This is a 36 y.o. female that has been experiencing multiple hormonal issues, including severe PMS symptoms of headache and fatigue. Testing revealed imbalanced Phase I and Phase II detoxification, a low 2:16 hydroxy estrone ratio. After interventions consisting of neutraceuticals, craniosacral therapy and acupuncture, she is now “feeling great” This is a 36 y.o. female that has been experiencing multiple hormonal issues, including severe PMS symptoms of headache and fatigue. Testing revealed imbalanced Phase I and Phase II detoxification, a low 2:16 hydroxy estrone ratio. After interventions consisting of neutraceuticals, craniosacral therapy and acupuncture, she is now “feeling great”This patient is a 36 y.o. female that has been experiencing multiple problems since her vaginal delivery in August 2004. She was referred to me by an Integrative Physician after treating her for adrenal fatigue and multiple food sensitivities (leaky gut) and not being able to achieve the results they both wanted. Because she felt great when she was pregnant and has multiple hormonal issues, including severe PMS symptoms (headache and fatigue), they question if Progesterone cream might be helpful for her. 36FemaleOf note is that she is under tremendous stress and feels depressed about her many food sensitivities and dietary restrictions. Her headaches are severe and usually occur premenstrually and are also associated with stress. Her fatigue is also exacerbated premenstrually and with stress.My initial assessment is that because of her multiple hormonal symptoms she likely has impaired detoxification. Since estrogen and progesterone are eliminated through the body via Phase I and II detoxification, symptoms of hormone imbalance are frequently associated with abnormal detoxification. In addition, since hydroxilation is an important first step in estrogen Phase I detoxification, the 2:16 hydroxyestrone ratio needed to be assessed. Therefor the plan was to test detoxification function and 2:16 ratios. I wanted to consider reintroducing her eliminated foods with her referring physician as her diet was a tremendous source of stress and anxiety. After my initial visit I also recommended acupuncture and craniosacral therapy, both as stress relievers themselves but also to help the body achieve energetic balance (acupuncture) and a more healthy flow of CSF in the brain (crabiosacral therapy). We had a follow up visit one month later to see how the treatments effected her and discuss the results of her testing. She reported great results from her acupuncture and reflexology. Detoxification testing showed her to be an imbalanced detoxifier, with markedly increased Phase I and normal Phase II function. This creates a buildup of toxic intermediates and clearly explains her many symptoms. Unfortunately it also puts her at increased risk of many diseases later in life. She also has a low 2:16 estrogen ratio, with not enough of th ehealthy 2 hydroxylated estrogens and too much of he unhealthy 16 hydroxylated estrogens. I then prescribed a supplement regimen to address the detoxification imbalance consisting of : Medcaps DPO (Xymogen): 2 caps bid PMS Soothe (Xymogen): 1 cap bid CDG Estrodim (Ortho Molecular): 1 cap bid and scheduled f/u in one month. One month later she stated that she was “feeling great” and her food allergy tests with her referring physician had improved dramatically. She feels great on her regimen and considers herself “where she wants to be.” Would anyone have approached this case differently?