FEATURE sensitivities can contribute to chronic low-grade inflammation, pain, and changes in mood and sleep. Digestion and food sensitivity assessment can be done in a number of ways: 1. Comprehensive food sensitiv-ity testing: this involves a simple blood test that will map out your IgG immune reaction to a number of foods you consume. This will rank them as high, borderline, or low/no immune re-sponse. Food sensitivities can take 4 hours up to 4 days to have their nega-tive impacts on the body, and can have broad acting negative impacts from joint pain, to hair loss, to depression. This can be why it is hard to pinpoint the exact foods. Testing makes it easier. 2. 30-day elimination diet [in-cluding nightshades]: An alternative means of testing for food sensitivities or pain aggravators is by simply remov-ing all suspected and common food allergens from the diet for 30-60 days, then slowly and carefully re-introduce using a particular re-introduction schedule. The elimination phase allows the body and the gut to rest and “cool” off by reducing the ongoing daily in-sults to the gut and immune system. The reintroduction phase is a process of testing each food one by one, and logging any return of symptoms in a food journal. PATIENT CARE Addressing the “drains” P Functional medicine treatment approaches for chronic pain BY DR. ASHLEY NELSON, ND better position to top back up. CORTISOL DYSREGULATION DR. ASHLEY NELSON is a Naturopathic Doctor practicing in Barrie, ON at the Rallis Wellness Group and Virtual Medicine across Ontario. She has a clinical focus in Women’s Health, Hormones, and Mental Health. For more information, visit: www.ashleynelsonnd.com. 14 Chiropractic and Naturopathic Doctor May/June 2022 www.Cndoctor.ca Photo: WavebreakMediaMicro/Adobe Stock ain can be elusive. It can defy explanation, it can worsen or spontaneously improve without clear reasons, and there are multiple factors that influ-ence individual expression and tolerance to pain. To address and treat an individual’s pain, we can apply the broad acting anti-inflammatories, pain relief topical or oral support whether conventional or “natural” but we still need to under-stand the unique individual factors. If we think of the body as a leaky bucket, we all have various sources of leakage, or drains on our system. If we can address multiple sources of “drains” on our body, we will be in a INFLAMMATION Whether you use high dose omega 3 fish oils, PEA, curcumin, willow bark, or feverfew, for example, these can help at least control, or reduce the anti-in-flammatory cascade allowing the tis-sues to heal, but alone, they still may be setting the bar too low for how we can address chronic and systemic in-flammation. While pain reduction or resolution may be a by-product, we are also supporting risk reduction for things like cardiovascular disease by taking on the bigger picture. One way of looking at an individual’s inflammatory profile is by digging into nutrition and gut health. Food In acute stress, pain, or injury we may experience elevated levels of cortisol. We can adapt to this high level and often continue to function well despite elevated cortisol if it extends past the immediate alert phase. However, con-tinuous elevated cortisol can have negative effects. After prolonged stress, the cumulative and additive end effects begin to occur – we experience a more dysregulation or overall reduced corti-sol output, and many of the nutrients involved in the previously high cortisol consumptive state has depleted as a result. Stress can be mental or emotional, but it can also be physical. It is cumu-lative and additive. The “burnout,” low dysregulated cortisol can creep up over time. The problem with this is that cortisol is our master anti-inflamma-tory hormone. When the brain has downregulated production of cortisol from the adrenal glands [as either a
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