Nov. 14, 2014

Carolynn Romaine is a gifted athlete. She's good at everything she tries, but she loves to ride her bike. I first met her at the famous Downieville All Mountain Bike Race in 2012, two years after she made the brave decision to follow her passion, quit her job, sell her possessions and take to the road. Competing in enduro mountain races across the country, Carolynn was living the dream.

Competition was stiff, and Carolynn was soon feeling the pressure. She spent her winter in Arizona, taking advantage of the exceptional weather to pack in the extra training hours. Recovery times gradually started to lengthen, and benefits rapidly diminished. The niggling digestive issues that had plagued her for as long as she could remember became unbearable. Her legs were constantly tired. Even climbing stairs was a big ask. Eventually the joy of riding disappeared, and by the time we got together to discuss functional medicine as a potential solution, she was ready to chuck it all in and return home to New York.

Now Carolynn is back, energized and free of digestive issues, winning the Tiger Mountain Enduro in Washington last weekend. So how exactly did she do it?

In contrast to dysfunctional medicine, functional medicine addresses the root causes of common chronic health complaints. If you're a women with PMS symptoms, your doctor will likely prescribe oral birth control. If you're a man with low libido, Viagra will be the answer. But what do either of these do to address the underlying root cause of the problem?

I found this out the hard way, having spent thousands on medical bills figuring out my own digestive and hormonal issues. The solution was elegant and exciting enough to persuade me to become trained in functional medicine, leaving a position as a software engineer at a hedge fund to start a new practice. 

First of all, Carolynn slowed down. The temptation to push even harder when the results aren’t happening is strong, but it must be resisted. Long endurance rides and strength training were switched out for yoga, mindfulness meditation and nature walks with the dog.

Secondly, Carolynn hired an expert cook and food scientist to assist her with optimizing her diet via a shared food diary. Out went the added sugar and gluten free baked goods, and in came quality grass fed protein and healthy fats. Skinless, boneless chicken was replaced with a diversity of meats and nose-to-tail eating. Liver is rich in B vitamins and vitamin A and several other nutrients lacking in Carolynn’s diet. Since dietary cholesterol does not have a significant impact on blood cholesterol, eggs were back on the menu because of the choline in the yolks. Fermented foods, like sauerkraut, were introduced. Because they are loaded with good bacteria, fermented foods are excellent for gut health. Carolynn’s overall macronutrient ratios are now around 60% fat, 15% protein, 35% carbohydrate.

Thirdly, Carolynn collected samples of saliva, urine and stool for lab analysis. The saliva revealed low levels of the primary stress hormone cortisol, in addition to low levels of its anabolic counterparts DHEA and estrogen. Progesterone was extremely low, and testosterone was normal. As these hormones work together in unison, the numbers pointed towards testosterone dominance, a strong risk factor for polycystic ovary syndrome (PCOS). This kind of hormone imbalance is extremely common in athletes with any kind of health complaint, and the primary underlying root causes are chronic stress and blood glucose instability.

The urine sample gave insight about the inner workings of Carolynn’s metabolism, and it enabled me to design a highly targeted nutrient replacement program. This type of organic acid test reveals problems with fat burning, blood sugar stabilization, energy production, methylation, oxidative stress, neurotransmitter turnover and intestinal bacterial overgrowth, all of which are crucial for the highly tuned athlete. The most significant findings for Carolynn were insufficient coenzyme Q10 (an essential component for energy production), B vitamin deficiency and intestinal bacterial overgrowth. At this point, we had an excellent understanding of why Carolynn felt so tired and bloated after consuming carbohydrates. 

The final test that Carolynn took was designed to detect the presence of specific pathogenic bacteria (like H. pylori and C. difficile) and parasites (like Cryptosporidium parvum and Entamoeba histolytica). In this case, none were found, but this is the exception rather than the rule. Typically, I see about 60-70% of these come back with some abnormality, and it’s the leading cause of fatigue that I see. Why such a high rate? Because everybody I work with has suffered from chronic stress, and stress lowers immunity.

There’s no doubt the solution to most chronic health complaints is rooted in diet and lifestyle, but for the hard charging athlete targeted supplementation is important, too. Carolynn got relief from her fatigue symptoms shortly after starting an adrenal support program consisting of adaptogenic herbs. A sixty-day antimicrobial program dealt with the bacterial overgrowth. A high quality multivitamin, fish oil, soil-based probiotic, liver support, CoQ10, and free-form amino acid supplement took care of the rest.

You spend countless hours training, working out, eating right and buffeting your body, and hundreds or even thousands of dollars on gym equipment, training equipment, health supplements, healthy food. Perhaps you spend cash on race entry fees, too. If you’re overlooking your hormone and digestive health, you’re often either taking two steps forward and one step back, or stagnating in your performance and fitness. Worse yet, you could even be getting worse results. Go take a look at the results from your last workout or event. What was the time gap between you and the top of your category? Did you beat your last workout or make the progress you wanted? 5%? 10%? Functional medicine can make up that gap and more.

No need to see me in person, sample collection for lab work is done at home and consultation done online.

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