Sustaining Health. Treating Root Causes. Functional Medicine.


Anne Sherman, MSN Family Nurse Practitioner, ANCC Board Certified Institute of Functional Medicine, Member

Functional Medicine


Functional Medicine


Functional Medicine is the practice of identifying and treating underlying causes of symptoms.  It also is truly preventive, because dysfunction/imbalance of systems typically occurs long before disease is evident.  Identification relies on history, physical exam, and laboratory testing.  Usually, when the following areas are functioning at their best, symptoms improve:

  • Gut Health: ability to digest, absorb and excrete food
  • Immune Function: sensitivities, allergies, and immune regulation
  • Structural Integrity: skin, bone and cardiovascular integrity
  • Biotransformation: ability to metabolize well and rid your body of toxins
  • Hormones and Communication: regulation of mind and body functions through neuro/endocrine systems
  • Energy Production: ability of each cell to produce energy to function properly
  • Genetic Predispositions: this is an emerging field. Genetic information can give us some clues to unraveling sickness and sustaining health.


Treatments fall into four categories, typically in the order listed :

  • Optimize nutrition, exercise, sleep, and stress management
  • Supplementation of existing nutrients
  • Herbal remedies
  • Pharmaceuticals (IE: prescription medications).  As a nurse practitioner, I am able to prescribe medications.


In order to find solutions that work for you, your role in this partnership includes (to the best of your ability/circumstance):

  • Being honest about what you can or cannot do.
  • Listening to your body and tell me what is happening.
  • Consuming clean food and water.
  • Keeping your environment free of chemicals/contaminants.
  • Being active.
  • Nurturing healthy relationships.


Family Medicine Meets Functional Medicine


Colds and Flu

Focus is on ensuring a properly functioning immune system to prevent illness, and fight infection. I avoid antibiotics unless absolutely necessary. Supplements that have been shown to be antibacterial are offered as an option when appropriate.

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Health Screening

I use the US Preventive Task Force recommendations for health screening. And more. I go into detail regarding lifestyle, ability to detoxify, and early signs of inflammation. As we are learning, over time these problems lead to diabetes, cardiovascular disease, Alzheimers, and osteoporosis. You will need to go to a gynecologist for paps.

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Vaccinations

I do not provide vaccinations at my office. However, I will remind you of when they are recommended and discuss your concerns with you (both medical and religious). The decision is a personal one, but should be well informed. A healthy immune system is essential to safe vaccination. So, before getting vaccines I review the individual's vitamin D and other factors.

Genetic Predispositions

Epigenetics is the exploding science of how environment turns genes on and off, affecting our health. While we are still learning, certain genetics can be part of a wellness initiative, or used to help understand specific health problems in the long term.

Fatigue, "Brain Fog", and Mitochondrial Function

Solutions are multifactorial and may include endocrine (thyroid/adrenal), toxins, nutritional deficiencies, impaired mitochondrial function, immune, infection, and more. Solving these problems can take a bit of detective work.

Weight Gain

The standard approach is to address calories in and calories out. We delve into the details: eating habits, sleep, exercise, adrenal function, thyroid, inflammation, hormones, and more. The goal is sustainable life changes, not fad diets. It takes time, but it lasts a life time.

PMS, PCOS, Acne

Cycle problems and hormone imbalances are often a sign of other problems. A functional approach usually involves testing hormones (via saliva, urine, or blood spot) and/or charting cycles. Solutions vary from food choices to bioidentical hormones.

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GERD (symptoms can include heart burn, difficulty swallowing, cough, sore throat...)

Untreated, GERD can lead to esophagitis and worse. The long term effects of a PPI (pill to lower stomach acid) can include bloating, increased risk for cardiovascular disease*, vitamin B12 deficiency, and more. The functional approach is to help the gut work well by ensuring adequate stomach acid and enzymes for digestion, a healthy mucus barrier, and relief of leaky gut and dysbiosis. Stool testing is often very helpful as a first step.

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Anxiety, Depression, ADD

SSRIs (antidepressants) are now in the top 3 most often prescribed medications--they are showing up in our drinking water! There are alternatives. Ensuring adequate neurotransmitter function, particularly along with a good counselor, can provide relief.

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Brain on Fire: PANDAS, PANS, Autism, Functional Movement Disorder...

Functional Medicine looks to root causes, so is not too concerned about what you call it, and there is no medical diagnosis (label) for these syndromes. In many cases, there seems to be a immunomimicry or other mechanism causing high levels of oxidative stress: The Brain is on Fire. The science is emerging, so interventions are often "off label". My approach is to optimize function (EG gut, hormones, detoxification...), to control oxidative stress (through antioxidants and mitochondrial function), and to find ways to moderate immune function (EG: address infection, low dose naltrexone).

Anne Sherman MSN APNP


My journey to functional medicine is rooted in my family: health issues have caused me to delve deeply into many areas of function medicine to address problems when conventional medicine did not have solutions.  

I have a life-long commitment to research and education:
I am forever a home school mom, taught nursing, and mentor high school students doing research projects.

I love teaching my patients, especially young adults just starting to take on responsibility for their own health.  My dream is develop an active network of education and support to help real people make real changes.

I am intellectually curious.  If we don't have solutions, I am willing to explore.  This has lead to me learning about not only functional medicine, but appropriate use of integrative/alternative approaches, "off label" use of low dose naltrexone (LDN), and other options.  My conventional education is from UW-Milwaukee.  I am Board Certified in Family Practice.   I will soon receive a Certificate in Functional Medicine through the Institute of Functional Medicine (typically a 5-7 year process).  

I believe in Creating a Sustainable World
.  (Click Here for more information).

I want to work with you.

Appointments


Making Appointments

Office hours are part time, and vary in order to be able to offer morning and afternoon times every day of the week, and some evenings. Please email or call to make an appointment (see Contact tab).

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Preparing for Appointments

There are many things you can do to make the most of your appointment time.

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Video/Long Distance Visits

First appointments are done in person except in very rare situations. Subsequent appointments can be done via secure web video (IE: Telehealth) unless a physical assessment is necessary.

Follow Up

After each appointment I will share our plan with you via a HIPPA secure patient portal. Non-urgent communication is also best accomplished through the patient portal.

Supplements


Supplements

Supplements are substances that our bodies need to function properly. These may be obtained through the food we eat or isolated in capsule form. Herbs are plants that typically have multiple mechanisms of action that change gene expression or other functions. Technically, vitamins, minerals, trace elements, amino acids, herbs, or homeopathic remedies are not classified as drugs. However, these substances can have significant effects on physiology and must be used appropriately.

Many conventional providers avoid using supplements.  Some of the reasons are:

  • Supplements are not tested or regulated in the same way as pharmaceuticals.
  • Supplements are generally not as strong and need to be taken more often than prescribed medications.
  • Supplements/herbs are often provided in combinations, increasing the possibility of undesired effects or overdosing.
  • Different forms of supplements/herbs have different effects, so they are not interchangeable with respect to dosing.
  • Conventional providers are not commonly educated regarding supplements and their uses.

I, like most functional medicine providers, recognize these cautions, but choose to include supplements because:

  • Use of these substances can supply nutrition to support the physiological and biomechanical processes of the human body. 
  • Often the side effects are less with supplements than with prescription medication.
  • Herbs often have multiple mechanisms of action, creating a broader scope of benefits than a single action drug

Please Note: 

Supplements have side effects and can interact with drugs, too.  It is important to keep all of your healthcare providers fully informed about all medications and nutritional supplements, herbs, or hormones you may be taking.

Ordering Supplements


Email Me

I began offering supplements because I saw the difficulty patients had in making sure they were buying products consistent with needs. I see patients often spending much more than necessary. You are under no obligation to buy supplements from me. I select the supplements I carry carefully, considering purity, potency and cost. As a result, what I use periodically changes (e.g.: I find on equal product at a reduced cost).

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FullScript

My recommendations for common problems are listed. However, please note that the wrong supplement do you harm. If you are a patient of mine you can request that I create a "prescription" specifically for you (just call), and/or you can shop on your own . You will receive reminders when it is time to refill if you use this service. Shipping is free for orders > $50. Use like below to log on.

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Xymogen

Xymogen products are only available online through this site. You can request that Xymogen create individual packets of supplements for each day and each time of day. These are easy to carry wherever you go, and Xymogen will remind you when it is time for a refill. These products are available by prescription only. Contact me if you would like to order online.

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Pricing


I am out of network for all insurance companies. Labs done at in-network labs are paid for same as if ordered by an in-network provider (except some HMOs). You can use your HSA, Visa, MasterCard, Discover, American Express and direct bank transfer, or check to pay. You can also submit my charges to your insurance company (except for Medicare). Copays and deductibles vary by insurance policy. If you need a payment plan, please let me know!
The typical conventional visit is shorter, as it usually addresses 1 problem. Functional medicine visits typically address an average of 5-6 problems in one visit. Visits can also be longer because more time may be spent exploring causes and discussing treatment options, lifestyle changes (a fundamental part of the prescription), and education/problem-solving.
If you are my patient, you receive a $50 if I see someone you referred to me. No Limit. Gift certificates available. Pay 50% of face value up to $50. Limit 2.
Currently my practice is fee for service. This means you pay for each visit or service (EG phone consult > 15 minutes), tests, and other services. Soon you will have the option to purchase a long term (6-12 month) package of services including all visits, supplements, labs, and other services necessary to address the problem -- all financed through a 3rd party to allow for easy monthly payments, if you wish.

Laboratory


Laboratory


Labs often charge insurance companies a much higher rate than they charge individual patients. (A typical discount is over 90%!)   It is the law that if the lab charges your insurance company, they cannot later charge you a different rate.  It is best to know your coverage ahead of time.  If the test is through Genova, see  (see https://www.gdx.net/patients/billing-and-payments/insurance) regarding coverage.

Some Common Laboratory Locations:

Some Laboratories Used for Functional Assessment:

If you don’t have insurance or have an HMO:

  • Always find out ahead of time what the lab will charge (this should be done by a phone call to the lab’s billing department).
  • You may ask for a cash rate.  Many labs offer a discount if paid in cash.
  • Depending upon the tests, there are some online self-order laboratories that can be comparatively inexpensive.
  • http://selfpaypatient.com/selfpayhealthcaremarket may be helpful to you in finding resources, including various share plans.

Contact


10602 North Port Washington Road, Mequon, WI, United States