Clinical Neurochemistry & Nutrition Series Self Paced Prepayment

Benefits of the Neurochemistry and Nutrition Program

• • All recommendations are based on published literature and clinical experience supporting your evidence based practice.
  • No disclosures.

 

• Brand neutral. This program was designed to teach you exactly what will help your patients using a broad spectrum of nutriceuticals from multiple sources.
• Dr. Clark is a full-time solo practitioner, with a very successful practice who’s treatment protocols are evidence based and have been tested on the field.  He has worked with a wide range of neurological, endocrine and immune system problems with consistent and reproducible results.
• Practice management – In addition to learning which protocols will help your patient best, also learn from the instructor how a true functional medicine clinic (structural care + neurological care + nutrition) is implemented as a cash practice with a logistical and methodical implementation plan that you can begin to implement into your practice right away.
• Generate another revenue stream in an ethical manner.  On average, the instructor distributes $25,000/month of supplementation from various companies using protocols that genuinely help patients.
• Attendees will be taught a way to think, understand & apply neurochemistry and nutrition for their patients, rather than pathways or protocols to memorize.
• This program series will focus on natural, non-pharmacological methods that are within your scope of practice.
• Case-based learning…this is practice for the real world.
• Each module will provide actionable, implementable intake, diagnostic and treatment procedures that you can begin using immediately.

Clinical Neurochemistry & Nutrition Program Outline

Module 1 – The 4 Neurochemical Priorities and Brain Basics

• How to Use This Course
• The 4 Neurochemical Priorities (never get lost!)
• The Road map
• Logistics of lab assessment
  • How to order labs
  • Who pays for labs?
• Blood Tests and Codes for this Module
  • CBC
  • Phosphorus
  • Comp Metabolic Panel
  • Magnesium
  • Hemoglobin A1c
  • LDH
  • GGT
• How to Work Up a Real Patient
• Every Case Study details the patient’s presentation, work up, treatment plan and follow up.
• Case Study – 17 year old female with headaches, fatigue, neck/back pain
• The 10 Core Principles
• What Does a Brain Do?
  • Global view of Brain function and purpose
  • A primer on the  evolutionary development of brain structure and function
• Structural Components of the CNS – Brain macrostructure
• Concepts of Neuron Structure & Function
  • How Neurons Work – Thresholds and Potentials
  • Neurotransmission, Transmitters and Receptors
    • Dopamine
    • GABA
    • Serotonin
    • Acetylcholine
  • NMDA Receptors, Glutamate and Long-Term Potentiation
  • Transneuronal Degeneration and Diaschisis
  • The DARK Side of NMDA Receptors (creepy!)
    • Excitotoxicity – what promotes it and what inhibits it
  • Synaptic Integration
• Case Study – 27 year old woman with agitation and delirium
• Clinical Point on Ions
  • sodium, potassium, calcium
• Glial Cells
  • Macroglia
    • Focus on Astrocytes
    • Clinical Point on Aquaporins
    • Oligodendrocytes and Schwann Cells
  • Microglia
    • Normal role and pathophysiological role
• Blood-Brain Barrier
  • Neurovascular unit aka Gliovascular Unit
  • What crosses and what doesn’t
• Membranes and Lipids
• Clinical Point on CoQ10 and Statin Drugs
• Case Study – 65 year old male with high cholesterol
• A Statin Alternative that actually works
• Amyotrophic Lateral Sclerosis
  • When is ALS not ALS?
  • A reasonable evidence-based approach to ALS
• Energy Metabolism in the Brain -glycolysis and oxidative phosphorylation
• Stroke
  • What happens to energy production during and after stroke?
  • Stroke-induced inflammation
  • The Stroke-Migraine Continuum
• Epilepsy
  • Pathophysiology
  • Nutritional and Metabolic Factors to consider in Epilepsy
  • The Ketogenic Diet for Seizures
  • How to work up, manage and treat a patient with Seizures.
• Case – 10 year old girl with irritability, ADHD and recent seizure
• Case – 16 year old girl with Hashimoto’s, Brain Fog and Vomiting
• Case – 39 year old man with Seizures, dizziness and depression
• Case – 64 year old woman with concerns about her Hemoglobin A1c and Lipids
• Understanding Blood Chemistry – For each test:
  • What physiology is actually being tested?
  • What makes it high?
  • What makes it low?
  • What are the lab reference ranges?
  • What is the functional/optimal ranges?
    • Comp. Metabolic 14 PLUS
      • Glucose
      • Calcium
      • Protein
      • Albumin
      • Globulin
      • Sodium
      • Potassium
      • Chloride
      • Carbon Dioxide
      • Anion Gap
      • BUN
      • Creatinine
      • eGFR
      • Phosphorus
      • Alkaline Phosphatase
      • ALT
      • AST
      • GGT
      • Bilirubin
  • Hemoglobin A1c
  • Lactate Dehydrogenase
• Special Section on Magnesium
  • Normal roles in physiology
  • Testing
    • What makes it high?
    • What makes it low?
  • Magnesium in Migraine
  • Magnesium in Stroke
  • Magnesium in Chronic Pain
• Pattern Analysis of Blood Test Results
• Case – 63 year old man with hypertension, diabetes, edema and fatigue
• Case 66 year old woman with Diabetes and phospholipid antibodies
• More Blood Test results scenarios

Module 2 –  Energy Production: RBC physiology, Mitochondria and Related Nutrients

• How to Use This Course
• The 4 Neurochemical Priorities (never get lost!)
• The Road map
• How to Work Up a Real Patient
• The 10 Core Principles
• Module 1 Review
  • Myelination and Microbiota
  • Magnesium and Depression
  • Excitotoxicity and Glutamate
  • How to handle a patient with seizures
  • Key points about ALS
  • Functional/Optimal Lab Ranges so far
• Preview of Celiac Disease and Non-Celiac Wheat/Gluten Sensitivity
• Preview of Parkinson’s Disease
• Every Case Study details the patient’s presentation, work up, treatment plan and follow up.
• Case Study – 48 year old woman with fatigue, chronic frequent dry cough
• Blood Tests and Codes for this Module
  • CBC / Differential with Platelet Count
  • Iron
  • IBC
  • Serum Ferritin
  • Serum Methylmalonic Acid
  • Homocysteine
  • Serum Vitamin B12
  • Serum Folic Acid
  • Hereditary Hemochromatosis, DNA Analysis
  • cardiac CRP (or High sensitivity CRP)
  • H. Pylori Urea Breath Test
  • Helicobacter pylori Antibodies, IgA, IgG, IgM
  • Helicobacter pylori Stool Antigen
  • Intrinsic Factor Antibodies
  • Gastric Parietal Cell Antibodies
• Module 2 Tests Functional/Optimal Ranges
• Big Picture of the  Neurochemical Priorities
  • #2 – Cellular Energy: RBCs, Nutrients, MItochondria
  • #3 – Cellular Energy: HPA Axis and Glucose Handling
• Lab Reference Ranges vs. Functional/Optimal Ranges
  • What’s the difference?
• Energy Production in the Body
  • Citric Acid Cycle and Nutrient Co-factors
• Physiology of Red Blood Cells
• Understanding Blood Chemistry – For each test:
  • What physiology is actually being tested?
  • What makes it high?
  • What makes it low?
  • What are the lab reference ranges?
  • What is the functional/optimal ranges?
    • RBC
    • Hemoglobin
    • Hematocrit
    • MCV
    • MCH
    • MCHC
    • RDW
    • Platelet count
    • Reticulocyte count
  • CBC Red Blood Cell markers interpretation
    • Anemia Classifications
• Iron Physiology
• Iron Testing
  • What physiology is actually being tested?
  • What makes it high?
  • What makes it low?
  • What are the lab reference ranges?
  • What is the functional/optimal ranges?
    • TIBC
    • UIBC
    • Serum
    • Transferrin Saturation
    • Ferritin
• Iron deficiencies
  • Physical signs and symptoms
  • Iron deficiency and the brain
  • Causes of iron deficiency
• Work up for Iron deficiency and Iron deficiency anemia
• Treatment of Iron Deficiency and Iron deficiency anemia
• Hemochromatosis
• Iron Supplementation
  • How much, what kind and when to take it
• B12 Physiology
  • Absorption
• B12 Testing
  • the problem with the serum B12
  • Methyl Malonic Acid
• Metabolic B12 Deficiency
• Causes of B12 Deficiency
• What causes High levels of B12?
• Signs, Symptoms and Effects of Low B12
• B12 Lab testing interpretation
• B12 Supplementation
  • What kinds, how much and when
• Case Study- 68 year old woman with Parkinson’s
• Case Study – 62 year old woman with depression and dysautonomia
• Folate Physiology
• Testing for Folate status
  • Serum Folate
• Effects of low folate
• Causes of low folate
• Folate supplementation
  • how much, what kind of and when to take it
• Homocysteine and Remethylation
  • Causes of high homocysteine
  • MTHFR
  • Homocysteine and Depression, Bipolar, Schizophrenia, Parkinson’s, Alzheimer’s Disease
  • Testing for homocysteine
  • Treatment of high homocysteine
• Interpreting patterns of RBC markers, Iron, B12, MMA, Folate and Homocysteine
• Effects of Iron Deficiency Anemia
• Case Study – 25 year old woman with hemiparesthesia, blurry vision and dysautonomia
• Case Study – 64 year old man with Parkinson’s
• RBC Patterns on blood chemistry
• Anemias—there’s lots of them
• Treating underlying causes of an anemia
• Case Study – 42 year old woman with fatigue and depression
• Case Study – 29 year old woman with mental sluggishness, fatigue, insomnia
• Case Study – 38 year old woman with anxiety and heart palpitations

Module 3 –Glucose Regulation, HPA Axis, Gastrointestinal System and Liver

• The 4 Neurochemical Priorities (never get lost!)
• The Road map
• How to Work Up a Real Patient
• The 10 Core Principles
• Gastrointestinal Big Picture
• Review of Modules 1 and 2 through analysis of ELEVEN different real-life cases.
• Review of Functional/Optimal ranges from Module 1 and 2
• Glucose Regulation
• Hormones 101
• HPA Axis and Adrenal Function
• Adrenal Glands – Anatomy and Physiology
  • Pregnenolone
  • DHEA
  • Cortisol
• Glucose Regulation – Insulin, HPA and the Liver
• Assessing Adrenal Function (the real way)
  • Dynamic Tests
  • Serum DHEA-s
  • Cortisol testing
    • Salivary
    • Urinary
• Adrenal Insufficiency
  • Addison’ Disease
  • TBI and HPA/Adrenal Function
• Adrenal Fatigue – does it exist?
• Overtraining Syndrome – it’s not just for athletes
• Cushing’s Disease
• HPA/Adrenal Treatment
  • Lifestyle
  • Supplementation
    • Adaptogens and how to use them
    • And more…
  • Exercise
  • Stress Reduction
• Peripheral Glucose Regulation
  • C-peptide and insulin
• Insulin Resistance
  • Causes of insulin resistance
  • Effects of insulin resistance in the brain
• Hypoinsulinemia
• Type 2 Diabetes
  • pathophysiology
• Hypoglycemia
• Reactive Hypoglycemia
• Hypoglucocytosis
• Glucose Regulation and Autoimmunity
  • Cross Reaaction
• Type 1 Diabetes
  • Latent Autoimmune Diabetes of the Adult
  • Antibody testing
• Lab Diagnosis of hyperglycemia
• Lab Diagnosis of hypoglycemia
• Glucose Regulation Treatment
  • Therapeutic Targets – what are you shooting for?
• Diet for hyperglycemia modulation
  • Therapeutic Fasting – how to do ti
• Supplementation for Glucose Regulation
  • What to use, how much and when to take it
• Every Case Study details the patient’s presentation, work up, treatment plan and follow up.
• Case Study – 30 year old woman with Hashimoto’s, depression, anxiety, fatigue
• Case Study – 14 year old boy with headaches, fatigue and dizziness
• Gastrointestinal Physiology
  • Digestion
  • Absorption
  • Elimination
  • How to use GI symptoms to triangulate the location of the problem
  • Intestinal Barrier- Anatomy and Function
    • Tight Junctions, Zonulin, Occludin
  • Gut Permeability
  • Hyper-leaky gut
• SIBO
• Inflammatory Bowel Disease
• Support strategies for integrity of the gut barrier
• Liver physiology
  • Normal Biotransformation
  • Xenobiotics
  • Toxicants
• How to improve liver function
• Blood tests for assessing liver function
• Gluten
  • What is it?
  • What does it do?
• Celiac Disease
  • Pathogenesis
  • Clinical Features and Manifestations
  • Diagnosis
• Non-Celiac Gluten/Wheat Sensitivity
• Testing for Celiac and NCGWS
  • Deep dive into wheat proteome and related markers
• Gluten-related disorders
• FODMAPS
  • Low FODMAPS Diet
• The Anti-Inflammatory Repair Diet
  • What’s allowed, what’s not allowed and why
• Testing for Food Sensitivities
  • What does it really mean?
  • What are you really testing?
• Case Study – 38 year old male with fatigue and elevated transaminases
• Case Study – 64 year old woman with increasing Hemoglobin A1c
• Case Study – 66 year old woman with chronic diarrhea and fatigue
• Case Study – 10 year old girl diagnosed with Multiple Sclerosis

Module 4 –Gut Part 2, The Immune System and Autoimmunity

• The 4 Neurochemical Priorities (never get lost!)
• The Road map
• How to Work Up a Real Patient
• The 10 Core Principles
• Review of Modules 1, 2 and 3 through analysis of SEVEN different real-life cases.
• Review of Functional/Optimal ranges from Module 1 and 2
• Schematic view of the Immune System
  • Barriers
  • Acute Phase Response
  • Innate Immune System
  • Adaptive Immune System: T cells, B cells and more
  • Cytokines
  • Immunoglobulins, Antibodies and Isotypes
• How the Immune System Works
• Challenges for the Immune System: Discrimination, Flexibility, Managing Infection, Memory
• Antibody Generation, T Cell Receptors
• Autoimmunity
• Lab testing: WBC and Differential, C-Reactive Protein/hs CRP, Vitamin D
• Microbiome/Microbiota
  • Microbiota-Gut-Brain Concepts
  • Microbiota-Gut-Brain-Immune Axis
  • Short chain fatty acids and their clinical applications
  • Dendritic Cells
  • Induction of Treg cells
  • Effects of Antibiotics
  • Ectopic Colonization
• Intestinal Permeability Revisited: Tight Junctions
• Gut Barrier and Blood-Brain Barrier
• Feeding Microbiota and Protecting the Barrier
• Autoimmunity…the Deep Dive
  • Pre-requisites
  • Clinical Presentations
• Food Antigens and the Immune System
  • Oral Tolerance
  • Cross-reactivity
  • Food Sensitivity Testing: the good news and bad news, and the really bad news
• Testing for clinically significant autoimmunity
  • Clinical Immune System Challenge: the rules and how to interpret
  • Predictive Antibody testing
    • Survey of common antibody tests and what they mean clinically
• Type 1 Diabetes
• Celiac Disease
• Regulating the Immune System with Diet, Exercise and Supplementation
• The Anti-inflammatory Diet
• Anti-inflammatory/Immune Regulatory Supplementation
• Case Study – 60 year old woman with bone loss throughout her body
• Case Study – 55 year old woman Rheumatoid Arthritis
• Case Study – 20 year old man with brain fog, low motivation, low energy, lack of focus and low affect
• Case Study – 15 year old boy with muscle fatigue, joint pain, migraines, brain fog and balance deficits
• Case Study – 19 year old male with irritable bowel syndrome, ADD and Autism
• Case Study -10 year old girl with pediatric Multiple Sclerosis

Module 5 – Neuroimmunology, Vestibular Conditions and Neuropsychiatric Conditions

• The 4 Neurochemical Priorities (never get lost!)
• The Road map
• How to Work Up a Real Patient
• The 10 Core Principles

• Cases to reinforce previous 4 modules
• Review of Module 4
• New immune system test: The Lymphocyte MAP Immunophenotyping Test
  • Analysis and explanation of the 13 Immunophenotypes

• Why order a Lymphocyte MAP?

• Review of Modules 1 – 4 using 13 different REAL clinical cases
• Current Topics: Tics and COVID-19, Adverse Childhood Experiences and Neurologic Disease, Vitamin D and SARS Cov-2, Statins and Diabetes progression

• Sleep

• Normal physiology including stages and Melatonin
• Abnormal sleep patterns
• Sleep hygiene
• Sleep Scenarios

• Acute Pain Relief
• Pain—in general and in specific clinical conditions
  • The NLRP3 Inflammasome
  • Autoimmunity and Pain

• Complex Regional Pain Syndrome
• Case Study – 29 year old woman with CRP and two spinal cord stimulators
• Fibromyalgia – short and sweet
• Peripheral Neuropathy – overview (there’s a separate course on PN)
• Case Study – 64 year old woman with REM Sleep Behavior Disorder
• Vestibulo-Cochear System and Disorders
• Labyrinthine physiology including the Blood-Labyrinth Barrier
• Inner Ear Immune System
• Vertigo
• How does the immune system affect the Vestibulocochlear System
• Vertigo in Autoimmune Disorders
• BPPV: causes and treatments
• Vitamin D and BPPV
• Thyroid, BPPV and recurring BPPV
• Recurrent BPPV Treatment
• Meniere’s Disease
• Meniere’s and Autoimmunity
• Gluten and Meniere’s
• Meniere’s Disease Treatment
• Tinnitus: Definition, sources and clinical applications
• Vestibular Migraine
• Otolithic Vertigo
• Mesencephalic Dizziness

• Locus Minoris Resistentiae

• Case Study – 53 year old man with ocular migraines, double vision and pre-syncope and vertigo
• Case Study – 54 year old woman with hearing loss and tinnitus
• Case Study – 62 year old man with vertigo and hearing loss
• Case Study – 38 year old man with feelings of being on a boat and dysequilibrium
• Case Study – 32 year old woman with dizziness, lightheadedness and vertigo
• Case Study – 48 year old man with hearing loss due to bilateral Meniere’s disease
• Case Study – 51 year old woman with dizziness, fatigue, dysequilibrium
• Case Study – 24 year old woman with feeling of being on a boat, anxiety, brain fog
• The Gut and Psychiatry
• Major Depression Disorder:
  • inflammation, homocysteine, oxidative stress, Vitamin D, Thyroid autoimmunity, SAMe, Folate, B12, Tryptophan, probiotics, HPA, micronutrients, NAC
• Bipolar Disorder:
  • Inflammation, thyroid autoimmunity, homocysteine, oxidative stress
• Obsessive Compulsive Disorder
  • Autoimmunity

• Schizophrenia
  • homocysteine, EBV, Autoimmunity, gluten-free diet, copper, lithium,

  Module 6 – Neurodegeneration, Course Review and Special Section on Patient Management

• • • How to Use This Course
    • The 4 Neurochemical Priorities (never get lost!)
    • The Road map
    • How to Work Up a Real Patient
    • The 10 Core Principles
    • Big Brain Review
    • Autophagy – how to induce it
    • Mitophagy – how to induce it
    • Neuroinflammation for homeostasis
    • Neuroinflammation in CNS diseases: Parkinson’s, Alzheimer’s, Huntington’s, MS, Depression, Sleep Disorders
    • Necrosis vs. apoptosis – cell death and survival
    • Neurodegeneration: the role of the immune system, glucose, metals, mitochondria, microbiome, astrocytes, microglia, oral health, tryptophan/kynurenine, sex hormones, gluten, vitamins, NRF2
    • A short course on TBI ( an official Primer course is coming)
      • Definitions
      • Clinical presentation
      • Pathophysiology
      • Downstream effects
      • Diagnostic workup for a TBI a patient
      • How to help a patient with TBI with diet, exercise, supplementation
    • The clinical expressions of neuroinflammation and neurodegeneration
    • Sleep and Cognitive decline
    • Parkinson’s Disease: brain first type , body first type
    • Risk factors for Parkinson’s: Diet, Diabetes, Influenza, Statins, Air pollution
    • Parkinson’s Pathophysiology: alpha-synuclein, Autophagy, Tau, glutathione, Gut microbiome, immune system and inflammation, Kynurenine pathway, autoimmunity, mitochondria
    • Medical Management of Parkinson’s
    • Diet: fasting and more
    • Exercise
    • Supplementation
    • Dementia: SCD, MCI, Alzheimer’s
    • Dementia pathophysiology
    • Dementia evaluation and diagnosis
      • How to use the MOCA and SAGE