Functional Medicine Overview

What is Cognitive Health?
Cognitive health includes several daily functions: 1) memory and learning, 2) language comprehension and word finding, 3) executive function and decision-making, 4) concentration and attention, 5) social and facial recognition, and 6) perception, orientation to time/place, and motor functions.

Mild changes in any of these functions may indicate damage to the brain that can lead to dementia. There are currently four stages of cognitive function, spanning normal function to severe dementia:

• Stage 1: No Cognitive Impairment (NCI)
• Stage 2: Subjective Cognitive Impairment (SCI)
• Stage 3: Mild Cognitive Impairment (MCI)
• Stage 4: Dementia (e.g., Alzheimer’s)

How Can We Promote Cognitive Health?

The most innovative approach to maintaining cognitive health and reversing cognitive decline is called the Bredesen Protocol. The Bredesen Protocol is based on research conducted by the neurologist, Dr. Dale Bredesen. The protocol has two options:

• PreCODE Program: this is for people who have no cognitive impairment, with or without a family history of dementia, who seek ways to optimize cognitive health
• ReCODE Program: this is for people with any stage of cognitive decline who seek a comprehensive approach to care. The program can be done while taking medications or participating in a research trial.

How Can We Help?

Dr. Jacobson is a Bredesen 2.0 Certified physician and leads the cognitive health program at Rochester Clinic. She provides the cognitive assessments, lab testing, food plans/recipes, lifestyle activities (sleep, stress management, exercise), toxin reduction strategies, and supplements to address the root causes of cognitive health.

Must-Know Facts About Cognitive Health

• Progression from subjective cognitive impairment to severe dementia is not a foregone conclusion.
• The most powerful activator of healthy neuron growth in your brain is aerobic exercise.
• The brain thrives when eating an olive-oil, plant-based food plan along with meal timing that promotes ketogenesis (fat burning).
• Bredesen protocol trained physicians assess your cognitive health more frequently to ensure steps are taken as soon as possible to reverse early signs of cognitive decline.

What are Common Digestive Imbalances?

• Irritable Bowel Syndrome (IBS) with one or more of the following symptoms: constipation, diarrhea, bloating, heartburn, abdominal pain
• Small Intestinal Bacterial Overgrowth (SIBO)
• Candida/Other Yeast Overgrowth
• Parasite Infections
• Autoimmune Colitis (Crohn’s Disease, Ulcerative Colitis, Microscopic Colitis)
• Gastritis (stomach inflammation)
• Esophagitis (esophagus inflammation)

How Can We Help?
The Rochester Clinic Functional Medicine program offers a comprehensive assessment of GI symptoms and uses microbiome testing to determine the root cause of your GI imbalance. Treatment includes a personalized GI Healing Protocol with herbs, therapeutic food plans, and vagal tone stimulation.

• Tests offered include:
  SIBO breath test
• Comprehensive stool test with advanced parasite testing
• Blood tests for histamine intolerance, common food allergies, and food sensitivities

Must-Know Facts About Healthy Digestion

• Frequent bloating, farting, burping, and heartburn are not normal. They indicate imbalanced digestion that can be improved with treating the root cause.
• A key indicator of healthy digestion is having 1 to 3 well-formed bowel movements daily.
• Untreated digestive imbalances may lead to rashes, itching, headaches, depression, fatigue, and joint/muscle pain.

What Are Common Metabolic Disorders?

• Prediabetes, diabetes: these are conditions where blood sugar is higher than normal. High blood sugar levels cause cell damage in the brain, nerves, kidney, heart, and blood vessels.
• Insulin resistance: this is a condition when the pancreas needs to secrete higher amounts of insulin to keep your blood sugar normal. If not treated, this frequently leads to diabetes.
• Metabolic syndrome: this syndrome includes high blood pressure, increased waist circumference, high blood sugar, and abnormal blood lipids.
• Elevated cholesterol and other lipid abnormalities: these are conditions when cholesterol and other types of fats are at a level in your blood that causes them to diffuse into blood vessels.

How Can We Help?

The Rochester Clinic Functional Medicine program offers a comprehensive approach to identify metabolic disorders as early as possible. Reversing these conditions decreases your risk of heart disease, stroke, dementia, and cancer.

Testing is essential to understand overall severity of risk, develop personalized food plan and lifestyle support, and prescribe evidence-based supplements, herbs, and medications.

Test offered include:

• Continuous glucose monitor
• Ketone breath analyzer
• Advanced lipid panels
• Nutrigenomic tests
• Coronary artery calcium (CAC) score
• Carotid intimal media thickening (CIMT) study

Must-Know Facts About Metabolic Health

• Metabolic disorders can occur whether a person is normal weight, overweight, or obese.
• Stress is a key driver of metabolic disorders. Nervous system relaxation practices are often needed to improve metabolic biomarkers.
• Eating 25 – 35 grams of fiber daily can decrease high cholesterol and other blood lipids.
• Personalized food and lifestyle changes can begin improving metabolic health within 2-3 weeks!

What Are Hormone Imbalances?

There are three main hormone types that affect our physical and emotional health:

• stress/adrenal hormones
• thyroid hormones
• reproductive hormones (estrogen, progesterone, testosterone)

All three categories influence each other, with the greatest effect being the persistent release of stress hormones on thyroid function and reproductive hormone levels. Hormone imbalances affect energy, sleep, mood, appetite, weight, blood sugar, blood pressure, blood lipids, hair growth, acne, libido, and regularity of menstrual periods.

How Can We Help?

The Rochester Clinic Functional Medicine program offers a comprehensive approach to identify hormone imbalances and their impact on physical health and quality of life.

We offer comprehensive hormone panel testing to understand the synthesis and metabolism of hormones in relationship to your symptoms. Treatment includes personalized food plans, lifestyle support, vitamins, herbal therapies, and bio-identical hormone replacement (HRT).

Must-Know Facts for Hormone Balance

• The primary driver of many hormone imbalances is stress. This is a mind-body phenomenon that can be measured with salivary cortisol testing to determine optimal treatment.
• Bio-identical hormone replacement therapy during menopause/andropause is a reasonable, and effective, alternative to synthetic hormones.
• We all need to give our thyroid gland more tender loving care! The thyroid gland is one of the most sensitive tissues in the human body. Prior infections, gluten and dairy intake, radiation (including x-rays, CT scans), and common environmental toxins (e.g., lead, mercury, microplastics, pesticides) can damage thyroid tissue.

What Are Immune System Imbalances?

• Examples of an overactive immune system: autoimmunity, allergies, mast cell activation syndrome (MCAS), metabolic-related inflammation, and chronic inflammatory response syndrome (CIRS)
• Examples of an underactive immune system: frequent infections (bacterial, viral, fungal, parasitic), long post-infection recovery time, prolonged healing after injuries, pre-cancerous lesions in one or more areas of your body.
• You can have an overactive and underactive immune system at the same time. This is a complex imbalance that can lead to chronic fatigue syndrome, fibromyalgia-like symptoms, post-Covid syndrome, intractable migraines, total body itching, and other chronic issues.

How Can We Help?

The Rochester Clinic Functional Medicine program offers a comprehensive approach to identify the root causes of immune system imbalances. This is one of the most complex topics in Functional Medicine, and time and patience are often required to find the optimal healing path.

Testing is essential to understand whether one or more root causes are present, develop a personalized food plan and lifestyle support, and prescribe evidence-based supplements, herbs, and medications.

Testing includes:

• Comprehensive autoimmune panels, blood allergy testing, MCAS markers
• Identification of persistent effects of prior infections based on the approach used by Stanford, including Lyme, Lyme-infections, Epstein-Barr Virus, Herpes Simplex Virus, and more.
• Assessment of current and prior mycotoxin exposure
• Tests for digestive imbalances. salivary cortisol levels, and mitochondrial health to assess for other functional imbalances that often contribute to immune dysfunction.

Note: Dr. Jacobson is not a Lyme or mold treatment specialist. If either is identified as a primary root cause of immune dysfunction, she will refer you to a Lyme-literate specialist or mold specialist for in-depth treatment.

Must-Know Facts About Immune Health

• A key driver in immune function is the health of the GI tract. At times, a GI Healing protocol is the first treatment step to reduce symptoms of immune dysfunction.
• Eating wheat/gluten and highly processed dairy products can initiate an autoimmune response in some people.
• Multiple treatment approaches are often needed for complex immune imbalances.

What Are Therapeutic Food Plans?

Most people will benefit from starting a core food plan that is personalized to their current health status and lab results. Other people will need to follow a physician-led therapeutic food plan for a few months to heal and fully rebalance their body.

• Core Food Plan: This food plan has balanced macronutrients with a focus on anti-inflammatory and antioxidant foods to stay well, maintain energy, and promote long-term health. The core food plan varies in the types of favored foods (including meat options), but all are centered on a whole-food, plant-based (WFPB) diet.
• GI Healing Food Plan: There are several food plans that are prescribed to heal GI imbalances. These are meant to be done temporarily with a return to the Core Food Plan over time.
• Ketogenic Food Plans: These food plans have been studied in the context of improving cognitive health, especially as part of the Bredesen ReCODE and PreCODE protocol. The brain thrives when it periodically uses ketones for fuel (created from fat metabolism) in addition to glucose (sugar metabolism). Many people inaccurately equate high fat intake, and particularly high meat intake, with a ketogenic diet. An olive-oil, plant-based ketogenic food plan works just as well and is favored to maintain optimal blood lipid levels.
• Autoimmune Paleo (AIP) Food Plan: These food plans have been studied in the context of improving autoimmune-related symptoms and lowering the need for medications.
• Therapeutic Detox Food Plan: This food plan includes foods that support the detoxification functions of the liver, kidneys, and GI tract. Doing a seasonal detox program 1-3 times per year is an excellent way to reduce your total toxic load, minimize cellular damage, and support overall health.

How Can We Help?

There is conflicting information about which food plans, diets, intermittent fasting approaches, and nutrient support are the best for specific health concerns. We start with a detailed discussion about which foods are your favorites and which you believe are related to your symptoms. This is followed by comprehensive biomarker testing to determine your unique nutrient needs, metabolic health, and hormone balance. Food allergy and food sensitivity tests are done when indicated.

Why Consider Working with a Health Coach?

Health coaches provide regular check-ins, education on food plans, resources for recipes and kitchen prep, assistance with establishing daily routines, and much more for your health! Many people optimize their health more quickly when brainstorming ideas and creating clear goals with their coach.

Must-Know Facts About Food Plans

• The best way to assess whether a food plan is working for you is through biomarker testing (before and after starting the food plan) and a symptom journal to track how you feel over time.
• To maximize the healing power of foods, 11-14 servings of vegetables and fruits daily are best.
• Optimal hydration is a key part of all healthy food plans.
• It is not only what you eat, but also when you eat and how you eat, that can be optimized to leverage the healing power of foods.