We encourage you to take a look at the multiple options for weightloss and overall improvement strength and stamina.

Prediabetes means you have a higher than normal blood sugar level. It's not high enough to be considered type 2 diabetes yet. But without lifestyle changes, adults and children with prediabetes are at high risk to develop type 2 diabetes.

If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There's good news, however. Progression from prediabetes to type 2 diabetes isn't inevitable.

Eating healthy foods, making physical activity part of your daily routine and staying at a healthy weight can help bring your blood sugar level back to normal. The same lifestyle changes that can help prevent type 2 diabetes in adults might also help bring children's blood sugar levels back to normal.

Functional Diagnosis of Hormone Issues

In diagnosing a hormonal imbalance, we want to look broadly (i.e., at as many of the body systems as possible) and as far back as we can (with a detailed history) to be as comprehensive as possible in our perspective of what is happening now. Having a patient fill out a signs-and-symptoms questionnaire is a great way to learn whether the hormonal system is a primary issue, and to begin to discern which hormones need attention. The following presenting signs and symptoms are suggestive of a hormonal imbalance:

Sleep irregularities

Mood swings

Heavy or irregular periods

Hot flashes

Breast tenderness

Anxiety

Low libido

Depression

Adult acne

Lack of concentration.

The more information we can get and the more specific it is, the easier it will be to get an idea of what is actually happening and how to treat the most basic causes.

Predisposing Factors That can Underlie Hormonal Imbalances

With hormonal disturbances, look for pre-disposing factors and possible triggers that affect optimal hormonal function. These may not be the presenting signs and symptoms, but elements in the medical history that have led the patient to the situation they present with. Some common examples include:

Chronic stress Chronic stress can lead to “Pregnenolone Steal” or “Cortisol Escape.” When the body is in a “chronic stress response,” pregnenolone, the precursor to the rest of the steroidal hormones, is diverted to cortisol. This is at the detriment of all the other steroidal hormones; i.e. progesterone, aldosterone, DHEA and its metabolites: the sex hormones, estrogens and testosterone. As pregnenolone is diverted to cortisol-cortisone, DHEA depletion begins. The result is a depressed cortisol-to-DHEA ratio and an imbalanced hormonal system. This is measurable with a Functional Adrenal Stress Profile.

Toxicity/xenoestrogens Many of the toxins we are exposed to on a daily basis have hormone-like activity and are known as xenoestrogens. They have the ability to either mimic estrogen or act as endocrine disruptors sitting on estrogen receptors, kicking off the real hormone and creating a myriad of problems in the body.

Nutritional deficiencies Certain nutrients act to detoxify hormones and act as essential cofactors in not only the synthesis of hormones but the biotransformation of hormones in peripheral tissues.

History of synthetic hormone use This would include oral contraceptives and infertility treatment.

Some questions to ask yourself when looking at hormone systems concern the function of the hormones. A practitioner would want to look at how the process of hormone synthesis is working, as well as how the hormone is getting distributed. Other factors include the hormone’s interaction with other hormones, the function of the hormone receptors (i.e., if they are too sensitive or not sensitive enough), how the cells are functioning, and how the hormones are being broken down and excreted. These factors open up the hormone issue to look at the whole cycle of creation of the hormone, how it works and interacts with other hormones and cells, and how it gets broken down and excreted. It is a much more comprehensive and therefore effective way of addressing a case with these issues.

In other words, once we have a sense of the possible triggers and predisposing factors, we need to look at their impact on hormonal function and ask these questions:

Is there a problem in the synthesis and production of a particular hormone?

Is there disruption at the cellular receptor level that would have an impact on how the hormonal message is received by the target tissue?

Is there a problem with the detoxification of hormones?

Is there a problem with the excretion of hormones?

Is there a problem with a downstream metabolite of a hormone?

The next step is to order lab tests to help evaluate the hormonal balance. Consider running saliva and/or blood tests to check hormone levels, looking at estrone, estradiol, estriol, progesterone and testosterone. I would also check for adrenal function with in-office techniques, such as the paradoxical papillary response test and Ragland’s test (orthostatic hypotension) as well as the salivary adrenal stress index. If you suspect thyroid involvement, you might want to order a comprehensive thyroid panel, which would include TSH, free T4, free T3, reverse T3 and thyroid auto-antibodies. I always recommend a comprehensive chemistry screen and CBC because elements such as glucose, triglycerides, fasting insulin and cholesterol are greatly impacted by hormonal dysregulation.

Once the underlying causes have been confidently identified and looked at from this broad perspective, treatment can be advised with greater confidence. Protocols might include stress reduction, botanical/herbal medicine, HRT, nutritional supplements, diet and lifestyle changes, acupuncture, and naturopathic treatments such as castor-oil packs and hydrotherapy.

When a patient is fatigued, their quality of life suffers. Morning routines may turn into energy-draining chores, work can become unbearable, and personal relationships might decline. How many of your patients report fatigue? What can be done to help them? Functional Medicine is uniquely positioned to help patients with fatigue, as this model of care examines an individual’s individual life course for underlying causes and helps patients change their lifestyle to promote improved function and quality of life.

The thyroid is a gland that secretes hormones and plays a major role in the regulation of many body processes, especially those related to metabolic function. Maintaining optimal function of the thyroid and balanced levels of its main hormones, triiodothyronine (T3) and thyroxine (T4), is vital for overall health. Dysfunction of thyroid hormone performance is quite common and may result in conditions such as thyroiditis and hypothyroidism. In the United States, hypothyroidism reportedly affects up to 10% of adults, with a potentially higher prevalence in older populations. The autoimmune condition known as Hashimoto’s thyroiditis is the most common type of hypothyroidism, affecting one to two percent of people in the US, most of them women. In this disorder, a dysregulated immune response impairs the production of thyroid hormones. On the flip side from a low-functioning thyroid is hyperthyroidism, which impacts about one percent of people in the US, with women two to ten times more likely to develop the condition. Graves’ disease is the most common type of hyperthyroidism in the US. In this autoimmune disorder, autoantibodies activate the thyroid-stimulating hormone receptor, inducing excessive thyroid hormone secretion.

A low-functioning thyroid is conventionally treated by taking the thyroid hormone medicine levothyroxine, while hyperthyroid conditions such as Graves’ disease may be conventionally treated by antithyroid drugs, radioiodine, or potentially surgery. How can the functional medicine approach help restore thyroid hormone balance and promote thyroid health? Understanding the factors that may be at the root of an imbalance is an important place to start.

The Microbiome, Stress Hormones, & Gut Function

The personalized treatment strategies that address root causes of chronic conditions are the cornerstones of the functional medicine model, and stress is but one modifiable lifestyle factor that may be addressed in a patient’s intervention. Transforming the body’s response to stress may lead to more positive health outcomes, and some techniques have the potential power to bolster immune function, strengthening overall resilience.

A recent review evaluated the effectiveness of stress management for inflammatory bowel disease (IBD), a chronic intestinal inflammatory condition associated with dysfunctional interactions between the gut and the brain. While there are some inconsistencies among studies, many found that stress management techniques had beneficial effects on inflammatory activity, anxiety status, and quality of life in IBD patients.8 These include:

Mindfulness meditation practice.

Relaxation training that creates physiological and mental rest. The training may be given to patients by a therapist or in a self-directed manner.

Combined therapies of relaxation and guided imagery, which replaces stressful thoughts with mind-relaxing images.

Multi-convergent therapy that combines mindfulness meditation and cognitive behavioral therapy.

Exercise is another lifestyle strategy that may mitigate the detrimental impact of stress, and in general, moderate exercise is considered a positive modulator of gut microbiota biodiversity.

As a low-cost and effective stress reduction treatment, incorporating an appropriate exercise program into an intervention strategy may increase enteric microbial species and metabolites that have stress-protective properties.

Consultation and Evaluations for Toxic Substance causing Immune Mediated Responses

Nutrition assessment available

We use state of the art genetic testing in order to create your profile. Dr. Espinosa is a cancer survivor and dedicated her practice to cancer support and recovery. Improvement of symptoms post chemotherapy and radiation is paramount. Understanding your risk factory is as important as knowing what you can actively do to grow a terrain that does not allow weeds to grow. “Build you terrain against cancer cells.”

Dr. Espinosa runs one of the few Long Haul Covid clinics in South Florida dedicated to the normalization of Cytokines and reducing oxidative stress causing symptoms of extended duration.

Our office has an innovative way of testing for real time autoimmune dysregulation of the immune system and takes the needed measures to treat this immune modulation that leads to recovery in record time.

Testing available using Cogence Immune Modification.

The need for micronutrient analysis and telemore testing leads to the most advanced and successful prevention strategy for dementia.

Functional Medicine is looking for root cause analytics and creating the change that is needed today to prevent disease in the future Your risk factors are assessed using genetic technology along with serum analysis to determine your course of action in prevention. Your health can change and disease is reversible with knowledge and food as medicine.