Gil Winkelman ND

Restore your heart-body-brain balance for optimal health

You are here: Home / Archives for Uncategorized

How to Benefit from Online Doctor Consultations

by 6 Comments

Online doctor consultations are becoming more popular. And why not? Patients don’t have to travel to the office, park the car, and wait for the doctor. You can stay in the comfort of your home and consult with the doctor through your computer or phone. But are online doctor appointments good for everyone? Not likely. But for many people, virtual medical visits provide a simple approach to medical care. Let’s explore what online doctor consultations look like with Dr. Gil and what sort of conditions are appropriate for treatment.

Online Doctor Consultations with Dr. Gil

Dr. Gil has been using telehealth services for mental health for many years. The process begins with either a phone call or email and determine if labs need ordering. If you have the correct labs run relatively recently, there’s no need to repeat them just yet. Sometimes Dr. Gil orders additional labs, especially if you attempted similar treatments that didn’t work or only had partial results. Labwork performed by other providers may be reviewed before your appointment.  Labs aren’t required for every patient before the first appointment but can expedite the treatment process. For most patients in the US, we can arrange for the lab collection to occur near your location. Outside the US, some results are challenging but not impossible to obtain. The office staff assists as best it can to help you get what is required.

Before the appointment, you will fill out an extensive questionnaire that combined with the lab results helps Dr. Gil uncover possible causes of the ailment.  The first appointment lasts up to an hour whereby Dr. Gil comes up with a treatment plan for your condition. You can merely order the vitamin and supplements from Dr. Gil’s medicinary or obtain through another source.

Conditions Treated During Online Doctor Consultations

It is difficult to say what conditions can or cannot be treated online. New technologies are making it possible to do medicine via telehealth services. Dermatology, for example, is moving to a model that allows doctors to diagnose skins conditions via online doctor consultations. Some situations require an in-person visit before telehealth services will be useful. The Walsh Protocol, a system that uncovers nutrient deficiencies causing mental health issues, can be productive using telehealth services for mental health.  Some of the conditions that Dr. Gil treats using online doctor consultations include:

Insurance may or may not cover telemedicine visits but may reimburse the lab fees. Check with us first about whether coverage is possible. Neurofeedback services typically require appointments to be in-person.

Demand for online doctor visits has increased as patients discover its advantages.  Find out for yourself how easy it is to get help for you or your family member. Schedule today for a free pre-consultation.

The Colossal Mistake of Everyone Taking Methylated Folate

by

NB: This article was modified March 2024. I am offering two new courses about this. The short course covers the specifics of folate, what to do, how to figure out if there’s an issue, and a decision tree to determine what to do if you have trouble with folate. The longer course goes into other problems related to anxiety and other mental health issues

(I also published this article in Holistic Primary Care about the topic.)

I get a lot of questions about the methylation cycle and taking methylated folate. In articles and podcasts, I go into great detail about undermethylation. This causes a lot of confusion amongst patients because most providers don’t understand the full impact of methylated folates. Folate is a wonderful vitamin for many people. But for undermethylators, folate can cause problems. Why is that? To understand the issue, we have to first understand more about the methylation cycle, DNA, and why genetic tests may not be the right approach.

Methylated folateUndermethylators are one of the primary subtypes described by the Walsh Protocol. To understand why folate is a problem for them, we should discuss undermethylation.

Methylation is the process where DNA gets “tagged” by a small hydrocarbon group. Methyl is one carbon and three hydrogens. Carbon can bond to four different atoms, so a methyl group has one spot that allows it to attach somewhere else. The body uses methyl in many reactions and one of them is to turn off DNA.

How does it do this?

Though we are not exactly sure, methyl groups change the charge of chromatin, making it bind tighter to histones. What does this mean? The DNA is less accessible for transcription, so turning off those genes. Acetylation has the opposite effect. Here DNA becomes more available and turns genes on. Folate appears to increase acetylation of chromatin, though the mechanism is unknown.

One gene methyl turns off is the serotonin reuptake gene. Folate or folic acid appears to turn this gene on. If you have too much serotonin reuptake happening, serotonin levels will be low. If you have too little reuptake, serotonin will be too high. (Yes, you can have too much serotonin in your body and some people do.)

Undermethylators with anxiety or depression are vulnerable to folates. The folates turn on the serotonin reuptake gene that is already not downregulated because of the lack of methyl. For some people, they find that a sudden intake of folic acid causes a precipitous drop in mood or exacerbation of symptoms.

This gets further complicated when you add in high S-Adenyl-Homocysteine (SAH) a substance that regulates the enzyme methyltransferase. (This is a topic beyond the scope of this article for the moment. But the plasma methylation test is a wonderful way to determine if one is an undermethylator and the best treatment approach.)

NOTE: If you are a pregnant woman, it is advisable to have your folate levels measured to determine the amount of folate to take.

What about Methylated Folate?

What about methylated folate? Isn’t that supposed to help undermethylators? Many providers prescribe it because folate is intimately involved with recycling homocysteine into methionine. This drives the production of methyl in the 1-carbon cycle in the body. But Dr. Walsh has shown something odd about this. All folates turn on the serotonin reuptake gene so that serotonin levels drop and you have a recipe for problems. Likely, this happens because the DNA responsible for the production of the SERT gene has greater exposure to transcription factors. Increasing methyl causes this to reverse so there is less transcription of the gene.

Having said that, many undermethylators show temporary improvement because of taking methyl folate. After two to three months, the person devolves again. The methyl donation from the methyl folate gets overshadowed by the effects of folate on the body. So the person gets worse.

This is when patients call me. Fortunately, it’s not too late to feel better under this circumstance. A proper treatment plan can benefit everyone. Undermethylators respond slowly; some people may not get a benefit for almost a year after treatment starts.

To learn more about methylation, I’m planning a course that goes into greater detail about the topic and how to recognize the differences between overmethylation, undermethylation, and another underlying issue. A deeper course covers more information  Or if you think you may be an undermethylator or overmethylator, call today to schedule an appointment. Let me review your medications and supplements to ensure you are taking what is right for your healing process.

What you Need to Know About Getting Pyroluria Disorder Symptoms

by 8 Comments

Pyroluria is more common than previously though. Pyro-what? What is this disease? The word pyroluria is a combination of pyrrole and urine. It refers to a molecule that shows up in the urine in most people.  There are different things that can cause pyroluria. For many people, pyroluria treatment can be life changing.  And many kids with Reactive Attachment Disorder or RAD Disorder have pyroluria. Behavior problems can disappear with simple natural treatments. Pyrrole Disorder symptoms are diverse. Let’s explore what pyrrole disorder is and what the symptoms look like.

Pyroluria is a condition that leads to an incomplete breakdown of red blood cells. This causes the formation of small molecules called kryptopyrroles that bind to zinc and B6 in the body. As a result, the body registers a deficiency of both those nutrients. There are many theories about what causes pyroluria but the reality is that we don’t know.  It is definitely a sign of inflammation in the body. Some of the possible causes are as follows:

  • Genetics. Pyroluria does seem to run in families. I have tested kids who are siblings where both have had it many times. But not all the time. If a relative suffered from depression, schizophrenia, bipolar disorder, alcholism, or another mental health condition, get tested.
  • Childhood Trauma. There may be an epigenetic component to the condition. Trauma may cause a rise in inflammation in the body and lead to this condition.
  • Chronic infection. It is difficult to know if the problem exists because of the infection or if the lack of zinc leads to poor immunity.
  • Alcoholism of the sufferer or parents.
  • Environmental toxicity. Heavy metal poisoning in particular could play a factor in the cause of pyroluria.
  • Processed foods. A standard American diet of processed foods and sugar can stress the body out and lead to absorption problems.

Stress may be a trigger to pyroluria or it could be a result of it. It is not clear at the moment.

What are Pyrrole Disorder Symptoms?

Pyroluria has some distinct symptoms. I have a questionnaire that helps people determine if they have the condition. Most of the symptoms that I see in my practice revolve around mental health problems. But many people experience problems with other areas of the body.  Let’s start with the mental health symptoms first though.

Mentally, people feel stressed. There is a high amount of severe inner tension or anxiety. Tolerance to stress is low. For example, someone who easily stresses out with minimal traffic may have pyroluria. Social withdrawal is common as is sensitivity to crowds.

But more severe mental health symptoms exist too. There can be periods of mild to severe depression followed by hyperactivity. Episodic anger outbursts or other mood swings are common. Panica attacks or severe anxiety. They may enjoy an argument but be upset by criticism. In severe cases, pyrolurics may hallucinate or have delusion disorder.

Physical symptoms also exist though. Here’s a partial list:

  • Fatigue easily likely due to nervous exhaustion.
  • Insomnia.
  • Poor dream recall
  • Ringing in the ears.
  • Digestive disturbances including irritable bowel, abdominal pain, and frequent gas and bloating. (They may have tried avoiding meat as a way to deal but this actually makes the problems worse as we’ll see.)
  • Gluten intolerance
  • Blood sugar control. There may be hypoglycemia with blood sugar drops.
  • Allergies to food or the environment
  • Frequent illnesses
  • Morning nausea and poor appetite in the morning. They may skip breakfast.

There are some people who have few of these symptoms but may still have pyroluria. You may have done blood work for zinc for example and shown that it is normal but still have symptoms of zinc deficiency. This is typically caused by pyrrole disorder. So what can you do? My article about pyroluria gives suggestions but the short answer is get tested! I can do pyroluria testing and help develop a custom treatment plan via telemedicine services. Call today to learn more.

Contact Me

P: 808-726-2772 (phone and text)
F:503-200-1044
E: info@askdrgil.com

Recent Posts

Ask Dr. Gil Podcast

Dr. Gil Winkelman ND

36 episodes