TELEMEDICINE Thyroid Health Practice with a Functional Medicine Approach

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Thyroid Retreat Days

For the first time everything required for a unique and bespoke residential program for clients with thyroid health problems will be available under one roof. Ours.

The thyroid system plays a critical role in your metabolism. Along with insulin and cortisol, your thyroid hormone is one of the big three hormones that control your metabolism and weight.

We have been running a successful Thyroid Clinic and learned that accurate testing, supplements and medication is often not enough.

Lifestyle changes are paramount to improve chronic health conditions and cannot be taught in a report or a short consultation.

This is why we created the Thyroid Retreat Days. We want to give our clients all the tools they need to make them feel better, after already implementing medication and supplements.

Our motto is: learning with fun

Cooking Workshops

From healthy breakfasts to dinner party food – you will learn how to make delicious and thyroid friendly food – quickly.


Learn in several very interactive workshops what makes you tired, the links between adrenal fatigue, thyroid health, Hashimotos’ and how to drum up your metabolism.

Sleep Well

Have a cosy night in a sumptuous room and wake up refreshed, ready for the next day.


From Mindfulness to Reflexology – a healthy mind makes a healthy body.

Evening Entertainment

Murder Mystery, Bingo and Rat Race are only a few events to keep you entertained.

Download our brochure and call Dena on 01473 218 373 or 01449 833 833 NOW to book your slot.

Only 6 places per event available!

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Lyme Borelliosis

The majority of our patients suffer from tiredness. The underlying causes can be many and often we find that their thyroid gland is not working well. However, tiredness can also be caused by infections and chronic Lyme Borrelliosis is one of the possible causes which is often difficult to detect.

The infection can linger around in your body for years and even decades.

We have now teamed up with ArminLabs in Germany and are able to offer their comprehensive tests.

If you are concerned about Chronic Lyme Borelliosis, you can find out more HERE.

Should you worry about an acute Lyme infection, you can find out more HERE about testing.

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Why you struggle to lose weight on a diet

Successful weight loss is doomed to failure unless the reduced intracellular thyroid levels are addressed. Chronic and yo-yo dieting, frequently done by a large percentage of the population, is shown to be associated with reduced cellular T4 uptake of 25%-50% (2-7). Following repeated cycles of dieting, weight loss occurred at half the rate and weight gain occurred at three times the rate compared to controls with the same calorie intake (1). The reduced cellular thyroid level is generally not detected by standard laboratory testing unless a free T3/reverse T3 ratio is done.

Finally a study explained why it is very difficult for obese patients to lose weight; as calories are decreased, thyroid utilisation is reduced and metabolism drops. Additionally, there are increased levels of free fatty acids in the serum with chronic dieting, which further suppresses T4 uptake into the cells and further cellular hypothyroidism (8-12).

In a study published in the American Journal of Physiology-Endocrinology and Metabolism, Van der Heyden et al studied the effect of calorie restriction (dieting) on the transport of T4 and T3 into the cell (13). It was found that dieting obese individuals had a 50% reduction of T4 into the cell and a 25% reduction of T3 into the cell due to the reduced cellular energy stores, demonstrating that in such patients standard thyroid blood tests are not accurate indicators of intracellular thyroid levels.

Many overweight individuals fail to lose weight with dieting. While it is always assumed they are doing a poor job of dieting, it has been shown, however, that chronic dieting in overweight individuals results in increased levels of NEFA, which suppresses T4 uptake into the cells (14). This suppressed T4 uptake results in reduced intracellular T4 levels and subsequent T4 to T3 conversion and a reduced metabolism (14-18).

How you can find out, whether you are affected?

Standard TSH, T4 and T3 testing will not detect this problem. Instead, a free T3/reverse T3 blood test can aid in the diagnosis of reduced uptake of thyroid hormones and intracellular hypothyroidism. It is proving to be the best physiologic marker of intracellular thyroid levels and supplementation with T3 should be considered.


  1. Brownell KD, Greenwood MR, Stellar E, Shrager EE. The effects of repeated cycles of weight loss and regain in rats. Physiol Behav 1986;38(4):459-64.
  2. Lim C-F, Docter R, Krenning EP, et al. Transport of thyroxine into cultured hepatocytes: effects of mild nonthyroidal illness and calorie restriction in obese subjects. Clin Endocrinol (Oxf) 1994;40:79-85.
  3. van der Heyden JT, Docter R, van Toor H, et al. Effects of caloric deprivation on thyroid hormone tissue uptake and generation of low-T3 syndrome. Am J Physiol Endocrinol Metab 1986;251(2):156-E163.
  4. Leibel RL, Jirsch J. Diminshed energy requirements in reduced-obese patients. Metabolism 1984;33(2):164-170.
  5. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  6. Manore MM, Berry TE, Skinner JS, Carroll SS. Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in nondieting control subjects. Am J Clin Nutr 1991;54:41-6.
  7. Croxson MS, Ibbertson HK, Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endorinol Metab 1977;44:167-174.
  8. Brehm A, Krssak M, Schmid AI, Nowothy P, et al. Increased Lipid Availability Impairs Insulin-Stimulated ATP Synthesis in Human Skeletal Muscle. Diabetes 2006;55:136-140.
  9. DeMarco NM, Beitz DC, Whitehurst GB. Effect of fasting on free fatty acid, glycerol and cholesterol concentrations in blood plasma and lipoprotein lipase activity in adipose tissue of cattle. J Anim Sci 1981;52:75-82.
  10. Lim C-F, Bernard BF, De Jong M, et al. A furan fatty acid and indoxyl sulfate are the putative inhibitors of thyroxine hepatocyte transport in uremia. J Clin Endocrinol Metab 1993;76:318-324.
  11. Lim C-F, Docter R, Visser TJ, Krenning EP, Bernard B, et al. Inhibition of thyroxine transport into cultured rat hepatocytes by serum of non-uremic critically ill patients: Effects of bilirubin and nonesterified fatty acids. J Clin Endocrinol Metab 1993;76:1165-1172.
  12. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  13. van der Heyden JT, Docter R, van Toor H, et al. Effects of caloric deprivation on thyroid hormone tissue uptake and generation of low-T3 syndrome. Am J Physiol Endocrinol Metab 1986;251(2):156-E163.
  14. Lim C-F, Docter R, Krenning EP, et al. Transport of thyroxine into cultured hepatocytes: effects of mild nonthyroidal illness and calorie restriction in obese subjects. Clin Endocrinol (Oxf) 1994;40:79-85.
  15. Leibel RL, Jirsch J. Diminshed energy requirements in reduced-obese patients. Metabolism 1984;33(2):164-170.
  16. Elliot DL, Goldberg L, Kuehl KD, Bennett WM. Sustained depression of the resting metabolic rate after massive weight loss. Am J Clin Nutr 1989;49:93-6.
  17. Manore MM, Berry TE, Skinner JS, Carroll SS. Energy expenditure at rest and during exercise in nonobese female cyclical dieters and in nondieting control subjects. Am J Clin Nutr 1991;54:41-6.
  18. Croxson MS, Ibbertson HK, Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J Clin Endorinol Metab 1977;44:167-174.
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How Stress affects your Thyroid

A study published in the Journal of Clinical Endocrinology and Metabolism found that significant physiologic stress inhibits the transport of the (inactive) T4 thyroid hormone into the cell while non-physiological stress had no effect. Serum T4 levels were artificially elevated in physiologically stressed individuals which confirms that serum T4 and TSH levels are poor markers for tissue thyroid levels in stressed individuals (1).

One study found that with significant physiological stress, tissue levels of T4 and T3 were dramatically reduced by up to 79% without an increase in TSH. T4 and T3 levels in different tissues in different individuals showed a significant variation which was not reflected by TSH or serum T4 and T3 levels. This explains the wide range of symptoms that are due to tissue specific hypothyroidism not reflected or detected by standard blood tests, including TSH and T4 (2).

A confirming study published in the Journal of Clinical Endocrinology and Metabolism has shown that the free T3/reverse T3 ratio was the most accurate marker for reduced cellular uptake of T4 (3).

A number of substances have been identified that are produced in response to physiologic stress or calorie reduction. These include billirubin and fatty acids and can results in a 27%-42% reduction in cellular uptake of T4 but has no effect on T4 or T3 uptake into the pituitary (4,5,6,7,8) (see thyroid transport graph).

What does this mean for you?

If you are stressed, you enter a state of hypothyroidism which cannot be detected by routine NHS blood tests. Typical symptoms are fatigue, tiredness, weight gain.

What you can do about it?

It is important to get your stress under control. Our complementary therapists can help you with this. You might also want to have an in-depth thyroid laboratory test as you could benefit from (temporary) thyroid replacement medication with Nature-Thyroid.


  1. Sarne DH, Refetoff S. Measurement of thyroxine uptake from serum by cultured human hepatocytes as an index of thyroid status: Reduced thyroxine uptake from serum of patients with nonthyroidal illness. J Clin Endocrinol Metab 1985;61:1046–52.
  2. Arem R, Wiener GJ, Kaplan SG, Kim HS, et al. Reduced tissue thyroid hormone levels in fatal illness. Metabolism 1993;42(9):1102-8.
  3. Vos RA, de Jong M, Bernard BF, et al. Impaired thyroxine and 3,5,3′-triiodothyronine handling by rat hepatocytes in the presence of serum of patients with nonthyroidal illness. J Clin Endocrinol Metab 1995;80:2364-2370.
  4. Everts ME, De Jong M, Lim CF, Docter R, et al. Different regulation of thyroid hormone transport in liver and pituitary: Is possible role in the maintenance of low T3 production during nonthyroidal illness and fasting in man. Thyroid 1996;6(4):359-368
  5. Everts ME, Docter R, Moerings EP, van Koetsveld PM, Visser TJ, et al. Uptake of thyroxine in cultured anterior pituitary cells of euthyroid rats. Endocrinology 1994;134:2490–2497.
  6. Lim C-F, Bernard BF, De Jong M, et al. A furan fatty acid and indoxyl sulfate are the putative inhibitors of thyroxine hepatocyte transport in uremia. J Clin Endocrinol Metab 1993;76:318-324.
  7. Lim C-F, Docter R, Visser TJ, Krenning EP, Bernard B, et al. Inhibition of thyroxine transport into cultured rat hepatocytes by serum of non-uremic critically ill patients: Effects of bilirubin and nonesterified fatty acids. J Clin Endocrinol Metab 1993;76:1165-1172.
  8. Everts ME, Lim C-F, Moerings EPCM, Docter R, et al. Effects of a furan fatty acid and indoxyl sulfate on thyroid hormone uptake in cultured anterior pituitary cells. Am J Physiol 1995;268:E974-E979.


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Is your Thyroid working with or against you?

Hypothyroidism is one of the most common thyroid disorders. One recent analysis suggested that up to one in 10 women over age 60 has clinical or subclinical hypothyroidism. Hypothyroidism is characterised by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other unpleasant symptoms. In fact, every cell in the body has receptors for thyroid hormone.

Though not as common as hypothyroidism, hyperthyroidism is often a more serious condition, because it is associated with an increased risk of heart attack, stroke, and death. Symptoms of hyperthyroidism include palpitations, rapid heartbeat, excessive sweating, weight loss, diarrhoea, anxiety, feeling warm even when others are not, increased appetite, and insomnia.

Should you identify a problem, we are happy to help!

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Thyroid Self-testing now available

We are excited to announce that we now offer the possibility of self-testing for thyroid function. 

Instead of having to book a blood sampling appointment, we can send you a simple test kit with all the instructions. You take the sample at a convenient time, send it to the laboratory and within a weeks time receive your Thyroid Report from us.

We recommend to use Special Delivery by 1 pm next day for sending samples.

For further information, please do not hesitate to contact us. You can order a test kit for the Thyroid Profile without antibodies HERE. and with antibodies HERE. ​

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13 must-know Secrets to tackle Musculoskeletal Pain

The earlier a musculoskeletal injury is treated, the sooner healing can begin. An untreated injury can easily slide from “acute” to “subacute” and even into “chronic”.

Conventional medicine is keen to find a label, to make a diagnosis. This guides the treatment of the condition. Typical causes of musculoskeletal pain are osteoarthritis, rheumatoid arthritis, and gout. Unfortunately, this approach does not address the underlying cause of the symptoms.

Conventional treatments are directed to suppress symptoms with little consideration to the reasons why a person is sick. Instead of treating the individual patient with the disease, the disease is treated instead. This type of treatment DOES NOT take into consideration the unique makeup of each individual.

An abundance of literature shows that chronic use of anti-inflammatory drugs will damage the lining of the intestines and cause increased permeability which is called “leaky gut syndrome”. Leaky gut is linked to inflammation which can cause further aggravating and potentially worsening of arthritis pain.

In this ebook, we will discuss the typical diagnoses for musculoskeletal pains from a functional medicine perspective, highlight the need for further analysis and suggest functional treatment approaches, that address the causes rather than covering up the symptoms.

Order the ebook from our shop

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Autoimmune Paleo Diet


The Autoimmune Paleo Diet is an elimination diet that has been specifically designed to help those suffering from autoimmunity determine their food allergies and sensitivities, reverse nutrient deficiencies, balance gut flora, and heal their bodies over the long-term. The protocol, otherwise known as “The Paleo Approach” has been developed and refined by Dr. Sarah Ballantyne, and is outlined in detail in her book The Paleo Approach. We believe this is the best and most specific elimination protocol for those with autoimmune disease, and following it gives you the best chance to come up with your personalized healing diet.

In a nutshell, the Autoimmune Protocol calls for removing foods that are most likely to be problematic for people with autoimmune disease—grains, beans, legumes, dairy, eggs, nuts, seeds, nightshades, as well as food chemicals and additives. In addition, nutrient-dense foods are added to restore nutrient status, such as bone broth, high-quality meat and wild-caught fish, as well as organ meats, fermented foods and a wide variety of fruits and vegetables. Over the course of the elimination phase (which can last from a month to a year), you take note of the changes you experience in your health. When it comes time to slowly and systematically reintroduce foods, you will be able to tell exactly which foods are holding you back, and able to use this information to construct a diet that will best support your healing needs.

Image source: Pharma Nord Academy


Autoimmune disease is all about an immune system that has gone awry. Micronutrient deficiencies are common in autoimmune disease. The Autoimmune Protocol provides us with a clean slate.

  1. It removes foods that may trigger an immune response, are harmful to the gut, and lead to hormone dysregulation.
  2. It restores nutrients and flora that promote a healthy gut and well-regulated immune function.
  3. It provides a framework for building a life-long diet exactly suited to you.

CountryHealth takes no responsibility for any links shared in this blog. Please see our disclaimer. 

Paleo in the UK

Offering a complete resource for the Paleo Diet and Lifestyle and the Autoimmune Paleo Protocol run by a UK-based Functional Medicine Consultant & Health Coach

Paleo-Vegan = PEGAN

The pegan diet is a style of eating inspired by two of the most popular diet trends — paleo and vegan.

According to its creator, Dr. Mark Hyman, the pegan diet promotes optimal health by reducing inflammation and balancing blood sugar.

The Pegan Diet features 21 simple, straightforward principles that answer the question, how do we eat to prevent and beat disease?

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What Are The Differences Between Functional Medicine And Conventional Medicine

A science-based, natural way to become healthy again

Functional Medicine is patient-centered medical healing at its best. Instead of looking at and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions.

As the graphic of an iceberg shows, a named disease such as diabetes, cancer, or fibromyalgia might be visible above the surface, but according to Functional Medicine, the cause lies in the altered physiology below the surface. Almost always, the cause of the disease and its symptoms is an underlying dysfunction and/or an imbalance of bodily systems.

If health care treats just the tip of the iceberg, it rarely leads to long-term relief and vibrancy. Identifying and treating the underlying root cause or causes, as Functional Medicine does, has a much better chance to successfully resolve a patient's health challenge.

Using scientific principles, advanced diagnostic testing and treatments other than drugs or surgery, Functional Medicine restores balance in the body's primary physiological processes. The goal: the patient's lifelong optimal health.

How Functional Medicine Heals a Key Health Care Gap

Today's health care system is in trouble because it applies a medical management model that works well for acute health problems to chronic health problems, where it is much less successful.

If you have a heart attack, accident or sudden lung infection such as pneumonia, you certainly want a quick-thinking doctor to use all the quick-acting resources of modern medicine, such as life-saving technology, surgery and antibiotics. We are all grateful about such interventions.

However, jumping in with drugs, surgery and other acute care treatments too often does not succeed in helping those with chronic, debilitating ailments, such as diabetes, heart disease or arthritis. Another approach is needed.

The Two-Pronged Healing Approach of Functional Medicine

To battle chronic health conditions, Functional Medicine uses two scientifically grounded principles:

  • Add what's lacking in the body to nudge its physiology back to a state of optimal functioning.
  • Remove anything that impedes the body from moving toward this optimal state of physiology.

Plainly put, your body naturally wants to be healthy. But things needed by the body to function at its best might be missing, or something might be standing in the way of its best functioning. Functional Medicine first identifies the factors responsible for the malfunctioning. Then it deals with those factors in a way appropriate to the patient's particular situation.

Very often Functional Medicine practitioners use advanced laboratory testing to identify the root cause or causes of the patient's health problem. Old-fashioned medical diagnosis helps too, in the form of listening carefully to the patient's history of symptoms and asking questions about his or her activities and lifestyle.

For treatment, Functional Medicine practitioners use a combination of natural agents (supplements, herbs, nutraceuticals and homeopathics), nutritional and lifestyle changes, spiritual/emotional counseling, and pharmaceuticals, if necessary to prod a patient's physiology back to an optimal state. In addition, educating the patient about their condition empowers them to take charge of their own health, ultimately leading to greater success in treatment.

Treating Symptoms Versus Treating the Person

In the dominant health care model today, medication is used to get rid of people's symptoms. If the patient stops taking the medication, symptoms generally return.
Functional Medicine approaches health problems differently. Instead of masking the problem, it aims at restoring the body's natural functioning. Although Functional Medicine practitioners may prescribe pharmaceuticals, they are used to gently nudge the patient's physiology in a positive direction so the patient will no longer need them.

For example, conventional doctors would normally prescribe pharmaceuticals like Prilosec, Prevacid or Aciphex to treat acid reflux or heartburn. When the patient stops taking such drugs, the heartburn symptoms come back. In contrast, a Functional Medicine practitioner might find that a patient's acid reflux is caused by Helicobacter pylori bacteria. Eradicating the Helicobacter pylori might very well lead to the end of heartburn symptoms, permanently.

It's also important to note that in Functional Medicine, treatment for similar symptoms might vary tremendously for different patients, according to their medical history and results of laboratory tests. Factors that can come into play in producing the same symptoms include toxic chemicals, pathogenic bacteria, parasites, chronic viral pathogens, emotional poisons like anger, greed or envy, and structural factors such as tumors or cysts.

The Roots of Functional Medicine

Sir William Osler
You may be surprised to learn that Functional Medicine isn't new. It actually represents a return to the roots of modern scientific medicine, captured in this statement by Sir William Osler, one of the first professors at Johns Hopkins University School of Medicine and later its Physician-in-Chief: "The good physician treats the disease; the great physician treats the patient who has the disease."
Another important saying by Osler is "If you listen carefully to the patient, they will tell you the diagnosis." This encapsulates the importance placed in Functional Medicine on taking a thorough history from the patient.

Dr. Ron Grisanti of

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Functional Approach to Uterine Fibroids

Uterine fibroids are benign oestrogen-sensitive growths made out of smooth muscle cells and connective tissue. They appear during the reproductive years, grow during pregnancy, and regress after the menopause. Sometimes growth spurts can happen in perimenopausal years during anovulatory cycles with irregular oestrogen excess.

Order the ebook from our shop

Find out what uterine fibroids are, other conditions that could present similarly, symptoms of uterine fibroids, which functional tests are useful, conventional vs functional treatment approaches, and which supplements can be helpful

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Lipoprotein(a) – a strong risk factor for heart disease

Official statements are clear: the risk of atherosclerotic vascular disease is directly related to plasma cholesterol levels. Accordingly, all of the national and transnational screening and therapeutic guidelines are based on total or LDL cholesterol.

On the contrary, the risk appears to be rather related to the number of circulating plaque forming particles than to the measured concentration of cholesterol.The concentration of apo B provides a direct measure of the number of these circulating particles.

According to a study published in 2006 in the prestigious Journal of Internal Medicine evidence indicates that apo B is superior to any of the cholesterol indices to recognise those at increased risk of vascular disease and to judge the adequacy of lipid-lowering therapy. The evidence also indicates that the apo B/apo A-I ratio is superior to any of the conventional cholesterol ratios in patients without symptomatic vascular disease or diabetes to evaluate the lipoprotein-related risk of vascular disease.

Lipoproteins are the particles that transport cholesterol and triglycerides in the blood stream. Lp(a) is a lipoprotein rich in cholesterol. It differs from LDL as it contains an additional protein, apolipoprotein (a). Similar to LDL, an Lp(a) particle also contains one molecule of apolipoprotein B.

Recently measures of lipoprotein particles involved in atherosclerosis, which is the main underlying cause of CVD, have been found to be very useful to assess risk. Examples of such measurements are LDL particle number (LDL-P), apolipoprotein B and lipoprotein(a).

The Copenhagen City Heart Study found that individuals with plasma Lp(a) levels above 50 mg/L had 2 to 3 – fold increase risk for heart attack (myocardial infarction).

In 2010, the European Atherosclerosis Society (EAS) consensus panel recommended screening for elevated Lp(a), in people at moderate to high risk of cardiovascular disease. Desirable Lp(a) levels < 50 mg/dL were considered a treatment priority, after therapeutic management of LDL-C.

Desirable: < 14 mg/dL (< 35 nmol/l)
Borderline risk: 14 – 30 mg/dL (35 – 75 nmol/l)
High risk: 31 – 50 mg/dL (75 – 125 nmol/l)
Very high risk: > 50 mg/dL (> 125 nmol/l)

The EAS Consensus panel recommends that Lp(a) should be measured in high risk individuals such as those with premature CVD, familial hypercholesterolemia, family history of premature CVD and/or elevated Lp(a), and individuals with recurrent CVD despite statin therapy.

How Is Lp(a) Involved in Atherosclerosis and Heart Disease?

Lp(a) and LDL penetrate the inner layer of the arterial wall and accumulate together at sites for atherosclerotic plaque formation.

Evidence suggests that Lp(a) may be more strongly retained in the arterial wall than LDL. Furthermore, Lp(a) transports oxidized phospholipids whose plasma levels are strongly correlated with the severity of coronary artery disease. Interestingly, these Lp(a) associated oxidized phospholipids possess pro-inflammatory activity. This might be one of the links between lipids and inflammation in atherosclerosis.

There is also some experimental data suggesting that Lp(a) may promote clot formation in arteries burdened by atherosclerotic plaque. This may be one of the mechanisms behind the involvement of Lp(a) in heart attack and stroke.

How Can Lp(a) Be Modulated?

Lp(a) is mainly genetically determined and therefore refractory to lifestyle intervention.

Dietary changes, exercise and weight loss have not been shown to lower Lp (a).

Fat consumption has not been shown to raise Lp(a). One study documented a lowering of plasma Lp(a) levels in individuals placed on diets rich in saturated fat (a palm oil enriched diet). In keeping with this, other investigators have reported an increase in Lp(a) levels in individuals after they reduced their saturated fat intake. Monounsaturated fats also seem to reduce Lp(a) levels, as shown by a study that reported a significant decrease in Lp(a) levels in individuals whose diets were supplemented with almonds.

Niacin lowers Lp(a) by approximately 30 percent. Therefore, the EAS Consensus Panel has recommended niacin as the primary treatment for lowering elevated Lp(a) levels. However, these recommendations may have to be reevaluated in light of the results from the recentAIM-HIGH and HPS2-THRIVE trials. These trials did not show any clinical benefits of adding niacin to statin therapy.


Check Your Lp(a) levels with CountryHealth

Our Comprehensive Heart Risk Assessment tests not only for Lp(a) but also 6 further independent risk factors. 

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PLAC Test – a clever way to check your cardiovascular risk

Cholesterol testing alone is not enough - 50% of heart attacks occur in patients with normal cholesterol.

Arteries are blood vessels that supply oxygen-rich blood to your heart and other parts of your body. Atherosclerosis is a disease in the arteries in which the build-up of plaque can decrease blood flow to the heart or brain.Plaque is made up of fat, cholesterol and other substances found in the blood. Over time, the amount of plaque can increase, causing narrowing of the arteries. When this happens, it is more difficult for the blood to flow.

The majority of heart attacks and ischaemic strokes are caused by ruptured plaques.

When the plaque ruptures, the flow of blood to the heart or brain can become blocked, which results in a heart attack or stroke. 

The PLAC Test goes beyond what routine cholesterol testing can do by identifying active cardiovascular inflammatory disease. The PLAC Test measures an enzyme that, when elevated, indicates arterial inflammation, making heart attack or stroke more likely.The PLAC Test provides additional information that, when combined with standard cholesterol tests and an exam, can help determine whether or not you are at an increased risk for a heart attack or stroke.

A PLAC test can be useful if you have two or more of the following risk factors:

  • Male 45 years or older or female 55 years or older
  • Family history of early heart disease or stroke
  • Diabetes
  • Obesity
  • Smoker
  • Borderline high or elevated cholesterol levels

Are You at risk of a heart attack or stroke?

The PLAC test is part of our Comprehensive Heart Risk Assessment.


Cholesterol testing alone is not enough.
50% of heart attacks occur in patients with normal cholesterol.
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Your Gut – Your Second Brain

In recent years scientists have discovered that our gut contains a vast amount of bacteria which are called the microbiome. The number of genes in these bacteria is about 3.3 million whilst the human body has around 23.000. The total weight of the microbiome is about three pounds – the same as our brain, which is why it is also called the Second Brain.

One millilitre of colonic contents contains more bacteria than there are humans on this planet.

One of the important functions of the microbiome is to provide immunity (70% of our immune system is located in the gut), and this starts at birth. The birth canal is filled with lactobacilli – which prevent the growth of candida (which causes vaginal thrush). Lactobacilli are the first thing that enters the baby’s mouth during birth.

When mothers have C-sections the child does not get these beneficial lactobacilli. 80% of babies born via c-section are likely to develop asthma versus those born naturally, and they are also more likely to develop diarrhoea in the first year of life, have a tendency to be allergic to cow’s milk and have food intolerances.

Mothers milk also contains lactobacilli. They help to break down lactose, which is the major sugar in milk. The first milk also contains a lot of antibodies for the baby. Later breast milk contains carbohydrates (sugars) and prebiotics which provide food for the microbiome.

People often say they have a “gut feeling” and this is true as the brain is connected to our gut and vice versa.

The gut contains as many nerve cells as the spinal cord. The microbiome affects not only our nerves and immune system, but also our endocrine system. It modulates our emotions, desires and moods. The microbiome also produces neurotransmitters. Imbalances or deficiencies of neurotransmitters are known to cause, among other things, behavioural problems in children and psychiatric problems such as depression.

Environmental chemicals can change the gut microbiome. They can trigger inflammation and metabolic disorders.

Functional medicine is the new way of investigating how your body works and can often provide answers for chronic diseases.

Healthy regards

Dr Oliver Frey, MD MRCGP

Picture: UAB Comprehensive Cancer Centre
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Babies need to be in nappies as they cannot control their bladder. As they get older and turn into little people their nervous system is moving along nicely and the frequency of bedwetting goes down and eventually stops. 

Bedwetting is one of the most common disorders among children. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. Approximately 5% to 10% of all seven-year-olds have enuresis.

The reasons for bedwetting involve the inability to awaken from sleep in response to a full bladder, coupled with excessive nighttime urine production or a decreased functional capacity of the bladder.​

​Children who wet the bed may do so for emotional reasons. They may feel insecure due to the arrival of a new baby, a change of school or because of the parents' marital problems. In these cases, the child needs love and reassurance.

Why do some children have a problem?

There are numerous possible reasons why children - and their families - suffer from bedwetting: 

Enter your text here...

  • Slower central nervous system development
  • Food allergies or intolerances
  • Infections (kidney or bladder)
  • Diabetes
  • Excess water consumption prior to bed
  • Being scared of the dark
  • Laziness
  • Side effects of medication
  • Caffeine (some give this to their kids – and I highly suggest not doing it), e.g in tea, coffee and many fizzy drinks

Vitamin B12, folate and iron levels 

ISRN Urol. 2012;2012:789706

Pak J Med Sci. 2015 Jan-Feb; 31(1): 87–90.Pak J Med Sci. 2015 Jan-Feb; 31(1): 87–90

A study from 2012 found significantly lower mean vitamin B(12) and folate levels in patients who suffered from bed wetting. These findings were confirmed in a study in 2015 which also identified that average blood iron was significantly higher. 

A February 2018 study in the Journal of Pediatric Urology may offer hope for those pursuing non-drug options. 

Based on these results, the authors concluded that supplementation with vitamin D and omega-3 fish oil could help prevent nighttime bedwetting episodes among children seven to 15 year of age:

  • Vitamin D – 1,000 IU minimum but children frequently take up to 2,000 IU daily under the guidance of their physician.
  • Omega 3 – 1,000 mg daily, can be taken as a capsule, gummy or liquid.

Traditional Approach

Parents and children are often given the following advice by doctors  to curb bedwetting:

Bed alarms – alarms have sensors that detect moisture, which wake the child up as they begin having an accident.

Education and reassurance – diet changes, avoidance of caffeinated drinks and also avoidance of fluid before going to bed.  Make sure the child urinates before going to sleep.

Positive reinforcement – encouraging the child after dry nights.

Medications Commonly used include:

Desmopressin – Taken at night with a small sip of water, this medication can be used for children age 6 or older.  Common reactions listed by Epocrates Drug Database include headaches, nausea, abdominal pain, high blood pressure and rarely seizures, respiratory arrest and anaphylactic allergic reactions.

Imipramine – This medication can also be used for those 6 or older.  Epocrates lists a “black box warning” for this medication, stating that it may increase suicide risk in children, adolescents, and young adults with major depression. Additional common reactions listed include drowsiness, dizziness, and blurred vision to name a few.

Due to the possible side effects of medications, more natural alternatives are desired as first line by most.

​Common strategies to help with bedwetting

  • Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day.
  • Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
  • Be encouraging. Make your child feel good about progress by consistently rewarding successes.
  • Eliminate bladder irritants. At night, start by eliminating caffeine (such as chocolate milk and cocoa) and if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate a child’s bladder.
  • Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
  • Consider if constipation is a factor. Because the rectum is right behind the bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one third of children who wet the bed, though children are unlikely to identify or share information about constipation.
  • Don’t wake children up to urinate. Randomly waking up a child at night and asking him or her to urinate on demand isn’t the answer, either – and will only lead to more sleeplessness and frustration.
  • Don’t resort to punishment. Getting angry at your child doesn’t help him learn. The process doesn’t need to involve conflict.

What can you do to identify the cause of bedwetting in your child?

  • Identify food allergies and remove (gluten and dairy are big)
  • Avoid caffeine and fizzy drinks
  • Limit intake of water and fluids prior to bed
  • Always have them go for a whee right before bed
  • Use a night light 
  • Star board (get a star for each night they don’t wet their bed and a prize at X stars)
  • Taking off their bedsheets self and taking them to the laundry
  • Supplement with Fish oil
  • Give a Multivitamin
  • Give a Probiotic
  • Give a methylated B-complex

A known cause of bedwetting is slower development of the central nervous system + low b12 and low folate contribute to a slowed central nervous system = increased susceptibility to nocturnal enuresis (ie. bedwetting).

If one has low folate and low B12, then their methylation system is going to be less functional.

As their methylation is not up to speed, then the development of the CNS is hindered.

As the CNS development is hindered, so is the nervous system of the bladder which leads to nocturnal enuresis.

Restoring nutrients for CNS development is critical to reducing bedwetting.

The younger the child, the more development they are experiencing. The more development they are experiencing, the more methylation they are utilizing. The more methylation they are utilizing, the more nutrients they require to support methylation.

If the child’s methylation is not supported with nutrients, then bedwetting may show up.

Before you start blindly supplementing your child we would highly recommend to arrange some of the following tests which are all available from CountryHealth:

Which Lab Tests can be useful?


  1. Journal of  Pediatric Urology. 2018 Feb 5. pii: S1477-5131(18)30034-2. doi:10.1016/j.jpurol.2018.01.007. [Epub ahead of print]

Do you want your child to be tested?

We are keen to help you finding the root causes of bedwetting in your child

Why do some kids get dry and others struggle with bedwetting?

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Vitamin D

Human adult physiology requires 3000 to 5000 international units of vitamin D3 per day to maintain baseline metabolic and steady-state dynamics (Heaney et al in 2003).

Vitamin D is more hormone-like in its action and not a true vitamin. It remains stable with heat and oxidation. It is not required in the diet if there is sufficient sunlight to allow the production from provitamin D molecules in the skin. The liver then converts it into the active vitamin D. Boron seems to be important for this process. Also parathyroid hormone will stimulate the kidneys to produce active Vit D3 in kidneys when blood calcium levels are low.


The primary role of Vitamin D is regulation of calcium and phosphorus absorption in the gut, regulation of calcium balance and stimulation of bone cell mineralisation.

Vitamin D seems to be also extremely important in immune function - research is ongoing.

How much Vitamin D do we need?

It is essential to test your Vitamin D levels even if you take a supplement or spend time in the sun. 

Especially in view of the Covid-19 pandemic, you need to keep your Vitamin D levels in the optimal physiological range!

Source: Vasquez A. Vitamin D3 Dosing and Dogma: Mechanistic Explanation for the Relative Failure of the Bolus Depot. Int J Hum Nutr Funct Med 2020;8:5


Vitamin D from animal foods occur in liver, eggs, fatty fish, butter, and fortified foods. Vegetables are low in vitamin D. Ten minutes of summer sun exposure to the face and hands results in the production of about 400 IU Vit D.

Therapeutic uses

Vitamin D deficiency leads to rickets in children and osteomalacia in adults. Today both are rare, but most notable in the elderly and in people who don't spend time in sunlight.

People with poor fat absorption may become vitamin D deficient, (e.g. gluten-sensitive enteropathy), as the vitamin is fat soluble.

Studies throughout the year 2020 showed that vitamin D could effectively treat clinical coronavirus infections – but not when delivered in bolus/depot doses.

Safety and toxicity

Vitamin D production through sun exposure does not produce toxicity, as it is closely regulated.

2,000-5,000 IU Vitamin D3 - or more depending upon genetic issues (e.g. Vitamin D receptor SNPs that result in poorly formed cell receptors for vitamin D - see KASHI Bone profile) and other factors like the latitude where you reside (the further away from the equator, the fewer months sun exposure), digestive function is considered to be safe. Vitamin D3 is the preferred form.

Functional medicine considerations

Patients who are seldom exposed to the sun should be evaluated for vitamin D deficiency. Recently research as expanded the important functional interactions of vitamin D tin the prevention of cancers, type 1 diabetes, heart disease, osteoporosis and persistent, nonspecific musculoskeletal pain.

Source: Clinical Nutrition - A functional approach
Picture: wikipedia
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Zinc is important to the function of many enzymes and hormones. It is critical to immune function.

Iron, calcium supplements, alcohol, infections, and surgery may alter the absorption of zinc.


Zinc is a cofactor in a number of enzymatic reactions. It is important for protein and DNA synthesis, wound healing, bone structure, immune function, healthy prostate tissue, and skin oil gland function.


Oysters are a good source of zinc, but also red meat and other shellfish. Whilst high in whole grains, legumes, and nuts, it is not very absorbable from these sources.

Therapeutic uses

Zinc deficiencies can show as skin changes, hair loss, recurrent infections, and diarrhoea. While severe zinc insufficiencies are rare, simple insufficiencies are common. The may show as sleep disturbances, slow wound healing, acne, psoriasis, dandruff, rheumatoid arthritis, reduced appetite, and inflammatory bowel disease.

Zinc has also shown to be deficient in non-insulin-dependent diabetics.

Zinc may help relieve the common cold.

Safety and toxicity

Zinc supplementation should be kept at 15 mg a day or below for general, chronic consumption. Short-term supplementation may be beneficial, but should be kept below 80 mg per day.

If safe levels are not adhered to, a copper deficiency anaemia may result, because zinc and copper compete for absorption. Too much zinc can result in a depressed immune function.

Toxic effects may include dizziness, vomiting, lethargy, and anaemia.

Functional medicine considerations

Smokers have lower zinc levels, and zinc may help protect against damage to blood vessel walls. If a patient has a history of recurrent infections, skin conditions, slow healing wounds, or disrupted inflammatory response, zinc status should be assessed.

Source: Clinical Nutrition – A functional approach
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