Nurse Practitioner

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Lisa Wilkinson, NP
Rudy Spector, NP

Medication and Supplement Management

Lisa and Rudy’s initial interview with a new client, whether for medication management or alternative treatments, encompasses a discussion of your history, physiology, and lifestyle. They believe in a comprehensive approach to working with you and, with your permission, will collaborate with your family practice physicians, the school counselor, or other healthcare providers to enhance communication and positive outcomes for you. Lisa and Rudy will sometimes use laboratory testing or other diagnostic techniques to determine the source of the symptoms you may be having. Together, you and your Nurse Practitioner will formulate a plan to improve your mental health which may include therapeutic lifestyle changes, supplements, and prescriptive medications. If it is your goal to taper off your medications, Lisa and Rudy will also work with you on tapering off psychiatric medications, and use alternative approaches to support mental well being.

Psychiatric initial consultation:
-A 2-hour in depth interview exploring physical symptoms, lifestyle choices, nutrition and mental health questions. I believe that taking the time to explore contributing factors as well as current symptoms allows us to form a plan to move a client back to health and well being. I have extensively studied psychiatry from a functional medicine perspective, looking at the mind and body as a whole interactive unit. I believe the body has an innate ability to heal and utilizing an integrated approach allows the body and mind to heal.

Medication checks (1/2 Hour) to monitor effectiveness of the treatment process

Collaboration with your primary care physician, therapist and/or functional medicine physician to enhance the healing process.

Additional Testing and evaluation available if warranted:
Micronutrient Testing-
Be Proactive, NOT Reactive
Traditionally, a person waited to go to the doctor at the first signs of a symptom. Today, individuals are looking for way to not only manage illness with personalized treatment plans, but they are also seeking to achieve a higher level of wellness.
Eating a balanced diet, exercising and taking a multivitamin is simply not enough. Each person’s body is unique in its own way. Due to the complexity of the human body, an individualized healthcare approach is one of the best ways to guarantee optimal results.

What is Micronutrient Testing?
Spectra Cell’s Micronutrient tests measure the function of 35 nutritional components including vitamins, antioxidants, minerals and amino acids within our white blood cells. Scientific evidence shows us that analyzing the white blood cells gives us the most accurate analysis of a body’s deficiencies.

What results will I see?
Spectra Cell’s Micronutrient lab results include an overview page with all deficiencies listed, numeric and graphic reports easily identifying deficiencies and repletion and supplementation recommendations.

Spectra Cell’s Micronutrient test includes:

Vitamin, mineral and antioxidant deficiencies have been shown to affect the function of the immune system, which can contribute to degenerative processes such as arthritis.

The Diagnos-Techs Adrenal Stress Index (ASI) is a noninvasive way to evaluate the effects of stress on your body. It includes 10 tests for six different hormones and immune markers that may be affected by chronic stress and stress-related conditions.

The Adrenal Rhythm and Its Importance
The adrenal glands secrete cortisol in a 24-hour cycle (circadian rhythm), with the highest amount released in the morning and the lowest amount released at night. This 24-hour cycle is called the circadian rhythm and is depicted below in Figure 1.

Certain situations such as stressful events, skipping or delaying meals, or sleep disruptions can cause the adrenals to secrete excess cortisol. Abnormal cortisol levels can have widespread effects throughout the body and may contribute to a wide range of health conditions, but treatment options are available if these abnormalities are detected.
Cortisol levels can influence:

Energy Production
Abnormal adrenal function can alter the ability of cells to produce energy for the activities of daily life. People who have a hard time rising in the morning, or who suffer from low energy throughout the day, often have abnormal adrenal rhythms and poor blood sugar regulation.
The maintenance of a stable blood sugar level depends on food choice, lifestyle, adrenal function, and insulin activity. The Adrenal Stress Index panel measures stress hormones and insulin, to help clarify the causes of fatigue, cravings, and obesity.

Immune System Function
Various immune cells (white blood cells) cycle in and out of the spleen and bone marrow. The immune system trafficking follows the cortisol cycle. If the cycle is disrupted, especially at night, then the immune system is adversely affected.
Short- and long-term stress is known to suppress the immune response in the lungs, throat, urinary tract, and intestines. With lowered levels of mucosal antibodies (secretory IgA), our resistance to infection is reduced and allergic reactions may increase.

Skin Integrity
Human skin regenerates mostly during the night. With higher night cortisol values, less skin regeneration takes place. Therefore a normal cortisol rhythm is essential for optimal skin health.

Muscle and Joint Function
Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint wasting with chronic pain.

Bone Health
The adrenal rhythm determines how well we build bone. If the night and morning cortisol levels are elevated, our bones do not rebuild well, and we are more prone to osteoporosis. Stress is the enemy of the bones. In postmenopausal women, the effect of stress worsens due to the naturally lower levels of female hormones.

Allergies/Autoimmune Disorders
More than fifty years ago, Dr. Jefferies (author of Safe Uses of Cortisol) discovered that patients with environmentally triggered allergies and autoimmune diseases dramatically improved when given cortisol for other purposes. More recently, German researchers reported that disruption of the adrenal axis and cytokine relationships lead to predisposition and aggravation of autoimmune diseases. The ASI panel can help identify patients with autoimmune diseases and adrenal problems who may improve with cortisol support.

Sleep Quality
The ability to enter REM sleep cycles and to experience regenerative sleep are interrupted by high cortisol values at night and in the morning. Chronic lack of REM sleep can reduce a person’s mental vitality, vigor, and induce depression.

Thyroid Function
The level of cortisol at the cell level controls thyroid hormone production. Often, hypothyroid symptoms such as fatigue and low body temperature are due to an adrenal maladaptation.

Blood Sugar Regulation
Chronic hypoglycemia can impair normal adrenal function by repetitive overstimulation of cortisol production. Recurring exposure to high cortisol will impair insulin activity and invariably lead to insulin resistance and beta-cell exhaustion (diabetes). The ASI panel investigates the insulin-cortisol relationship under real-life conditions to allow targeted and meaningful interventions. This panel is useful in the following clinical situations: rapid weight gain and obesity, imbalanced blood lipids, sugar blues, early diabetes, and associated emotional disturbances.

Brain Function and Emotional Health
Several recent publications report a hyperactive HPA axis in depressed patients. Elevated midnight salivary cortisol is now considered one of the best tests in diagnosing endogenous depression. Other anomalies in cortisol rhythm usually accompany the midnight elevation. On the other hand, cortisol elevations and rhythm disruptions throughout the day are typical of attention deficit disorders (ADD). The anomalous cortisol findings in depression and ADD can be diagnosed successfully with the ASI panel. Subsequent interventions to rectify specific cortisol elevations (during the day or night) are usually effective when applied under proper supervision.

Five saliva samples are used to assess the following: