Meet Kim, a vibrant 69-year-old who walked into The UltraWellness Center frustrated with stubborn symptoms. Despite switching to a “Pegan” diet six months earlier, she still battled tinnitus, insomnia, and swollen hands. Though not her primary concerns, Kim also complained of constipation, eczema, sinusitis, anxiety, and headaches. Her HemoglobinA1c (HbA1c), a marker of your average blood sugar over the last 3 months, was 5.7%, prediabetes territory—and she wisely connected blood sugar swings to inflammation and poor sleep. Yet her efforts hadn’t moved the needle much.
Kim noticed her hands swelled after salty foods like fish sauce or tamari, though it eased after a few hours. Her tinnitus roared constantly for over three months, and she woke every night between 2 and 4 a.m., despite excellent sleep hygiene: Epsom baths, wind-down rituals, breathing exercises, and early dinners. Kim decided to do a functional nutrition consultation to see if there was anything about her diet that was interfering with her body’s ability to heal.
Getting to the Root: First Steps
We started with a comprehensive evaluation of Kim’s medical history, dietary and lifestyle patterns, and evaluated basic labs done through her primary care physician (PCP): iron, thyroid panel, vitamin D (all tinnitus suspects), plus fasting insulin, a continuous glucose monitor (CGM), and a sleep study. To dig even deeper, I also suggested a 3×4 Genetics cheek swab—a simple at-home test revealing diet- and lifestyle-tailored genetic insights.
For her constipation, we added herbal digestion and motility support, plus a supplement for circadian rhythm, sleep, and stress.
Lab Revelations Light the Way
Labs showed striking hypothyroidism (TSH 18.6) and high MCV/MCH signaling folate/B12 needs. Kim’s low-normal insulin levels, paired with her elevated A1c, indicated that hypothyroidism—not poor blood sugar control—was the primary driver of her HbA1c reading. Given the known link between hypothyroidism and tinnitus, I urged Kim to follow-up with her PCP for thyroid treatment.
I suggested further testing through Function Health labs (convenient and affordable!) to assess for low nutrients related to thyroid health. This second round of tests revealed low-normal ferritin (the storage form of iron), zinc, and iodine—key thyroid nutrients—plus signs of low-calorie intake, which can impact thyroid function.
Her sleep study showed mild sleep apnea, common in post-menopausal women.
Genetic Gems Unlock the Puzzle
The 3×4 DNA report was instrumental in connecting dots. We found:
- A variant slowing T4-to-T3 conversion (inactive thyroid to active thyroid hormone), so we increased her intake of zinc and selenium, two nutrients that support this conversion, using both food and supplements. Individuals with this variant often do best with combination T4/T3 therapy, so I flagged this for her doctor.
- Three variants that impair histamine clearance which can be linked to her headaches, eczema, sinusitis, anxiety, and insomnia. Histamine intolerance can manifest as a constant immune “hypervigilance,” which was keeping her awake at night.
- Methylation variants impairing SAMe production, the methyl donor needed for histamine breakdown by her already sluggish enzymes. Folate and B12 are key, and her variants required special forms—sublingual B12 in three types—to restore levels.
Tailored Action Plan
We worked on repleting nutrients found low on her testing and added histamine breakdown support. Kim took a break from high histamine foods like tamari/fish sauce, introduced diamine oxidase (DAO) enzymes which break down ingested histamine in the digestive tract, methylation support (B12, folate), worked on thyroid nutrients via food/supplements, and increased calories. This marked the start of Kim’s next healing phase: targeted dietary changes and closer attention to food-symptom links through her new genetic insights.
Beyond diet, Kim worked hard in other arenas. She incorporated daily morning and sunset walks, leveraging the healing power of outdoor light and movement to help with resetting her circadian rhythms. She also upped her exercise, noting energy expenditure during the day really helping with anxiety and her ability to fall asleep.
Progress on the Journey
Kim’s journey began before we met and continued beyond our work together. We made progress in understanding the why of her symptoms and further refined her diet to address the gaps found through testing. Kim’s sleep improved with histamine focus, plus adding in more exercise. After six months, she moved on to work with a histamine specialist and the sleep gains continued! The tinnitus lingers unfortunately, but she has a plan to work with a specialist in the coming months.
Healing is often a winding road with starts, stops, and surprising insights. In-depth Function Health and 3×4 genetic testing paired with comprehensive nutrition evaluation, skilled interpretation of her multiple tests, and a personalized diet plan provided Kim’s major breakthrough, propelling her forward. What’s your health puzzle? Testing might hold the key.
