Anne Sherman, MSN
Family Nurse Practitioner, ANCC Board Certified
Institute of Functional Medicine, Member
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:
Treatments fall into four categories, typically in the order listed :
In order to find solutions that work for you, your role in this partnership includes (to the best of your ability/circumstance):
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.Learn More
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.Learn More
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.
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.
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.
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.
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.Learn More
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.Learn More
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.Learn More
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).
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).Learn More
There are many things you can do to make the most of your appointment time.Learn More
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.
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 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:
I, like most functional medicine providers, recognize these cautions, but choose to include supplements because:
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.
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.