Connie Casebolt, MD: Getting Back to the Fundamentals

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When you’re teaching or coaching a sport, you’ve always got to go back to the fundamentals. So what are the fundamentals of good health? First of all, we’ve got to make sure there’s good gut health, so we take a history. We find out what you’re eating. Do you have bloating? Are you eliminating properly? We want to make sure that’s all on track.” — Connie Casebolt, MD

You could say that Dr. Connie Casebolt has a gut feeling about what ails most of the patients she sees in her practice.

“We typically will find things like dysbiosis, which is an improper collection of bacteria in the gut,” Dr. Casebolt explained. “We also will find leaky gut — where your gut cells are supposed to be tight together. We call it ‘tight junctions.’ Leaky gut is big, gaping holes. And, so, bad things that shouldn’t be absorbed end up getting into your system. So we assess for that.”

Dr. Casebolt sees gut dysfunction as a potential culprit in conditions such as Lyme disease, fibromyalgia, food allergies, skin rashes, and more. She agrees with Suzanne Somers that leaky gut (also known as increased intestinal permeability) can be a result of gluten sensitivity even in the absence of celiac disease. It can also be caused by lipopolysaccharides that are the byproduct of gram-negative bacteria in the gut, which supports her statement concerning the culpability of unwanted collections of bacteria in leaky gut syndrome. “We do have some protocols that we use,” Dr. Casebolt shared. “We can test for leaky gut, and then we put people on certain dietary regimens and supplements. It takes time, but the leaky gut can get healed. That’s the good news.”

Blood testing is an essential component of Dr. Casebolt’s patient evaluation. A panel that evaluates fibrinogen, CRP, and myeloperoxidase indicates the level of inflammation that may be present in many patients. Increased fibrinogen which, when elevated, means that blood has a greater tendency to clot, can be associated with Lyme disease, heart disease, and cancer. This can often be countered by something as simple as drinking more water. Additionally, the supplement nattokinase, which is derived from soy but doesn’t provoke allergies in soy-sensitive individuals, can help.

She also looks at the patient’s vitamin D level. “I find if a person has any immune system challenge, if their vitamin D level is low, I cannot help them until we get it back up again.”

“This is where you want a doctor who’s trained in the functional lab values,” Dr. Casebolt recommended. “Because if I get a test from any of the common labs, they’re going to say 30–100 (nanograms per deciliter 25-hydroxyvitamin D) is fine. Well, 30 is very low in my book.”

Replying to Suzanne Somers’ question about how much vitamin D we need to take, Dr. Casebolt said the recommended daily allowance is woefully inadequate. She finds that most adults need 5,000 IU per day. However, the amount that someone takes should be guided by the results of periodic blood tests.

Blood testing should additionally assess vitamin B12 and minerals, particularly magnesium. The organism that causes Lyme disease lowers the body’s magnesium level, which can be the cause of some of the achiness and fatigue that characterizes the disease. Therefore, supplementing with magnesium becomes critical. Dr. Casebolt recommends magnesium glycinate and magnesium malate although she notes that, if consumed to encourage proper elimination, any kind of magnesium will do. Vitamin C is also helpful for this purpose.

According to Dr. Casebolt, there’s a lot of overlap between Lyme disease and fibromyalgia. One needs to fix the patients’ nutrition and their gut, and elevate their levels of magnesium, vitamin B12, and vitamin D. People with fibromyalgia are often low in thyroid hormone as well as sex hormones. She has found that some cases believed to be fibromyalgia are, in actuality, hypothyroidism. To assess thyroid status accurately, a patient needs to undergo a blood thyroid panel that includes T4, T3, TSH (thyroid stimulating hormone), reverse T3, and the two thyroid antibodies. Symptoms of low female hormone levels, such as fatigue, insomnia, and brain fog can also be present in someone with fibromyalgia. If diet, supplements, and thyroid and other hormones can be addressed, 80% to 90% percent of the time the patient is going to get at least 80% percent better.

Treatment options can include intravenous therapies individualized to the patients’ needs. Vitamin C is often used for Lyme disease, detoxification, and quality of life issues. Also used is Myers’ cocktail, which is a combination of vitamin C, magnesium, and B vitamins, to which Dr. Casebolt adds the trace minerals zinc and selenium (which are typically low in most people). “The advantage of intravenously administered nutrients is that if someone has gut function that may be compromised — maybe they can’t absorb like we want them to — you can put these nutrients in an IV and the cells just soak it up like a sponge. They’ve got instant access to all of these nutrients. Sometimes we see some amazing results with energy right away.”

Suzanne Somers noted that the information imparted by Dr. Casebolt is not commonly understood by doctors. “That’s why you have to find a doctor such as Dr. Casebolt who’s gone out on a limb to re-educate themselves on what they didn’t learn the first time around in medical school,” she said. “Going to a doctor who hasn’t chosen to specialize in this arena is like going to a plumber for a heart bypass.”

Referring to the name of Dr. Casebolt’s practice, which is “Wellness by Design,” Suzanne observed: “There is just a new way to approach health, and that is what you are doing here.”

“You’re dealing on two levels,” Suzanne remarked. “One is if you have a condition — if it’s lupus or fibromyalgia or M.S. or Lyme disease. But, on the other hand, in your ‘Wellness by Design,’ you’re essentially making them well and it’s the new concept of a patient going to the doctor to remain well. It’s just such a wonderful concept. It makes so much sense.”

“On one side, you’re treating the negative conditions,” Suzanne noted. “On the other side, your practice is about quality of life and restoring quality of life.”

“This is what I teach people because we incorporate a curriculum,” Dr. Casebolt agreed. “We have a full-time health coach. We actually conduct classes here. We’re always trying to teach people, so that they have an ongoing understanding of what they need to do to stay healthy. And it’s pretty basic: It’s diet, it’s detox, it’s proper sleep, it’s maintaining adequate hormones. It’s not rocket science. But it works.”

“The wrap up,” Dr. Casebolt concludes, “if anybody wants to manage the aging process . . . they need to seek out a center like this where we have this comprehensive holistic approach that’s going to work, instead of just putting Band-Aids on, which is what drugs are. That’s my message to folks. Find a place where you can get this holistic thing that works for you and then you’re not doomed to chronic illness.”

To learn more about Dr. Connie Casebolt in Greenville, SC - visit her Forever Health profile.

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