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  • Writer's pictureStephanie Lum

What To Do If You Have Symptoms But No Diagnosis

Updated: 19 hours ago

Countless individuals have spent years in diagnostic purgatory. After a series of seemingly endless referrals they are often sent home with no treatment options. 


Frequently, symptoms are not seen as a part of a wider picture of health but as an isolated problem that needs to be contained.


Symptoms are your body’s way of signaling a problem.  Covering them up with a symptom-suppressing medication is often an inadequate stopgap and certainly no replacement for a thorough medical inquiry.


Functional medicine, and our clinic in particular, seeks to address the unique needs of patients who feel they have been left behind.

a map and compass with the text overlay Dr Brian Lum

A Shift in Diagnostic Perspective 


One of our patients developed Raynaud's syndrome at 9 years old (an autoimmune reaction that causes vascular constriction).  She told us that a doctor told her and her mother that her circulation was 'bad' and that they could probably perform surgery to 'open up' the veins in her hands. 


Her doctor failed to recognize her condition and focused only on the primary symptom, which led to the recommendation of a surgery that would have been pointless and destructive.  


Stories like hers are common, especially among people with unusual symptoms or who do not fit typical diagnostic guidelines.  


The administration of symptom-suppressing pharmaceuticals is common for those with mysterious symptoms.  While pharmaceuticals can sometimes be the correct approach, they are too often administered to simply quiet symptoms. 


Once the symptom is suppressed, any diagnostic investigation usually ends.  


How Functional Medicine Approaches Idiopathic Symptoms 


When symptoms have an unknown origin, they are often labeled as idiopathic.  Yet it is helpful to consider the body to be, for the most part, an inherently rational interconnected system.  


Symptoms usually have a specific purpose - a cough is your body trying to expel viral debris from your lungs, and sinus inflammation occurs so that your body can better contend with an airborne invader.  


Even conditions and symptoms that have their root in emotional trauma can be the articulation of that pain as a kind of pressure valve.  This pain is as ‘real’ as any other pain and should be taken just as seriously. 


While doctors often dismiss complex patients as having symptoms that are “all in their head” - the reality is that there is no symptom or sensory experience that is not modulated by the brain.  


Fortunately, the latest research on neuroplasticity shows that even symptoms originating from an emotional adaptation or Post Traumatic Stress Disorder (PTSD) can be reduced or eliminated using relatively simple lifestyle interventions. [1] [2] [3]


Whatever collection of symptoms you are dealing with - you are not alone.  All of our patients have felt the isolation and hopelessness that comes with being marginalized by the wider medical field. 


Upon investigation, mysterious symptoms and conditions are rarely that mysterious. With time and targeted treatment even the most long-term and complicated cases can see a complete resolution of symptoms.


The Standard Approach For Complex Symptoms


Typically, your general practitioner investigates a collection of symptoms with a physical examination and basic testing. A complete blood count or metabolic panel is often ordered. If your symptoms sound like an autoimmune disease, for instance, a test would be ordered to confirm that suspicion.  


If all of these tests come back normal or negative, medication is often administered to alleviate symptoms. If your symptoms are joint pain, gastrointestinal symptoms, migraines, or fatigue, you may be given an antibiotic or a steroid. If you are referred to a specialist and they still find nothing of consequence, there is often no other place to go. 


Frustratingly, this is often where patients are left as the object of many doctors is not to get you completely healthy but to ensure that you do not immediately die. Painful and debilitating symptoms, once they are determined not to be life-threatening, are not considered clinically important. 


In a hospital setting, even if they wanted to, most practitioners are simply not allotted enough time for each patient to investigate further.  At this point, functional medicine's wide variety of targeted testing and personalized treatment can be your method of navigation forward.


Addressing Treatment Biases 

Two biases frequently hold patients back from exploring viable treatment options. 


The Stronger Is Better Bias 


It is a natural response to alarmingly strong symptoms to think that you need an equally strong treatment to fix them.  In cases of long-term, complex, or severe symptoms, however, it is often the comparatively gentle treatment approach that yields the quickest recovery. 


For instance, a patient presenting with severe gastrointestinal symptoms had been through various in-patient hospital stays and was living on a permanent antibiotic regimen.  His doctors advocated removing his colon when, remarkably, his health status dramatically improved when we removed dairy from his diet. 


Somehow, despite all the cutting-edge, advanced medicine he had been exposed to, no one had checked what he was eating or measured the nature of the inflammation causing his gastrointestinal distress.  


In other instances of gastrointestinal distress, high-quality herbal supplementation of ‘herbal antibiotics’ - like oregano oil and olive leaf extract - can be remarkably effective at clearing infection and repleting beneficial bacteria.


These supplements need to be tailored to a patient's specific infection, as even the ‘best’ performing supplement in the latest research will not work for everyone. 


The One Pill Solution Bias


Many patients seek a one-step solution or a straightforward explanation for their symptoms.  Lacking the reference point of a diagnosis, they want the certainty of a mechanism of illness or a simple treatment. 


This is where extreme diets, drastic detox ‘cleanses,’ and miracle supplements promise much but deliver very little.  Complex problems take time to develop, and it will take a multifaceted approach to extract you from them.


Sometimes diets like keto or paleo can be great at symptom reduction but the second you stray from the diet, all of your symptoms return. By addressing your underlying issues you will not have to be tied to extreme diets or detox protocols forever.


Even when the solution is as ‘simple’ as mold toxicity or cell danger response, the pathway back from these conditions will take a treatment plan that is gentle enough to be sustainable and quick enough to get you back to life as quickly as possible. 


Americans have been inundated with drug commercials from our childhood. Multiple times a day, we receive messages that the frolicking families we see in advertisements only have to “ask their doctor” to get medication to fix their problem quickly.  It's important that we see this messaging as a marketing ploy and not indicative of a typical healing trajectory. 


Functional Medicine Testing and Interpretation

The most useful testing is that which specifically matches your symptom presentation and medical history. It is also important that your testing be interpreted using expanded standards. 


Often, latent infections are detectable on a test like a CBC, but since the values are still within the ‘normal’ classification, they are dismissed because the problem is not big enough to be considered clinically significant.  These ‘high normal’ and ‘low normal’ values can signal underlying infection, mold exposure, or an allergy response. 


Helpful Tests for Patients with Chronic Symptoms

These are just a few useful tests for patients with chronic, complex symptoms. This list is certainly not exhaustive. Heavy metal and chemical toxicity from contaminated drinking water, building materials, and even poor-quality cookware is not uncommon in our patients.


  • Urine Mycotoxin Test - This test detects if there are mold toxins in your urine. Mold toxicity refers to the accumulation of mold toxins which can adversely affect every system in the body. Mold toxicity is different from a mold allergy. Mold toxicity can manifest as a wide range of unusual and severe symptoms unrelated to traditional respiratory allergy symptoms. These symptoms can include chronic fatigue, migraines, nausea, anxiety, depression and underlying infections. [4] Mold symptoms can originate from mold spores, pieces of destroyed mold spores (mold fragments), or mycotoxins. Importantly, in the majority of complex cases we see, mold toxicity is a primary driver of chronic inflammation and immune/neurological dysfunction.  While we often detect other imbalances, this test should be a high priority for anyone with mysterious symptoms, especially those with histamine intolerance-related symptoms.  Remember that toxic mold does not necessarily have a scent, nor is its presence in a home always obvious. Your genetics will play a large role in how well you are able to detoxify mycotoxins from your system. Certain genetics can make you more disposed to accumulation. This causes everyone to react differently to the same mold exposure. We often see families where one or two members are severely affected and the rest are healthy.  


  • Comprehensive Stool Analysis - For complex patients, this is a test that can illuminate potential contributing factors like infections and inflammation.  It can assess digestive health, bile flow, probiotic quality, intestinal lining integrity, the presence of Small Intestinal Bacterial Overgrowth (SIBO), and pancreatic health. 


  • Micronutrient Testing - Nutrient deficiencies can cause widespread severe symptoms throughout the body. For instance, a patient with a Thiamine (B1) deficiency presented with blurry vision, poor glucose regulation, seemingly random neuropathy, fatigue, severe brain fog, and insomnia.  They were taking a multivitamin with B1, but it was not enough for repletion. This deficiency was due to SIBO because B1 is supposed to be absorbed in the first part of the small intestine. This part of the intestine was impaired due to the bacterial overgrowth.  B1 is critical for blood sugar regulation and nerve conduction, hence the abnormal blood sugar levels, the brain fog, and the neuropathy. [5]


  • Neural Zoomer Plus - This test can assess the integrity of the Blood Brain Barrier and assess neurological inflammation. 


  • Viral infections - Testing specifically for EBV, HHV6, HHV7, CMV in cases of long term chronic symptoms is worthwhile as they frequently are an underlying factor.


Functional Medicine’s Growing Tendency to Overprescribe

While patients are often quick to point out how often their general practitioners offer them prescriptions, even functional medicine practitioners are tending to overprescribe. They often order elaborate testing and give patients excessive supplements (sometimes over 10) - one for each marker that is out of the normal range.  


This is typically far too much for the average patient and certainly too much for the sensitive or long-term chronic patient.  There is an 'order of operations' in addressing multiple dysfunctions within the body and, generally speaking, when more important imbalances are corrected, lesser dysfunctions will correct themselves.  


The Power of Neuroplastic Techniques

It is worth pursuing the wide range of mind/body techniques that can be employed to reduce the severity of pain and inflammation-based symptoms.  Yoga, Tai Chi, Qigong, and other meditation practices can be life-changing in their ability to support the nervous system and retrain the brain's stimulus response. [6] [7] [8]


More subtle shifts in perspective on chronic illness can also reduce or completely resolve symptoms. These techniques are encouraged alongside our functional medicine protocols as they are very effective in speeding up the healing process. 


A good introductory book about these approaches with a pain-specific focus is The Way Out by Alan Gordon.  We have seen that shifting the rhetoric used to describe pain and chronic illness can result in ‘book cures’ - the dramatic improvement of symptoms upon reading this and other books on neuroplasticity.  


Remote Consultations For Complex and Chronic Symptoms

Health is so much more than the elimination of debilitating symptoms. Until patients start seeing some improvement, their illness is understandably all they can think about.


Friends and family members may make light of how uptight these individuals have become or how reactive they are to everyday stimuli, but these reactions are natural reactions to an unnatural situation.


A person should not have to be their own health advocate or be medically hypervigilant because no one else seems to be interested.  


Our clinic has been comprised entirely of outliers, as we have specialized in chronic, complex illnesses for over a decade. Dr. Brian Lum, an IFMCP functional medicine practitioner, sees patients remotely from all over the world and is currently accepting new patients.


New patient appointments are an hour long, and follow-up appointments are 30 minutes. All pricing is listed on our website. Testing kits can be sent to most locations, and testing can be arranged through a local hospital or a blood draw location near you. 



If you would like to schedule a free 15 minute consultation with Dr. Lum to ask questions about becoming a patient click the link below.



 

Written by Stephanie Lum with Dr. Brian Lum ensuring medical accuracy. 


Disclaimer: If you think that you may have a medical emergency, call your doctor or 911 immediately. No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website. The information on this Website is not intended to diagnose, treat, cure, or prevent any disease or medical condition. The information discussed is not intended to replace the advice of your healthcare provider. Reliance on the information provided by this Website, Dr. Brian Lum, or Functional Healthcare Institute is solely at your own risk.


Bibliography


[1] Yi, Lei, Yunling Lian, Ning Ma, and Ni Duan. 2022. "A Randomized Controlled Trial of the Influence of Yoga for Women with Symptoms of Post-Traumatic Stress Disorder." Journal of Translational Medicine 20 (2022): 1-7. doi:https://doi.org/10.1186/s12967-022-03356-0. http://search.proquest.com.ezp-prod1.hul.harvard.edu/scholarly-journals/randomized-controlled-trial-influence-yoga-women/docview/2652204744/se-2.


[2] Berk-Clark, Carissa van den, Scott Secrest, Jesse Walls, Ellen Hallberg, Patrick J Lustman, F. David Schneider, and Jeffrey F Scherrer. 2018. “Association Between Posttraumatic Stress Disorder and Lack of Exercise, Poor Diet, Obesity, and Co-Occuring Smoking: A Systematic Review and Meta-Analysis.” Health Psychology 37 (5): 407–16. https://doi.org/10.1037/hea0000593.


[3] Braun, Tosca D., Lisa A. Uebelacker, Mariana Ward, Cathryn Glanton Holzhauer, Kelly McCallister, and Ana Abrantes. 2021. ““We Really Need This”: Trauma-Informed Yoga for Veteran Women with a History of Military Sexual Trauma.” Complementary Therapies in Medicine 59: 102729–102729. https://doi.org/10.1016/j.ctim.2021.102729.


[4] Brewer, Joseph H., Jack D. Thrasher, David C. Straus, Roberta A. Madison, and Dennis Hooper. 2013. “Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome.” Toxins 5 (4): 605–17. https://doi.org/10.3390/toxins5040605.


[5] Skelton, William P., and Nadine K. Skelton. 1989. “Thiamine Deficiency Neuropathy: It's Still Common Today.” Postgraduate Medicine 85 (8): 301–6. https://doi.org/10.1080/00325481.1989.11700760.


[6] Jiang, Wei, Shaojun Liao, Xiankun Chen, Cecilia Stålsby Lundborg, Gaetano Marrone, Zehuai Wen, and Weihui Lu. 2021. “TaiChi and Qigong for Depressive Symptoms in Patients with Chronic Heart Failure: A Systematic Review with Meta-Analysis.” Evidence-Based Complementary and Alternative Medicine 2021: 1–12. https://doi.org/10.1155/2021/5585239.


[7] Basavegowda, Madhu, Sujan M. Umeshchandra, Patteswari Duraisamy, Rajesh K. Thimmulappa, Mounika S. Manivasagan, Chaithra Mallaiah, Jahnavi V. Madhu, et al. 2023. “The Effect of Yoga on Insomnia and Quality of Life Among Nursing Professionals During COVID-19: A Pre-Post-Test Interventional Study.” Indian Journal of Psychiatry 65 (11): 1143–50. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_573_23.


[8] Long, Chunyan, Jingyi Ye, Mengting Chen, Dong Gao, and Qingling Huang. 2022. “Effectiveness of Yoga Therapy for Migraine Treatment: A Meta-Analysis of Randomized Controlled Studies.” The American Journal of Emergency Medicine 58: 95–99. https://doi.org/10.1016/j.ajem.2022.04.050.






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