ACE · Perceived Stress · Sleep · Social Connection · Meaning · Trauma · Attention · Brain-Body Integration
Test, Don't Guess · Stephen Duncan Nutrition · Edinburgh
High ACE scores correlate with elevated hs-CRP, altered cortisol rhythm, HPA dysregulation, impaired gut barrier, and reduced NK cell function. Chronic displacement grief and loneliness produce measurable inflammatory burden equivalent to smoking 15 cigarettes/day (Holt-Lunstad). These are not soft measures — they are physiological realities that appear in your blood chemistry. Scores feed into the TDG Master Dashboard alongside physical toxic load.
Validated research instrument. ACE score is the most powerful predictor of chronic disease across virtually every system. Each additional ACE increases risk of heart disease, cancer, autoimmunity, and mental illness in a near-perfect dose-response relationship (Felitti et al., 1998; Kaiser Permanente).
During the first 18 years of your life, did a parent or other adult in the household often or very often...
Cohen's validated measure of current subjective stress. In the past month, how often have you felt...
0 = Never | 1 = Almost never | 2 = Sometimes | 3 = Fairly often | 4 = Very often
Pittsburgh Sleep Quality Index — validated 7-domain tool. Score <5 = good sleep. Score 5–10 = moderate difficulty. Score >10 = poor sleep with significant health consequences.
Blue light from screens suppresses melatonin via ipRGCs (intrinsically photosensitive retinal ganglion cells). This is well-established photobiology, not speculation. Delayed melatonin → delayed cortisol awakening → HPA axis dysregulation cascade.
Loneliness is as powerful a cardiovascular risk factor as smoking 15 cigarettes/day (Holt-Lunstad meta-analysis, 300,000+ participants). Social connection mediates inflammatory pathways, HPA axis function, and immune regulation.
How often do you feel the following? (1=Never, 2=Rarely, 3=Sometimes, 4=Often)
Forced or involuntary displacement from homeland creates chronic unresolved grief — a sustained physiological stressor that accumulates over decades. The "healthy immigrant effect" shows migrants typically arrive healthier than host populations but health declines toward host-country norms, driven by acculturative stress, dietary change, and loss of social fabric. This is a legitimate clinical variable.
Peer-reviewed: dog ownership associated with lower CVD mortality, lower cortisol, and higher oxytocin (Nagasawa et al., 2015, Science — bidirectional oxytocin increase during mutual gaze). Early-life pet exposure reduces allergy and asthma (multiple birth cohort studies). The oxytocin and unconditional positive regard that animals provide are not trivial — they are measurable biological inputs.
Purpose in life and ikigai-type alignment are independent predictors of longevity and cardiovascular health. Blue zone populations share purpose as a common factor alongside diet and movement. Viktor Frankl's logotherapy and Antonovsky's salutogenesis — what makes people healthy — both centre meaning.
Attentional fragmentation from technology use is acquired and environmentally driven — distinct from neurodevelopmental ADHD. Mechanism: dopaminergic reward conditioning to short-cycle stimulation + sleep disruption via blue light + chronic partial attention state. Distinguishing these has important intervention implications.
Unresolved trauma drives chronic sympathetic activation, impairs vagal tone, alters gut microbiome via HPA-gut axis, and suppresses NK cell function. The body keeps the score. Van der Kolk's work is now mainstream neuroscience.
Functional Neurological Disorder (FND) and functional somatic syndromes involve disrupted predictive processing — the brain's model of the body becoming uncoupled from sensory reality. TDG functional medicine may identify the biochemical substrate that destabilised that prediction machinery. These are not competing frameworks — they are different resolutions of the same picture.
The two "functionals" explained: When a neurologist says "functional," they mean symptoms arising from disrupted brain function without structural lesion — a software problem, not hardware. When functional medicine says "functional," it means measurable physiological dysfunction not yet at disease-diagnosis threshold. These are not contradictory. LPS from gut dysbiosis crossing a leaky gut barrier triggers microglial activation → neuroinflammation → disrupted interoceptive prediction. The functional medicine labs may explain WHY the brain's prediction machinery went wrong. A neuro rehab physio treating FND and a functional medicine practitioner addressing gut-brain biochemistry are working on the same problem from different angles.
Porphyromonas gingivalis isolated from coronary atheromas in multiple studies. The American Heart Association acknowledges the periodontal-cardiovascular epidemiological association. Mechanism: periodontal bacteraemia → systemic CRP elevation → endothelial dysfunction → accelerated atherosclerosis. Dental health is cardiovascular health.
Iatrogenic harm is a legitimate, mainstream medical category. Medical errors and adverse drug reactions cause significant burden and are documented in pharmacovigilance systems. This section records clinical exposures with neutrality — no political framing, no presumption of causation.
Recorded for clinical completeness. PFAS from synthetic mask materials (surgical/N95) is published literature — Chiu et al., 2020 detected volatile fluorinated compounds from mask materials. Methanol contamination in some pandemic-era hand sanitisers caused documented harm. Psychological impacts of isolation, hygiene ritualisation, and circadian disruption are measurable.
Salutogenesis — what creates and maintains health. Antonovsky's sense of coherence (comprehensibility, manageability, meaningfulness) is a stronger predictor of health than absence of risk factors. These inputs raise the resilience score and are the targets alongside burden reduction.
Auto-generated from assessment data. Clinical hypotheses — not diagnoses.
Complete sections above to generate pattern analysis...
HRV integrates psychosocial load into objective physiology — the most direct bridge between mind and body in measurement terms.
Low HRV = high allostatic load, poor stress recovery. Optimal: typically 40–80ms depending on age/sex.
Chronic sympathetic activation raises resting HR. Optimal: 55–65 bpm.
Complete sections above to generate protocol priorities...