Do you know the Cause of your Autoimmune Disease?

Do you know the Cause of your Autoimmune Disease?

Table of Contents

I faced my own health journey as I struggled with serious and rare autoimmune disease, before I ever became a physician, got my board certification in family medicine, certified in Anti-Aging And Regenerative Medicine and a certified Functional Medicine expert, athlete, and much later pregnancy, becoming a mother at the age of 43.

Those days were dark days in my life as I struggled not knowing how I got there, offering through debilitating gut issues, chronic sinus and bronchial infections, severe chronic muscle aches, hair loss, and other symptoms that destroyed my well being and nearly my life and left me desperate for answers.

I am so thankful however because even though I was disappointed over and over again as conventional medicine not only had no answers but continued to fuel the disease with drugs they prescribed making it worse I knew inside that there is something better and I am able to take control of my health.

Conventional medicine not only failed me but contributed and likely caused the triggers for my disease. It is therefore an important part of my life’s purpose to not have medicine you.

The conventional medicine offers one size fits all medicine does not work, because we are all different and masks symptoms with drugs and surgery without ever addressing the root causes.

There is a better way, no matter the diagnosis, wether it’s Hashimoto’s, lupus, psoriasis, Crohn’s, ulcerative colitis or any of the other almost one hundred named autoimmune diseases, you can take back control of your health, feel better, identify the root causes, and get more and more healthy, living a vital life, rather than accept and cope with the diagnosis and stand by as your health slowly deteriorates.

You can take the necessary steps to reverse autoimmunity by identifying triggers that include toxins, imbalanced gut microbes, inflammation, infections, and stress and restoring balance.

The first steps are understanding what are the causes of autoimmunity and later I will describe the steps needed to heal.

What Is Autoimmune Disease?

Autoimmune diseases are a family of nearly 100 chronic, often debilitating and, in some cases, life-threatening named illnesses that affect the immune system. According to the National Institutes of Health, about 24 million Americans (more than seven percent of the population) suffer from an autoimmune disease – and the prevalence is rising. 

They include rheumatoid arthritis, lupus, multiple sclerosis, Hashimoto’s and Graves thyroid disease, celiac disease, psoriasis, inflammatory bowel disease, and many others. When the process of autoimmunity begins, your body begins to make antibodies against its own tissues, and attacks itself.

Something confuses the body into confusing self from invaders, which is what the immune system does in a healthy state. The function of a healthy immune system is to protect your body from foreign invaders that can make you sick like bacteria and viruses and to help destroy any abnormal cells that a healthy immune system destroys so they do not continue to grow and make more normal cells, and growth called cancer.

Conventionally physicians are not trained to ask where does this disease come from and why are so many Americans and children falling ill with these diseases.

Autoimmune Disease Does Not Have To Be Lifelong

Conventionally autoimmune disease is incurable and the cause is unknown.

At best you are offered pharmaceutical drugs that suppress your immune system, since the root causes are not investigated a all that can be done conventionally is look very superficially and suppress the entire immune system hoping to slow down the autoimmune process by slowing down your whole immune system.

That’s a huge problem though because you need your immune system to fight infections and even cancer cells and the side effects of these drugs include severe infection, cancer and even death.

There must be a better way. Functional medicine identifies and addresses the root causes of autoimmunity thereby supports the immune system rather than suppressing it.

Two of the most common autoimmune diseases are Hashimoto’s autoimmune thyroiditis, and celiac disease. In Hashimoto’s the body starts to attacks its own thyroid tissue destroying thyroid cells and eventually decreasing and destroying thyroid function.

Celiac disease is the process of immune activation by gluten that results in immune system attacking its own tissues beginning in the digestive system and small intestine.

Symptoms Of Autoimmune Disease Include:

  • Fatigue
  • Joint Pain
  • Rashes
  • Eczema
  • Abdominal Pain
  • Bloating
  • Constipation or Loose Stools
  • Brain Fog
  • Depression/Anxiety
  • Thinning Hair or Hair Loss
  • Burning Eyes
  • Anemia
  • Swollen Glands
  • Muscle Aches

Autoimmune Disease Is Difficult To Diagnose

Autoimmune diseases can be difficult to diagnose because symptoms can fall under the umbrella of other diseases, vary, and affect virtually any organ system.

Most physicians, unless specialized in autoimmune disease may not be ale to recognize the signs of autoimmunity and an accurate diagnosis may be difficult to get until you work with a physician experienced with autoimmunity.

Conventionally, there is no cure for autoimmune disease. However autoimmune disease does not have to be lifelong or progressive. It can certainly be life long if there is no investigation of what are the root causes and triggers for the disease.

Conventional testing only involves testing to identify present inflammation and autoantibodies, there is no investigation of the potential root causes which we will discuss below.

When we identify and address the underlying triggers of autoimmune disease significant improvements are seen, without any need for immune suppression, and even resolution can occur.

Examples Of Autoimmune Disease

There are more than 80 different autoimmune diseases named and diseases are complex and far reaching. Autoimmune Disease can affect any organ system in the body or be multi systemic.

A few examples of autoimmune disease include Hashimoto’s Thyroiditis, Systemic Lupus, Celiac Disease, Ulcerative Colitis and Crohn’s Disease, Type I Diabetes, Vasculitis, Psoriasis, Scleroderma, Acquired Partial Lipodystrophy, Multiple Sclerosis, and Sjogren’s Syndrome.

What Causes Autoimmune Disease?

Autoimmunity can be caused by anything foreign to the body that triggers the immune system to fight, but in the process, the immune system gets confused and attacks self by making autoantibodies (antibodies against self). 

Triggers can vary and be multifactorial meaning there could have been one trigger or a number of factors together triggered the disease.

Triggers for autoimmunity include microorganisms (such as bacteria, fungus, parasites or viruses), pharmaceutical drugs, intestinal hyper permeability (leaky gut), environmental toxins and heavy metals, inflammatory foods like gluten, lectins, viral infections, and stress. drugs may trigger changes that confuse the immune system.

Any of these these factors can turn on autoimmunity. This may happen more often in people who have genes that make them more prone to autoimmune disorders.

However, it is environmental triggers that can turn those genes on meaning if those triggers from the environment were not present the gene may have never turned on. It can also happen in individuals with no genetic predisposition at all, just an environmental trigger. Now let’s discuss the underlying causes of autoimmunity.

Imbalanced Gut Microbes and Candida

Our gut microbiome is an integral part of our health, houses more than 70% of our immune system and communicates with the entire body as a second genome, maintaining homeostasis.

The gut microbiota that reside in the gastrointestinal tract provides essential health benefits to its host, particularly by regulating immune homeostasis.

Moreover, it has recently become obvious that alterations of these gut microbial communities can cause immune dysregulation, leading to autoimmune disorders. (1) So changes in the gut microbiome result in dysbiosis, which can include overgrowth of bad bacteria, diminished good bacteria, overgrowth of candida or fungus that disturb immune balance, causing autoimmunity.

Your gut microbial balance can be taken off track by antibiotics, oral contraceptives, processed foods, and toxins.

When the gut goes off track and good bacteria are decreased it’s not uncommon to see overgrowth of fungus-like candida. Fungal infections can cause severe autoimmune diseases. (2) Just as we know that bacterial and viral infections can trigger autoimmunity, fungal infections can cause severe autoimmune diseases, by increasing inflammatory cytokines and decreasing regulatory cells.

Several factors can cause fungal infections, including antibiotic use and use of oral contraceptives.

A great way to tackle all gut problems and get your gut health back on track is Health Restore Total Gut Repair Kit which includes seven hand-picked powerful, healing and gentle supplements that I recommend to help anyone struggling with gut challenges to restore microbial balance to your GastrointestinaI tract, heal your gastric lining, restore optimal intestinal barrier function, and support optimal digestion and absorption of vitamins and micronutrients to repair and revive your total gut function.

Keeping your gut healthy and functioning optimally is one of the most powerful things you can do to improve and protect your Health and health and well-being.

Oral Contraceptives and Oral Estrogens

Most are not aware that oral contraceptives trigger new onset autoimmune disease, especially in predisposed individuals.

Oral contraceptives and their counterparts like implantable synthetic hormone contraceptives like Nexplanon or injectables like Depo-Provera are prescribed to so many young girls and women, for reasons far beyond birth control, can have detrimental effects on a woman’s heaIth including the trigger of what can be life long autoimmunity.

In fact this is written in the drug information pamphlet included with the drugs however most don’t read those page to page and count on physicians to provide informed consent. This is was the most significant trigger of my rare autoimmune condition that came on within a month of starting the drugs to ‘regulate’ periods’ when I was 21.

Of course the disease itself was not easy to diagnose although the symptoms were suffered I was able to diagnose it with appropriate labs only when I myself became not only a physical but started Functional Medicine training. Studies have also established that that birth control pills have a negative impact on the vaginal microbiome, as it is well documented that the pill increases the incidence of vaginal yeast infections.

Also, the pill and other synthetic contraceptive hormone modalities have negative effects on gut microbiome and overall gut health. This ill effects are not new findings but were established 60 years ago.

The association between oral contraceptives and intestinal inflammation was first reported in the late 1960s. It was found that birth control pill use was associated with inflammatory bowel disease, namely Crohn’s disease, and discontinuation of the pill demonstrated resolution of the disease.

More recent research found that the use of birth control pills is associated with an almost 50% increase in the risk of developing Crohn’s disease. (2) Oral estrogen has been shown to cause intestinal hyper permeability, altering the barrier function of the gut.

Exposing the digestive tract to exogenous synthetic hormones can disrupt the normal gut flora, creating an unhealthy environment.

However, the negative impact oral contraceptives and oral estrogens on gut microbiome disturbances go well beyond just affecting gastrointestinal health.

We now know that our gut bacteria affect most all of our physiologic functions, including metabolism, immune health, and protection from infection. These synthetic hormones are also shown to alter the immune system, leading to inflammation.

When we measure markers of inflammation in the blood, like C-reactive protein (CRP), women who use birth control pills have double the levels of inflammation that those who do not use them. The systemic chronic inflammation caused by the pill not only causes gastrointestinal disease but can lead to and advance many common chronic diseases so its negative effects are critical and wide-reaching. (2)

After some dedicated work and investigation into my health I was able to reverse the detrimental effects. An important point is that it is not easy to piece together why you are not feeling well and that a main cause may be the synthetic hormones in the pill because effects may progress, be cumulative, be affected by other factors and not exactly linear in time. Working with an expert, Institute of Functional Medicine certified Functional Medicine Physician can help you investigate, identify, and address the imbalances.

Leaky Gut

Leaky gut or intestinal hyper-permeability refers to changes that occur in your intestinal cells as a result of toxins, damaging the way cells are held together. In a healthy gut wall, cells are held tightly together by gap junctions that allow nutrients to pass into your blood stream selectively while keeping toxins out.

The intestinal cell barrier, with its tight junction holding cells together, controls the balance between your immune system, tolerance and non-self. As a result, attention is being placed on leaky gut and autoimmunity.

The intestinal wall can be damaged by chronic bacterial, fungal or parasitic infections, toxins, allergens, medications, damaging the tight junctions between the cells, resulting in increase in leaky gut.

When the toxins, or allergens leak into the bloodstream your immune system activates to attack them. When this goes on, chronic inflammation and immune activation results in the immune system mistaking self for non self and attacking its own tissues which is autoimmunity.

This can affect any organ including the thyroid causing Hashimoto’s autoimmune thyroiditis, or joints causing Rheumatoid Arthritis for example.

Heavy Metals

Heavy metals including mercury, cadmium, lead, arsenic, gold and others are linked to autoimmune disease with a solid body of evidence.

Heavy metals interact with your immune system and cause direct toxicity leading to the malfunctioning of the system as a whole. Cadmium from Cigarette smoke and mercury found in fish, dental amalgams, cosmetics, vaccines, air and water have known strong associations with autoimmunity. Lead from paint, cosmetics, glazed pottery and plates and imported consumer goods, and arsenic in poultry, rice, and fruits and vegetables because it is in the soil where they are grown.

Gold, used in preparations containing gold salts, that have been widely used in the treatment of rheumatoid arthritis also causes autoimmunity.

Gold may cause autoimmune thrombocytopenia, immune complex-mediated glomerulonephritis and other autoimmune disorders. Similarly, there is solid evidence that mercury can induce autoimmune disease in humans.

One study even found that women with high mercury exposure were more than twice as likely to have the antibodies found in Hashimoto’s and Graves’ disease.

Mold And Mycotoxins

Mold and mycotoxins which are toxic mold by products, attack both the immune system and nervous system, leading to chronic inflammation and trigger for autoimmunity. Autoimmune conditions are much more frequent in those people who are exposed to mold and mycotoxins. 

Mold toxicity is not uncommon, but it is not commonly diagnosed by conventional physicians. Some of the ways you can be exposed to mold and mycotoxins can be in your food, eating grains, walls, carpet, air, and vents. Symptoms are far reaching and include digestive problems, fatigue, difficulty concentrating, headaches, sinusitis, skin rashes, depression, anxiety and muscle aches.

Diseases and symptoms linked to mycotoxin exposure include autoimmune disease, pneumonia-like symptoms, heart disease, rheumatic disease, asthma, cancer, memory loss, vision loss, chronic fatigue, ADHD, and liver damage.

Because the symptoms can vary and include autoimmune disease it is not easy to diagnose by the average physician. In my practice I do hold a high index of suspicion for mold and candida and use specialty testing for mold and mycotoxins as well as yeast overgrowth.

Pesticides

Pesticides and other toxic chemicals used on food are highly linked to autoimmune disease including Systemic Lupus and Rheumatoid Arthritis as confirmed by the National Institute Of Health.

Those exposed to pesticides the best example being farmers are far more likely to die of autoimmune disease shown in one study. You can do your best to avoid pesticides by eating organic foods whenever possible.

Buy local, organic produce whenever possible. When buying packaged products, look for those that contain organic ingredients—the more organic, the better. Don’t limit your organic products to food alone – look for organic varieties of body care products and clothing as well. Stay away from the “dirty dozen”, and know about the “clean fifteen”, you can learn more at https://www.ewg.org/foodnews/.

Viral Infections

Viral infections can be a major trigger for autoimmune disease by causing viral induced autoimmunity by either affecting cellular proteins or directly activating the immune system and releasing inflammatory lymphokines. Infections like Herpes from Herpesvirus family has been linked to systemic autoimmune disease including Multiple Sclerosis (MS).

Epstein Barr Virus can also play a central role in autoimmune diseases such as Lupus, Rheumatoid Arthritis, and Sjogren’s Syndrome through molecular mimicry that leads to loss of tolerance by the infected person resulting in autoimmunity.

Many other viruses have also been linked to autoimmunity. Many viruses like Epstein Barr Virus, Cytomegalovirus (CMV) or viruses from the Herpesvirus family including HHV1, HHV2, or HHV6 are chronic and lifetime once infected, although they can have periods they are dormant they can be reactivated and pose a burden to the immune system. Once identifies strengthening the immune system and removing or decreasing all other threats outlined in this article will help decrease their reactivation and threat.

In addition there are targeted treatments that you can use including g prescribed botanical antivirals when you work with a physician who uses them that can be very effective.

I use these formulas regularly in my practice as part of a comprehensive approach to treating autoimmune disease.

Gluten

The connection between gluten and autoimmunity is well established. Most know about celiac disease, an autoimmune disease where gluten damages the intestines causing tremendous problems for the individual. But gluten and non-celiac gluten sensitivity are also linked to autoimmunity especially by way of increased intestinal permeability.

There are numerous studies identifying the negative effects of gluten triggering autoimmune disease and improvements with gluten withdrawal. Studies have described detrimental affects of gluten on human health including negative effects on the digestive system and microbiome, resulting in increased intestinal permeability and leaky gut, inflammation and oxidative stress that can cause autoimmune disease in distant organs and systemic disease. For

These reasons eliminating gluten from the diet is a good idea for anyone who is concerned about or is addressing autoimmune issues.

It is worthy to note that there are non gluten foods that can cross react with gluten as far as the immune system is concerned and about half those sensitive to gluten have sensitivities to these foods. A good way to avoid most of these foods is following a true Paleolithic way of eating that eliminates corn, soy, grains, beans, and dairy.

Although there are other foods that can cross react with gluten eliminating non Paleolithic foods helps you stay away from most without extreme dietary limits. If symptoms continue or come up with certain foods it will be worthy to eliminate those specific foods as well.

Food Allergens and Food Additives

We know that the incidence of autoimmune disease is increasing along with the expansion of industrial food processing and food additive consumption.

There are more than 10,000 food additives used in the US and many of these are banned in other countries including the European Union, China, Australia, Japan and New Zealand because of their detrimental affects on human health. Side from other health problems, food additives injure your intestinal layer, damaging the tight junctions, causing increased intestinal permeability or leaky gut, that is a known gateway to autoimmune disease.

Leaky gut can be caused or worsened by commonly used industrial food additives such as glucose, salt, emulsifiers, organic solvents, gluten, microbial transglutaminase, and nanoparticles that are extensively and increasingly used by the food industry which all increase intestinal permeability by damaging the integrity of tight junctions between cells.

Many of these food additives are unlabelled and hidden from consumers. The best and most simple way to try to avoid your exposure and consumption of these additives is to avoid processed food whenever possible such as conventional commercially cooked Meatballs, Baked goods, Cheese, Yogurt, Hot dogs, Beef, Tofu, and Salad dressing.

Lectins

Lectins are proteins found on top of certain foods that bind to carbohydrates and are resistant to human digestion. As a result they enter the circulation, cause nutrient deficiencies, disrupt digestion, and cause severe intestinal damage and intestinal microbial imbalance especially when consumed in excess, and especially in an individual with lectin sensitivity.

The intestinal damage caused by lectins causes increased intestinal permeability and inflammation which is the gateway to various autoimmune diseases. The immune system makes antibodies against lectin proteins that may lead to cross-reactivity with body tissues and cause diseases like rheumatoid arthritis and type 1 diabetes. Most people are unaware of lectins and the problems they can cause, especially for predisposed individuals.

Studies describe autoimmune glomerulonephritis or kidney disease caused by lentil lectin proteins. I personally experienced this years ago when I was eating lentils thinking they are healthy and developed proteinuria which is early kidney damage.

I was able to reverse this through my functional medicine protocols and removing dietary lectins and beans and the problem resolved. In my practice I carefully consider each unique individuals history and symptoms when dietary plans are suggested. Dietary advices today and confusing terms like plant based can be very dangerous for some because they are seemingly ‘healthy’ but completely ignore or are ignorant of the consequences for some individuals.

I continue to see this in my practice, when patients who are healthy for the most part lean away from Paleolithic foods and toward ‘plant based’ diets, the term which can be confusing, due to hearing advertisements, and the result is autoimmunity and poor health. One size does not fit all.

Stress

Autoimmune disease is multifactorial, meaning it is triggered by different factors that can be genetic, environmental, hormonal, and immunological.

Despite that, the onset of at least 50% of autoimmune disorders is due to “unknown trigger factors”.

Numerous studies have described the negative effects of physical and psychological stress on the immune system and in the development of autoimmune disease. Many studies have found that (up to 80%) of patients report abnormal emotional stress before the onset of their disease.

Unfortunately, autoimmune disease is very stressful and creates a vicious cycle where stress can trigger the disease, and the disease itself can causes significant stress. Studies also describe the relationship between psychological stress, emotional and childhood trauma and stress-related hormones causing immune dysregulation, inflammation and autoimmune disease.

Therefore for those with an autoimmune condition, treatment should include not only include stress management but modalities like neuro-feedback, matrix re-imprinting and emotional freedom techniques to help work through the lifetime or past emotional trauma.

Steps To Reverse Autoimmunity

As someone who has had challenges with autoimmunity I will tell you that getting on a path to reverse autoimmunity is not a piece of cake. It requires dedication on your part and expert physician guidance.

It may not happen overnight and can have ups and downs but overall it is highly rewarding, empowering and in the process you may find yourself more healthy than most people around you, and getting healthier day by day as opposed to most who get less healthy with time. The process generally involves 6 steps some of which that can be done simultaneously.

Remember healing is usually not overnight, as opposed to disease management that may sound simple conventionally when people are offered a drug to take. Healing the body is a process, it takes time and dedication but in the end it’s your body and you deserve to be healthy.

Tackle Autoimmune Disease With Detoxification

Autoimmune disease is multifactorial, meaning that different causes and triggers can contribute and set your body off into autoimmunity.

An excellent way to begin to tackle autoimmune disease and restore a state of homeostasis and balance to your body is the Health Restore 6 Day Detox Program which includes the key nutritional supplements you need, along with guidelines on foods to eat, optional menu plans, nutrient-dense superfood detox recipes, shopping list, daily worksheets providing you with everything you need to feel better, detoxify, start healing and restore balance to your body.

Reversing autoimmune disease involves identifying triggers and imbalances in the body. The best way to start addressing what can be complex is an effective, simple detoxification Program.

I have used Health Restore Detox Program personally and with my patients and it’s a great way to take any negative load of the body, support the body with the right nutrients, support immune, liver and gastrointestinal health and start restoring balance.

My Health Restore Detox Program can be used for 6 days for anyone who want to feel better and set their body up for success and for anyone tackling autoimmune disease. If you’re tackling autoimmune disease you can start with the Health Restore Detox Program and continue the Health Restore Detox Kit for 6-12 weeks.

Identify Nutrient Deficiencies And Hormone Imbalance

An important initial step on the path to healing autoimmunity is identifying both nutritional deficiencies and hormone imbalances.

This is crucial because very often when correctly addressing this step most patient feel markedly better. It is also important because the deficient or imbalanced nutrients and hormones are needed for optimal body function, in other words the system does not work optimally when it does not have the right nutrients and hormones.

I always address female and male hormone and thyroid as well as adrenals and insulin. Addressing these helps you feel better while you investigate root causes for the imbalances and heal the root causes which takes more time.

I like to use a combination of serum blood tests along with functional tests to identify nutritional deficiencies and needs that include vitamins, minerals, fatty acids, amino acids and antioxidants.

There are many labs offering these tests however always remember that all labs are not equal and data can be inaccurate even when advertisements or lab samples look aesthetically pleasing.

Identify And Treat Gut Imbalances

The next step is identifying and starting to treat gut imbalances.a functional assessment of gut health that includes assessing levels of good bacteria, identifying any imbalanced bacteria, yeast or parasites, and identifying digestion markers, inflammatory markers and short chain fatty acid levels.

There are multiple tests on the market however in my 25 years of clinical experience the most accurate and clinically helpful has been the Complete Stool Analysis Parasitology (CSAP) you can get tested Here. CSAP by Doctors Data is a 3-Day stool culture, the gold standard for microbial testing and imbalances identified in this test can then be addressed with a targeted gut health restoration protocol to restore balance to your gut and microbiome.

Remove Common Allergens and Decrease Lectin Exposure

Next we assure that dietary changes implemented in the Health Restore Detox Program continue and include a low allergen low lectin diet that is Paleolithic.

There is detailed information provided on this as part of the Health Restore Detox Program. Eliminate beans, grains, dairy, corn, soy, processed foods, processed oils, chemical food additives and added sugars and add in organic vegetables, organic berries, beneficial fats, Ghee, organic grass-fed pasture raised meats, eggs, poultry.

Identify And Treat Environmental Toxin Exposure And Body Burden
Next or simultaneously I usually test for environmental toxins using a chelating age that helps pull out stored heavy metals in body tissues.

Assessing both acute toxicity with metals and cumulative body burden is important in identifying heavy metal issues that then can be appropriately detoxified with a combination of medication and natural detoxification support.

Identify And Treat Chronic Infections

Identifying chronic infections is an important part of addressing autoimmune disease. However treating chronic infections in isolation is meaningless in the long run without first addressing all other issues in the body such as gut imbalance, toxicity, hormone and nutritional imbalance.

The idea is to first strengthen the body so the body is better equipped to handle the chronic infection and then target the infection.

Remember that these infections are often chronic however by strengthening the body and immune system their burden can be less especially when they are targeted with treatments.

Heal Emotional Trauma And Address Stress

Treating any autoimmune process requires addressing life stressors both current and past including any trauma experienced throughout life, birth to present wether conscious or subconscious. Emotional Freedom Techniques (EFT), Matrix Reimprinting and neurofeedback are a great place to start. Matrix Reimrinting is a technique that you can use on yourself to heal past trauma. It can also be done with you by a highly qualified practitioner.

The best place to start learning about Matrix Reimprinting is by reading Matrix Reimprinting, Rewrite Your Past, Transform Your Future by Karl Dawson.

Neurofeedback is a process that retrains the brain away from the repetitive negative thoughts associated with emotional trauma, depression, anxiety and PTSD by decreasing brains overactive brain waves to a more calm brain wave state. It is practitioner dependent meaning if not done by truly expert individual it can not only be ineffective but even be problematic Yoga, mindfulness, meditation are also part of the healing process and can be used daily.

In Wellness,

Rashel J Tahzib DO AOBFP IFMCP
Functional & Functional Family Medicine

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