Issue 127: What is Clinical Nutrition?

It occurred to me that I share a lot of information about nutrition, the body, and integrative healing practices in Inner Workings, and yet my readers may not know how I got started or much about my clinic. Let me introduce myself!

In Wellness,  Mary Virginia

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Who I Am

Hello! I’m Mary Virginia. 😀 I am a clinical integrative nutritionist who owns Coffman Integrative Nutrition. My areas of expertise include mental health nutrition (especially anxiety, depression, ADHD), brain health, gut health, metabolic health, thyroid health, and stress resilience.

Many years ago I had my first baby, and I nursed her. As she grew and began to eat solid foods, it occurred to me that if breast milk was important for her growing body, then surely the rest of the food I chose for her was also important. Thus was born my first fascination with nutrition and health.

Later my third child developed chronic sinus infections as an offshoot of H1N1 (bird flu). As the one year anniversary of her monthly antibiotics approached, the importance of gut health was starting to be all over the news. I was beside myself that her microbiome was continually being wiped out and she would suffer long term health consequences.

That’s what really kicked off my research, and boy did I learn a lot on my own about the effects of nutrition on the body! My reading opened my eyes to gut health and inflammation and how they interact with mental health. I was hooked. This information built on my Master of Social Work, where I majored in Interpersonal Relations (i.e. therapy). Moreover, I was able to help her overcome those awful sinus infections. 🥳

I elected to pursue a Master of Science in Human Nutrition, earned the Certified Nutrition Specialist designation, and here I am now with my own clinical practice in Atlanta, Georgia!

What I Do

What many don’t really realize is that clinical nutrition is health care, not a sideline alternative path to health. It’s an expansion of standard care that uses the body itself to heal.

In fact, much of Western medicine is “disease care.” You get sick, and medicine is applied to stop the specific sickness. This is really important, and I am grateful for the advances in medicine that help so many people heal. However, it’s narrow in scope and often creates a domino effect of other illnesses.

Clinical integrative nutrition, also called functional nutrition, uses a different lens than seeing just a small fraction of the body. We really practice “health care.” That is, we identify the root contributors to your body’s illnesses, observe all the systems of your body and the environments that influence them, and then align with your body’s own healing mechanisms. This does not necessarily exclude medication, although it often turns out that medication is not necessary or is reduced. Certified Nutrition Specialists (CNS) coordinate with our clients’ doctors so that they really experience the fullest possible care.

My work takes a multidisciplinary approach. I use food, supplements, lifestyle choices, and coaching (behavior and mindset/perspective shifts) to support my clients in both prevention of illness and healing from being sick. I practice medical nutrition therapy (in states where I am legally allowed to practice), which uses these methods to manage and heal from chronic health conditions, such as autoimmune diseases, metabolic illness, digestive health issues, and emotional dysregulation.

Pointedly, my clients are all individuals with unique life experiences and preferences. I provide personalized nutrition and coaching care so that my recommended interventions feel authentic and accessible to my clients.

Doctors Don’t Talk About This

What I have learned is that many symptoms are manifestations of underlying dysfunctions that we can address.

For example, there is an ongoing conversation in America about people in larger bodies. Being in a higher weight body is described by itself as an illness. However, it’s typically not, even if reducing weight appears to solve health issues. Weight status is the cart, not the horse. I see weight increase as only one symptom of one or more root cause: hormone shifts, the gut microbiome/digestion, metabolic issues, medication, fatigue tied to autoimmunity, mental health status, stress, generational or personal trauma, mindset, genetic predisposition, sleep deprivation, behaviors tied to any of these, or other things. It’s a data point, but it’s not an end in itself.

Anxiety and depression are at epidemic levels now. While the conversations about environmental triggers (e.g. cell phones, social media) are worthy and salient, I can identify a number of points of dysregulation in the body that can be treated with great success. For example, people who are low in vitamin B6 and zinc are more prone to panic attacks. High stress depletes certain B vitamins and indicates a need for higher antioxidant intake, such as vitamin C and colorful, phytonutrient-rich foods. I wrote a whole article on the vagus nerve and nervous system regulation because of its importance to mood, focus, and cognition. Hypothyroid has an impact not just on metabolism, but also on mood and digestion. Cortisol rises or dips at the wrong time of day will create persistent over- or under-stimulation and symptoms of anxiety or depression, including overstimulation or fatigue. ADHD and anxiety have a strong Venn diagram of symptom overlap. Allergies (food and environmental) trigger anxiety and depression symptoms. There is a loop between poor digestion, nervous system dysregulation, and anxiety that we label Irritable Bowel Syndrome. And the gut microbiome is a key player in mood status and brain health. I address all of these and other root causes, and my clients report feeling so much more even keeled and well.

Genes are one of the most fascinating contributors to health status. I use a test by 3X4 Genetics that identifies your individual genetic blueprint on how your body is designed to interact with nutrients and lifestyle, such as exercise. Knowing your genes means that we can craft an integrative nutrition care plan that is specifically tailored to allow your body to function optimally. We can lower risks for potential future health problems and support you now to have your best health and energy.

Picture Yourself in Session With Me

Our first clinical session is a comprehensive intake. Before our 90 minute session, I will send you several forms to complete:

Health & Social History (Intake Questionnaire)
Nutrition Focused Physical Exam
Medical Symptom Questionnaire
Wellness Questionnaire
HIPAA Notice of Privacy Practice
Release of Protected Health Information

I also request that you upload your most recent lab results and provide any unique information that lets me understand your situation better. As part of this initial evaluation, I will review your medications for drug-nutrient interactions and delve into what your signs and symptoms indicate about your nutritional status.

We meet for a long initial session because I really want to know your story and your experience. Between the data on your forms and our conversation, I develop a timeline of your illness or health status and define the triggers and mediators that influence it. This is your body, and you are the expert of it. I will reflect back what I hear from you to confirm that I fully understand.

At the end of it I might make initial recommendations or lay out the first steps of the path that will move you toward better health. For example, it might be wise to pursue more data, such as updated standard blood work or functional testing, which might be a stool panel, a urine test called an organic acids test, or other specialized tests, such as 3X4 Genetics.

Follow-up sessions are designed to move you toward the health outcome you envision. Typically we will meet for an hour. This time might include my interpretation of labs and root causes of symptoms, education on food plans and choices, recommendations for supplements and my reasoning for offering them, education on the relationship between different bodily systems, presentations on the influence on your health of sleep, movement, time in nature, the vagus nerve, circadian rhythm, and more, and/or training in lifestyle practices that will support your body’s optimal functioning. This is also a time when you can ask questions, bring up new information, or participate in coaching to help you decide how to proceed.

May I Ask a Favor?

Inner Workings goes out to all of my former and current clients, as well as people simply interested in the role of nutrition and behavior choices on our health. It is humbling to work with such amazing people! I truly have the best job in the world and I am grateful for each of you.

Along those lines, I have a couple of favors to ask:

1. I’m seeking some positive Google reviews to help boost my business. I love my work, and this is a great way for me to attract clients! If you have worked with me in any capacity (nutrition or coaching), or even if you just read Inner Workings, it would mean a lot to me to have you reflect on it. No pressure and no worries if writing a review is not your cup of tea.
   
   
2. I really want to write about what interests you! I’d love to do an Inner Workings dedicated to a bunch of your questions (Ask the Nutritionist style) or doing a deep dive into something you’ve wanted to understand better.
   Please write to me with your questions!
   
   
3. I suspect you might not know that I do paid speaking engagements, especially anything related to nutrition, mental wellness, or stress resilience. Please feel free to refer me to your organization, or share a contact with me so that I can reach out to them. Let me know if I can use your name!