Work With Dr. Michael Smith
People rarely arrive with one symptom and one simple question.
You may be living with an established autoimmune diagnosis, several overlapping conditions, a recent flare, or years of symptoms that have never been adequately explained. You may already be working with physicians and specialists while still wondering how nutrition, digestion, sleep, movement, physical capacity, stress physiology, and the larger patterns of your health fit together. You may also be carrying a substantial collection of laboratory reports, medications, supplements, dietary rules, treatment plans, and conflicting advice.
Our first task is not to change everything. It is to understand the history, identify the present priorities, and decide what kind of support is appropriate now.
Online consultations and in-person care are available. In-person appointments are offered in Nelson, British Columbia. [NEEDS: confirm clinic location and jurisdiction]
This work may be helpful when
You have an established autoimmune diagnosis
A diagnosis provides important information about disease activity, risk, treatment, monitoring, and the medical care you may require. It may not explain the whole experience of living in your body.
Fatigue, digestive changes, disrupted sleep, pain, reduced physical capacity, medication effects, nutritional concerns, and the emotional burden of chronic illness may all require attention alongside specialist care.
My role is not to replace your physician. It is to help build a broader and more coherent plan around the diagnosis, treatment, and monitoring already in place.
You have complex or unexplained symptoms
Some people know that something has changed long before their symptoms form a pattern that testing can easily name. You may be living with persistent fatigue, pain, digestive dysfunction, sleep disturbance, cognitive changes, heightened sensitivity, or reduced exercise tolerance.
Integrative care does not mean assuming that every unexplained symptom is autoimmune. It means taking the experience seriously, developing a careful chronology, reviewing what has already been investigated, and identifying which questions deserve attention next. Sometimes the most appropriate recommendation is further medical assessment.
You are experiencing a flare or loss of stability
When symptoms intensify, the natural impulse is often to change everything at once. A flare may lead to greater dietary restriction, a rapidly expanding supplement programme, repeated testing, or physical demands that exceed the body’s present capacity.
The immediate work is usually more precise. We protect remaining resources, simplify unnecessary variables, identify signs that require medical attention, and restore enough predictability to understand what has changed. Once stability returns, the work can gradually become more constructive.
You are ready to rebuild
Recovery is more than the reduction of symptoms. It may include rebuilding nourishment, digestion, sleep, strength, metabolic range, connective-tissue health, confidence, and a more sustainable relationship with effort.
The body may need nourishment before further restriction, rest before conditioning, mobility before intensity, and confidence before ambition. Rebuilding is progressive. The goal is to create greater capacity without immediately spending every new reserve.
You want a broader view of your present care
You may already have excellent medical support and still want time to consider how its different parts relate. An integrative consultation allows us to examine your history, treatments, nutrition, daily function, laboratory information, physical capacity, and the practical realities of managing a chronic condition.
The purpose is not to collect more interventions. It is to determine which possibilities are meaningful and which can safely be left alone.
How the Epi-AIP informs your care
The Epigenetic Autoimmune Protocol — the Epi-AIP — is not a standardized programme imposed upon every patient. It is a clinical and educational map that helps us organize a complex process. During assessment, we consider three questions.
Where does the present pattern appear to sit on the Autoimmune Spectrum?
- Is the system becoming increasingly reactive?
- Has reactivity become more persistent and depleting?
- Is there established autoimmune activity or tissue involvement?
- Are several systems becoming involved?
- Is the overall direction moving toward greater renewal or further loss of adaptability?
The Spectrum does not replace diagnosis. It helps place the diagnosis and symptoms within a broader trajectory.
Which Phase describes the work required now?
- Rest and Recover
- Reset and Rebuild
- Restore and Realign
- Rebalance and Reawaken
The right intervention in the wrong Phase may become another burden.
Which Pillars are supporting — or consuming — adaptability?
- Good Food and Nutrition
- Metabolic Adaptability
- Physical Fitness, Rest, and Sleep
- Mindfulness and Mindset
- Supplementation
- Support and Spiritual Practice
The Pillars help us see where the process is coherent and where it is losing support.
A person in an active flare may need greater stability before beginning a strengthening programme. Someone who is medically stable but depleted may need nourishment and rehabilitation rather than continued restriction. A person who has rebuilt significant capacity may be ready to expand food, movement, work, travel, and participation.
You may be eating well while sleeping poorly. You may be physically active while becoming progressively less able to recover. You may have an impressive supplement programme but no clear sense of what is helping. You may meditate regularly while living inside a structure that continually exceeds your capacity.
The initial consultation
The initial consultation gives us time to step back and consider the whole landscape of your health. You do not need to arrive with a perfect theory, a complete medical archive, or a carefully rehearsed explanation of everything that has happened. The intake process helps us begin organizing the history together.
We may review:
- Present symptoms and concerns
- Established diagnoses and unresolved questions
- Major illnesses, infections, surgeries, injuries, and changes in health
- Current medications, supplements, and therapies
- Nutrition and digestive function
- Sleep, energy, pain, movement, and physical capacity
- Relevant laboratory and specialist findings
- Previous treatments and how your body responded
- The practical demands of work, family, finances, and daily life
The purpose is not to declare every event significant. It is to understand the chronology, notice meaningful relationships, and determine what deserves priority.
At the end of the consultation, you should have a clearer understanding of the immediate questions, an initial sequence of recommendations, and a sense of what should happen next. Complex cases are rarely resolved in one conversation. The goal is not to produce the longest possible treatment plan. It is to establish a clear and workable beginning.
A thoughtful sequence rather than an overwhelming protocol
Many people with chronic illness have already received more advice than they can reasonably follow. My approach is organized around four recurring movements.
1. Understand
We develop a chronology and look at the relationships among symptoms, diagnoses, treatments, nutrition, physical function, and the larger history of your health.
2. Prioritize
We distinguish among what is urgent, what is foundational, what may be useful to explore, and what can safely wait.
3. Support
We introduce a manageable number of recommendations suited to your present needs and available capacity.
4. Reassess
We observe what happens next. A useful plan provides direction while remaining flexible enough to learn from the response.
The process is iterative: Understand. Prioritize. Support. Reassess.
Clinical tools that may be included
The following are not separate packages or predetermined requirements. They are different ways of understanding and supporting the same person.
Traditional Chinese Medicine and acupuncture
TCM examines relationships among symptoms, constitution, nourishment, circulation, digestion, rest, and adaptation. For appropriate in-person patients, care may include Chinese medical assessment, pulse and tongue diagnosis, acupuncture, and other forms of traditional support.
Functional and nutritional assessment
Considers how symptoms may relate to digestion, nutrient sufficiency, metabolism, food tolerance, sleep, medication effects, inflammation, and available laboratory findings — a way of identifying modifiable influences worth addressing.
Laboratory review
Testing is useful when it can clarify a decision, identify a meaningful deficiency or risk, or change the direction of care. More testing is not automatically better care.
Nutrition and Epi-AIP guidance
Individualized rather than automatically restrictive. Food should gradually become a source of nourishment and information — not a permanent test of moral character.
Movement, breath, and physical rebuilding
Recommendations may include mobility, breathing practices, pacing, therapeutic qigong, restorative movement, gradual conditioning, or progressive strength work.
Somatic awareness and stress regulation
These practices help a person perceive the body more accurately, respond to symptoms with greater proportion, and develop a more trustworthy relationship with effort, recovery, and uncertainty.
Working with your healthcare team
Integrative care should not require you to choose sides. I encourage appropriate relationships with family physicians, specialists, pharmacists, counsellors, physiotherapists, and other regulated healthcare professionals.
My work does not replace:
- Emergency medicine
- Primary medical care
- Specialist evaluation
- Diagnostic imaging
- Necessary medication
- Surgery
- Medical monitoring required for an established condition
I do not recommend discontinuing prescribed medication without discussion with the practitioner responsible for prescribing and monitoring it. When appropriate, I may suggest questions to bring to your physician or recommend that a symptom, laboratory finding, or change in condition receive further medical assessment.
A collaborative process
Good care requires communication. You are invited to ask questions and to say when a recommendation is too expensive, restrictive, complicated, or exhausting. A plan can be adjusted. Silence is much harder to work with.
Patients are encouraged to provide accurate health information, maintain an up-to-date medication and supplement list, communicate significant changes, and try agreed-upon recommendations at a realistic pace.
You do not need to monitor every bodily sensation like a nervous air-traffic controller. We identify what is worth observing and why it matters.
You also do not need to perform illness perfectly. The purpose of collaboration is not to make you responsible for controlling every variable. It is to help us make better decisions together.
What I do — and do not — promise
I do not promise a cure, guaranteed remission, or a predictable outcome. I do not assume that every symptom has one discoverable root cause. I do not use one universal protocol for every patient. I do not expect you to abandon appropriate medication or conventional medical care. I do not recommend testing simply to appear thorough. I do not believe an exhausted person should be handed an enormous programme and then blamed for being unable to complete it.
What I offer is:
- Careful attention
- Three decades of clinical experience
- A broad integrative perspective
- Clear explanations
- Prioritized recommendations
- Respect for your autonomy and available capacity
- A willingness to reassess when new information emerges
The work is not built around certainty. It is built around thoughtful observation, proportionate action, and a clearer understanding of what should happen next.
Choose the appointment information you need
The Initial Consultation
What to prepare, what we review, and what you may receive afterward.
Online Consultations
What virtual care can include, where it is available, and its limitations.
In-Person Care and Acupuncture
Traditional Chinese Medicine assessment, acupuncture, clinic location, and practical information for visiting the clinic. [NEEDS: confirm clinic location]
Follow-Up Care
How recommendations are reviewed, refined, progressed, or simplified over time.
Fees and Practice Policies
Appointment lengths, fees, insurance receipts, payment, cancellation, and other practical details. [NEEDS: fees, appointment lengths, cancellation policy]
Frequently Asked Questions
Answers to the most common questions about diagnosis, medication, testing, food protocols, online care, and what to bring.
Begin by understanding where you are now
You do not need to arrive with a complete theory about your illness. The initial consultation gives us time to understand the history, identify the present priorities, review the care already in place, and determine whether my approach is a useful fit for your needs.
Please do not use the general contact form for emergencies, urgent medical concerns, or detailed private health information.
The information on this website is provided for general educational purposes. It is not a substitute for individualized medical advice, diagnosis, emergency assessment, or treatment from your physician or another qualified healthcare professional.