Nutri Advanced News

Low Energy & Anxiety Case Study: A Multifaceted Approach

We are thrilled to share with you this case study from the busy clinic of Fiona Campbell - an experienced clinician based in Bristol, who frequently works with patients with complex health problems. 

In this case study, Fiona has provided an overview of a client with a range of health issues whose primary aim was to improve her energy levels.  Thank you Fiona for sharing this case with us. 

Outline

Miss Ward was a 34 year old with a history of breast cancer (18yrs prior), anxiety, irregular periods, constipation and depression.  Her primary aim was to improve her energy levels as she was suffering with ongoing fatigue, which was also underpinned by restless sleep. She also wanted to start trying to conceive.  

Based on our initial phone conversation she immediately opted for Genova’s Adrenal Stress test to see how her anxiety was potentially affecting her hormone levels and overall health.  Her results showed that both DHEA and cortisol were low and outside of the healthy range, suggesting that supporting adrenal function was one of the most important aims for this case.

Being a very intelligent and inquisitive person, she also had a tendency to become incredibly anxious from all the reading she was doing on the internet, so my main role was to satisfy her curiosity as a single point of sanity (I spent a lot of time on PubMed!) and to reassure her that she was already doing everything she could to stay healthy and prepare for the journey of becoming a mother.  All she needed to do was implement a few, but very important tweaks.

Approach

Miss Ward’s diet was already rich in a wide variety of local, seasonal and organic wholefoods and her balance of protein, complex carbohydrates, fibre and fats was impressive (I thought she was managing to eat better than I was!).  So I gave her a selection of new recipes to try such as almond coated fish and celeriac chips (low GI, source of omega 3), cauliflower curry (rich source of sulphoraphanes for liver detox pathways), kale and pomegranate salad with oily fish (sulphoraphanes, iron and other micronutrients, protein and omega 3), turkey burgers (rich in protein and the serotonin precursor tryptophan), and Kenyan spiced vegetarian stew.

Lifestyle changes included gentle morning yoga, and eating smaller meals that were rich in protein and sources of unsaturated fats.  Making more time for meals, eating smaller meals, slowing down and chewing more thoroughly, and eating her last (and smallest) meal by 7:30pm would enable her body to focus on healing and repair at night.  How you eat is just as important as what you eat!

Turning off any light emitting devices (e.g. phone / laptop) at least 2 hours before bedtime was also suggested to prevent blue light-associated dips in melatonin levels. In place of this we introduced magnesium rich Epsom salts baths and bedtime reading.  A hypnotherapist was also recommended to help with her anxiety.

Supplemental nutrients included CoQ10, a female multivitamin complex, additional magnesium and zinc, high strength fish oils, l-glutamine, probiotics, and vitamin D.  Upon confirming that she was using contraception for the time being, I organised for a licorice tincture to be sent to her home address.

Further suggested tests included the Vitamin D blood spot test offered by CityAssays, and a fasting glucose, TSH and ferritin test via her GP.

Progress

At the second visit 6 weeks later she confirmed that she hadn’t read a single online article, which was a significant step forward for her.  She had made good progress with the hypnotherapist and had also been advised by her consultant to start trying for a baby as soon as possible, so we agreed to hold off on the licorice tincture and swapped her over to a fertility multinutrient complex which was rich in energy-producing and adrenal-supporting B vitamins instead.

She was also curious to know what my thoughts were on the role that food sensitivities and allergies were potentially playing in her symptom profile and medical history - and equally we had discussed the importance of gut health for all ongoing health concerns, so I arranged for Genova’s FACT and Comprehensive Digestive Analysis test kits to be sent out to her.

At her next appointment to discuss the test results she told me that she was pregnant and absolutely thrilled.  Her energy levels were steadily improving and balancing out throughout the day, and she was waking up feeling much more energised than she had done previously. 

With respect to the FACT test she had yielded a negative result for individual food sensitivities and the overall marker for food allergies.  The Comprehensive Digestive Analysis test yielded a number of interesting findings, as follows:

 • Low level of pancreatic elastase (one of the enzymes that helps to break down protein, suggesting that supplemental enzymes could be beneficial
 • Low level of putrefactive short chain fatty acids (a by-product of protein breakdown), suggesting that protein intake should be increased
 • Gut integrity was fine
 • N-Butyrate would ideally be higher, to continue to feed and protect the cells that line the colon – and indicated that fibre intake should be increased or that butter / ghee could be added to the diet
 • Lactobacillus didn’t grow in culture, suggesting that a revised probiotic supplement could be beneficial
 • Klebsiella levels were high, and as we couldn’t use berberine or other herbals due to pregnancy this added to the argument that a probiotic rich in Lactobacillus bacteria would be ideal
 • No parasites or ova were spotted

I saw Miss Ward every 3 months on average for just over 2 years, in which time she gave birth to two healthy children and now enjoys a much better standard of health and improved enjoyment of life.  She achieved this against the much less favourable odds she was originally given by her consultant as a result of the chemotherapy she had previously received.

 

About Fiona Campbell BA GNC BANT MTI CNHC
- Registered Naturopath and Nutritionist

Fiona Campbell is a writer, TV and radio presenter, and experienced clinician who has featured in several magazines nationally and internationally.  She is a regular guest on BBC Radio Bristol and Sky News and recently led the debate on sugar with NTV Kenya.  She also works with some of her favourite brands, such as Lizi’s Granola, Nutri, Pulsin and Naturya on new product development and consumer education.

Fiona’s key mission is to dispel the myths and “food fear” we encounter through the press and social media, and to direct us back towards whole healthy food, sensible things like getting a better night’s sleep, and a balanced lifestyle that allows for prosecco, chocolate and cake!  For daily inspiration you can check her out on Instagram @fionanutrition, and Facebook/Twitter @topbodytips. www.fionanutrition.com