The patient: “Denise” was a normal suburban housewife who had become horribly dysregulated after a car accident.
Why she came to see me: Referred by a friend, Denise had a “virtual conference” with me and told me of how she had suffered after the trauma of almost losing a sibling to a horrific car accident that had left them both in the intensive care unit for many weeks. She was waking repeatedly during the night profusely sweating and fearing that someone was breaking in. Not only was she afraid to drive but her anxiety was producing an angry disposition and short temper that she feared was threatening her marriage.
How I evaluated her: Denise had sent over consultation notes and laboratory test results from the many physicians that she had consulted, with from her primary care doctor to a psychiatrist. There was precious little revealed in any of it. We discussed the various ways in which her life had become dysregulated, from sleep disruption and irritable bowel to menstrual irregularity and emotional outbursts. She admitted to being extremely sensitive to pharmaceuticals and even found taking the vitamin B12 that her psychiatrist had prescribed disruptive.
How we addressed her problem: I explained to Denise that profound stress can not only deplete vitamin and nutrient reserves but also degrade and disrupt communities of hormones and neurotransmitters. We agreed to put in place a regime of improved diet, more attention to regular sleep/wake cycles and supplements that would be introduced in stages.
I had her begin with a “broad spectrum” multi-B vitamin, twice daily, at a reasonable therapeutic level and a twice daily small dose of DHEA, a hormone precursor, in a form that would be absorbed directly from her mouth. These interventions would replenish the raw materials to allow Denise’s body to create and balance her stress and reproductive hormones. This is often a better approach than providing direct hormone replacement therapy.
The patient’s progress: My office received a call from Denise the next day. I was somewhat concerned to hear bad news that she had experienced some worsening of symptoms. Instead she was bubbling over with enthusiasm at how well she had slept and how improved her mood and temperament was after only 12 hours. We are waiting for a bit longer to allow the initial regime changes to “settle in,” discussing areas of improvement and identifying any outliers. We’ll design the second phase based on outcomes rather than supposition.