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Real Life Case Study by Dr. Davina Soernssen DNP, FNP-BC, DCNP
Client Profile:
Name: John Doe
Age: 52
Condition: Vaso Vagal Syndrome
Duration of Condition: 25 years
Practitioner: Dr. Davina Soernssen DNP, FNP-BC, DCNP
Facility: The Med Spa at Clinical Edge
Background:
John Doe, a 52-year-old male, has been suffering from Vaso Vagal Syndrome for 25 years. His symptoms included frequent fainting spells, dizziness, and severe fatigue, significantly impacting his quality of life and even triggered several 911 calls. Cardiology workups using a traditional approach provided no relief, prompting him to seek a more holistic and regenerative medicine approach. Eliminated triggers that included inflammatory foods helped make his episodes less frequent and severe but still was not completely effective.
Vasovagal Syndrome, also known as vasovagal syncope, is a common cause of fainting due to a sudden drop in heart rate and blood pressure. This condition is typically triggered by factors such as prolonged standing, emotional stress, pain, or seeing blood. Here's how it happens:
Trigger: A trigger (e.g., emotional distress, prolonged standing) activates the vagus nerve.
Vagal Stimulation: The vagus nerve (part of the parasympathetic nervous system) overstimulates, leading to a decrease in heart rate (bradycardia) and dilation of blood vessels (vasodilation).
Blood Pressure Drop: The combined effect of decreased heart rate and vasodilation results in a significant drop in blood pressure.
Reduced Brain Perfusion: The drop in blood pressure reduces blood flow to the brain, leading to dizziness, lightheadedness, and often loss of consciousness (syncope).
Symptoms: Patients may experience dizziness, nausea, sweating, pallor, and blurred vision before fainting.
Regenerative Medicine Approach
Gut Dysbiosis refers to an imbalance in the gut microbiota, where harmful bacteria outnumber beneficial ones. Leaky Gut Syndrome involves increased intestinal permeability, allowing bacteria, toxins, and undigested food particles to enter the bloodstream, some of which can cling to the vagus nerve and travel from the gut to the SA node in heart and even all the way up to the brain.
How Gut Dysbiosis and Leaky Gut Relate to Autonomic Dysfunction
Chronic Inflammation:
- Mechanism: Dysbiosis and leaky gut can lead to systemic inflammation. The translocation of microbial products like lipopolysaccharides (LPS) from the gut into the bloodstream triggers an inflammatory response.
- Impact on Autonomic Nervous System (ANS): Chronic inflammation can affect the ANS, leading to dysregulation. This may manifest as vasovagal syncope or postural orthostatic tachycardia syndrome (POTS).
Immune System Activation:
- Mechanism: Persistent gut permeability can cause continuous activation of the immune system.
- Impact on ANS: Immune system activation can lead to autonomic dysfunction, contributing to symptoms of both vasovagal syncope and POTS.
Nutrient Absorption Issues:
- Mechanism: Gut dysbiosis and leaky gut can impair nutrient absorption, including vitamins and minerals critical for nerve function, such as B vitamins.
- Impact on ANS: Deficiencies in these nutrients can impair autonomic function, leading to symptoms of autonomic dysregulation.
Enteric Nervous System (ENS) Connection:
- Mechanism: The ENS, often referred to as the "second brain," is directly connected to the CNS via the vagus nerve. Dysbiosis and leaky gut can disrupt ENS function.
- Impact on ANS: Disruption in the ENS can affect vagal tone and lead to autonomic symptoms, including vasovagal syncope and POTS.
Vasovagal Syncope:
Gut-Brain Axis:
- The gut-brain axis involves communication between the gut microbiota and the brain via the vagus nerve. Dysbiosis can disrupt this communication, leading to altered vagal activity and increased susceptibility to vasovagal syncope.
Inflammatory Mediators:
- Increased levels of inflammatory mediators from gut dysbiosis can affect the baroreceptor reflex, leading to inappropriate vasodilation and bradycardia, which are hallmark features of vasovagal syncope.
1. Finding the inflammatory mediators by Testing the Gut Biome
Dr. Davina started with comprehensive gut biome testing, which revealed an overgrowth of Enterobacter cloacae and Candida parapsilosis. These pathogens were contributing to systemic inflammation and exacerbating John's Vaso Vagal symptoms.
2. Removing Harmful Ingredients from the Diet and Reseeding the Gut Biome:
Following the antimicrobial phase, Dr. Davina focused on removing other harmful ingredients from John’s diet that could trigger Vaso Vagal responses and contribute to gut dysbiosis.
Treatment:
Antimicrobial Therapy: John was prescribed a tailored course of natural and pharmaceutical antimicrobials to reduce the overgrowth of harmful bacteria and yeast.
Dietary Adjustments: He was placed on a low-sugar, anti-inflammatory diet void of processed foods, whole grains and glutens to starve the pathogens and support a healthy gut. John was started on a diet rich in antioxidants, polyphenols, essential fatty acids and aminos acids, and medium chained fatty acids (MCTs).
Reseeding the Gut: Following antimicrobial therapy, a regimen of high-quality probiotics and prebiotics was introduced to reseed the gut with beneficial bacteria. Foods rich in natural probiotics, like fermented sheep yogurt, were incorporated into his daily meals.
3. Testing DNA Status for Detoxification, Methylation, and Inflammation Pathways:
To tailor the treatment further, Dr. Davina conducted DNA testing to assess John’s genetic status concerning detoxification, methylation, and inflammation pathways. This personalized genetic insight allowed for targeted nutritional and supplemental support.
The following High impact genes were identified and addressed in order to support John detoxification, inflammation and methylation pathways.
The following high impact genes were identified that could negatively impact John's autonomic nervous system if his body was chronical inflamed.
ACE II : Lower blood pressure, reduced cardiovascular risk, enhanced endurance performance but also contributing in a negative way during a vasovagal episode.
COMT GG: Faster breakdown of dopamine, increased risk of anxiety and stress-related disorders.
CYP2R1 GG: Reduced vitamin D activation, higher risk of vitamin D deficiency.
GSTT1 DEL: Reduced detoxification capacity, higher oxidative stress, and potential cancer risk.
IL-1+: Increased inflammatory response, higher risk of inflammatory conditions.
MAOA GG: Slower neurotransmitter breakdown, increasing his risk for the ability to regulate his autonomic system.
Outcome:
Using a variety of dietary changes and supplements to improve his detoxification, inflammation and methylation pathways tailored to his needs John experienced a remarkable reversal of his symptoms. His fainting spells completely ceased, and he reports increased energy levels and overall enhanced well-being to this day. The targeted approach of addressing gut health, personalized dietary changes, and genetic-based supplementation proved effective in managing and reducing the symptoms of his long-standing Vaso Vagal Syndrome.
Conclusion:
John Doe's case demonstrates the potential of a regenerative medicine approach in treating complex and chronic conditions like Vaso Vagal Syndrome. By addressing gut health, removing harmful dietary elements, and providing personalized genetic support, Dr. Davina at The Med Spa at Clinical Edge successfully improved John's quality of life, showcasing a holistic pathway to health and healing.
If you or someone you know is struggling with Vaso Vagal or POTS syndrome call or text 609-336-3313 and find out how the Med Spa at Clinical Edge can help.
References:
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4. Schemann, M. (2005). The enteric nervous system: Pathophysiology and clinical implications. Neurogastroenterology & Motility, 17(3), 199-209. doi:10.1111/j.1365-2982.2005.00687.x
5. Aponte, M. M., & Zierler, M. A. (2021). Postural orthostatic tachycardia syndrome (POTS) and the role of the gut microbiome in its pathogenesis. Journal of Clinical Medicine, 10(4), 742. doi:10.3390/jcm10040742
6. Turnbaugh, P. J., Ley, R. E., Mahowald, M. A., Magrini, V., Mardis, E. R., & Gordon, J. I. (2006). An obesity-associated gut microbiome with increased capacity for energy harvest. Nature, 444(7122), 1027-1031. doi:10.1038/nature05414
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