Dr. John Stracks: Top FAQs Answered

A: Our practitioners treat all kinds of medical conditions. They commonly see people with chronic pain, chronic fatigue, women’s health, sinus issues, digestive issues, mental health conditions, migraine headaches, menopausal symptoms, and thyroid disease. No matter the condition, though, our practitioners are happy to offer an opinion about whether nonmedicinal strategies might be helpful.

A: Cormendi Health practitioners do not do disability determination examinations or prepare reports for Social Security or other disability insurers. In addition, they do not treat the following: Mast Cell Activation Syndrome, Lyme, Candida, or weight loss. 

A: Dr. Stracks’s goal when practicing Integrative Medicine is to provide solutions for chronic health issues that lie outside the medical mainstream. This means that he focuses on nonmedicinal, nonsurgical treatments, such as the role of vitamins, herbs, diet, stress, the alternative use of hormonal medications, and referrals to other Integrative Medicine practitioners such as acupuncturists, chiropractors, massage therapists, naturopaths, and psychologists.

A: All treatment plans are individualized, so the recommendations for you will be unlike those for any other patient that Dr. Stracks sees. That said, he will frequently make recommendations to change diet (such as eliminating gluten, dairy, or sugar), use vitamins and supplements, try herbal combinations, have bodywork done (such as acupuncture or massage), and pay attention to the connection between stress or anxiety and chronic physical symptoms. He also may will order a battery of tests before making any recommendations. 

A: Frequently Dr. Stracks will order nutritional tests such as iron levels, Vitamin B12, Vitamin D, and magnesium. Sometimes he will order more comprehensive nutritional tests observing a wide variety of vitamin and mineral levels. Food allergy testing is often ordered as a test to try to measure levels of urinary neurochemicals, especially when anxiety or depression is the main issue. Comprehensive stool tests are run frequently. Hormonal tests are also ordered, looking at thyroid, adrenal, and ovarian or testicular function.

A: Occasionally. In general, blood tests such as basic nutrients and hormonal tests are covered by insurance as long as your deductible has been met for the year. The tests run by alternative labs (such as Genova Diagnostics or Immuno Labs) are generally not covered or only partially covered by insurance. Our staff will do their best to let you know the exact cost of a test before it is run.

A: No, we do not. Please see our office policies for the rates for all of our practitioners and a full discussion of why we do not accept insurance under the Primary Care FAQs.

A: Great! Please see the thyroid FAQs below and contact our office for FAQs about menopausal management and bioidentical hormones.

A: Dr. Stracks has a limited number of openings for primary care clients. Please contact our office at 312-489-8890, ext. 1, for more information.

A: When scheduling your initial appointment, please make sure to check with our staff about getting labs drawn so Dr. Stracks can review the results with you at your first appointment. (Please note that several thyroid labs are sent to other states for analysis, so it can take up to two weeks to receive results.) During your appointment, he will also get a sense of your history, i.e., if you are taking medication, what kind you are taking, when you started taking it, and how you are feeling on it. If you are not on medication, he will want to know how you are feeling, what makes you think thyroid is an issue, and what your previous experience is with medication, if any. He will also gather information about other medical conditions you have, what medications and supplements you take, whether thyroid disease runs in your family, and what kind of health habits you have in terms of eating, exercise, stress, and sleep.

Once he has compiled all that information, he will make an initial assessment to determine whether he thinks you need additional labs, supplements, changes in eating, changes in medication, or different medication(s). His style is cooperative, so he will take your preferences into account as long as he believes the interventions are safe for you.

Please note that Dr. Stracks treats thyroid symptoms to alleviate the effects of thyroid disease. While weight management may occur as a result of treating thyroid properly, he does not use thyroid medication specifically to address weight issues. 

A: Dr. Stracks finds that a TSH, free T4, free T3, total T4, total T3, reverse T3, TPO antibodies, and anti-thyroglobulin antibodies labs give them the information they need. Each lab gives him a piece of information he is looking for. Between all these labs, he will get a 360-degree picture of what’s going on with your thyroid.

A: Dr. Stracks has a limited number of openings for primary care clients. Please contact our office at 312-489-8890, ext. 1, for more information.

A: The conventional way to diagnose hypothyroidism is with a TSH greater than 4. Labs, however, do not tell the whole story. Dr. Stracks makes the diagnosis based on the entirety of the lab results along with a careful assessment of your symptoms. If you are feeling cold, tired, dry, constipated, depressed, or overweight, he doesn't need the labs to tell him that you are hypothyroid. Other symptoms such as joint aches, foot pain, thinning eyebrows, thinning hair, forgetfulness, hives, skin rashes, or difficulty swallowing can help him make the diagnosis as well.

A: Dr. Stracks normally looks at optimal levels and try to get the T3 toward the top of the normal range, with the T4 and Reverse T3 in the middle to lower part of the normal range. He will tolerate a low TSH if you are feeling well (although over the age of 65 there is some risk with a low TSH), but he generally discourages T3 and T4 levels far outside the bounds of normal. Most of our patients can feel well with a T3 toward the top of the normal range or just slightly above as long as the reverse T3 is on the low side. 

A: The labs give Dr. Stracks some information, but not as much as you do. The labs help guide the therapy, especially when the clinical picture is unclear. However, he would rather gather information by speaking to you about your experiences.

A: Depending on the situation, he often looks at nutrients such as iron/ferritin, B12, D, copper, and zinc. Also, if you are not feeling well and can’t tolerate enough thyroid medication to raise your numbers, he will evaluate adrenal function with serum or saliva testing.

A: Dr. Stracks regularly prescribes Natural Desiccated Thyroid (NDT) but not always the Armour brand. His experience is that Armour has not been the same since coming off and then back on the market in 2010. He prescribes NP Thyroid or WP Thyroid; has Natural Desiccated Thyroid compounded by compounding pharmacies; and occasionally uses other brands, such as Westhroid and Erfa.

A: Dr. Stracks rarely mandates a certain treatment. If your TSH is above 20, though, he will strongly recommend medication.

If your TSH level is below 20 and you'd prefer not to take medication, he will tell you about managing thyroid disease using diet, vitamins, supplements, and other holistic strategies. Some of his patients find that these strategies work well for them, and he's happy to work with you if you decide to manage your disease in this way.

Also, note that some people feel fine with a TSH in the 5–15 range and seem not to need any treatment at all. If you are in this category, he will monitor you and provide input on whether you are safe to continue on without medication.

A: Remember, the labs give some information, but you give Dr. Stracks more information. Thus, at your first follow-up appointment, he will talk with you to find out how you are doing on the medication. Usually, he can get enough information from you to make a decision about the best next course of action. From there, he will adjust your medication and see how you do.

Note that Dr. Stracks normally orders labs in advance of the next appointment, so please allow enough time for the results. While looking for the best dose of thyroid medication for you, he may run labs every 3–6 months. Once you're on a stable dose of medication, he normally orders labs once per year.

A: As you may know, TMS is a term coined by Dr. John Sarno, who was a physician in New York City, that describes the human tendency to express physically what doesn’t get expressed in other ways. Thus, what feels physical, such as back pain, neck pain, headaches, or even fibromyalgia, can ultimately be the physical expression of stress, past experiences, or strong emotions. The fact that we do this is not necessarily a problem, but it does become one when we encounter a medical system that assumes all physical symptoms are physical in origin. When this happens, the only treatment options become medication, surgery or physical therapy; many of which do not work, or do not work well. A diagnosis of TMS opens up other healing options that can be more effective.

A: Recovery from TMS is a two-part process. The first part involves simply recognizing that physical symptoms can have non-physical roots. Again, this is not bad and does not mean that the symptoms are imaginary, being made up, or somehow not real. It only means that the root of the symptoms is in the heart or the mind and not the body. Once this recognition takes place, it opens up a wealth of healing opportunities that don’t have to do with medications or surgery. 

A: In an initial TMS consultation, you and Dr. Stracks will discuss your symptoms (how long they have been present, what helps them, what makes them worse, what they feel like, etc), discuss the various nonphysical factors that may be contributing to your symptoms (such as stress, past experiences, and personality traits), and then discuss why a diagnosis of TMS does or does not make sense for you. If it does seem like TMS is the correct diagnosis for you, he will then put together the beginning of a treatment plan to get you started. Expect the initial consultation and treatment planning to take about 60 minutes.

A: There is no test for TMS. Rather, any chronic symptom—pain or otherwise—can be a physical manifestation of TMS. People who develop symptoms in this way tend to be good people, want to be liked, don’t like to rock the boat, tend to take care of others before taking care of themselves, tend to keep their emotions inside, and tend to be people-pleasers and somewhat perfectionistic. When people carry most or all of these personality traits and have chronic symptoms that have not responded to other forms of treatment, TMS should be strongly suspected. Other signs that point to TMS include physical symptoms that don’t have a clear physical explanation, symptoms that began at times of intense stress or life changes, symptoms that tend to move around the body into different locations, and symptoms that don’t get better no matter what type of treatment is attempted.