Frequently Asked Questions

For non-urgent concerns, the best way to reach Dr. Birkmeier is by sending a message through the patient portal or leaving a voicemail at the office. She will get back to you as soon as possible during office hours.

For urgent matters, please call the Answering Service at 248.656.4545. Keep in mind that depending on the clinical situation, there may be a charge for after-hours consultations.

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For most acute illnesses, Dr. Birkmeier recommends seeing your primary care provider (PCP) or visiting urgent care, as they are best equipped to handle immediate medical needs.

However, if your acute issue is directly related to a treatment plan prescribed by Dr. Birkmeier, she’s happy to provide guidance and support to ensure continuity of care. Her focus remains on addressing the root causes of chronic conditions while ensuring patients get the right care for urgent medical concerns.

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We use a combination of standard and specialized labs to get a comprehensive understanding of your health. These typically include:

• LabCorp – For bloodwork to assess immune function, nutrient levels, and genetic predispositions (often covered by insurance).
• Mosaic MycoTox – To detect environmental mold exposure.
• DNA Connexions Lyme Panel – A PCR test for vector-borne infections.
• Stool Testing & Urine Organic Acid Testing – To evaluate gut health and fungal overgrowth.

The specific labs we use depend on your unique health needs, previous testing, and treatment goals and often include more that the labs listed above.

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Chronic Inflammatory Response Syndrome (CIRS) is a complex, multisystem illness caused by prolonged exposure to biotoxins, such as mold, bacteria, and other environmental toxins. CIRS can affect multiple organ systems and lead to a wide array of symptoms, which can often mimic other chronic conditions. Common symptoms include:

1. Neurological and Cognitive Symptoms:
   
   • Brain fog and difficulty concentrating
   • Memory impairment and slowed mental processing
   • Mood swings, anxiety, and depression
   • Chronic fatigue and unrefreshing sleep
2. Respiratory and Sinus Issues:
   
   • Shortness of breath
   • Chronic sinus congestion or infections
   • Asthma-like symptoms or wheezing
3. Gastrointestinal Disturbances:
   
   • Nausea, bloating, and abdominal pain
   • Food sensitivities and weight fluctuations
4. Musculoskeletal Symptoms:
   
   • Joint and muscle pain
   • Unexplained weakness or stiffness
   • Exercise intolerance
5. Skin and Sensory Issues:
   
   • Unexplained rashes or skin sensitivity
   • Light and sound sensitivity
   • Temperature regulation issues

At the Restorative Medicine Center, a specialized approach to CIRS treatment includes advanced diagnostic tools, detoxification strategies, and immune-modulating therapies to help patients recover and restore their health.

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The Restorative Medicine Center takes a root-cause, patient-centered approach, which is fundamentally different from the conventional medical model in several key ways:

1. Comprehensive and Holistic Evaluation:
   
   • Unlike conventional medicine, which often focuses on symptom suppression, functional medicine looks at the "big picture" and explores how different systems in the body are interconnected.
   • Advanced testing methods go beyond standard labs to identify underlying imbalances, such as chronic infections, environmental toxins, and nutritional deficiencies.
2. Personalized Treatment Plans:
   
   • Conventional medicine tends to follow standardized treatment protocols based on diagnosis, whereas Restorative Medicine tailors interventions based on each individual's unique health history, genetics, and lifestyle.
3. Proactive Health Optimization:
   
   • Instead of waiting for symptoms to develop into a diagnosable condition, the focus is on early detection, prevention, and optimization of health through nutrition, lifestyle modifications, and targeted supplements.
4. Emphasis on Patient Empowerment:
   
   • Patients are actively involved in their healing journey, receiving education and tools to make informed lifestyle changes that support long-term health.
5. Multi-System Approach:
   
   • Functional medicine examines how different systems (gut, immune, neurological, endocrine) work together, addressing health concerns from a whole-body perspective instead of treating isolated symptoms.

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The Restorative Medicine Center specializes in diagnosing and treating a wide range of chronic and complex conditions that often go unrecognized or untreated in conventional medicine. Some of the key conditions treated include:

1. Chronic Infections and Immune Disorders:
   
   • PANDAS/PANS (Pediatric Autoimmune Neuropsychiatric Disorders)
   • Lyme disease and co-infections
   • Epstein-Barr Virus (EBV) and chronic viral syndromes
   • Stealth infections (mycoplasma, mold-related illnesses)
2. Inflammatory and Toxicity-Related Conditions:
   
   • Chronic Inflammatory Response Syndrome (CIRS)
   • Mold illness and biotoxin-related diseases
   • Heavy metal toxicity
   • Multiple Chemical Sensitivity (MCS)
3. Hormonal and Metabolic Disorders:
   
   • Thyroid dysfunction (hypothyroidism, Hashimoto’s)
   • Adrenal fatigue and HPA axis dysfunction
   • Metabolic syndrome and insulin resistance
   • Hormonal imbalances affecting mood, weight, and energy
4. Neurological and Cognitive Conditions:
   
   • Brain fog and cognitive decline
   • ADHD and focus-related issues
   • Mood disorders linked to underlying biological imbalances
5. Gastrointestinal Disorders:
   
   • Leaky gut syndrome
   • Small Intestinal Bacterial Overgrowth (SIBO)
   • Irritable Bowel Syndrome (IBS)
   • Food sensitivities and intolerances

By offering an integrative and investigative approach, the clinic helps patients uncover the true causes of their chronic symptoms and provides targeted treatment plans to support long-term healing.

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The "Root Cause Triad" is a foundational concept in functional medicine that examines three key interrelated factors that contribute to chronic illness and unresolved health conditions. Dr. Birkmeier-Fredal’s approach at the Restorative Medicine Center incorporates this triad to uncover the underlying imbalances driving patient symptoms. The triad consists of:

1. Infections and Stealth Pathogens:
   
   • Many chronic conditions are triggered or worsened by hidden infections such as Lyme disease, Epstein-Barr virus (EBV), mold toxicity, and other stealth pathogens. These infections can evade the immune system, leading to persistent inflammation and multisystem dysfunction.
   • The practice utilizes specialized testing to identify these infections and offers targeted antimicrobial, immune-supportive, and detoxification therapies.
2. Toxicity and Environmental Exposures:
   
   • Toxins from mold, heavy metals, pesticides, and other environmental pollutants can accumulate in the body, leading to systemic inflammation and disruption of key biological pathways.
   • Restorative Medicine focuses on identifying sources of exposure and implementing detoxification strategies to support the body's natural cleansing processes.
3. Immune and Inflammatory Dysregulation:
   
   • Chronic inflammation and an overactive or suppressed immune response can lead to autoimmunity, fatigue, and neurological symptoms.
   • By addressing gut health, diet, stress levels, and inflammatory triggers, the practice works to restore balance and resilience in the immune system.

By addressing these three core areas, the Restorative Medicine Center aims to create a comprehensive, personalized strategy to heal the body at its foundational level.

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Integrative Functional Medicine is an advanced, patient-centered approach to healthcare that focuses on identifying and addressing the root causes of disease rather than simply managing symptoms. At the Restorative Medicine Center, this model combines the best of conventional medical diagnostics with cutting-edge functional and integrative techniques to create a personalized plan for each patient.

Functional medicine considers the complex interplay between genetics, lifestyle factors, and environmental exposures that contribute to health and disease. Instead of a one-size-fits-all approach, this method seeks to understand the “why” behind a patient’s symptoms by conducting comprehensive assessments that include:

• In-depth health history and lifestyle analysis: Understanding how factors such as diet, sleep, stress, and toxic exposures influence health.
• Advanced diagnostic testing: Utilizing tools such as hormone panels, microbiome analysis, food sensitivity testing, and genetic markers to uncover hidden imbalances.
• Personalized treatment plans: Integrating evidence-based therapies such as nutritional counseling, detoxification protocols, immune support, and mind-body interventions.

At the Restorative Medicine Center, the goal of Integrative Functional Medicine is to empower patients with the knowledge and tools to restore their health, prevent chronic diseases, and achieve optimal well-being through sustainable lifestyle modifications and targeted interventions.

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No

We are a consultative specialty practice, and we advise all patients to continue working with a Primary Care Physician to ensure they receive recommended general health screenings.

Sometimes

Dr. Birkmeier is considered an out of network physician will all insurance carriers, and does not bill insurance directly, so payment is due at the time of service. However, many patients are able to receive reimbursement from their insurance companies, after the fact, by filling out and submitting the Member Reimbursement forms available online.

Absolutely

Establishing and using an FSA or HSA is a great way to make out of pocket costs more reasonable and is highly recommended.

Most recommended supplements can be ordered from Full script - our online dispensary.
Please use the following link to access the 25% discount on all products:
https://us.fullscript.com/welcome/tbirkmeier-fredal1553779100

The cost of the appointments is 100% based on the time spent on your case. This starts with reviewing labs and questionnaires and ends with ordering labs, creating instructions and sending in prescriptions - so it will include more than just the time spent face to face, on zoom or on the phone. Dr. Birkmeier-Fredal strives to work quickly and efficiently to help minimize your out-of-pocket costs, and does record the beginning and ending time of your appointments on your invoice. Most appointments are between 10-60 minutes and charged as follows:

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Established Patients $9/minute:

10 minutes - $90

20 minutes - $180

30 minutes - $270

60 minutes - $540

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New Patients $10/minute:

30 minutes - $300

60 minutes - $600

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Please see the Blog entitled Tips on Optimizing Your Appointment Time to learn to save time and money while still effectively addressing your health issues.