What we treat — and how.

We start with comprehensive stool testing (GI Map or Doctor's Data) to see what's actually living down there, plus an organic acids panel for systemic markers. From there, the protocol generally moves through removal of triggers and inflammatory foods, herbal antimicrobials calibrated to what showed up on the panel (berberine, oregano, neem, allicin), repopulation with strain-specific probiotics, and reintroduction in a structured order.

Our gut-track patients tend to feel meaningfully different in 8–12 weeks. We co-manage with gastroenterologists when there's IBD or anything structural to rule out — never instead of them.

The DUTCH-method dried urine test gives us a complete picture of estrogen, progesterone, testosterone, DHEA, cortisol, and how each is being metabolized. Combined with a full thyroid panel (free T3, free T4, reverse T3, antibodies — not just TSH), it usually surfaces something within the first month.

For perimenopause, we discuss bio-identical HRT alongside herbal options (vitex, black cohosh, ashwagandha) — the right choice depends on where you are, your symptoms, and your risk profile. We co-manage with OB/GYNs and endocrinologists when needed.

For Hashimoto's, RA, lupus, psoriasis, MS, ankylosing spondylitis, Crohn's, ulcerative colitis — we never replace the rheumatologist or gastroenterologist. We work alongside them with food protocols (autoimmune Paleo, low-lectin), gut repair, glutathione support, vitamin D optimization, and adaptogenic herbs to modulate stress response.

Our patients in this category report meaningful drops in flare frequency and labs (CRP, ANA titers, antibody levels) over 6–12 months. We document everything and share it with your specialty team.

The work-up usually involves a comprehensive metabolic and micronutrient panel (NutrEval), a four-point cortisol curve, ferritin, full thyroid, EBV titers if relevant, and sometimes mold/mycotoxin testing. From there we layer mitochondrial support (CoQ10, PQQ, B-complex, NAD+), targeted antivirals, sleep architecture rebuilding, and graded movement.

We're realistic: this category usually takes 6–12 months of patience. We pace the protocols carefully because patients in fatigue states crash easily. You'll feel better in stages, not steps.

Most patients in this track come in already working with a therapist or psychiatrist, or wanting to. We add neurotransmitter testing (organic acids), check methylation status (MTHFR, COMT), full thyroid, B12, vitamin D, and look for the dysregulations that medication alone often doesn't address.

Then we layer adaptogenic herbs (ashwagandha, rhodiola, holy basil), amino-acid therapy (5-HTP, L-theanine, GABA), targeted micronutrients, breathwork practices, and where appropriate refer for somatic experiencing or EMDR. For patients tapering off SSRIs, we build the transition slowly and in coordination with the prescribing doctor.

Standard work-up includes a full hormone panel (free + total testosterone, SHBG, estradiol, DHT, LH, FSH, prolactin, DHEA, full thyroid), comprehensive metabolic markers (HbA1c, fasting insulin, lipid subfractions), inflammation markers, and a sleep questionnaire. We refer for sleep studies when indicated.

Treatment varies — sometimes it's lifestyle and herbal optimization (tongkat ali, ashwagandha, fadogia agrestis), sometimes it's testosterone replacement, often it's both, plus thyroid support, weight loss work, and apnea treatment. We co-manage with urologists when needed.

Common case patterns: post-chemo fatigue, neuropathy, brain fog, hot flashes from aromatase inhibitors, GI dysfunction, sleep, anxiety. We focus on whatever's most disrupting day-to-day life and work it down the list.

We're explicit about scope: any herb or supplement that could interact with active treatment is run by the oncologist first, in writing. Mistletoe injections (as practiced in Europe) are available with appropriate oncology coordination. Dr. Reyes leads this track and has trained at the Helfgott Research Institute.