Functional Medicine and Dementia Consultation

A Functional Medicine Consultation is for people that want “the whole enchilada”. Rather than simply addressing a particular problem, this is for people with long-standing or multi-system diseases who want the most comprehensive evaluation and treatment plan possible. Addressing all of the systems simultaneously allows you to move much faster than working on one problem at a time.

This consultation is for you if:

• You don’t want to work piecemeal on your problems
• You want to move quickly
• You want the most comprehensive program we offer

Background:

Functional medicine is a health-care approach that looks at your body as a whole organism, rather than simply a collection of organs or diseases, and seeks to treat the underlying root causes rather than simply give Band-Aids for the symptoms of disease. We look at “Why” and not “What” (is the disease). This approach is an exciting new way to manage, cure, and prevent a range of diseases, and it’s especially effective for chronic diseases of the body and/or the brain.

Our Functional Medicine treatment is best described as a highly individualized “Targeted Healing Plan” which seeks to return your body (and spirit) to a healthy balance. We cast a wide net to look at all of the factors that can be out of balance and contributing to illness or cognitive decline, and work with all of these simultaneously to restore balance and health.

Functional Medicine is not cookie-cutter medicine – there is no one-size-fits-all. We listen to your story and put together your timeline - the various factors on your path that resulted in your current constellation of symptoms. In understanding this, we can begin to work backwards to unravel the symptoms and restore the body, mind, and spirit to health.

To achieve this, Dr. Toups’ functional practice requires much more patient-doctor interaction and teaching than is the current medical standard. During your first 3 appointments you will spend around 5 hours with Dr. Toups so she can fully understand your medical situation and test results. She will help to design your targeted healing plan, as well as teach you about your medical picture and the steps you can use to get well.

Dr. Toups is a highly trained physician with 27 years of experience as a practicing Psychiatrist. Before she started her current practice, Dr. Toups was a successful researcher, serving as the Principal Investigator on over 100 clinical trials as the Medical Director at Bay Area Research. Prior to that, she was on the faculty at U.C. Davis, where she was the Chief of Inpatient Psychiatry and the Residency Training Site Director. Dr. Toups became a Distinguished Fellow of the American Psychiatric Association in 2009, which is the highest honor that can be awarded to a Psychiatrist - given annually to the top 0.25% of Psychiatrists who have made significant contributions to the Psychiatric profession in multiple domains.

Dr. Toups started studying Functional Medicine in 2009 for her own health issues, and immediately saw the immense benefit that this offered for her patients. She completed all of her training for the Institute for Functional Medicine (IFM) Certification in October 2013, with modules in Immune/Allergy, GI, Cardio-Metabolic Disease, Detoxification, Nutrition, Energy Regulation, and Hormone related problems. Dr. Toups has trained and mentored with Mark Hyman, MD, Dr. Datis Kharazzian, and Alex Vasquez, DO, who have been instrumental in the development of her Functional Medicine approach. Dr. Toups currently serves on the Medical Board of the International Association for Functional Neurology and Rehabilitation (IAFNR).

Dr. Toups is constantly attending conferences and studying the latest research to bring you the best validated cutting-edge treatment options. She is also the organizer/administrator of the Bay Area Functional Medicine Study Group, comprised of some of the top Functional Medicine practitioners in the San Francisco Bay Area, as well as the BAFM ListServe where several hundred Functional Medicine practitioners share the latest research and cases.

Deciding to take a Functional Medicine approach to improve your health is a serious decision because of the time, effort, and cost involved, but it offers the chance to truly get well. Dr. Toups has many more requests for consultation than she is able to accommodate. Therefore, we have instituted an application process so we can determine if a Functional Medicine approach will be helpful for you, and if Dr. Toups's practice will be the right fit (application link is below).  Dr. Toups will personally review your application to ensure that working together offers a good chance to benefit you, and will do her best to provide referrals if it does not seem like the best fit or she cannot accommodate you in a timely manner.

The Functional Medicine Approach:

Functional Medicine is collaboration between the practitioner and the patient. Rather than simply writing a prescription for each of your medical problems, a good Functional Medicine doctor will work with you to dig deep into the root causes of your illness and symptoms in order to actually resolve your medical problems and help restore your system to health and balance.

The Functional Medicine process works best with highly motivated patients who understand the power of diet, lifestyle, and exercise in healing their bodies and their brains. People make the most progress when they commit to regular follow-ups during the first six months. Chronic and multi-systems illness can certainly be resolved, but healing is a process and will not happen in 2 or 3 visits for people that have been ill for a long time. It generally takes three visits to complete the first layer of history taking and lab assessments, and to dial-in a targeted, individualized treatment plan. Thus we now offer a three visit comprehensive consultation package (see below).

Functional Medicine offers the opportunity to truly get well, without the reliance on chronic long-term medical visits or prescriptions.

Conditions Helped by Functional Medicine

• Autoimmune disorders:

•      Hashimoto’s Thyroiditis

•      Psoriasis

•      Eczema

•      Chronic Fatigue Syndrome

•      Fibromyalgia

•      Multiple Sclerosis

•      Parkinson’s

•      Crohn’s Disease

•      Ulcerative Colitis

•      Graves Disease

•      Rheumatoid Arthritis

•      Sjogren’s

•      Ehrlos Danlos Syndrome

•      Lupus

•      Raynaud’s

•      Rosacea

•      Multiple Chemical Sensitivity (MCS)

•      Lyme

•      Mold, and more

• Digestive Problems (Gas, Bloating, Constipation, Diarrhea, IBS, Burping, Gastritis, Reflux, SIBO)
• Migraines/Headaches
• Weight Loss
• Pain Management
• Psychiatric disorders (Anxiety, Depression, ADHD, PTSD, OCD, Bipolar, Schizophrenia, Depersonalization/Dissociation)
• Sleep Disorders/Insomnia

• Adrenal Fatigue (low energy)

• Sex Hormone Imbalances (Menopause, PMS/PMDD, Menstrual Irregularities, PCOS, Endometriosis, Estrogen Dominance, Low Testosterone in Men & Women)

• Thyroid Disease

• Allergies
• Alzheimer’s Dementia

• Cognitive Problems

• Brain Fog

• Athletic Performance
• Lipid and Cholesterol Problems, Metabolic Syndrome
• Hypertension

• Blood Sugar control/Pre-Diabetes/Diabetes/Insulin Resistance

• Anemia

• Cancer
•  Infections: Lyme, Lyme co-infections, Mold, chronic viruses, low-level chronic dental infections, C. difficile

What to Expect:

A Functional Medicine consultation is for people who want “the whole enchilada” – to look at the big picture and investigate all of the factors leading to imbalance and illness. This allows us to correct these over time so that wellness can be restored, rather than having a life-long reliance on doctor’s visits and medications.

1. Before your initial appointment, Dr. Toups will spend 1 - 2 hours going over your in-depth Intake Forms. She will gain an understanding of your health time-line starting with your mother’s pregnancy and extending to your present conditions. The goal is for the doctor to understand all of the factors in your Timeline that have contributed to your present state of health or illness.
   
   
2. At your initial appointment, you will meet with Dr. Toups for 2 - 3 hours to further review your in-depth Intake Forms. At your appointment, she will obtain additional history and discuss the application of a Functional Medicine approach to your health care problems. She will order appropriate laboratory testing, discuss nutritional/dietary approaches for your healing as well as other mind-body interventions as indicated, and make recommendations for basic supplements personalized for your situation.
   
   You will also have a 60 minute session with our Nutritional Consultant to review your diet and the dietary changes suggested by Dr. Toups. Diet and Nutrition are the foundation of a Functional Medicine approach, and our Nutrition Consultant will help you to customize recommended dietary changes, as well as trouble-shoot any problem areas with your diet.
   
   Please allow 3 – 4 hours for this appointment.
   
   
3. After your first appointment, Dr. Toups will start to develop the first phase of your targeted healing plan, which she will post to your confidential patient portal. Since each plan is individualized, this process generally takes the doctor between 1 - 2 hours after your appointment to formulate.
   
   
4. Your second appointment with Dr. Toups will be approximately 3 weeks later. At this follow-up Dr. Toups will discuss your initial laboratory results in detail, review the progress of your dietary changes, and create the next phase of your targeted healing plan.
   
   Please allow 90 minutes for this appointment.
   
   
5. The third appointment will incorporate results from specialty lab testing, like a Comprehensive Stool Analysis, Cortisol or Melatonin testing, Genetic Testing, Allergy Testing, etc. This appointment generally occurs approximately 2 -3 weeks after your second visit.
   
   Please allow 45 minutes for this appointment.

Note: We request that you schedule all three appointments in advance to assure availability and to allow you to continue to make maximum progress in a timely manner.

Please Note: There is a 7 day (one week) cancellation policy for new patient appointments and a 3 business day cancellation for follow-up appointments. We always have a waiting list for new patient appointments, so this will help us to accommodate others if you are unable to make your scheduled appointment.

FUNCTIONAL MEDICINE APPOINTMENT FEES

Consultation Packages are $2995, which includes:

• 2-3 hour initial Comprehensive Consultation with Dr. Toups

• 1 hour Nutritional Consultation with Kasin Anton, Nutritional Consultant and Health Educator

• 15 minute Nutritional and General Support phone follow-up with Kasin

• One 90 minute follow-up appointment with Dr. Toups to review lab testing and targeted Treatment Plan

• One 45 minute follow up with Dr. Toups
  

• 10% discount on Professional Grade Supplements for you and your family

Additional follow-up visits or extended visits will be billed based on the amount of time involved:

• 12 minute Follow-Up  $150
• 25 minute Follow-Up  $300
• 45 minute Follow-Up  $400
• 60 minute Follow-Up  $500
• 75 minute Follow-Up  $600

Please note that this program is not a typical fee-for-service medical model – rather, it is a transformational program designed to create wellness and not to simply give you a prescription for a single symptom. Dr. Toups will spend several additional hours pondering and formulating your case beyond the face-to-face time as she looks obsessively at your labs and your timeline and the intricacies of your case, so the value of the process is not simply based on the time spent in an appointment.

Laboratory Testing Costs:

Lab testing is an integral component of a Functional Medicine evaluation, as it is vitally important to rebalance and restore all of the dysfunctional body systems simultaneously. People do not get well by working on one system at a time, as of course everything in the body is interconnected.

To understand the workings of the biochemistry, physiology, genetics, hormones, nutrients, toxins, and possible infections/dysbiosis in the body, we must do the proper detective work. Part of this process involves testing.

Dr. Toups preferentially orders tests from laboratories that will accept and bill through your traditional medical insurance coverage. At the initial visit, virtually all testing ordered should be eligible for reimbursement through your PPO insurance, with the exception of a Comprehensive Stool Analysis that she uses to assess the integrity of your microbiome and other factors affecting the gut – brain axis. The cost of this testing is $295. (It is actually reimbursed by Medicare, but generally not covered by traditional insurance.)

There may be additional outside lab testing needed later, but of course all lab costs will be discussed with you, and every effort is made to code the requisitions properly in order to maximize your insurance reimbursement. Dr. Toups does not mark up the costs of any labs, nor does she charge any additional interpretation fees. She does not believe in ordering unnecessary tests that will not change your treatment plan.

Insurance:

Dr. Toups is an out-of-network provider, and will provide an Insurance Superbill invoice at each visit that can be submitted for insurance reimbursement. Patients with PPO insurance are often reimbursed 50% or more of the charges after their deductible has been met, though we are unable to guarantee this due to the variability and unpredictability of health insurance plans. 

Dr. Toups is not contracted with Medicare, so unfortunately you will not be able to bill Medicare for her services. She is an Ordering & Referring Physician with Medicare, which means she is able to order laboratory tests on your behalf.

Payment Options:

• We accept credit card (MasterCard, VISA, Discover, and American Express), check, or cash payments, and require payment at the time of your visit.
  
• In addition, you can also use funds from a Health Savings Account (HSA) card.

Appointments:

Please Note: Dr. Toups is on a research and writing sabbatical, and is unable to accept new patients at this time.