MM19 Conference Book V1final
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5/17/2017<br />
✓<br />
The Six Elemental Steps<br />
© 2017 Gary Weiner, N.D., L.Ac.<br />
Bottom-Up and Top-Down<br />
Certolizumab pegol (Cimzia®)<br />
Adalimumab (Humira®)<br />
Infliximab (Remicade®)<br />
Natalizumab (Tysabri®))<br />
Azathioprine (Imuran®)<br />
6-Mercaptopurine (Purinethol®)<br />
Methotrexate, MTX (many generics)<br />
Tacrolimus (Prograf® & others)<br />
Cyclosporin<br />
Ciprofloxacin<br />
Metronizadole<br />
Rifaximin<br />
INDUCE<br />
Total Colectomy, Ileostomy,<br />
ileoanal anastomoses,<br />
Strictureplasty<br />
Etc.<br />
REMISSION<br />
Surgery<br />
Biologics<br />
Immunomodulators<br />
Corticosteroids<br />
Antibiotics<br />
Aminosalicylates<br />
Dietary Management<br />
Prednisone<br />
Prednisilone<br />
Methylprednisilone (“Medrol”)<br />
Budesonide MAINTAIN<br />
(Entocort® &<br />
Uceris®)<br />
Hydrocortisone<br />
Sulfasalazine (Azulfadine®)<br />
Mesalamine:<br />
Canasa®<br />
Rowasa®<br />
Asacol®<br />
Pentasa®<br />
Lialda®<br />
Apriso®<br />
Osalazine (Dipentum®)<br />
Balsalazide (Colazol®)<br />
The management objective?<br />
Exclusive or Partial Diet<br />
INDUCE<br />
REMISSION?<br />
Or “support”<br />
of induction?<br />
MAINTAIN<br />
REMISSION?<br />
Or “support” of<br />
maintenance?<br />
RESOLVE<br />
MALNUTRITION?<br />
Or supplement<br />
“undernutrition”<br />
MANAGE<br />
SIBO?<br />
100% of<br />
calories<br />
Exclusive<br />
Elemental<br />
Diet<br />
”Half or “Partial”<br />
Elemental<br />
Diet<br />
~ 900-1200 Kcal<br />
Remaining calories<br />
From whole food<br />
Induction<br />
SIBO<br />
Nutritional<br />
Support<br />
Maintenance<br />
Aminosalicylates<br />
The Six Elemental Steps<br />
Calcuate<br />
✓ ✓<br />
Men: BMR = (10 x weight in kg) + (6.25 x height in cm) – (5x age in years) +5<br />
Women: BMR = (10 x weight in kg) + (6.25 x height in cm) – (5 x age in years) - 161<br />
First calculate BMR using Harris-Benedict Equation:<br />
Then multiply the BMR x an activity factor<br />
Activity level<br />
Activity<br />
Factor<br />
Little to no exercise 1.2<br />
Light exercise (1-3 days per week) 1.375<br />
Moderate Exercise (3-5 days per week) 1.55<br />
Heavy Exercise (6-7 days per week) 1.725<br />
Very heavy exercise (twice daily, extra heavy workouts) 1.9<br />
© 2017 Gary Weiner, N.D., L.Ac.<br />
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