Carolynn Romaine is a gifted athlete. She's good at everything she tries, but she loves to ride her bike. I first met her at the famous Downieville All Mountain Bike Race in 2012, two years after she made the brave decision to follow her passion, quit her job, sell her possessions and take to the road. Competing in enduro mountain races across the country, Carolynn was living the dream. Competition was stiff, and Carolynn was soon feeling the pressure. She spent her winter in Arizona, taking advantage of the exceptional weather to pack in the extra training hours. Recovery times gradually started to lengthen, and benefits rapidly diminished. The niggling digestive issues that had plagued her for as long as she could remember became unbearable. Her legs were constantly tired. Even climbing stairs was a big ask. Eventually the joy of riding disappeared, and by the time we got together to discuss functional medicine as a potential solution, she was ready to chuck it all in and return home to New York. Now Carolynn is back, energized and free of digestive issues, winning the Tiger Mountain Enduro in Washington last weekend. So how exactly did she do it? In contrast to dysfunctional medicine, functional medicine addresses the root causes of common chronic health complaints. If you're a women with PMS symptoms, your doctor will likely prescribe oral birth control. If you're a man with low libido, Viagra will be the answer. But what do either of these do to address the underlying root cause of the problem? I found this out the hard way, having spent thousands on medical bills figuring out my own digestive and hormonal issues. The solution was elegant and exciting enough to persuade me to become trained in functional medicine, leaving a position as a software engineer at a hedge fund to start a new practice.  First of all, Carolynn slowed down. The temptation to push even harder when the results aren’t happening is strong, but it must be resisted. Long endurance rides and strength training were switched out for yoga, mindfulness meditation and nature walks with the dog. Secondly, Carolynn hired an expert cook and food scientist to assist her with optimizing her diet via a shared food diary. Out went the added sugar and gluten free baked goods, and in came quality grass fed protein and healthy fats. Skinless, boneless chicken was replaced with a diversity of meats and nose-to-tail eating. Liver is rich in B vitamins and vitamin A and several other nutrients lacking in Carolynn’s diet. Since dietary cholesterol does not have a significant impact on blood cholesterol, eggs were back on the menu because of the choline in the yolks. Fermented foods, like sauerkraut, were introduced. Because they are loaded with good bacteria, fermented foods are excellent for gut health. Carolynn’s overall macronutrient ratios are now around 60% fat, 15% protein, 35% carbohydrate. Thirdly, Carolynn collected samples of saliva, urine and stool for lab analysis. The saliva revealed low levels of the primary stress hormone cortisol, in addition to low levels of its anabolic counterparts DHEA and estrogen. Progesterone was extremely low, and testosterone was normal. As these hormones work together in unison, the numbers pointed towards testosterone dominance, a strong risk factor for polycystic ovary syndrome (PCOS). This kind of hormone imbalance is extremely common in athletes with any kind of health complaint, and the primary underlying root causes are chronic stress and blood glucose instability. The urine sample gave insight about the inner workings of Carolynn’s metabolism, and it enabled me to design a highly targeted nutrient replacement program. This type of organic acid test reveals problems with fat burning, blood sugar stabilization, energy production, methylation, oxidative stress, neurotransmitter turnover and intestinal bacterial overgrowth, all of which are crucial for the highly tuned athlete. The most significant findings for Carolynn were i