FRONT COVER -- A Practitioner's Handbook: Biochemical Imbalances in Disease -- CONTENTS -- Foreword -- Chapter 1 The Healthcare Futurescape: How Did We Get Here and Where Are We Going? -- 1. Some key shapers of medicine -- 1.1 Hippocrates, Galen and humorism -- 1.2 The nineteenth century medical revolution -- 1.3 The twentieth century -- 2. Homeostasis and allostasis -- 2.1 Homeostasis -- 2.2 Allostasis -- 3. Functional medicine (FM) -- 3.1 The adoption and usage of the FM model among UK nutritional therapists -- 4. The chapters -- Chapter 2 Gastro-Intestinal Imbalances -- Part 1 The gastro-intestinal tract - Use and abuse -- 1. Gastro-intestinal imbalances and disease -- 2. Physiological imbalances of the human digestive system -- 2.1 Oral cavity and oesophagus -- 2.2 The stomach -- 2.3 The small intestine -- 2.4 The colon -- 3. Microflora supplementation and the human gut -- 4. Diagnostic testing -- Part 2 Functional disorders of the gastro-intestinal tract -- 5. Functional gastro-intestinal tract disorders -- 5.1 Irritable bowel syndrome (IBS) -- 5.2 Functional abdominal pain (FAP) -- 5.3 Functional bloating (FB) -- 5.4 Functional constipation (FC) -- Chapter 3 Compromised Detoxification -- 1. Introduction -- 2. Sources and routes of entry of toxins -- 3. Biochemical pathways of detoxification -- 3.1 Phase I (biotransformation) -- 3.2 Phase II (conjugation) -- 3.3 Phase III (transporters) -- 3.4 Metallothioneins -- 4. Factors affecting detoxification processes -- 5. The impact of toxins on nutrients -- 6. Clinical assessment of detoxification capacity and the body burden of toxins -- 6.1 Tests to consider -- 6.2 Functional tests -- 6.3 Genetic tests of detoxification capacity -- 6.4 Assessment of toxic exposure or load -- 7. The detoxification programme -- 7.1 New and/or exacerbated symptoms during detoxification.

7.2 Considerations for the detoxification programme -- 8. The dietary management of detoxification -- 8.1 Aims of a dietary detoxification programme -- 8.2 Protein -- 8.3 Carbohydrates -- 8.4 Fats -- 8.5 Dairy -- 8.6 Herbs and spices -- 8.7 Fasting and dietary restriction -- 8.8 Food preparation -- 9. Lifestyle interventions -- 9.1 Exercise -- 9.2 Sauna -- 9.3 Hydrotherapy -- 10. Supplement treatment regimes -- 11. Chelation therapy -- Contraindications of chelating drugs -- 12. Other considerations for successful detoxification -- 13. Compromised detoxification and chronic disease -- 13.1 Examples of common conditions and compromised detoxification -- 14. Conclusion -- Chapter 4 Polyunsaturated Fatty Acid (PUFA) Imbalances -- Part 1 The health effects of imbalances in PUFA status and metabolism -- 1. What are essential fatty acids? -- 2. EFA metabolism and eicosanoid synthesis -- 3. Changes in dietary fat intake over time -- 3.1 The n-6:n-3 FA ratio -- 3.2 Trans fats -- 4. Signs and symptoms of PUFA deficiency -- 5. A closer look at some of PUFAs' mechanisms -- 5.1 The role of eicosanoids -- 5.2 Cellular signalling and transcription -- 5.3 Membrane structure and organisation -- 6. PUFA modulation of some specific disease processes -- 6.1 Cardiovascular disease (CVD) -- 6.2 Insulin resistance, obesity and metabolic syndrome -- 6.3 Cancer -- 6.4 Multiple sclerosis (MS) -- 6.5 Other chronic inflammatory disorders -- 7. General recommendations and therapeutic considerations -- 7.1 Patient testing -- 7.2 General dietary recommendations -- 7.3 Supplementation -- 8. Conclusion -- Part 2 PUFAs in the brain -- 9. PUFAs in the brain -- 9.1 The role of fatty acids in brain development and function -- 9.2 PUFAs in ADHD, dyslexia and dyspraxia -- 9.3 The role of PUFAs in depression -- 9.5 Cognition, behaviour and mood in the general population.

9.6 PUFAs and the brain: Conclusion -- Chapter 5 The Metabolic Syndrome: Insulin Resistance, Dysglycaemia and Dyslipidaemia -- 1. Imbalances of affluence -- 1.1 Feast or famine -- 1.2 Xenohormesis -- 2. Physiological responses to food intake -- 2.1 Glycaemic index and glycaemic load -- 2.2 Insulin resistance and blood sugar control -- 3. Consequences of dysglycaemia -- 3.1 Diabetes and more -- 3.2 Dyslipidaemia -- 3.3 Hyperinsulinaemia and heart disease/CAD -- 3.4 Insulin's effects on IGF-1 and other hormones -- 4. Metabolic syndrome: Contributory factors to consider -- 4.1 The 'chicken and egg' conundrum -- 4.2 Insulin and oxidative stress -- 4.3 High risk carbohydrates -- 5. Preventing and reversing insulin resistance and metabolic syndrome -- 5.1 The role of physical activity -- 5.2 The roles of calorie restriction and sirtuins -- 5.3. The role of diet and nutrients -- 6. Specific functional [AQ]nutrient deficiencies and metabolic syndrome -- 6.1 Magnesium -- 6.2 Chromium -- 6.3 Herbal medicines and phytochemicals -- 7. Are drugs better? -- 8. Summary of prevention and treatment recommendations -- Chapter 6 Compromised Thyroid and Adrenal Function -- Part 1 The Thyroid Gland -- 1. Thyroid function -- 1.1 The thyroid gland -- 2. Imbalances in thyroid function -- 2.1 Hyperthyroidism or thyrotoxicosis -- 2.2 Hypothyroidism or myxoedema -- 3. Diagnosis of thyroid function problems -- 3.1 Blood tests for thyroid dysfunction -- 3.2 Radioactive iodine uptake (RIU) -- 3.3 Urine hormone assays for thyroid function -- 3.4 Functional tests -- 4. Conventional treatment approaches for thyroid conditions -- 4.1 Hyperthyroidism -- 4.2 Hypothyroidism -- 4.3 Subclinical (mild) hypothyroidism -- 4.4 Combination treatment -- 5. Issues in the standard approach to diagnosis and management of hypothyroidism -- 5.1 Interpreting thyroid function tests.

5.3 Dissatisfaction with thyroxine therapy -- 6. Thyroid function and other conditions -- 6.1 Pregnancy -- 6.2 Non-thyroidal illness or euthyroid sick syndrome (ESS) -- 6.3 Other related conditions -- Part 2 - The Adrenals -- Part 2 The Adrenals -- 7. Adrenal function -- 7.1 The adrenal glands -- 7.2 Functions of cortisol -- 7.3 Cortisol production -- 8. Imbalances in adrenal function -- 8.1 Adrenal fatigue -- 9. Tests for adrenal function -- 9.1 Blood tests -- 9.2 Adrenal stress index test (ASI) -- 10. Links between thyroid function and adrenal fatigue -- 11. Nutritional support for the modulation of thyroid and adrenal function -- 11.1 Overall nutritional approach -- 11.2 Specific dietary actions for thyroid function -- 11.3 Nutritional supplements for adrenal function - use and cautions -- 11.4 Herbal medicine -- 11.5 Additional support for thyroid and adrenal function -- Chapter 7 Sex Hormone Imbalances -- 1. The environment, hormonal and developmental health -- 1.1 Endocrine disruptors -- 1.2 Obesogens -- 2. Conceptual frameworks for viewing hormonal health -- 2.1 Systems Biology -- 2.2 Allostasis -- 2.3 Resilience theory -- 2.4 Moving towards 'ease' -- 3. Sex hormones -- 3.1 Synthesis of steroid hormones -- 3.2 Oestrogen - not just one hormone -- 3.3 Oestrogen dominance -- 4. Functional processes involved in the safe management of oestrogen and other hormones -- 4.1 Detoxification (digestion and absorption) -- 4.2 Phase I detoxification of sex hormones -- 4.3 Phase II detoxification of sex hormones -- 4.4 Transport and binding of oestrogen -- 4.5 Cholesterol transport -- 5. Immune system health (defence) -- 6. Communication -- 6.1 Phytoestrogens -- 6.2 Oestrogen and tryptophan metabolism -- 6.3 Oestrogen and monoamine oxidase -- 7. Mitochondrial function - oxidative stress -- 8. Conclusion.

Chapter 8 Dysregulation of the Immune System: A Gastro-Centric Perspective -- 1. Introduction -- 1.1 What is a functional approach to innate immunity? -- 2. Immunology's developmental history -- 2.1 Phase 1 -- 2.2 Phase 2 -- 2.3 Phase 3 -- 3. A review of key immune components -- 3.1 The innate immune system -- 3.2 The adaptive immune response -- 3.3 Humoral immunity -- 3.4 Secretory IgA (SIgA) -- 4. Developing tolerance -- 4.1 Oral induction of tolerance -- 4.2 Environmental contributors -- 5. Contemporary understanding of microbiota and human immunity -- 5.1 The microbiota and mucins - protection in the gut -- 5.2 Biofilms -- 5.3 The microbiome -- 6. Gut and disease association -- 6.1 Leaky gut -- 6.2 Small intestinal bacterial overgrowth (SIBO) -- 7. Manipulating mucosal immunity to manage systemic health -- 7.1 Germ Theory vs Symbiotic Theory -- 7.2 Antibiotics -- 7.3 Probiotics -- 7.4 Metagenomics and nutrigenomics -- 8. Clinical application -- 8.1 Examination thoughts -- 8.2 Possible natural therapeutic agents to consider -- Chapter 9 Poor Energy Production and Increased Oxidative Stress -- Part 1 Oxidation and oxidative stress -- 1. Mitochondrial energy production -- 1.1 Micronutrients in mitochondrial metabolism -- 2. The drawbacks of aerobic energy production -- 2.1 Other sources of endogenous oxidants -- 2.2 Environmental sources of reactive oxygen species -- 2.3 Oxidative stress and disease -- 2.4 Mitochondria as targets of oxidative injury -- 3. Cycle of oxidative stress -- Part 2Antioxidant defences -- Part 2 Antioxidant defences -- 4. Antioxidant defence: An overview -- 4.1 Endogenous antioxidants -- 4.2 Micronutrient antioxidants -- 4.3 Antioxidant regeneration -- 5. Therapeutic intervention: Antioxidants in the diet -- 5.1 Rating antioxidant potential of food -- 5.2 Guidelines for improving baseline antioxidant status using foods.

5.3 Antioxidants: Foods in focus.