Clinical case presentations are not statistical evidence — but they illuminate. They make abstract principles tangible and reveal how theory applies to real biological variability. All cases have been rigorously anonymised.

Case 1 — Refractory irritable bowel syndrome. A 34-year-old woman with six years of diarrhoea-predominant IBS refractory to multiple conventional interventions. Integrative assessment identified marked dysbiosis, elevated intestinal permeability markers and SIBO. The plan combined SIBO eradication, progressive microbiome restoration and mucosal rehabilitation. At six months, significant reduction in symptom frequency and documented improvement in quality of life.

Case 2 — Chronic burnout with endocrine comorbidity. A 47-year-old executive with progressive fatigue, sleep disturbance, difficulty concentrating and reduced libido. Assessment revealed compromised T4-T3 conversion, elevated reverse T3 and an inverted salivary cortisol pattern. The plan combined circadian rhythm structuring, thyroid nutritional support, micronutrient optimisation and structured stress management — without hormone therapy. At nine months, normalisation of markers and functional recovery.

Case 3 — Metabolic syndrome in pre-diabetes. A 52-year-old man with HbA1c 6.2%, mild hypertension and marked insulin resistance (HOMA-IR 4.8). Plan with Mediterranean nutritional matrix, combined physical activity and targeted supplementation. At twelve months: HbA1c 5.5%, HOMA-IR 1.9, 11% weight reduction and overall improvement in cardiometabolic profile.

Case 4 — Endometriosis with persistent symptomatology. A 38-year-old woman with two surgical cycles and continuous hormone therapy, with incapacitating dysmenorrhoea. The plan combined continuation of conventional gynaecological therapy with anti-inflammatory nutritional intervention and specific supplementation. At six months, significant reduction in pain intensity and decreased need for rescue analgesia.

Case 5 — Non-specific chronic fatigue. A 41-year-old healthcare professional with eighteen months of fatigue with no identified cause on conventional investigation. Extended reassessment revealed functional iron and B12 deficiency, severe vitamin D deficiency and flattened cortisol rhythm. Structured deficit repletion and progressive physical activity rehabilitation. At four months, full return to professional activity and normalisation of markers.

A cross-sectional reading reveals three patterns. First: no case would have been adequately understood without prior exclusion of organic pathology — integrative medicine builds on conventional medicine, it does not replace it. Second: in all cases, integrative assessment identified functional markers outside the scope of standard investigation. Third: no intervention was limited to supplementation alone — all required longitudinal coordination of multiple interventions around a personalised plan.

Clinical and ethical note: cases were rigorously anonymised in accordance with the Code of Ethics and GDPR. The outcomes described should not be interpreted as a guarantee of results — each patient is a unique case.