on medication for RLS. She said at least 85% of her RLS patients see improvement on iron alone. I restarted it when the trembling and weakness returned due to borderline anemia from the drug Losartan. I take a liquid supplement added to water for better absorption and fewer side-effects.
  • Acetyl L-Carnitine – 1500mg 2x/day  This is an essential amino acid necessary in the conversion of fatty acids to energy by the mitochondria. It can interfere with thyroid replacement meds but has been shown to protect the heart from damage, increase energy and help with memory retention in Alzheimer’s patients. Acetyl L-carnitine passes through the blood-brain barrier and increases energy production in brain cells. After three weeks on it my Spasmodic Dysphonia stutter disappeared and my constant brain fog vanished. When I first started taking it I’d experience an energy crash in the afternoon if I missed taking it or waited too long to take it. That’s no longer the case though I still consider it necessary for me to function.
  • N-Acetyl Cysteine (NAC) – 600mg/day This is an amino acid which converts to Glutathione, another powerful antioxidant. It also helps with oxidative stress as well as respiratory disorders and drug toxicity. It’s often given short term to protect organs before medical tests requiring contrast dye. My levels were critically low but I couldn’t tolerate Glutathione supplements so I switched to NAC. I’m currently taking a sustained release variety.
  • Omega 3 Fish Oil with DHA – 1000mg/day More essential fatty acids needed for healthy heart, good cholesterol and reducing inflammation throughout the body. I used to take 3000mg/day but decreased it when I added more flax seed and chia seed to my diet.
  • Probiotics – 2 tab/day This is the good bacteria that lives in the gut and is essential for the absorption of nutrients and a healthy immune system. My tests showed I had very little bacteria, good or bad, likely caused by years of antibiotic use and Prednisone. Hopefully once I build a healthy colony of good bacteria then most of my malabsorption issues will be resolved.
  • PQQ (Pyrroloquinoline quinone) – 10mg/day A redox cofactor important for metabolism. It’s been shown to assist in mitochondrial biogenesis and is thought to help those with mitochondrial dysfunction. Studies have been mostly on mice rather than humans but my MD let me try it once I found a brand she trusted. Combined with CoQ10, it has greatly increased my recovery time from activities. I tried going without it and within a week saw a marked increase in my fatigue.
  • Vitamin D3 – 4000UI/day This is a powerful antioxidant that helps with emotional stability, bone density and wound healing plus it boosts the immune system. I’ve been taking it for years and every time I lower the dose to 2000IU my levels drop too low. My genetic tests showed a mutation in the VDR gene that effects metabolism of vitamin D which may account for my greater need for it.

Hypothyroidism

  • Synthroid (levothyroxine) – 50mcg/day This is the T4 thyroid hormone only drug that most doctor’s prescribe for hypothyroidism. I took it for years without too much trouble but since nearly doubling my dose at the end of 2011, I’ve had nothing but problems keeping it balanced. Too little and the fatigue and weight gain would drag me down, too much and the heart palpitations and trembling would get out of control.
  • Cytomel (liothyronine) – 6.25mcg 2x/day I recently added this T3 only drug to my regime by replacing 50mcg of Synthroid with 12.5mcg of Cytomel. So far it seems to be working really well. I have more energy and fewer hypothyroid symptoms. Blood tests are next week so we’ll see if they match up with how I’m feeling.

Other Genetic Mutations

  • L-theanine – 100mg 2x/day I have two COMT gene variants that affects dopamine, epinephrine, norepinephrine, and estrogen reuptake. If these genes are expressed then mood swings, anxiety, insomnia, inability to deal with stress, and other mental dysfunctions can occur. Treatment with L-theanine, an amino acid found in certain mushrooms and green tea, can silence the genes. Since starting L-theanine 2x a day, my mood has never been so stable. I feel mentally healthy for the first time in my life.

Mold/Biotoxin Illness (temporary meds)

  • Losartan – 25mg/day This blood pressure medicine has many other uses. I’m taking it to lower Transforming Growth Factor Beta-1 but it’s also used to protect the kidneys from diabetes and to make chemotherapy drugs more effective.
  • Propolis – 500mg/day Propolis is a resin collected by bees from tree sap, tree buds, and other botanicals. Bees use it to fill holes in the hive that are too small to fill with wax to reinforce the structure, reduce vibration, and protect against bacteria, fungus, and parasites. It’s been used medicinally for thousands of years and recent medical research shows it has antibacterial and antimicrobial properties and is especially useful to treat mouth sores. Dr. Dietrich Klinghardt, a Functional/Integrative Medicine MD who specializes in Lyme Disease, recommends it to increase MSH levels so I’m trying it. We’ll see if it works after my next inflammation biomarker test results come in.

My experience with the Shoemaker Mold/Biotoxin Protocol

I started the Shoemaker Protocol in November 2013 with 625mg of the cholesterol drug Welchol (colesevelam hydrochloride) 4x a day while we waited for the blood test results to come in. My fatigue got frighteningly worse since it affects absorption of other medications and supplements. I had to change the scheduling to 2 tablets 2x a day and well away from my other medication times. Every month I tested my Visual Contrast Sensitivity on a free website. Visual Contrast Sensitivity (VCS) checks visual acuity with light and dark gray lines on a gray background. Mold/biotoxin illness patients who have active neuroinflammation have problems differentiating the lines from the background. There are quite a few free and paid VCS testing sites out there so find one that you are comfortable with. I asked my eye doctor about VCS testing but currently his clinic doesn’t offer it though the next computer upgrade may include it.

My initial blood test results came back in December. I was pleasantly surprised that I had fewer mold/biotoxin biomarkers than expected which meant that the protocol wouldn’t be quite as complicated as it could be.

  • Human Leukocyte Antigens (HLAs) help the immune system tell the difference between body tissue and foreign substances. Genetic testing of the sixth chromosome (HLA DR) indicates susceptibility to mold/biotoxin illness and how sensitive a person is to the illness. My test result came back with the same two alleles on each gene which means I inherited the same gene sequence from both of my parents. I have DRB1 of 15, DQ of 6, and DRB5 of 51. This gives me high susceptibility to chronic Lyme disease and a lesser susceptibility to molds and other biotoxins. This explains how I was able recover from my other major mold/biotoxin exposures once I was out of those environments until I reached my body’s tipping point and I couldn’t recover without medical intervention.
  • Matrix metallopeptidase 9 (MMP-9) delivers inflammatory elements in blood into subintimal spaces. From there inflammation is delivered to other areas of the body like the brain, lungs, muscles, nerves, and joints. It’s a main biomarker for systemic inflammation. My result was high at 780 ng/ml. Normal range is 85-332 ng/ml.
  • C4a is one of the first and major indicators of mold/biotoxin illness and systemic inflammation from innate immune responses. My test came back very high. Normal range is 0-2830 ng/ml. My result was 11492 ng/ml.
  • My Human Transforming Growth Factor Beta-1 was high. TGF Beta-1 is a protein that has regulatory effects throughout innate immune pathways. It helps control the growth and division of cells, the process by which cells carry out specific functions, cell movement, and the self-destruction of cells. My result was 5820 pg/ml. Normal range is 0-2380 pg/ml.
  • Melanocyte Stimulating Hormone has multiple anti-inflammatory and hormonal regulatory function. MSH deficiency means increased susceptibility to mold illness, ongoing fatigue, pain, hormone abnormalities, mood swings, and much more. My result was very low at less than 8 pg/ml. Normal range is 35-81 pg/ml. Currently there are no drugs on the market to improve MSH levels.
  • There were also a couple of tests in the von Willebrand’s profile where the results were far from normal. Coagulation Factor VIII was 214 H. Normal range is 50-180. And Collagen Binding Assay was >400 H and normal range is 45-198. This means there are errors in my body’s clotting ability. These errors can be inborn/genetic or acquired from illnesses like autoimmune diseases. From my genetic tests I already knew I had high susceptibility to blood clots, especially from medications like hormone birth control, so this was confirmation of that.

It took three months for my VCS testing to come back as normal before I could stop taking Welchol and start the next step. I took 45mg of the diabetes drug Actos (pioglitazone hydrochloride) for two months before my MMP-9 levels dropped down into the normal range. Due to my clotting factor errors I couldn’t take the drug recommended to lower C4a so we skipped that step. In April I started 25mg of the high blood pressure medicine Losartan (Cozaar) to lower my TGF Beta-1. In the intervening months while I was working on the first steps of the protocol my TGF Beta-1 level nearly doubled to 11,020 pg/ml. Losartan increased my fatigue so I had to adjust the time I took it to evening rather than morning and add a liquid iron supplement in order to stave off the anemia symptoms it caused.

I went off Losartan in May while waiting for my test results and felt better than I had in years. There was a huge decrease in my fatigue and, while I still had a bad hour or two each day and the week before and during my menstrual cycle, I could leave the house every day for a few hours and I could work in my garden with rest breaks every 30-45 minutes. I went back on Losartan in June when my test results showed it had only decreased by 3,000 pg/ml. Unfortunately my fatigue increased again and I’ve been on the drug since then because my TGF Beta-1 levels keep jumping up and down.

When my October tests showed my TGF Beta-1 and MSH levels were worse than they were the month prior, I started looking outside the Shoemaker Protocol for other options. A chronic Lyme specialist recommends the supplement Propolis to his patients to increase MSH; I added a 500mg capsule once a day. Several studies show a low protein diet lowers TGF Beta-1 so I moved from the high protein, grain free/Paleo diet I’d been doing since last November to a low protein diet. Studies also show that the high blood pressure drug Vasotec (enalapril maleate) combined with the hyperparathyroid D2 analog Zemplar (paricalcitol) lower TGF Beta-1. I’ll discuss all options with my MD when I see her later this month. Lowering my TGF Beta-1 and increasing my MSH are the last steps in the Shoemaker Protocol and it looks like fixing those two things will return me to full health.

Recent changes have greatly increased my energy levels and stamina. I feel better than I did in May and am up to 12 miles a day on my recumbent stationary bike. It’s hard to know how much of the improvement is from seasonal changes (I always feel best in spring and fall and worse in the summer), dietary changes, drug changes or the addition of Propolis,  but it’s very nice. I’m hoping for continued progress and energy stability; only time will show if I have them.

Mold and Me (part 4)

Integrative Medicine was unlike any medical specialty I had previous experience with. My first appointment was scheduled for 90 minutes. Follow up appointments were a standard 30 minutes but 45, 60, 75, and 90 minutes could be requested. I returned the huge packet of health information they sent weeks before my appointment so the doctor had a chance to get familiar with my medical history prior to seeing me.

We went over my immediate health issues and the test results from the nerve pain specialist and my last blood tests. I was given homework: an extensive medical and environmental history that included my parents health going back six months prior to my conception. My MD didn’t promise miracles but improved quality of life. Considering 99% of my time was spent lying on the couch if I wasn’t sleeping in bed, any improvement would be better than continuing to decline.

Based on my blood tests and Small Fiber Neuropathy, my MD took me off inactive cyanocobalamin (synthetic B12) and folic acid (synthetic folate) and put me on bioavailable methylcobalamin (methyl B12) and 5-MTHF folate (5-methyltetrahydrofolate). We started me out on a small dose since I didn’t react well to the synthetic vitamins and I slowly increased them over the course of six months to a year. She also recommended I read Terry Wahls’ website and books. Dr. Wahls is a family medicine MD who healed herself of secondary progressive MS using food. She’s now an Integrative/Functional Medicine doctor. I found her book “Minding My Mitochondria” especially helpful. Healing with food alone doesn’t work for me but there are great possibilities in it and her approach to diet from a scientific view is inspiring.

At my next appointment we went through my extensive medical history. My MD suspected that my dad’s tours in Vietnam played a part in my health issues along with my extensive antibiotic use and the mold and VOCs I’d been exposed to. Six months on Prednisone certainly didn’t help, either. She recommended in depth nutrient testing along with heavy metals and known toxins. The tests required blood, urine, and stool samples and were shipped to an independent lab. Results took about 6 weeks. I was also tested for the common chronic fatigue suspects: Lyme Disease and known viruses like Epstein-Barr and HHV6.

My virus and Lyme tests were negative but the other tests showed a lot of deficiencies and a few environmental toxins. I was in critical need of Alpha Lipoic Acid and Thiamin (B1) and had low levels of Vitamin C, Riboflavin (B2), Folate (B9), Cobalamin (B12), and Glutathione. My mitochondrial function wasn’t quite critical but wasn’t good, either. Neither was my toxin exposure (specifically styrene, aka plastics, and MTBE, a gasoline additive). My body’s ability to methylate was compromised and I had elevated levels of bacterial markers and borderline yeast/fungal markers. Out of the six beneficial gut bacteria they test for I was missing three.

The results gave us plenty of data to start treatment as well as a diagnosis of acquired Mitochondrial Dysautonomia. Besides supplements to improve the nutrient deficiencies, it was recommended I add more plant based antioxidants, probiotics, and Omega 3 fatty acids to my diet. I had to stop using Teflon cookware and, while freezing and storing food in plastics was okay, reheating wasn’t. MTBE was most likely in the water supply so I couldn’t eliminate it completely from my diet but by improving my methylation with supplements and diet I should be able to get it out of my body.

I spent months slowly adding and increasing supplements and reading all I could about methylation and mitochondrial dysfunction. I added Acetyl L-Carnitine to improve energy production and within 4 weeks my Spasdmic Dysphonia was gone as was most of my mental fatigue/brain fog. Six months after starting treatment my neuropathy and IH headaches had improved enough that I no longer needed pain medication. A year later I weaned myself off Nortriptyline. I got approval to add PQQ and CoQ10 and within a few weeks my fatigue had improved enough I could leave the house every 3 days instead of once a week if I was lucky. I got a prescription for 3mg of Low Dose Naltrexone and within a month my sleep had improved to the point that 85% of the time I awakened on my own before my 8:30am alarm went off. That has improved to 98% of the time within the last year.

I ordered a genotyping kit from 23andMe and, when the results were in, I used 23andYou to get the most out of my raw data. Isolating the methylation genes was particularly helpful to me. I had two heterozygous mutations in the MTHFR gene that greatly decreased my ability to obtain folate and B12 from food. Add that to the decreased bacteria in my gut from antibiotics and Prednisone and it was no wonder I got Mitochondrial Dysautonomia from nutrient deficiencies. I also had a COMT gene variant that affects the reuptake of dopamine and causes unstable moods. Treatment was either lots of green tea or the amino acid L-theanine. I added a new supplement to my daily regime.

Progress stalled and then went backward as I approached another summer. My health was much better but the debilitating fatigue was clinging on. I started allergy shots in July 2013 after learning I was allergic to a number of things that are very prominent in this area: grasses and filbert/hazelnut trees. I kept tweaking my supplement regime, increasing or adding things to get the best results. Progress had slowed to a crawl but I was still inching forward.

Two years after leaving the coast I learned that the basement I lived in 2011 had been infested with mold from a broken pipe in the wall under the closed in staircase. This revelation lead me to Dr. Ritchie Shoemaker’s books and website. My MD agreed to use me as a guinea pig for the treatment protocol. It’s meant lots of blood tests at out of town labs but again I had abnormal results, this time in inflammation biomarkers that no doctor thought to check. I have a HLA-DR haplotype that makes me particularly sensitive to chronic Lyme disease and to a lesser extent mold and other biotoxins. With mold/biotoxin illnesses the rule seems to be that the more exposure to them, the quicker one gets sicker. This certainly explains why my sophomore year in college I got so sick so fast after moving back into the moldy building I lived in my freshman year and why my health declined so quickly after I left my moldy apartment for an even moldier basement.

I’m at the last phase of the Shoemaker Protocol, lowering my Transforming Growth Factor Beta-1 and increasing my MSH, and finally this month I feel like there’s been a big breakthrough. Only time and more blood tests will tell if it’s from the mold protocol or from other changes I’ve recently made. I’ll discuss my multifaceted treatments further on in this blog. For now I’m very hopeful about the future. My health has improved immensely in a relatively short amount of time and an end to this dark, painful segment of my life is within sight.

 

Mold and Me (part 3)

After losing my voice to a severe and painful stutter I was tested for a stroke. When the tests came back negative my neurologist put me on high doses of Klonopin to “reset my brain.” It helped with some of the anxiety of being diagnosed with a serious and disabling illness but it didn’t help the stutter and it made my brain work much slower.

I worked closely with my PCP on treatments for the Intracranial Hypertension and the accompanying headaches, often seeing her once a week. My headaches improved through the course of the year but didn’t go away completely. I felt well enough to work at several points but the stutter was persistent and didn’t respond to treatment and the headaches always returned. Being unable to communicate clearly was a big disadvantage in this information and telephonic age. Attempting to talk on the phone was enough to make me cry from pain and frustration. I took to writing notes to my doctors so I could communicate with them easier.

I finally saw a speech specialist and was diagnosed with atypical Spasmodic Dysphonia. The standard treatment for it was Botox injections in the vocal cords. I did three courses of it but the improvement wasn’t enough to make it worth continuing. After the injections I could speak in a strangled, rough voice for a few weeks that still hurt. One friend said I sounded like “a sexy Marge Simpson.” I was warned not to whisper as it would damage my vocal cords beyond repair but I ended up communicating that way because it was easier and more clear than stuttering.

I had an opportunity to move into a friend’s daylight basement and I jumped at the chance to get out of my moldy apartment building. The basement smelled odd but I only found a few spots of mold in the window sills and in the bathroom. I kept the heat on and placed air purifiers throughout the space. A few weeks before moving at the end of November I started Predinsone to reduce the inflammation on my brain and help the persistent headaches. My PCP commented that it was obvious I had systemic inflammation but it didn’t appear on standard blood tests. I felt surprisingly well before and immediately after the move; I weaned myself off Klonopin and I was gaining strength. Then in January 2011 the muscle spasms began.

Things escalated quickly from that point. Within weeks the muscle spasms turned into muscle cramps. I started trembling, got pins and needle pain in my feet, had presyncope episodes where I’d nearly black out upon standing, and my fatigue returned worse than before.

My neurologist ordered blood work to check for vitamin deficiencies and autoimmune diseases. When they were negative, she ordered MRIs of my brain and lumbar spine to look for lesions that would indicate MS and did an EMG in my right arm, hand, and leg to check for large nerve impingements. She found osteoarthritis in my lower lumbar region but nothing else. By this time the pins and needles pain increased and spread. Besides my feet, it attacked my thighs, buttocks, lower back, hands, and forearms. At various times it felt like I was being attacked by fire ants, clawed by tigers, zapped by electric eels, and stung by jellyfish. I had other weird sensations that felt like cats purring and frogs jumping under my skin. There were days I couldn’t wear clothing or have anything touch my skin. I spent most of my time lying on my left hip, the one place I could stand to put pressure on. I slowly weaned myself off Prednisone against my PCP’s advice because I had a feeling it had something to do with my new and rapidly progressing health problems.

I ended up in my PCP’s office in tears when the electric shocks started in my crotch area. She put me on Amitriptyline, an antidepressant often used to block nerve pain signals to the brain. I placed a desperate call to my neurologist’s office and saw her about it as well. She offered to refer me to a rheumatologist for the osteoarthritis but wouldn’t do anything about the neuropathy since the tests she ran all came back as normal. She told me it was probably Fibromyalgia and I should learn to live with it. I’d lived with Fibromyalgia for more than 20 years; it wasn’t Fibromyalgia.

My PCP was more sympathetic. She referred me to a nerve pain specialist at the teaching hospital in Portland. In July 2011 I spent the better part of a day in testing: more blood tests, another EMG, skin biopsies, and autonomic testing. I left like I was getting close to some answers. After the testing I switched from Amitriptyline to Nortriptyline. It eased the pain better and didn’t have the severe fatiguing side-effects I had with Amitriptyline.

Since I was becoming more and more disabled and my parents took me to all my out of town doctor’s appointments, I decided to move closer to them when they offered to buy a house for me. They were 80 miles away from me and out of town trips usually ended up being all day or over night trips. In September 2011 I moved inland. A few days later I got the test results from the nerve pain specialists. For the first time since my Spasmodic Dysphonia diagnosis I had abnormal results. I was diagnosed with Autonomic Nervous System Dysfunction (Dysautonomia), Small Fiber Neuropathy, and Carpal Tunnel. The EMG, skin biopsies, and autonomic tests all came back abnormal. The specialist was too far away to be my primary doctor so he released me to the care of my PCP which was fine with me. I just needed him to diagnose me.

Immediately I started reading about Dysautonomia. I needed a new primary care doctor since I’d moved and finding one familiar with SFN and Dysautonomia was important to me. Numerous blogs by other Dysautonomia patients recommended Integrative/Functional Medicine. They had improved quality of life with IM if not complete control of their symptoms. My PCP had also recommended them since I reacted so poorly to standard medical treatments and IM is based more on scientific evidence than the guesswork used in the naturopathy I’d tried in 2009. My first appointment with my Integrative Medicine MD was in January 2012.

Mold and Me (part 2)

Between 1993-2001 my health was okay. I had problems but nothing that impeded my ability to go to school or work. I preferred late morning or afternoon shifts instead of mornings, I had several bouts of systemic yeast infections, I had lots of issues with food sensitivities, and most winters I got bronchitis at least once. Fibromyalgia wasn’t a word recognized by the general public at that time so I simply told people I had a sleep disorder.

In 2001 I changed jobs and started working at a marine hardware store around VOCs from industrial paints and resins. My desk was in the marine paint storage area and the off-gassing was overwhelming. That winter I started getting giant (3 inch) hives every time snow touched my skin. It was painful, disconcerting, and a puzzle to doctors.

In 2003 I moved away from snowy Alaska to the more temperate Oregon Coast. My apartment had evidence of minor water damage in the past but it wasn’t anything I worried about. Shortly after moving I was diagnosed with minor hypothyroidism and put on Synthroid. A year later I was diagnosed with tachycardia. In 2007, after nearly a year of extreme fatigue, I was diagnosed with sleep apnea. By the end of 2008 I had problems controlling my Fibromyalgia symptoms. I didn’t react well to standard or experimental treatments so by mid-2009 I had to take short term medical leave in order to get a handle on my pain and fatigue.

In the midst of my dealing with another major Fibromyalgia flare the people in the apartment next to mine were evicted. The apartment manager found water damage and mold throughout the first floor of the apartment from a leaking washing machine. Mold was growing at least a half inch up the walls and not only did the carpeting have to be replaced, so did the subfloor.

I was off work for almost 3 months and it took another 3 months for me to control most of the pain, fatigue, and sleep issues that accompany Fibromyalgia with the help of a Naturopathic Doctor, an acupuncturist, a massage therapist, and my own intuition. Going back to what the MD in Alaska told me in 1993 about the link between unrefreshed sleep and pain gave me something to focus my energy on improving and it worked. By December I only experienced increased pain and fatigue during the week before and during my menstrual cycle.

Then the headaches started. They were unlike any headache I’d experienced before. Not migraines since they originated at the top of my head. My head would even get hot to the touch from them. I thought they were thyroid headaches at first since my mom has similar headaches when her thyroid levels are unbalanced. I returned to my primary care physician and switched back to Synthroid instead of the T3/T4 compounded thyroid med my ND put me on in June.

By March 2010 we knew something was seriously wrong. Migraine meds didn’t help and pain meds barely touched the pain. The headaches kept increasing in intensity until the left side of my face and my left arm went numb and it felt like bugs were eating my brain. An MRI was ordered and, after it came back as normal, my PCP sent me to an ophthalmologist. After waiting for hours to see him, he diagnosed me with Pseudotumor Cerebri/Intracranial Hypertension. There was too much fluid in my skull and it was pushing on my optic nerves. It could cause blindness as well as all the symptoms of a brain tumor. It was March 26th, 2010.

I attempted to work with a constant headache and while on pain meds. It was stressful and difficult but I was able to split my lunch hour into two half hour segments so I could lay down and rest for a short time in the afternoon. Then on April 15th I started stuttering. It sounded and felt like I had had a stoke. By the end of the next week it got so bad I couldn’t speak at all without it feeling like something was stabbing me in the brain. I left work on my lunch break on April 23rd and never returned.

Mold and Me (part 1)

Learning in September 2013 that the basement I lived in from November 2010 to September 2011 was teeming with hidden mold opened up a whole new avenue of treatments and health implications.

I’m not unfamiliar with mold. I grew up in a moldy trailer, went to a moldy school, lived in a flood damaged house, lived in a moldy dorm, and moved in 2010 to get out of a moldy apartment. I’d also been diagnosed with Sick Building Syndrome several times, an illness which now falls under the biotoxin umbrella of Mold/Biotoxin Illness. My entire life was spent in or around mold and biotoxins. It’s a credit to my admittedly faulty genes that I managed to partially recover from each major exposure until I was disabled in 2010 at age 36.

From infancy to age 10 I had allergies, asthma, food sensitivities, sleep issues, and fatigue. I had a lot of respiratory illnesses. My health improved after we moved into a new house and I started getting allergy shots. There’s a gap in my medical records for two years as I was healthy enough that I wasn’t seeing the doctor constantly. I even joined the volleyball team in middle school despite morning practices.

Then in October 1986 the first floor of our house flooded with five feet of water. My migraines started shortly after. It took nearly two years to get them under control with the help of a chiropractor who diagnosed me with inverted curvature of my neck. It’s a common whiplash injury but I’d never had whiplash. Spinal molding techniques and many chiropractic appointments eased my migraines and currently I average 2-3 a year. A visit to a chiropractor to pop my neck back into place eases them almost immediately.

In high school, I was diagnosed with chronic sinus issues that cleared up when I wasn’t in school. The school’s swimming pool exhaust fan was right next to the school’s fresh air intake vent. The chemicals from the pool circulated throughout the school. Poorly designed HVAC systems are a major source of biotoxins. On top of that, the school had a flat roof that was prone to leaking. It wasn’t unusual to see garbage cans in the first floor and second floor hallways during the winter, catching water that leaked through the roof and through the floor above. The presence of that much water means mold was growing unseen within the floors and walls. My doctors had no idea what to do about my inflamed sinuses so I was put on antibiotics for approximately 20 days a month, 9 months a year, for 4 years. Now many doctors recognize allergic sinusitis but in the late ’80’s- early ’90’s I was diagnosed with sinus infections, again often accompanied by respiratory issues, and given antibiotics.

I left the cool, dampness of the Alaskan coast for the desert of eastern Washington for college. We hoped the dry heat would be better for my health. It wasn’t. My dormitory was an older building that had the bathrooms/showers renovated over the summer. Soon after moving in my knees started hurting, swelling, and were hot to touch. Weather changes made it worse and I became a reliable barometer. The pain continued to get worse but an appointment with an orthopedic surgeon didn’t show any damage. By the end of the school year, I was on Tylenol 3 with codeine to control the pain and spent many days lying in bed in haze of pain and drugs. My health improved when I went home for the summer.

I moved into a different dormitory the next year and, while the knee pain wasn’t as severe that semester, I started getting sinus problems again. Appointments with ENT’s, multiple sinus x-rays, multiple courses of antibiotics, and even Prednisone barely helped. I went home for Winter Break and my health improved again. As soon as I returned to school, the sinus issues returned. It was another case of Sick Building Syndrome like I experienced in high school. I never learned what I was reacting to in that building but it was probably another poorly designed HVAC system. I moved back into the building I lived in my freshman year. That was a mistake.

Almost immediately the pain that started in my knees started spreading to other joints. At my worst, I couldn’t type because my hands/fingers hurt so much and I couldn’t chew solid food because of the pain in my jaws. I could barely walk and was living on strong NSAIDs and Percocet. A visit to a rheumatologist halfway across the state got me close to a diagnosis but her own health issues meant I never saw her again. I finished out my sophomore year with the understanding that if we couldn’t get my health under control, I wouldn’t be returning in the fall for my junior year.

Soon after my 21st birthday, I saw an Internal Medicine MD in Anchorage who took a look at my medical records, poked me in a few places, and proclaimed he knew what was wrong with me. I had Fibromyalgia. He explained that it was chronic pain condition caused by a sleep disorder. For some reason my body wasn’t getting stage 4 sleep on its own but with proper medication, lifestyle changes, and regular exercise I could control my symptoms. It took several months of trying medications before I found one that helped (cyclobenzaprine). The drug combined with a sleep schedule and walking almost daily pushed the pain and fatigue down to manageable levels. I finished out my college career in fairly good health and in off campus housing.

Is Integrative/Functional Medicine Right For You?

That is a question you have to ask yourself before seeking out a clinic. I went with IM because my health was continuing to decline and I had multiple bad reactions to standard treatments used by conventional doctors. Many dysautonomia patients have blogged about their experiences with IM and how it their improved their quality of life. My previous medical provider also recommended it.

Integrative/Functional medicine uses a holistic method of medicine and many IM clinics have Osteopathic doctors on staff as well as massage therapists, nutritionists, and acupuncturists. They treat the whole body as one interconnected system and use a variety of evidence based methods to improve the quality of life of their patients. It requires a shift in thinking from the treating symptoms model of medicine to finding the underlying causes of illness, which may be genetic, cellular, hormonal, microbial, viral or any combination there of, and personalizing treatment to improve function. It’s not a cure for chronic systemic illnesses but it is a method to gain control over them. It’s also not an easy process – there are no taking pills and you feel better in a few weeks. It requires experimentation with supplements, medications, diet, exercise, and alternative therapies to find the best combination for you. You’re also not a passive participant in your care when it comes to Integrative/Functional Medicine. My MD encourages me to read about my health problems and bring the information to her. She believes that a good patient is a well-informed patient. No one is more invested in improving your health than yourself.

I’ve been criticized for advocating Integrative/Functional Medicine and sharing my journey with the world. Make no mistake, this is my journey and my experiences with Integrative/Functional Medicine and I am seeing improvement using their methods. My health still has lots of ups and downs but overall I am improving. I won’t stop advocating or writing about my experiences because if it helps one person improve their own symptoms that’s more than my detractors can say about their negativity. Hope is never a bad thing whereas negativity is toxic.