What do you do when you have health problems and you have tried all the conventional medical approaches to help yourself recover but nothing helped. If you’ve been seeing doctors and they can’t figure out how to help you, my recommendation is to see a clinician who is specializes in functional nutrition and holistic medicine.
Today, I have the pleasure of talking to Andrea Nakayama, one of the leading functional nutrition experts. She is considered the crème de la crème of functional nutrition, which is saying a lot. She will tell you about the importance of the functional nutrition and holistic medicine approach to healing ”incurable” diseases, and why functional medicine can help people fix health problems even when conventional medical approaches have failed. She’ll also talk about the functional approach to overcoming fatigue, and how to avoid many common traps that health seekers fall into.
In this podcast, you’ll learn
- Why functional nutrition and medicine is so important to getting results
- The most common triggers for chronic fatigue
- Why and when conventional medicine is crucial (and when to go another route)
- What testing is all about and how you can use it to your benefits
- The dark side of elimination diets
- How valid are many commonly used lab tests (hormone tests, food intolerance tests, etc.)
- Why therapeutic diets can become COUNTERPRODUCTIVE and make your health worse (and how you can fix it)
- Why passion and purpose are crucial for good health
- How your gene tests are used in the practice of functional nutrition and holistic medicine
- Andrea’s top 3 strategies for optimizing your health and energy
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How functional nutrition and holistic medicine can heal chronic diseases and fatigue with Andrea Nakayama – Transcript
Ari Whitten: Everyone, welcome back to the Energy Blueprint Podcast. I am Ari Whitten and today I’m here with Andrea Nakayama who is a Functional Nutrition Guru/Expert. And someone who is, I can tell you is regarded by our peers, our colleagues as really the crème de la crème of functional nutrition, which is saying a lot.
I know a lot of my peers and colleagues really look to her as a true expert. Really it’s an honor and a privilege to have you on, Andrea.
Andrea Nakayama: Thank you so much for having me, Ari, I’m excited to be here.
Ari Whitten: Yeah, so you do a lot of different things now, you’ve been a clinician for a long time and you also train other clinicians and you have certification programs to guide people from all the way from, I think without any credentials or prior credentials whatsoever, all the way to being a functional nutrition and lifestyle practitioner. Is that right?
Andrea Nakayama: Yes. People do typically have some training before they come in, but everything from a health coach to an MD who wants to know more about how to put functional nutrition and lifestyle practices into their practice. Yes, that’s major training.
Ari Whitten: Beautiful. We were talking a couple of weeks ago and I know that you have kind of a fascinating story of origin, how you got into all of this and kind of what you’ve been doing for the last 20 years or so. I would love if you could just tell people that story of how it all started for you.
Andrea Nakayama: Yeah, I think it’s a great question because I do see our stories as such a huge part of our health journey and it’s a place where I think we need to spend more time as practitioners getting into the stories of our patients and clients. For me, my story and my health journey are definitely rooted in the experiences I’ve had, so back in 2000 in the April of 2000, I was pregnant seven weeks pregnant and my husband was diagnosed with a very grave brain tumor, a brain tumor called a Glioblastoma Multiforme.
He was given about six months to live, they didn’t expect him to see our baby born and we kicked into high gear, so we did everything and anything we could do to help prolong his life and give him a good quality of life and make sure that he saw our son born. We were even going for much more than that. He lived, my husband lived two and a half years with his diagnosis so well beyond the six months, he did have a good year and a half with our son, some good imprinting there and he died back in 2002. I don’t even know how to say that anymore.
2002 in July he died at home and it was that in itself was a transformative experience for me as well as a clinician, it really took me into the place of suffering and what a patient goes through during their health journey.
Ari Whitten: Yeah, and so how did that transition, so that kind of sparked your interest in learning more about health and becoming a practitioner yourself?
Andrea Nakayama: Well, I was already a real health food junkie, so I had been taking care of my own health and we were living in the bay area at the time, so we would shop at the farmer’s markets and we ate all organic and I grew my own herbs. I had a real passion for health and nutrition in relation to my own energy and performance and also to fertility.
It did take me a little while to get pregnant and it wasn’t until after my husband passed away that I really got the spark and realize this was my calling in life and then put myself back through years of school and education and started practicing …
Back in 2009 is when I first hung my shingle and things grew really quickly because I was already pretty entrenched in the world of health and healing, especially in relation to food.
Ari Whitten: Functional medicine is now like a big trend, it’s very, very popular everybody is calling themselves a functional medicine practitioner. Even I would say people who are not really functional medicine practitioner.
Andrea Nakayama: Absolutely.
The definition of functional nutrition and medicine, and how that differentiates from conventional medicine
Ari Whitten: I mean, this kind of idea of functional nutrition, functional medicine has become very popular. What does that even mean for people… I know kind of like within our peers, everyone knows what it means and for regular people who maybe have heard this term here and there, but don’t really understand what it’s all about. Can you talk a bit about what functional medicine is and functional nutrition and how that contrasts with maybe standard sort of conventional paradigms?
Andrea Nakayama: Yeah, absolutely. I first have to say that, I have a real mission to serve the underserved population and by that I mean the people who are sick and not getting better, they’re looking, they’re doing everything, they’ve been everywhere and that are often being treated like their diagnosis. For me, that’s what I experienced and watched with my husband. He was treated like a walking dead man in his early 30’s. We’d walk into a doctor’s office, they wouldn’t even speak to him, they’d speak to me like he wasn’t even there and it was very proud half Japanese man, that didn’t sit well for me.
My mission is to serve this population. My passion is that functional medicine has the power to do that when done appropriately. In a functional medicine practice, there are three major tenants that were paying heed to and those are that we are working in partnership with the patient, so the patient and practitioner have a really therapeutic partnership.
Again, the practitioners really looking to learn as much as possible about that patient so that we’re treating the individual and not the diagnosis that we look for the root cause, that we’re always asking why and we understand what the history means there, what the genetics, the triggers, what is working for a person, what isn’t, what’s happening physiologically, and then the third tenant is that we work in systems so we understand the biological systems in the body, how is everything interrelated so you’re not just going to a gastroenterologist and then an immunologist and then your OB-GYN and then your therapist.
It’s all connected, it’s all interrelated and we have systems as well that help us think into the complexity of the human body. So that is a functional practice and I would say if it doesn’t have those three things in place, it’s just not functional. That’s not what we’re seeing in conventional medicine, conventional medicine is very diagnostic or sign and symptom-based, so there is a place, I’m a yes end clinician, so there is a place for conventional medicine, especially in acute situations.
When it comes to chronic health issues, we really need to take a whole person approach and then I can talk a little bit more into functional nutrition versus functional medicine, but I’ll pause and see if you have any.
Why there is a place for conventional medicine as well as functional nutrition and medicine
Ari Whitten: Yeah, well I would love if you could elaborate a bit more on that point, which I think is a critical one of this idea that conventional medicine is really good sometimes in acute situations like, if you get shot or stabbed or you have a life-threatening infection that you’re going to die in the next few days.
Like you probably don’t want to go to a functional medicine practitioner. You probably want to get to the ER and like get surgery to get the bullet out of you and so on.
Why does that matter or why what you said was that, an acute situations, there’s a place for conventional medicine, but when we’re dealing with chronic disease, we really need to address the whole person and figure out kind of deduced detective work it sounds like, and figure out what’s going on with that person? What’s that all about?
Andrea Nakayama: Exactly, so we do have to do a lot of detective work and the things that you mentioned that are a part of an acute situation are going to impact long-term health. A gunshot wound and acute infection, the need for surgery, all that becomes part of a patient’s story that is going to impact. We can’t say that huge life event and we can add huge life events into that like divorce and death of a loved one and financial woes.
All of those things start to make an impact on what our body can handle, and that’s where the chronic health issues start to form. They’re not just one thing, there are all these life events that are really adding up to bring us to a place where there is a chronic health condition. That chronic health condition can manifest as something that is a diagnosis, like an autoimmune diagnosis like Hashimoto’s or Lupus.
It can also manifest as signs and symptoms that don’t go away with the quick fixes like energy and fatigue and insomnia and weight loss resistance. All of those things are there for a reason and like you said, as clinicians, we have to be detectives to figure out what led us here, what’s the trajectory, and that’s where we get to the roots of the situation and start to reverse it as opposed to just keeping putting band-aids on while ignoring.
Wait a minute, there was a surgery that happened when you were 10 that you didn’t tell me about and that was the point where you started to have GI issues. Let’s put those two together and figure out how we address this.
The truth about testing and why it is not to be relied upon
Ari Whitten: Gotcha. Let’s dig into that a little bit more because I think there’s a lot there. As far as what that detective work actually looks like, and I also know that this is… can kind of confound it a little bit by the fact that there are some diagnostic testing or tests I should say. Even that functional medicine practitioners use that are seemingly very scientific and very cutting-edge and very accurate and yet are not really …
To give you an example of this, I was actually exchanging emails the other day with our mutual friend Alan Christianson and he was telling me about a story where he was training a particular physician in 2012 and it was a new physician and she was very enamored with tests like all the different labs that you can get done, blood, and saliva, hormone, panels and urine testing, hormone panels and so on.
He said that he did a comprehensive test on himself of blood tests, urine tests, and saliva tests, complete hormone panels from multiple different labs. He sent me the results of all of these tests the other day and they were just wildly inconsistent with one another. The only one that was even compatible with like him that was even kind of even made sense, was just kind of the standard blood test, all, all the other full saliva hormone panels and urine hormone panels, you’d look at them if you’re looking at them only in isolation with that one test and you’d say, “Wow, this is giving the amazing data.”
Yet, when you do all these other tests, you realize, “Wow, there are huge inconsistencies here, and if I’d only done one of these tests, I might have been chasing after all these abnormalities that aren’t even really there.”
Andrea Nakayama: Yeah, so I’m going to back way up and talk about the systems and tools we use and then where testing has a place and what kind of testing, if that’s okay.
Ari Whitten: Absolutely.
Andrea Nakayama: From a functional nutrition perspective, and this is where the difference between functional nutrition and functional medicine exists. I have a lot of systems that I’ve developed that enable us to really do this detective work, and there’s a system that I’ve developed what’s called the three tiers of epigenetic mastery. I know those are maybe confusing words, but we really want to master our genes and master our destiny so it’s really the three tiers that we need to look at.
Tier one is what I call the non-negotiables, tier two is deficiency to sufficiency, and tier three is dismantling the dysfunction.
The definition of epigenetics
Ari Whitten: Real quick, Andrea, just for anybody who’s not familiar with the term epigenetics, do you mind explaining what that is?
Andrea Nakayama: Exactly, yeah. I know it’s a big word. So the epigenetics are the factors that bathe our genes, everything we do, remember I was talking about our stories, the way all those things impact our health downstream. Epigenetics are the factors that bathe our genes and they’re made up of all the things we do every day and have done in our entire lifetime.
The funny thing if we talk about testing is if we look at genetic testing, it doesn’t tell us a whole lot in terms of therapeutics because it just tells us what the blueprint is, it doesn’t tell us what’s turned on or off. It’s the epigenetics that actually turn those genes on or off and the epigenetics are what you do with your life and what you have done with your life day in and day out, and that’s where we have a little bit more control and there are factors that we haven’t had control of like getting in a car accident or the death of a loved one, but those things impact our genetic expression and that’s where we have control.
In the three tiers of epigenetic mastery, and I have a handout that everybody can get here and will lead to that later. You’re really just looking at, how do I start to reverse what it is I’m feeling or the diagnosis that I have by looking through this different lens so that tier one, the non-negotiables are unique to every single one of us.
Tier two deficiency to sufficiency. Again, your deficiencies could be in love, community, hydrochloric acid in your stomach, adrenal hormones, they can be anything, vitamin D.
We have to look at those factors before we look at the dysfunction, which is most of where conventional medicine and also functional medicine is going. Let me go right to the dysfunction. Two different side notes, I was recently in a summit on heavy metals and people just wanted me to give an answer. They were very angry that what I was talking about was basic and dealing with the non-negotiables and the deficiencies are not basic, it takes a lot of work and a lot of detective work to figure out what are the non-negotiables for you and what are the deficiencies for you?
If we go right to the dysfunction, we’re not getting results, and that is a problem with a lot of the testing and the way I was just interviewing a functional GI doc who deals with complex Cebo cases. He calls that the attack phase versus the preparatory phase. If we don’t do the preparatory phase, we cannot go into the attack and too much of medicine functional or conventional is going for the attack.
That’s a distinction I want to make between functional nutrition and functional medicine. We are in that tier one, tier two, preparatory work so that if you have to do an attack. Again, this is talking about chronic healthcare we can go and do that with more efficacy.
In doing that tier one, tier two work, we do sometimes need to do testing, unlike my friend Dr. C, who you were referring to. I’m a fan of starting with good old serum lab tests because they tell us the gross situation, meaning the big situation that lets us know where we may need to go into more targeted testing and where that targeted testing is going to play a role in the therapeutics.
We’re not just doing it for the sake of doing a whole bunch of testing at once, we’re doing it for targeted information that allows us to methodically go through and change the inner ecology, change the terrain so that those signs, those symptoms, and those diagnoses don’t have a chance to exist.
How the three tiers work
Ari Whitten: Beautiful. Talking about these first tiers kind of the foundational work of addressing people’s nutrition and lifestyle habits. How often do you find that just doing that stuff completely resolves the person’s health and then you don’t even really need to go into the attack aspect?
Andrea Nakayama: Most of the time. I mean, that’s not who we see in our clinic. We deal with the people who have already done that work or think they have done all that work, but most of the time for most individuals doing that tier one work alone, not even doing tier two will begin to address and reverse the signs and the symptoms that they’re experiencing.
I can’t give you a percentage, but I think it’s what we would call those people Big Little’s, Big Health Issue, Little Effort Taken. Little Bigs, Little Health Issue, Big Effort Taken.
Ari Whitten: I love that distinction by the way. I read it in your book and I really enjoyed that, I’d never heard that before and I thought it’s such a nice way for the clinician, for the practitioner to conceptualize what kinds of person they’re working with and to not only kind of helped direct what treatments are going to be best, but also to help even just communicate with that person.
Andrea Nakayama: Exactly.
Ari Whitten: Because if you, I mean, if you’re talking to a person who’s a, let’s see if I’m going to get your terminology right, you’re a … I don’t know, let’s call it a big, big. What does that? It’s someone with big health problems who has taken massive efforts to try to resolve them but hasn’t been successful.
Andrea Nakayama: Exactly.
Ari Whitten: You, if they’ve been going out for five years or 10 years, trying to do everything to be healthy and then you talk to them about the basics, they’re going to be like, “Oh, this person doesn’t know what the heck they’re talking about.”
Andrea Nakayama: Exactly, yeah. It was a way that I designed for us to talk internally about how we categorize people because we have different opportunities in our clinic for different people who are coming in with different health issues. We have to put on the sorting hat really quickly if you’re familiar with Harry Potter. There’s the sorting hat, so we call it the sorting hat, how do we sort people quickly to understand what have they done? Who have they seen? What have they done? Who have they worked with already, what’s worked, what hasn’t?
Of course, if we have somebody who has three autoimmune diagnoses and they’re coming in eating three or four foods, that’s what we would call a huge, huge, a big, big, who’s become a huge, huge, huge health issues and huge effort already taken and yet they’re only cycling and cycling and cycling and not getting better and they may be working with the top doctors, but that process needs to be slowed down. They really need a partner in everyday.
Ari Whitten: Just trying to make sure I heard that correctly. Did you say eating three or four foods?
Andrea Nakayama: I did.
The darker side of elimination diets
Ari Whitten: As if they’ve gone on such elimination diets and they’re reacting to this or reacting to that, that eventually, they know much that all they can eat is three or four foods?
Andrea Nakayama: Exactly, that’s often who we see people coming in who are, they’re so reactive and they’ve done all the testing. They know they have leaky gut, they know they have these infections, they know they have adrenal issues, but they can’t digest and they can’t really process anything. We see a lot of those in our clinic.
Ari Whitten: Let’s digress into that a little bit more if you don’t mind. I’m curious to know maybe kind of an overview of what it looks like to get somebody from that situation back to a more normal diet with lots of variety and not being so reactive to every little thing.
Also, the actual objective reactions that a person experiences from food is one thing and then it’s also another thing to deal with what’s going on psychologically as far as Orthorexia and dietary neuroticism and phobias of lectins and gluten and with all the different toxins that all these different diet gurus have been talking about for the last 25 years…
Andrea Nakayama: Yeah, it definitely gets crazy and I definitely also want to come back to a little bit of the functional testing and the true but partial piece so we can bookmark that. For us, a lot of the tools that we’re going to use are in the realm of detailed tracking.
Oftentimes, when a patient comes in, in that situation like we’re talking about, they are very much stuck in the weeds. They can’t parse out what is making them feel bad, what’s making them feel worse, where might there be other factors besides the food that are impacting them, stressors in their life, in their home environment, toxicities, relational toxicities, sleep issues, the quality of their water.
There might be so many different things that are impacting their ability and they’re placing it all on the food when I eat that I’m reactive.
We actually do very, very detailed tracking with those individuals so that we can both assess their history. When did this happen? What was happening at the time that you became so reactive and we can look back to those roots as well as what else is happening physiologically, but particularly when does it feel better? When does it feel worse? What time of the day is it happening? When are you eating? What are you eating, what quantity are you eating? We’re looking at every detail so then we could try reintroductions very methodically based on bringing up the nutrient density to get them to a point where I think we had a success story this week in the clinic where somebody came in eating four foods and she’s now eating 50 foods.
Ultimately, we want people eating a diet that is as diverse as it can be because these limited diets introduce deficiencies. When we think we’re in a healing mode, we actually impact that tier two arena by introducing deficiencies by the limitations, and I’m a huge fan of therapeutic diets in a therapeutic manner, which means they shouldn’t be done long-term.
People are eating autoimmune Paleo for too long. If you’re not getting better on a therapeutic diet, there’s internal physiological work that’s not getting done while you’re eating the therapeutic diet.
The therapeutic diet isn’t meant to heal you, it’s meant to remove the reactive substances that are coming in so your body can do the healing. It’s both situations at the same time and people are using therapeutic diets as the healing mechanism and therefore introducing this cycle of deficiencies.
Ari Whitten: Yeah, that’s such an important point and I see it all the time where people just end up on more and more restrictive diets and they become afraid of foods. They’re convinced that they react to dozens of different foods and maybe they do in some cases, I’m sure that they actually do it. In other cases, it’s psychologically nocebo effects.
Then what happens there is really insidious because you may actually feel better initially, you may see improvements and so you think, “Ah, I’ve found the secret, the best way to eat and I’m going to eat this way forever and ever,” and then what happens is that, that way of eating that was once actually beneficial, now become something that’s counterproductive.
Andrea Nakayama: Yeah, I mean the reason why it might feel better if you’re not rubbing salt in the wound, but you’re also not healing the wound and so you have to do both those things. I think nutrition often is really relegated to the realm of just what the diet is, as opposed to bringing the body into its optimal function. That’s the difference between functional nutrition and just say, think what we culturally think of as nutrition.
You bring up two points that I want to speak to and remembering one, the other will come back to me, but one of them is that I like to … I remember, I like to think of it as the road, the bike lane, and the poison ivy and I live in Portland, Oregon, so that bike lane for others elsewhere in the country or the world might be the shoulder of the road.
When we’re on the road, that’s what is working for us right now and the poison ivy or things that we identify definitely don’t work for us. Then the shoulder or the bike lane is where we can maybe go once in a while, that works for us, and that might change over time.
Point one is that we have to identify the road, the bike lane, and the poison ivy and recognize that that might be different during different times in our lives, hormones change things, stressors change things.
Everything can change so there’s not just one way and really what we want is to be in touch with ourselves so we know and that works for me or that doesn’t work for me.
For me, gluten is poison ivy, it’s not something I’m going to do once in a while like it just won’t work for me and I won’t touch it and I won’t go anywhere near it. Eggs, which I think are a perfect food, but my body doesn’t tolerate them well are going to be in the bike lane for me and I’m going to be very judicious about when I eat something that has eggs in it.
If I’m going through a more stressful time, I’m not gonna eat the eggs. If I’m traveling, I’m not going to eat the eggs because that’s more stress for me. I have Hashimoto’s with my autoimmunity, so it’s that awareness that I think puts us as patients back in the driver’s seat knowing I have a little flexibility, here’s where it is, here’s where it is right now.
I know those things are off limits for me, can’t do them, they take me down too much. The risk-reward isn’t worth it and here’s my lane, or if here’s my lane, is too narrow, how do I get help widening my lane and widening my bike lane so I can actually live a fulfilled life and I don’t feel like I’m restricted all the time.
Again, it does change, it’s gonna change based on a number of factors because all those factors in our life really increase what’s called our allostatic load, our resilience, so to speak.
Ari Whitten: If I’m interrupting, was there a second point that you …?
Andrea Nakayama: That’s the second, the second point is it changes. The first point is identified and for ourselves as patients and I identify all of us as patients knowing those for yourself and getting help identifying those is what gives us a little bit more flexibility instead of feeling like we’re in that orthorexic place, and the second point is it’s going to change.
Ari Whitten: Yeah, and I love that analogy and I love like conceptualizing this idea that for someone who’s orthorexic and has developed all this neuroticism and phobias, it’s as if it’s all poison ivy now, and you’re just surrounded by poison ivy and you’ve completely lost track of where the bike lane and the road are.
Andrea Nakayama: Exactly, exactly.
Ari Whitten: Do you have any tips or any particular strategies that you’ve found effective for dealing with people in that kind of orthorexic place? How to get people out of it?
Andrea Nakayama: You don’t need to do it alone. I think that when you’re caught in that place of identifying everything as a problem, that’s a really good sign that you need to raise your hand and get some help from somebody who can track and look at it from a different vantage point. The model that I speak into in functional medicine is that we have the doctor who can see food matters, lifestyle matters, but they don’t necessarily know how to go there.
The patient, we as patients, we are literally in the weeds. We do not have the vantage point, especially if we’re experiencing signs and symptoms to see. The role of what I call an allied functional medicine practitioner, which is the realm of functional nutrition, getting that help from somebody who has a different vantage point but does understand the factors of your every day.
If you find yourself in that situation, I think it’s really important to find somebody to work with that isn’t just going to push food for the sake of pushing food, but it’s going to work with you to determine what works and what doesn’t work for your body and your system. That would be my number one tip, you don’t need to do it alone.
How functional lab testing works
Ari Whitten: Beautiful. Let’s go back to this, the functional lab testing.
Andrea Nakayama: Yes.
Ari Whitten: If now is a good time?
Andrea Nakayama: Yes.
Ari Whitten: I would love to get your input on that, on basically like kind of all these seemingly scientific things that maybe aren’t quite as scientific as one would think.
Andrea Nakayama: Yeah. For me, it really comes down to you and like I was saying, those serum labs are critical and we have an extensive list in our clinic of the serum labs that we like to get look at, like give us some baseline information. I mean some of that information is are you dehydrated for your body? Like we have to look at the function of your red blood cells. If your red blood cells aren’t functional, if they’re not doing what they need to do, you’re going to have a really hard time healing.
Somebody who’s not putting a functional lens on your regular old serum labs and is jumping to functional testing is bypassing what your body is actually capable of before dealing with any of those intricacies. There are then tests that I do think give us more information when we need it, whether that’s stool analysis and organic acids, different kinds of hormone testing. We use sometimes salivary, sometimes urinary, when we need further information there to help us with the next stage therapeutics because we’ve run our course, we will systematically do those based on the actual person and what we’re seeing that we need.
Also food sensitivity testing, every test is true but partial and what I mean by that is it doesn’t tell us the therapies, we can’t base our therapies on the information on the test. We’re not treating a test, we’re treating or making recommendations for a person.
It does give us some information that helps us to determine with everything else we know from timelining, from creating a functional nutrition matrix to that tracking that I talked about. A little bit more information that lets us know like, “Okay, this person is having difficulty digesting fats or there’s malabsorption of their proteins that we can see that gives us an indicator of where to go.”
I do like certain functional tests in a sequence, in a very methodical sequence in their care and only when other factors tell me it’s necessary. Again, that information is true but partial, we are not treating 4+ Klebsiella or treating a microbial environment where 4+ Klebsiella was allowed to proliferate and that’s an infection just to …
Ari Whitten: Yeah. It’s the name of bacteria.
Andrea Nakayama: Right.
Functional nutrition medicine and food intolerance testing
Ari Whitten: There are so many things I want to go to. Let’s digress on food intolerance testing just a bit because I don’t know if you use IGG food intolerance testing or another kind but …
Andrea Nakayama: That’s my preference.
Ari Whitten: Almost everything that I’ve read that the research on IGG food intolerance testing shows that it’s just not really valid.
Andrea Nakayama: Right, so again, true, but partial and here’s what I find clinically. We have five different kinds of antibodies in our body and the IGG’s are one of those antibodies. To break that down, antibodies are part of what is called our adaptive immune system. Our immune system has three layers, it has our skins and that’s the skin on the outside and the skin on the inside of your digestive system. That’s the first line of defense.
Bad guys stay out, we then have our innate immune system which is like the Pacman, they see something foreign and they’re going to go after it right away. After that, we have our adaptive immune system and that’s the immune system that we personally develop over time. In our adaptive immune system, we have different antibodies, five different kinds of antibodies. One of those antibodies is the IgE antibody, which we relate to allergies.
The other antibody, which is the most prolific antibody are the IGG antibodies. There are more IGG antibodies than any other antibody in the body overall. The IGG antibodies are usually the antibodies that we’ve developed personally that are activated in autoimmunity.
For me, as somebody with Hashimoto’s, I have IGG antibodies that my body has developed and trained to attack my thyroid tissue, so those are IGG antibodies. When we’re testing for food sensitivities and we look at IGG antibodies, what that’s telling me more than you can eat all these foods is the abundance of that kind of antibody in the body.
Prior to doing IGG antibody testing for foods, food sensitivity testing, I might want to look at a CBC, which is a Complete Blood Count including differential, which tells me the different kinds of white blood cells. In those different kinds of white blood cells, I’ll see the lymphocytes, which are where the antibodies exist. That lets me know if those are ample or overgrown or not. I then might look at a full serum immunoglobulin test. Are the IGG’s high overall? Before looking at Igg food sensitivity testing.
I don’t know if that makes sense, Ari in how I’m breaking that down.
Ari Whitten: It does.
Andrea Nakayama: But again, going back to the serum labs, where do the serum labs tell me I might need more serum labs before I’m doing any specialty testing, which may give me a true but partial but also a false negative or a false positive. The place where we see lots of IGG activity could indicate leaky gut, excess autoimmune activity. I’m reading those tests, I always joke that like almost there’s almost like a witchy way or there’s a way I’m reading it, like somebody might, who knows Taro cards might read that.
It’s information that tells me something but not, “Hey, you can’t eat eggs ever again,” that’s not what it’s telling me. In that way, I don’t think of it as scientific, but it is giving me some information so it’s probably a good example of how those things correlate.
Ari Whitten: Do you know how many practitioners I’ve met that have explained things in that way? Now there’s one but I’m pretty sure that it would probably stay at one for a long time.
No, and the reason I say that is it sounds like you have a very specifics … I mean, first of all, it sounds like you’ve done a lot of deep thinking based on accumulating a lot of knowledge about this subject and that you’ve developed a very sophisticated and nuanced system of systematically going through and doing this test and this test and this test. That’s beautiful and I know that you’re getting great results, but for the average person, how likely are they to go see their local functional medicine or functional nutrition practitioner who does things even remotely similar to the way that you do?
Andrea Nakayama: Well, my hope is that the students that I trained, the practitioners I trained, particularly those in the certification program, I’m drilling it into them. This is a way we really need to think and break things down and it does take drilling because I think it is a unique way to think in the clinical realm. I tend to have a sort of a renaissance way of thinking. For me, when people talk about evidence-based medicine, I get a little frustrated because the evidence is also true, but partial.
To me, the evidence is in the physiology and that’s what that explanation is rooted in. Like if the physiology tells us something and the test gives us a little bit of more information about the physiological function, how do we connect the dots and put that all together. I think it’s a thoughtful clinician who’s going to take time and unfortunately, I think we’re asking too much of the doctors to do that.
I think it’s out of their scope in a lot of ways and out of their pay grade in terms of time, which is why I think I need to train an army of practitioners that can work with the physician and with the patient to do that kind of critical thinking.
Ari Whitten: Yeah. I mean, I think most clinicians who even do the kinds of testing, and they may even do the exact same test from the exact same laboratory that you do, but they’re going to interpret them almost guaranteed to interpret them in a radically different way than you’re going to interpret them. I mean, most people who are going to do an IGG food intolerance tests are going to say, “Ah this means you’re intolerant to all these foods and you’ve got to get them out of your diet.”
Andrea Nakayama: Exactly, I think clinically we exist in an A equals B culture, and really A does equal B because A, in any one system, any one person’s system is going to mean different things and that’s why that whole, what I think of as a functional lens really does give us some different insights.
Ari Whitten: Yeah, so I want to go into fatigue and energy, but a real quick on the testing. I’m curious if you have any particular like favorite tests that you find really, really useful and insightful, like maybe organic acid tests or … I’m curious. I mean, I see so many claims for different things out there and a lot of it there’s no evidence whatsoever that the objective evidence that you can look to and say, “Oh, these claims have validity,” so I just see so many claims that I don’t know what to believe anymore.
I’m of the opinion that when there are so much information and conflicting information that doesn’t have any objective evidence, I’m skeptical of it all until you show me the evidence. I’m open to it all, but I just want to see the evidence. Organic acid testing, I’ve seen people claim it, it relates to neurotransmitter imbalances and mitochondrial function and all kinds of things. Anyway, I’m just curious if there are any particular tests that you find really useful.
Andrea Nakayama: Yeah, I think, I’m going to take us back to those serum tests because for me that’s number one and we track those because any test was just a snapshot in time and so any testing that we have that’s from serum labs, we have a lab tracker. So we’re tracking based on what we’re able to get with the patient in terms of who’s their physician or what are the out of pocket costs.
We’re tracking that every three to six months to see what we’re shifting so that we can look there. Then I do like organic acid tests in certain situations, we actually use different testing companies, whether we’re looking to see more gut issues versus more mental health and mitochondrial issues. There are different labs that we’ll use based on what we’re looking for there. I do like Dutch testing for hormones and understanding the metabolic pathways that are really insightful for us.
Again, those are down the line, we will do stool analysis also through Genova to look at diversity and to see some things there, but not as a first course of action and not as a direct indicator of a treatment or a recommendation more to give us a deeper insight into the ecology as I would call it, what’s happening in the terrain of this individual. I do like those and I do like IGG sensitivity testing, but not until I’ve done that previous work.
Then there might be some one-offs that are true for an individual. I’m not a huge fan of getting genetic testing, I think it’s going a little out of favor as we realized that less and less of those genetic markers actually are indicated in how we would do things clinically. I think there used to be a lot of emphases put on that. I think of genetic testing like a 23andMe as wallpaper. Oh yeah, we know this person has a COMT or an MTHFR. Those are genetic variants, genetic polymorphisms.
I know that, but I’m not treating that, I’m not addressing that. I just know that that’s part of the situation here. I think of it as the backdrop and those are the tests that usually come into our practice or that we’re recommending as next steps.
The most common triggers for chronic fatigue
Ari Whitten: Got you. Let’s talk about fatigue and energy issues specific. What are some of the most common causes or triggers for chronic fatigue in your experience?
Andrea Nakayama: Yeah, so this is where I’d love if people want to look at the functional nutrition matrix, you can just pull that up on your computer and it’s functionalnutritionlab.com/matrix, M-A-T-R-I-X, and you can see kind of how we map a case. Now, there is any number of reasons that somebody could be experiencing fatigue. They could be, it’s usually related to an overload in some area of their life that they cannot repair from. That overload could be due to factors like over-exercising and you can’t repair fast enough to get your energy.
They could also be due to immune function like co-infections or what’s now called Stealth infections, infections that have bypassed all three of those layers that I spoke into. It could be due to GI function and eating a really good diet, but not being able to utilize what you’re bringing into your body or having a toxic load because you’re constipated and you’re not eliminating what you do need.
They could be because of structural imbalances so you’re in pain even in a minor way, but your body is constantly trying to deal with that pain either from an accident or something that’s happened in your life.
Environmental overload, that environmental overload could be due to external factors or internal factors like we could have hormones and neurohormones that the body can’t process that become part of the load that the body has to deal with. When I’m looking at energy and fatigue, I’m usually looking at where is resilience compromised because we have bodies that very dynamic, we are meant to be able to process and adjust to everything.
If we can’t, it’s because some bucket is full somewhere, and the detective work we have to do is why is your bucket full and not able to empty? What’s happening, what did happen, what’s not functional that’s not allowing you to repair and recover? Then there’s one thing I was thinking about and talking to you, Ari, that I don’t think is spoken about enough, which is just passion in our lives, passion and purpose.
The importance of passion and purpose
Yeah. One thing, Ari, that I was thinking about in knowing that we were going to be talking today is that one of the main factors in life that I think has to do with energy is passion in our lives and I don’t think we pay enough attention to it. Now, I’m in my early 50’s, I never struggle with energy, knock on wood. That I think is really in part due to how fortunate I feel to be living the life despite some of the challenges I’ve had, the loss of my husband, being a single mom, growing a business all on my own.
Wow. I get to do what I love. I get to touch people’s lives. I get to live a life that’s filled with love because that’s what our work is about. For me, I think passion and knowing that we are living in some part of our lives, a life of passion really does fuel our energy and our ability to repair.
Ari Whitten: I’m so glad that you brought that up because I feel so many people in the functional realm and also conventional medicine. You look at people as a series of lab tests and as a series of numbers and data and trying to figure out their problem and the kind of intangible things that you’re alluding to there with passion and purpose, there’s no test for blood test or urine test or a saliva test, where they’re going to show your level of passion and purpose in life, and yet those factors have a huge impact on your health and certainly on energy and fatigue and motivation.
I mean, to put it differently. In my opinion, you can be on the perfect diet, you can have all the perfect lifestyle habits, you can be on the most amazing supplements in the world, but if you don’t wake up every morning with a strong sense of purpose and passion for what you’re going to do that day, I think … Honestly, my theory is that it switches off certain genes-
Andrea Nakayama: Yes, totally.
Ari Whitten: … that are involved directly with energy and I actually think that after a certain age, passion and purpose are like huge longevity factors where if you don’t have that and this is totally unproven speculation. I really think that it kind of signals to your genes epigenetically that there’s no real reason for you to stick around anymore. I mean, nature doesn’t have a purpose for you anymore.
If you don’t wake up with that motivation to go do something and that you’re passionate about, I think nature says, “Okay, this person is done and they don’t need to exist anymore.” It’s very reasonable that their cellular health will decline and they’ll age faster and meet their demise a lot sooner.
Andrea Nakayama: Yeah, and I think the field of psycho neuro immunology touches on this, but I think there’s more to be done there. I mean, I’m really curious about the impact of grief on our cellular function, the impact of love on our cellular function. Like we’re talking about the impact of purpose and that purpose doesn’t need to be such a huge big deal like changing the world.
It can be being in nature, it can be feeling the impact you’ve made on your kid’s life, your grandkids’ life, whatever it is, your partner’s life, and just living a life of love in the people that you touch. I know one of the things that I often experienced in my life, my dad passed away a couple years ago, but as I was building my business, he would say to me, “You really need to get a life, Andrea.”
I would think like, I have this rare opportunity to do this incredible work that I love and how is that actually fueling me and not something we see represented in our culture very much. We don’t get to see people living their purpose. People are more in a mundane way of living, so I do encourage people to find what resonates with you and tap into that.
The top three priorities for good health and energy
Ari Whitten: Yeah, so I would love if we could finish on the note of maybe your top one or two or three, whatever you want to do, a piece of advice or tip that you can give people struggling with their energy levels.
Andrea Nakayama: Yeah, I’m just talking from the functional nutrition realm less esoteric here and say you got to be sleeping, you got to be pooping and your blood sugar needs to be balanced. And if those aren’t dialed in, everything you do is an uphill battle and if you need help sleeping, pooping, or getting your blood sugar dialed in, then get some help to do those things. Those are critical for us to be in our fully functional place.
I truly do believe, and this goes back to the more esoteric aspect, that when our body is doing what it’s supposed to be doing, that’s when we can actually receive the messages of what our purposes. We can feel it more when we’re not physically and physiologically functional, it is harder to find that place in ourselves.
Ari Whitten: Yeah, beautifully said. Andrea, this has been an absolute pleasure and privilege to have you on and I really, really enjoyed this conversation and I think everyone’s going to really enjoy it too. Thank you so much for sharing your wisdom with my audience, it’s been a pleasure and I hope to talk to you again soon.
On one final note, you’re doing training obviously for lots of other practitioners and as I said Andrea is really looked to buy all of our peers and colleagues as an absolutely top notch in this area. I personally recommend her course and I’ve looked at some of her work and really I just want to give you my personal endorsement here.
I have a lot of people on the podcast, I don’t always necessarily agree with everything they say or want to personally send people their way.
In your case, for anybody listening to this who’s interested in getting training, who wants to get certified as a functional nutrition practitioner and functional nutrition and lifestyle practitioner, I liked that you had the lifestyle part by the way, because a lot of people are just myopically focused on nutrition and I think that’s really important. For anybody listening who wants to get certified, highly, highly recommend going to go through Andrea certification program.
I don’t know if you want to add a little bit of info on that and take through what that’s all about.
Andrea Nakayama: Thank you so much for saying that, Ari. I do have the three tiers of Epigenetics Mastery eBook. I do invite everybody, whether you’re a practitioner or a patient to get your hands on that and you can go to Fxnutrition.com/energy and that’ll give you an opportunity to let us know if you’re a practitioner or a patient and we will help you learn more about the program and you’ll be able to contact us that way, but you can always go to functionalnutritionlab.com to learn more about the curriculum, and always reach out to us as well.
I’d love for you to get your hands on the three tiers eBook so that you can learn those three tiers that we talked into and let us know a little bit more about yourself and your scope of practice.
Ari Whitten: Beautiful, and we’ll have links to all of that on the show notes page for this episode. Andrea, thank you so much-
Andrea Nakayama: Thank you.
Ari Whitten: … really been an honor and a lot of fun to have you on. Thank you and enjoy the rest of your day.
Andrea Nakayama: That’s so much fun. You too. Thanks, Ari. Bye.
How functional nutrition and holistic medicine can heal chronic diseases and fatigue with Andrea Nakayama – Show Notes
The definition of functional nutrition and medicine, and how that differentiates from conventional medicine (4:34)
Why there is a place for conventional medicine as well as functional nutrition and medicine (7:26)
The truth about testing and why it is not to be relied upon (10:06)
The definition of epigenetics (13:00)
How the three tiers work (17:01)
The darker side of eleliminationiets (20:00)
How functional lab testing works (30:17)
Functional nutrition medicine and food intolerance testing (33:11)
The most common triggers for chronic fatigue (43:56)
The importance of passion and purpose (46:38)
The top three priorities for good health and energy (51:08)
Get your own free copy of the Epigenetics Mastery eBook.