clinical ‘cause & effect’ - don’t miss it in your practice | by Andrea Nakayama, Functional Nutrition and Lifestyle Practitioner at Holistic Nutrition Lab

clinical ‘cause & effect’ – don’t miss it in your practice


In your practice you’ll likely encounter clients who are taking prescription medications. We see it all the time.

And while it’s not within the scope of our practice at the Functional Nutrition Alliance to advise people whether or not they should be taking pharmaceuticals, we do like to explain cause and effect.

Nothing that goes into the body goes without consequences – good, bad or both.

In the Functional Nutrition Lab trainings we talk extensively about the consequences of both functional and impaired digestion.

We look at ‘what’s going on in there’ that can lead to a host of symptoms seemingly unrelated to the gut – things like depression, psoriasis, joint pain, fatigue, Hashimoto’s and more.

Each year, I see that one of the biggest revelations for practitioners in the Digestive Intensive and Full Body Systems is the discovery of the importance of the role of THE STOMACH in both digestion and overall health.

The chemistry of the secretions, the mucous lining and the wicked strong muscles all have an important job in relationship to the food we eat.

There’s powerful stuff happening in there!

So what’s the cause and effect of taking a drug that affects the stomach?

Prilosec is a PPI (proton pump inhibitor). It’s used to decrease the production of stomach acid to help prevent heartburn or GERD (gastroesophageal reflux disease).

Prilosec isn’t the only one.

There are a good number of PPIs including Prevacid, Nexium and at least 40 other brand name pharmaceuticals that are among the third highest-selling class of drugs in the U.S..

It’s highly likely you’ll encounter a client or patient on a PPI in your practice.

By taking a PPI we miss the opportunity to uncover what’s going on in there.

What’s the cause?

  • Why is there heartburn or GERD?
  • Is there really too much stomach acid being produced?
  • Why does the body produce stomach acid anyway?
  • Is stomach acid a bad thing that should be squelched?

These are the questions I encourage you to be asking behind the scenes.

Do you need to know the pathophysiology of every drug? No way! (Unless pharmacology is your passion.)

But when your client’s success (and therefore yours), is being compromised by something other than their morning latte and doughnut, you might want to take note.

Let’s look at the simple pathophysiology of a PPI.

THE PATHOPHYSIOLOGY OF A PROTON PUMP INHIBITOR

Proton pump inhibitors suppress gastric acid secretion by inhibiting the hydrogen potassium ATP-ase enzyme system at the secretory surface of the gastric parietal cells.

SAY WHAT?

Here’s the breakdown…

  • gastric acid is a digestive fluid naturally formed in the stomach
  • gastric acid is composed of hydrochloric acid (HCl), potassium chloride and sodium chloride
  • gastric acid is critical for the proper digestion of proteins; it stimulates digestive enzymes which break down the long chains of proteins into their building blocks, amino acids
  • secretion is a key function of digestion where different fluids are introduced at different phases to induce the chemical processing of the food we eat
  • hydrogen potassium ATP-ase is an enzyme that initiates the action of the protein that acts as a proton pump (to release gastric acid)
  • parietal cells are the cells within the stomach’s tissue lining

Cut-to-the-chase: There are constituents within the sheath of your stomach that are meant to help you break down your food.

What are the consequences of inhibiting an essential digestive function?

What’s the effect?

  • risk of B12 deficiency (B12 utilization requires a healthy and not compromised stomach lining)
  • iron deficiency (ditto regarding the stomach)
  • additional nutrient depletion including folate, calcium and zinc, with longer term use
  • increased potential for food allergy or sensitivity (the poor body has to process food that hasn’t been fully broken down)
  • fatigue & low energy

Now, like I said, it’s not our job to take our clients off their meds. It IS our job to help them understand how to welcome and initiate better health.

That’s why they seek our help!

Our ability to connect the dots and support their transformation is in our hands.

Are you ready to understand what’s going on in there so you can help more people and touch more lives?

If you’re ready, then I’m here to help you help them.

Step 1: Start to incorporate the principles of cause and effect in your thinking today!

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Functional nutritionist and educator Andrea Nakayama (FNLP, MSN, CNC, CNE, CHHC) is leading patients and practitioners around the world in a revolution to reclaim ownership over our own health. Her passion for food as personalized medicine was born from the loss of her young husband to a brain tumor in 2002. She’s now regularly consulted as the nutrition expert for the toughest clinical cases in the practices of many world-renowned doctors, and trains a thousand practitioners online each year in her methodologies at Functional Nutrition Lab. Learn more about Andrea here.

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Cat Stuart

Thanks for the info. I have two friends on proton pump inhibitors, one is 42 and one is 70 years old. I’m going to find a delicate way to talk to them about this. What have you found that helps with easing the symptoms to eventually taper off the meds?

Andrea Nakayama
Andrea Nakayama
Hi Cat! One of the many coveted resources in the Digestive Intensive are the Done-4-You Protocols, and we have one dedicated to acid reflux, heartburn and GERD. To ease symptoms while tapering off medications, you’ll want to identify and avoid the triggering foods (perhaps avoid chocolate, citrus, tomatoes, onions, peppers and peppermint temporarily), bring in probiotics and some aloe vera juice, and make certain lifestyle modifications. It’s all about addressing the root cause of what’s causing the heartburn while trying to reduce the symptoms along the way. There really are no literal “done for you’s”—as each case is unique and… Read more »