An Integrative Pediatrician Answers More of Your Questions
A couple years ago, I had the opportunity to hear integrative pediatrician, Dr. Lisa Loegering, speak at a parenting event. I was impressed.
I remember taking copious notes and thinking to myself, this doctor knows her stuff and, boy would I love to interview her for the blog!
Fast forward to a few weeks ago when she graciously agreed to do an interview. She has a wealth of wisdom and expertise that I'm absolutely thrilled to share with you.
So, without further ado, here's the interview...
1.You had a regular western practice for many years before opening an integrative practice. Tell us a little about your background and how you became an integrative pediatrician.
I went to medical school at UCLA, where I did my pediatric training as well as an extra fellowship in developmental pediatrics. I started my career at Scripps Clinic with a traditional pediatric practice in which I also focused on developmental pediatrics.
I ended up eventually leaving Scripps Clinic because I got burned out. Western medicine is a rat race. You are seeing lots of kids and constantly prescribing antibiotics. When I was there, I was always interested in integrative medicine/ alternative medicine. I would work with patients with other providers, like herbalists, and would see that they would do quite well but I didn’t have the training to prescribe the herbs.
This was before the internet and it was hard to figure out where to get additional training. Once things became more accessible, I was able to start retraining. I began at the Institute for Functional Medicine. I loved it because everything was science-based and there was extensive training. So, that was my baseline training in integrative medicine. But, there wasn't a lot of information on pediatrics, so I had to go further and look at other groups to get that training.
I was then able to open up my integrative practice, which I've had for the past four years.
2. So many families I work with have the same story- they are concerned about their child’s development. They have noticed some “peculiar” behaviors and feel like something is “off” with their child’s development, yet when they bring their concerns up with their pediatrician, they are dismissed and told, “let’s just keep an eye on it,” or “all kids develop at a different pace, this is nothing to worry about.”
In your opinion, what are the strengths and weaknesses of western medicine and western trained doctors when it comes to addressing a child’s developmental challenges?
Now pediatricians are more alert for signs of Autism, but there isn't any training in residency on developmental pediatrics. When there are mild developmental issues that don't fit into a specific category, then pediatricians figure, there’s no treatment, so let's just wait and see - it will declare itself later. If it's a severe case, for example, a 4-year-old who isn't talking, that will get referred. But the milder developmental issues frequently get overlooked.
Since many of the neurodevelopmental disorders are not included in the curriculum during medical school, I think pediatricians figure, there’s not much I can do about it, so there’s nothing to treat.
When my daughter was two, she was having trouble with her enunciation. I immediately went to a speech therapist and also made the decision to hold her back a year from starting kindergarten. I was fortunate because I knew what to do. But, for many parents who have children with milder issues, they have no one to help guide them through decisions about therapy and school.
Most health plans do have some coverage for speech and occupational therapy and most pediatricians know about these services. If parents suspect something is off, they can push for a referral for an evaluation. Sensory processing problems tend to show up more severely when kindergarten hits. But, parents can do things earlier. The OT and speech therapists are where they want to start.
3. You specialize in working with children who have developmental challenges. Can you tell us a little about the patterns you’ve seen as far as the root causes of their dysfunction?
There are a number of things I think of as root causes that are applicable to more severe cases. I'm not sure I’m seeing a lot of the milder cases in my practice. Of the group I see, there are underlying genetic abnormalities that lead to abnormal brain chemistry, which is made worse by our stressful culture, processed food, and environmental toxins.
The tests I run are tests that western doctors don’t even know exist. And for a lot of testing, they don’t know the normal ranges. The normal range from a Labcorp lab is not based on optimal brain function. Western doctors will say "oh they’re fine," but they’re not fine.
If you think your child might have an underlying biochemical abnormality such as lower serotonin or dopamine, the lab I use, DHA Laboratory, has an online system where you can purchase a package of labs, have them drawn at Labcorp and then purchase a consult to go over the results. This can be done anywhere in the country.
Methylation is a chemical reaction that occurs in every cell in the body and is responsible for at least a hundred different jobs including creating serotonin and dopamine and breaking down toxins.
Kids with a low methylation cycle tend to have low serotonin and/or low dopamine which can present as anxiety or ADHD. These are the kids who are oppositional, argue about everything and have difficulty focusing.
It's something that often runs in families. It isn't the whole story of the child's struggles but is part of the picture. Fortunately you can use nutrients to boost up the cycle so the body is able to produce more of those neurotransmitters and the child becomes more regulated.
With pyrrole disorder, you see sensory integration issues, aggressive behavior, meltdowns, moodiness, anxiety, poor emotional regulation, violent and explosive behavior
4. Why aren’t more western doctors trained to understand these root causes?
It's not part of the training and they’re even suspicious of it. The young doctors are trained by old doctors who think alternative treatments are a scam. They think there's no science to back it up, but they haven’t actually looked at the data.
The research on alternative medicine is not in the journals that pediatricians read. It is in scientific journals, but just not the ones pediatricians read. Now with the internet, they could access the data, but they don’t seem to be too interested in doing that.
They don’t understand how nutrients work to support the system and will tell you it’s a scam. But, they haven’t gone back to the data.
5. What do you wish more families of children with developmental challenges knew?
There are two big things that are really important for parents to know.
Parents who have violent children don't want to talk about it. They are embarrassed and it's often kept a secret. Parents need to know that almost one hundred percent of these children have biochemistry that is off.
They need to know that they are NOT bad parents!
They can’t rely on their western-trained medical professional to know anything about this. For this group, the Walsh Institute is a great resource. Parents have to start researching the biochemical causes of violent behavior. When the biochemistry is treated and rebalanced, it makes a huge difference. So, parents need to know that if they have a violent child, they need to start looking at the biochemical causes and not blame themselves.
For Autism, parents need to know that if they can start early enough, their kids can get better. The earlier the better so don’t wait! MAPS is an organization I’ve trained with, it's a group of doctors who specialize in Autism and it's a wonderful resource for parents.
Parents have to be their child's advocate. A lot of it requires researching and figuring out things on your own, but there are many trusted professionals out there who can help. If you have a violent child, choose someone who is familiar with the Walsh Institute and if you have an Autistic child, look for a MAPS trained doctor.
There is a wonderful organization called TACA that provides mentoring for parents of kids with autism. You can be assigned a mentor who can help you through the phases of treatment and give you guidance.
6. Can you give a few examples of cases with a patient who was struggling with behavior, learning and/or attention issues and through testing, you discovered a physical or chemical imbalance, were able to treat it and saw a significant improvement in the child’s functioning?
I had an 8-year-old patient who was from a wonderful family but was struggling with very aggressive behavior. He wasn't able to attend a regular school, he tried to attack me during our first visit and tried to attack the psychologist he was seeing as well. The family was really struggling, they couldn't take him out in public.
I couldn't order labs because we were afraid he’d attack the phlebotomist, but I was able to do testing through hair and urine. It turned out he had high copper, so we treated that through supplementation.
Once his system became more balanced, his parents reported that he was doing much better. He still gets frustrated, but he cries instead of attacking. He’s more social and the family is very happy.
Prior to seeing me, he was on a low dose of medication. He would have been a perfect candidate for getting overly medicated since that’s the only thing in western tool box. Luckily we were able to get him off the meds and treat him through supplementation, which involved taking a high dose of zinc. It takes a lot of zinc to help the body get rid of excess copper. It's not dangerous or difficult, and it’s a protocol that's based on a study with thousands of patients.
I aslo had a 5-year-old, who said he was going to commit suicide. It turned out that he had high pyrroles. We treated it through supplementation and he improved dramatically.
Another example is a child who was mildly autistic child and was chronically constipated. Their western doctor had put him on Miralax which ended up making the constipation much worse. He had high copper, which we treated and we also focused on his gut. He ended up mainstreaming and is doing great.
A copper/zinc imbalance is common with children with Autism as are methylation issues. With Autism, you have multiple weaknesses that have combined to create the autism so you have to unwind and treat each one.
7. Are there certain supplements you recommend every child take?
Yes. I recommend the following:
- Magnesium gummies - very safe, 1 gummy day
- Omega 3 fish oil - 1 teaspoon 1000mg; 3 years and up
- Zinc- 15 mg a day is safe with no testing
- Vitamin C - 250mg a day; 2 and up
- A good probiotic - Klaire Labs chewable, Align and Culturelle are good brands
Tip for taking probiotics: switch them up every few months so you are gettig different strands of good bacteria.
8. For families out there who are in remote areas or don’t have the resources to see an integrative pediatrician, what do you recommend? Are there specific questions they can ask or tests they can request from their regular pediatrician?
Some doctors do online consults. For the Walsh Institute, there are some doctors who do telemedicine. Parents may have to travel for a few hours for the initial appointment, and then do telemedicine for follow-ups.
Great Plains Lab is another great resource. They have consults on their labs. So, you can buy the labs, like the Organic Acids Test for gut issues, and then you can order a consult when the results come in. It's not ideal to do this without a practitioner, but it's an option for families who don't have access to one.
9. Do you have any general dietary guidelines you recommend your patients follow, regardless of their specific issue?
My first recommendation is simple, but not easy: eat a whole food "rainbow" diet and avoid all processed foods. Processed foods bump up blood sugar and they increase toxins. As much as possible you want your kids to eat organic, whole foods. Each day the goal is to eat every color in the rainbow. Make it fun and offer plenty of choices.
If you eat dairy, make sure it is grass fed. If you eat beef, that has to be grass fed as well. Poultry should be free-range and organic. Fish should be wild-caught and low in mercury. Salmon, cod, sardines are good options. You want to avoid tuna and swordfish.
The next step, especially for kids who have sensory issues, ADHD and/or Autism is to cut out all dairy (casein) and gluten products. Start with a three month trial and make sure you're tracking your child's progress and any changes you notice (click here for a tool to help you track).
In order to make any other changes, I suggest getting some testing done first.
For example, for certain kids, I order an Organic Acids Test and based on the results we make additional changes. If there is a lot of yeast, we do a low-sugar, low-carb diet. Or we try the GAPS diet. Those are more difficult changes to make.
If your readers have more questions, I encourage them to write them in the comments and we can do another round of Q&A. I know how overwhelming this can be.
A HUGE thank you to Dr. Lisa for being so generous with her time and expertise. I hope this was helpful, and as Dr. Lisa said, please leave your questions in the comments. You are not alone and we are here to help!
If you live in the San Diego area and have a child who is struggling, click here to make an appointment with Dr. Lisa.