Conventional medicine is designed for acute care and disease management — and it excels at both. But it was not designed for the chronic, complex, multi-system conditions that define modern health failure: the fatigue that no test explains, the gut that never fully heals, the hormones that remain "normal" while you feel anything but.
Functional medicine operates on a different question. Not "what disease do you have?" but "what is driving your biology toward dysfunction?" It investigates the upstream causes — gut integrity, hormone signaling, mitochondrial efficiency, nutrient status, genomic vulnerabilities, toxin burden, and the interplay between all of them.
At ARBOUR, functional medicine is practiced by a triple board-certified clinician — board-certified in Family Medicine, Psychiatric Mental Health, and Functional Medicine — bringing a depth of conventional and integrative training that most functional medicine practices cannot match. The result is a diagnostic and therapeutic process that is both rigorously clinical and genuinely comprehensive.
How It Works
Comprehensive health history · Advanced diagnostic testing · Root cause identification · Personalized protocol · Ongoing follow-up care
Administration
Subcutaneous injection · Oral/sublingual · Nasal spray · Topical — protocol-dependent
Sourcing Standard
Pharmaceutical-grade · Regulated compounding pharmacies · Subject to current FDA regulations
Pricing & Availability
All pricing and current compound availability discussed at consultation — subject to regulatory status at time of prescribing
The ARBOUR Difference
Every focus area below is investigated as part of the whole — because gut dysfunction drives hormone imbalance, hormone imbalance drives brain fog, toxin burden drives mitochondrial failure. ARBOUR's functional medicine approach treats the system, not the symptom category.
Digestive Health · Microbiome
The gut is the origin of most chronic disease. We look there first.
Intestinal permeability, dysbiosis, SIBO, inflammatory bowel, and microbiome imbalance are implicated in conditions far beyond the gut — including autoimmunity, brain fog, hormone imbalances, skin conditions, and mood disorders. ARBOUR's gut assessment identifies the specific disruptions driving your systemic symptoms.
Hormones · Adrenal · Thyroid
Optimization beyond what a TSH and basic panel will ever show.
Thyroid dysfunction, adrenal dysregulation, cortisol imbalance, and sex hormone disruption are among the most common and most overlooked drivers of chronic illness. ARBOUR uses the DUTCH test and comprehensive thyroid panels to see what standard testing misses — then addresses what it finds.
Brain · Energy · Fatigue
The biology behind why you can't think, can't focus, can't recover.
Brain fog, cognitive decline, persistent fatigue, and burnout are not personality traits or lifestyle failures — they are biological states with identifiable causes. Mitochondrial dysfunction, neuroinflammation, HPA axis dysregulation, and nutrient insufficiency are among the most common and most treatable drivers.
Toxins · Heavy Metals · Environment
What your environment is doing to your biology — measured, not assumed.
Environmental toxin accumulation and heavy metal burden are direct drivers of mitochondrial dysfunction, thyroid disruption, neurological symptoms, and immune dysregulation. ARBOUR's toxin and heavy metal assessment identifies specific exposures and designs targeted detoxification and repletion protocols.
Longevity · Biological Age · Optimization
Measuring and addressing your biological age — not your chronological one.
Functional medicine for longevity goes beyond symptom resolution — it identifies the biological aging processes that determine healthspan. Mitochondrial efficiency, oxidative stress burden, genomic vulnerabilities, and nutrient sufficiency are the levers most predictive of how well — and how long — you function.
Immune · Autoimmune · Food Sensitivity
Quieting an immune system that has lost its context.
Autoimmune and inflammatory conditions rarely develop without identifiable biological triggers — leaky gut, molecular mimicry, infection history, toxin burden, and nutrient deficiency are among the most consistent root causes. ARBOUR's functional approach identifies and addresses these triggers alongside conventional management, not instead of it.
The ARBOUR Functional Medicine Process
Explore by Focus Area
Frequently Asked Questions
Functional medicine is a root cause approach to health — identifying the underlying biological mechanisms driving symptoms rather than managing those symptoms with medication alone. It uses advanced diagnostic testing, detailed health history, and personalized protocols to address gut health, hormone imbalances, metabolic dysfunction, nutrient deficiencies, toxin burden, and the interplay between these systems. At ARBOUR, it is practiced by a triple board-certified clinician.
Conventional medicine excels at diagnosing and treating acute conditions and disease states. Functional medicine addresses the biological terrain that precedes disease — the hormonal imbalances, gut dysfunction, nutrient deficiencies, inflammatory burden, and mitochondrial inefficiency that drive chronic symptoms for years before they become diagnosable conditions. At ARBOUR, these two approaches are integrated — our clinician's Family Medicine board certification ensures conventional rigor alongside functional depth.
ARBOUR Longevity in Ann Arbor offers comprehensive functional medicine evaluation and ongoing care from our triple board-certified clinician — board-certified in Family Medicine, Psychiatric Mental Health, and Functional Medicine (FM-BC). We serve Ann Arbor, Ypsilanti, Saline, Plymouth, Canton, and Southeast Michigan. Telehealth available for Michigan residents for follow-up care.
ARBOUR's functional medicine evaluation begins with a comprehensive 75–90 minute intake covering your complete health history and symptom timeline. This is followed by standard labs and advanced testing as clinically indicated — including the DUTCH test for hormone metabolites, organic acids testing (OAT) for mitochondrial and metabolic function, and genomic panels for MTHFR and key SNPs. The result is a complete biological picture and a personalized protocol addressing every identified root cause.
Hormone therapy replaces or supplements hormones directly — testosterone, estrogen, progesterone. Peptide therapy signals your body to produce hormones and other compounds more efficiently, working upstream of the hormone itself. Many patients benefit from both as part of a comprehensive longevity protocol — hormones restore deficient levels while peptides may optimize the signaling environment that makes hormone therapy more effective.
Three things distinguish ARBOUR's functional medicine program. First, triple board certification — our clinician holds FM-BC alongside Family Medicine and Psychiatric Mental Health certifications, covering the full spectrum of chronic illness including its neurological and psychiatric dimensions. Second, integration — functional medicine patients have access to ARBOUR's hormone optimization, peptide therapy, IV therapy, and weight loss programs as part of a seamless clinical system. Third, ongoing care — ARBOUR provides continuous follow-up, not a report and a goodbye.
"After five years of normal labs and no answers, ARBOUR found three root causes in my first evaluation. The OAT panel and DUTCH test showed things no one had ever tested. I finally understood what was happening in my own body."
"The brain fog I'd had for two years was gone within six weeks of the protocol. It turned out to be mitochondrial dysfunction and B12 depletion showing up on the organic acids test. No one had looked there before."
"The thing that sets ARBOUR apart is that the functional medicine is connected to everything else. My hormone protocol and my gut protocol were designed together, not handed off to different providers who don't talk to each other."
Functional Medicine · Ann Arbo
Schedule a functional medicine consultation at ARBOUR Longevity. Our triple board-certified clinician will take the most thorough clinical history you have experienced — and use advanced diagnostics to build the complete biological picture your health has been missing.
Physician-collaborative practice · FM-BC · FNP-BC · PMHNP-BC · Ann Arbor, Michigan · Accepting new patients
Intestinal Permeability
The barrier that isn't holding.
Intestinal hyperpermeability occurs when the tight junctions of the gut lining become compromised — allowing undigested food particles, toxins, and pathogens to enter the bloodstream and trigger systemic immune responses. It is implicated in autoimmunity, food reactivity, brain fog, skin conditions, and inflammatory disease. Assessment and targeted repair are among the highest-yield interventions in functional medicine.
ARBOUR approach: Gut lining assessment via OAT and clinical evaluation · Targeted repair with clinician-selected nutritional and supplemental protocols · Identification and elimination of driving factors (food reactivity, dysbiosis, medication burden)
Common Presentations
Microbiome Imbalance
The wrong bacteria, in the wrong proportions, in the wrong places.
Gut dysbiosis — disruption of the microbial ecosystem — and small intestinal bacterial overgrowth (SIBO) are among the most common and most underdiagnosed drivers of chronic gastrointestinal symptoms, fatigue, nutrient malabsorption, and mood disruption. ARBOUR's assessment identifies dysbiotic patterns and designs targeted restoration protocols.
ARBOUR approach: Comprehensive microbial assessment · Targeted antimicrobial or probiotic protocols · Dietary modification · Follow-up assessment to confirm restoration
Common Presentations
Immune-Mediated Food Reactions
Not an allergy. Something slower, subtler, and more damaging.
Unlike IgE-mediated food allergies (immediate, dramatic), food sensitivities involve delayed IgG and IgA immune reactions that can take 24–72 hours to manifest — making them nearly impossible to identify without testing. They are among the most consistent drivers of chronic inflammation, brain fog, joint pain, skin conditions, and gut symptoms.
ARBOUR approach: Food sensitivity panel (IgG/IgA) · Structured elimination and reintroduction protocol · Gut lining repair to reduce reactivity over time · Dietary framework built around individual response
Common Presentations
Autoimmune Trigger Identification
The gut connection most autoimmune patients were never told about.
The gut-immunity connection is one of the most established in functional medicine research. Intestinal permeability, molecular mimicry between gut antigens and self-tissue, and dysbiosis-driven immune activation are among the most consistent triggers for autoimmune flares and disease progression. ARBOUR's functional approach identifies and addresses gut-driven autoimmune triggers alongside — not instead of — conventional disease management.
ARBOUR approach: Gut-autoimmune trigger identification · Collaborative approach with conventional rheumatology/immunology when indicated · Anti-inflammatory nutritional protocols · Gut repair as adjunctive autoimmune support
Common Presentations
Gut Health · Ann Arbor
Schedule a gut health consultation at ARBOUR. We run the comprehensive assessment, identify what is disrupted, and build the targeted protocol — then follow up to confirm it's working.
Thyroid — Beyond TSH
The most common missed diagnosis in medicine. We look properly.
Standard thyroid testing measures TSH — a pituitary signal, not a thyroid function marker. ARBOUR measures Free T3, Free T4, Reverse T3, thyroid antibodies, and the conversion efficiency between T4 and active T3 — the complete picture of thyroid function that reveals the subclinical hypothyroidism, Hashimoto's autoimmune thyroiditis, and conversion dysfunction that TSH alone will never show.
ARBOUR approach: Full thyroid panel including Free T3, Free T4, Reverse T3, TPO/TgAb antibodies · Nutritional support for thyroid function (selenium, zinc, iodine assessment) · Autoimmune trigger identification · Integration with hormone optimization when indicated
Common Presentations
HPA Axis · Adrenal Function
The stress response that stopped responding correctly.
The hypothalamic-pituitary-adrenal (HPA) axis regulates the body's stress response — and its dysregulation is one of the most pervasive and most overlooked contributors to fatigue, sleep disruption, weight gain, immune dysfunction, and hormonal imbalance. The DUTCH test maps cortisol across the full diurnal curve — revealing patterns that a single blood draw cannot capture.
ARBOUR approach: DUTCH test for comprehensive cortisol metabolite mapping · Identification of HPA dysregulation pattern · Targeted adaptogenic, nutritional, and lifestyle protocols · Integration with sleep and stress physiology
Common Presentations
Sex Hormone Metabolism
It is not just how much estrogen. It is what your body does with it.
Estrogen dominance — driven by impaired clearance, gut dysfunction, or environmental xenoestrogen load — produces a distinctive symptom picture regardless of total estrogen levels. The DUTCH test reveals not just hormone levels but the metabolic pathways through which hormones are processed — identifying the specific methylation and detoxification dysfunctions driving symptoms.
ARBOUR approach: DUTCH full panel for hormone metabolite pathways · MTHFR genomic assessment for methylation capacity · Gut support for enterohepatic hormone clearance · Nutritional DIM/calcium-D-glucarate support when indicated
Common Presentations
Integrates with ARBOUR Hormone Optimization
Finding why, then treating what.
Functional hormone medicine and ARBOUR's hormone optimization program are designed to work together — not as competing approaches. Functional assessment identifies the root causes of hormone disruption: gut dysfunction impairing clearance, nutrient deficiencies limiting production, HPA dysregulation suppressing signaling. Hormone therapy then restores what functional interventions cannot fully correct. The two together produce outcomes neither achieves alone.
Functional Hormone Medicine · Ann Arbor
Schedule a functional hormone assessment at ARBOUR. We run the tests that reveal what is actually happening — not just whether you cross the threshold for disease.
Cellular Energy Production
When your cells' power plants are failing — everything suffers.
Mitochondria produce over 90% of cellular energy — and their dysfunction is the single most common undiagnosed cause of unexplained fatigue, brain fog, exercise intolerance, and accelerated aging. Organic acids testing (OAT) provides a direct window into mitochondrial function — measuring the metabolic intermediates that reveal exactly where energy production is breaking down and which nutrients are rate-limiting.
ARBOUR approach: Organic acids testing (OAT) for comprehensive mitochondrial and metabolic assessment · Targeted nutrient repletion (CoQ10, B vitamins, magnesium, carnitine) · NAD+ IV protocol for mitochondrial restoration · Toxin assessment for mitochondrial disruptors · Peptide protocols when indicated (MOTS-c)
Common Presentations
Cognitive Performance
Clarity is not a luxury. It is a biological output of a healthy system.
Brain fog — the constellation of poor concentration, word-finding difficulty, mental slowness, and memory disruption — is one of the most commonly reported symptoms in functional medicine practice and one of the most consistently under-addressed in conventional medicine. ARBOUR's brain fog assessment identifies the specific drivers — inflammatory, nutritional, hormonal, or mitochondrial — and targets each one with precision.
ARBOUR approach: Comprehensive inflammatory marker panel · Hormone assessment including thyroid and cortisol · OAT for mitochondrial and neurotransmitter metabolites · Micronutrient assessment · Cognitive peptide protocols when appropriate (Selank, Semax — investigational, disclosed at consultation)
Common Presentations
Stress Physiology
Not a lifestyle choice. A physiological state.
Clinical burnout and chronic fatigue syndromes represent a spectrum of HPA axis dysregulation, mitochondrial depletion, and neuroinflammation that cannot be resolved by rest alone. ARBOUR's approach maps the physiological underpinnings — cortisol curve via DUTCH, mitochondrial status via OAT, inflammatory burden, and nutrient depletion — and addresses each component with a targeted restoration protocol.
ARBOUR approach: DUTCH test for cortisol and adrenal assessment · OAT for mitochondrial status · Inflammatory marker panel · IV nutritional support (Myers, NAD+) · Adaptogenic and restorative protocols · Sleep physiology assessment
Common Presentations
Nutrient Biochemistry
The foundation no protocol can function without.
Almost every biological process implicated in brain fog and fatigue — neurotransmitter synthesis, mitochondrial energy production, methylation, hormone metabolism, cellular repair — requires specific micronutrients as cofactors. Deficiencies in B12, folate, magnesium, zinc, iron, vitamin D, and CoQ10 are among the most common and most consistently missed drivers of chronic cognitive and energy symptoms.
ARBOUR approach: Comprehensive micronutrient assessment · Standard and specialty lab evaluation for B12, folate, vitamin D, ferritin, zinc, magnesium, CoQ10 · Targeted IV and oral repletion protocols · Genomic assessment for absorption and metabolism variants (MTHFR)
Commonly Deficient
Brain & Energy Medicine · Ann Arbor
Schedule a brain and energy consultation at ARBOUR. We will find what is driving your cognitive and energy symptoms — not guess, not suggest lifestyle changes, but identify the specific biological mechanisms and address them directly.
Heavy Metal Burden
Lead, mercury, arsenic, cadmium — measurable, and addressable.
Heavy metal accumulation is among the most direct disruptors of mitochondrial function, thyroid hormone metabolism, neurological signaling, and immune regulation. Lead, mercury, arsenic, and cadmium are the most clinically significant metals in environmental exposure — and their burden is systematically underassessed in conventional medicine. ARBOUR's heavy metal panel identifies specific accumulation and designs targeted chelation support and nutrient repletion protocols.
ARBOUR approach: Comprehensive heavy metal panel (blood and/or urine) · OAT for detoxification pathway assessment · Targeted chelation support and mineral repletion · Genomic assessment for detox SNPs (MTHFR, COMT, GSTP1) · Environmental source identification guidance
Common Presentations
Mold & Mycotoxin Illness
One of the most consistently missed causes of multi-system illness.
Chronic inflammatory response syndrome (CIRS) and mold-related illness produce a distinctive multi-system symptom pattern — fatigue, brain fog, respiratory symptoms, joint pain, mood disruption, and sensory sensitivity — that is frequently misdiagnosed as fibromyalgia, depression, or CFS. ARBOUR's assessment includes mycotoxin evaluation and the clinical markers most associated with CIRS alongside targeted remediation support.
ARBOUR approach: Mycotoxin panel and CIRS markers · Environmental history and exposure assessment · Targeted binder and detoxification protocols · Supportive care for inflammatory burden reduction · Referral coordination for environmental remediation when indicated
Common Presentations
Genomic Detox Capacity
Why some people accumulate toxins while others clear them.
Genetic variants in detoxification enzymes — MTHFR, COMT, GSTP1, SOD2, and others — determine how efficiently your body processes and eliminates environmental toxins, hormones, and metabolic waste products. ARBOUR's genomic panel identifies variants that reduce detox capacity — allowing targeted nutritional and lifestyle support that bypasses these vulnerabilities rather than ignoring them.
ARBOUR approach: Targeted genomic panel for key detox SNPs · Methylation status assessment · Personalized nutrient support for impaired pathways · Integration of genomic findings into comprehensive protocol design
Common Presentations
Detoxification Support
Evidence-based. Clinician-designed. Never a cleanse.
ARBOUR's detoxification protocols are built around what the labs show — not generic cleanses or generalized supplement protocols. Glutathione repletion for oxidative burden. Targeted mineral repletion post-chelation. Methylation support for genomic variants. IV nutritional therapy for systemic detoxification support. Every intervention is specific, measured, and followed up.
ARBOUR detox tools: Glutathione IV (available in IV therapy program) · Oral and IV nutrient repletion · Genomic-targeted methylation support · Binder protocols for mycotoxin clearance · Follow-up lab assessment to confirm clearance
Toxin Assessment · Ann Arbor
Schedule a toxin assessment consultation at ARBOUR. We identify what has accumulated, assess your detoxification capacity, and design a targeted clearance protocol — then follow up to confirm it's working.
Longevity Functional Medicine at ARBOUR
The hallmarks of biological aging — mitochondrial dysfunction, genomic instability, epigenetic drift, cellular senescence, stem cell exhaustion, and altered intercellular communication — are not inevitable at any given chronological age. They are processes with identifiable drivers, measurable markers, and increasingly, targetable interventions.
ARBOUR's longevity functional medicine program assesses your biological status across every major aging pathway — then integrates functional medicine findings with our hormone optimization, peptide therapy, NAD+ IV protocols, and nutritional programs to address what it finds.
This is not a spa treatment. It is rigorous clinical biology applied to the problem of aging.
What We Assess
Mitochondrial function (OAT) · Hormone metabolites (DUTCH) · Genomic risk variants · Inflammatory burden · Nutrient sufficiency · Metabolic efficiency
Administration
Subcutaneous injection · Oral/sublingual · Nasal spray · Topical — protocol-dependent
Sourcing Standard
Hormone optimization · Longevity peptides (MOTS-c, Epithalon) · NAD+ IV therapy · Metabolic optimization · Ongoing functional follow-up
Mitochondrial dysfunction is a primary driver of biological aging — measurable via OAT and addressable with targeted nutrient support, NAD+ repletion, and MOTS-c peptide therapy. ARBOUR assesses and addresses mitochondrial status as the foundation of every longevity program.
MTHFR and key SNP variants determine your methylation capacity, detoxification efficiency, inflammation tendency, and nutrient metabolism — all of which directly influence aging rate. ARBOUR's genomic panel identifies your specific variants and designs protocols that work with your genetics rather than against them.
The DUTCH test reveals not just hormone levels but the metabolic pathways through which hormones age the body or protect it. Estrogen metabolism, testosterone catabolism, and cortisol burden are among the most important hormonal determinants of biological aging — and among the most actionable when assessed correctly.
Longevity Functional Medicine · Ann Arbor
Schedule a longevity functional medicine assessment at ARBOUR. We measure where your biology is today, identify every accelerator of biological aging, and build the integrated protocol to address them — across every relevant clinical program we offer.
Dried Urine Test for Comprehensive Hormones · Precision Analytical
The DUTCH test is the most comprehensive hormone metabolite panel available — measuring not just hormone levels but the specific pathways through which they are produced, metabolized, and cleared. It captures the full cortisol diurnal curve, estrogen and testosterone metabolites, progesterone, DHEA, melatonin, and organic acid markers for neurotransmitter metabolism. A single standard blood draw for hormones provides a fraction of this picture.
What it reveals that standard labs miss: Cortisol rhythm dysfunction (not just a single level) · Estrogen metabolite pathway (protective vs. carcinogenic) · Androgen conversion and clearance · Methylation capacity indicators · Neurotransmitter metabolism markers · DHEA-cortisol balance across the day
Comprehensive Metabolic Assessment · Great Plains / Mosaic Diagnostics
The organic acids test provides a systemic snapshot of metabolic function — measuring the organic acid byproducts of cellular metabolism in urine to reveal mitochondrial function, nutrient cofactor sufficiency, detoxification capacity, neurotransmitter metabolism, intestinal microbial activity, and oxidative stress burden. It is one of the highest-yield single panels in functional medicine practice.
What it reveals: Mitochondrial energy cycle function (Krebs cycle markers) · Vitamin and mineral cofactor depletion (B vitamins, CoQ10, magnesium) · Neurotransmitter metabolites · Detoxification pathway efficiency · Fungal and bacterial dysbiosis markers · Oxidative stress burden
MTHFR · Key SNPs · Functional Genomics
ARBOUR's genomic panel assesses the single nucleotide polymorphisms (SNPs) most clinically relevant to functional medicine — including MTHFR variants affecting methylation and B vitamin metabolism, COMT affecting catecholamine and estrogen clearance, detoxification SNPs affecting toxin processing, and inflammation variants affecting immune regulation. Genomic findings inform every other element of your functional medicine protocol.
Key variants assessed: MTHFR C677T and A1298C (methylation, B vitamins, homocysteine) · COMT (dopamine, estrogen metabolism) · GSTP1, SOD2 (detoxification and oxidative stress) · VDR (vitamin D metabolism) · Additional variants based on clinical picture
CBC · CMP · Thyroid · Hormones · Inflammatory Markers
Standard labs at ARBOUR are ordered comprehensively and interpreted through functional reference ranges — the narrower ranges associated with optimal health rather than the wide reference ranges designed to identify disease. The same CBC and CMP that looks "normal" through a disease lens often reveals significant functional findings when evaluated against optimal ranges. Full thyroid panel (TSH, Free T3, Free T4, Reverse T3, TPO/TgAb), advanced cardiovascular markers (hsCRP, ApoB), sex hormones, vitamin D, B12, ferritin, and fasting insulin are included in the ARBOUR standard workup.
What's included: Full thyroid panel · Sex hormones · Fasting insulin · hsCRP · ApoB · Vitamin D · B12 · Folate · Ferritin · CBC / CMP · Lipid panel · Additional markers as clinically indicated
How the Testing Panels Connect
Used in Isolation.
ARBOUR's diagnostic approach is system-oriented — not symptom-oriented. A patient presenting with brain fog may receive the OAT for mitochondrial status, the DUTCH for cortisol mapping, the genomic panel for methylation variants, and standard labs for thyroid and nutrient status — because brain fog has multiple biological causes and a single panel addresses only one dimension of the picture.
Not every patient requires every panel. Testing is clinician-selected based on your specific health history, symptom pattern, and clinical picture. The result is a diagnostic strategy that is both comprehensive and targeted — not an expensive panel ordered indiscriminately.
Gut Health · Ann Arbor
Schedule a gut health consultation at ARBOUR. We run the comprehensive assessment, identify what is disrupted, and build the targeted protocol — then follow up to confirm it's working.
Regenerative medicine and aesthetic arts — where science meets the artistry of transformation. Ann Arbor, Michigan.
