Master Sergeant Geoff Dardia has a no-legs plan.
He’s served as a U.S. Army Green Beret since 2004. If he loses his legs for an explosion or gunfire, he’s prepared to build his own “robot legs” so he can stay on active duty. This is something he learned from his Special Operations colleague Chuck, who served for 10 years on a leg he designed himself. Because of the deep trust Dardia shares with his fellow soldiers, he says he sleeps better on deployment — even when that means lying under a truck, within the field, protected only by his mates — than he does back home.
The no-legs strategy isn’t his only contingency plan. After a set of mysterious symptoms nearly forced his retirement this year, Dardia began to arm himself with a wealth of health knowledge that has allowed him to keep serving. Today, he and a growing number of forward-thinking military healthcare providers will work to expand access to unconventional, person-centered healthcare in the military. If they’re successful, they may help prove that a whole-person method of health is the best tool for the treatment of those who serve — and for the rest of us, too.
Force Multiplier
Dardia was first deployed to Afghanistan in 2005. After three successful tours, he was selected to work stateside as an instructor in a specialized advanced-urban-combat school. The job involved spending several hours each day and night in indoor shoot houses or outdoor ranges, inhaling a toxic mix of heavy metals from munitions and explosives.
By 2011 he began experiencing a mysterious set of symptoms: fatigue, migraines, short-term memory loss, vision problems, brain fog, putting on weight, no libido. Itchy rashes appeared on his legs. And though he was just 31, his hair was graying and falling out. His exercise and eating routine hadn’t changed, but anything else had. “I’m dragging a dead body here,” he told his doctor.
His symptoms confounded his healthcare providers. Apart from fatigue, they couldn’t provide a firm diagnosis, much less an answer. He was repeatedly told that his condition was all in the head. Some suggested PTSD, others depression. That didn’t feel right; Dardia loves his job. “The only thing I’m depressed about isn't being able to do what I used to do,” he said excitedly.
In the absence of a diagnosis, Dardia began approaching his condition as he’d been trained: He studied his environment. “Things i do as a Special Forces operator is consider the threats in the environment and just how they impact my operation. It’s not only me. You know, How do I communicate with my environment?”
He began reading medical journals. “I got obsessed with what was killing me,” he says. He learned that his symptoms matched the ones from neurotoxicity and discovered what types of diagnostic testing he needed. Everything pointed to heavy-metal poisoning, in addition to traumatic brain injury (TBI) and an adverse response to antimalarial medications.
In 2012 Dardia was finally referred for any comprehensive TBI evaluation at a high-level military hospital. His providers determined that along with brain injury, he had severe binocular-vision disorder (a condition in which the eyes stop working together), hormone dysfunction and fertility issues, leaky gut, a lesion on his anterior pituitary gland, and white-matter lesions on his brain.
These issues were not just bad luck. Dardia had been exposed to millions of rounds of ammunition, countless explosions, and a large number of explosive charges during his military training and career.
In 2021 he and the other soldier with similar symptoms met with Kevin Dorrance, chief of internal medicine at Walter Reed National Military Clinic. Dorrance suspected lead poisoning both in men and administered bone-lead x-rays. The scans showed the 2 soldiers were “packed” with the toxic mineral.
One might think that combat represents the greatest existential threat to military personnel, but most face a range of health hazards which are far less visible.
By then Dardia had begun volunteering for that Task Force Dagger Foundation (TFD), a Dallas-based nonprofit that provides support to injured Special Operations members. He knew that lots of his fellow service members faced complex symptoms like his, so he created a program for TFD to offer “next-generation health solutions” to other Special Operations Forces (SOF) as well as their families.
After returning from another tour in Afghanistan in 2021, Dardia, with the help of TFD, went to Cleveland Clinic’s Center for Functional Medicine to seek treatment.
“One of the major blind spots of conventional medicine is heavy-metal toxicity,” says Mark Hyman, MD, who treated Dardia at the Cleveland Clinic. “Heavy metals are stored with time in the organs, muscles, and brain, not the blood, so blood tests won’t reveal them.”
Hyman retested Dardia and found that he was overloaded with mercury as well as lead. Genetic tests also revealed a single nucleotide polymorphism that makes it harder for his body to pay off toxins.
Hyman and his team made a rigorous detoxification program to assist Dardia clear the heavy metals, after rebuilding his gut and his immune system so his body could be strong enough to tolerate it. “You can’t just randomly detoxify or people end up with sick,” Hyman explains. “But you can remove mercury and lead safely inside a controlled therapeutic environment.”
At the Cleveland Clinic, Dardia started a supportive regimen of supplements and cleared up his diet. His army physicians prescribed supplemental testosterone to assist with his dysregulated hormones. And after four years of struggle, he started to feel good.
“It was like a fog was lifted from me,” he recalls. “My speech, mental clarity, finding words, task organization, everything stuff . . . all the people at work noticed: ‘Hey, you’re different. You’re switched on.’”
Risk Assessment
One might assume that combat represents the best existential threat to military personnel, but many face a range of health hazards which are far less visible. These include hormone disruption from toxins emitted by munitions and burn pits, gut dysbiosis from prophylactic antibiotics accustomed to protect against malaria, and tissue damage from parachute jumps and routine hikes with 70-plus-pound rucksacks.
Service members frequently suffer brain injuries from external assaults, for example traumatic knocks to the head and contact with blast pressure waves, as well as internal forces, such as neurotoxins. Chronic pain could be a partner to all of these.
The basic conditions of military life will test the bounds of any healthy person. “Typically, we sleep around five, five and a half hours at a time,” explains Captain Bryan Stepanenko, MD, MPH, IFMCP. “And, in a deployed setting, these soldiers may be up all night and trying to rest all day, with mortars, rockets, or people working where they’re attempting to sleep.”
Stepanenko is an active-duty family physician at Fort Bragg in North Carolina. Trained in both conventional and functional medicine, he believes that regardless of the many health challenges soldiers face, there’s a great deal they can do to prevent damage — and heal it when it occurs. This requires the right perspective.
Going Deep
In complex cases involving chronic pain, that are common in the military, an extensive case history is a vital tool. There’s typically a threshold event, Stepanenko explains, then someone will say he or she has “never felt well since.”
“You will find the emotional and the psychological stressors, but then there are the physical stressors,” he notes. “You must know how much stress this body had handled already, because that tells you how resilient it may be, or how close that threshold might be.”
A soldier he calls “Jones” (not his real name) is really a case in point. Jones enjoyed a contented childhood and was active in a variety of sports, though persistent tonsillitis meant he'd to take more antibiotics than the average kid. He enlisted in the army in 2000, and seven years later was deployed to Afghanistan, where he was put on prophylactic doxycycline, as are many deployed service members, to protect against malaria.
His job involved monitoring burn pits, which the military uses in the absence of civic sanitation services to dispose of batteries, Styrofoam cups, medical waste, plastics, computer parts, and other trash. Usually ignited with jet fuel — which contains benzene, a known carcinogen — these pits emit a stew of potent airborne toxins comparable to those encountered by 9/11 first responders.
Eight months into Jones’s deployment, his health began to suffer. It started with gut problems and acid reflux. By 2008 he was suffering from chronic sinusitis and treating it with frequent courses of antibiotics. The year after, under intense stress while training for a Special Forces qualifying course, he required emergency gallbladder surgery after executing a parachute jump wearing nearly 200 pounds of apparatus.
This led to still more rounds of antibiotics, which were depleting an already-stressed microbiome. Jones also had sleep problems and suffered constant musculoskeletal pain.
Then, after deploying with the Special Forces in 2012, he a break down minor TBI that earned him a Purple Heart. Additionally, it broke him.
“He sustained four knockouts and 40 mild TBIs before the straw that broke the camel’s back, which was driving a heavily armored vehicle over an IED,” recalls Stepanenko. “It didn’t flip the vehicle or anything crazy, but it was enough to where he bumped his head while wearing his helmet and he said he was ‘never exactly the same since.’
“He had sustained exposure to antibiotics for antimalarial prophylaxis. He had sustained contact with burn pits multiple times. He had been exposed to multiple blast overpressure events in training as well as on deployment, and had sustained those head injuries. But that IED explosion was the brink.”
In 2021 Jones was found unfit for duty after nearly 15 years of service.
A case like this could easily puzzle a regular physician. That a minor head injury would be a breaking point doesn’t seem sensible on its face, yet many healthcare providers don’t have the time to learn what a body has handled.
They do their best using what they have, and that often involves prescribing drugs for symptoms. (The Dod spent an estimated $967 million on pharmaceuticals in 2021.)
By time Jones found his method to the Cleveland Clinic in 2021, he'd been placed on 44 different medications. His gut was swollen. He was in constant pain and routinely experiencing uncontrollable rage. He was anxious and depressed and contemplating suicide.
Learning what had preceded Jones’s head injury, Stepanenko says, helped providers put his crisis in context. Not only was he devastated by his medical discharge in the army, which cost him his mission and his community, he was also suffering from runaway inflammation from brain injuries and gut dysbiosis. He had a “brain on fire.”
Jones’s treatment began with an elimination diet, followed by a ketogenic diet. His gut health improved dramatically as he avoided wheat and sugar. He received testosterone-replacement therapy because his injured anterior pituitary gland had diminished production of the hormone. He adopted relaxation techniques and began practicing archery. He lost weight, his bloating disappeared, his depression and anxiety eased, and his cognitive function improved.
Within three years, he was off most of his medications. Chronic pain and occasional bouts of rage remain ongoing challenges, but even these are gradually dissipating.
Without understanding the root causes for his symptoms and receiving the tools he needed to heal himself, Jones would likely have continued to suffer from runaway inflammation and neuroendocrine dysfunction. The circumstances would probably have worsened, possibly costing him his life. The drugs he’d been taking to manage his symptoms were not enough. Yet recovery was possible for him; he just needed a different set of tools.
Geoff Dardia in 2009, serving at Zerkoh Valley, Afghanistan. This photo was taken by photojournalist David Gilkey of National Public Radio, who was killed while working in Afghanistan.
Runaway Inflammation
Brain injuries, toxic exposures, and gut dysbiosis create a broad range of downstream effects which are typically intertwined. All can trigger runaway inflammation and systemic health problems.
Based on his own experience, Dardia worries that PTSD, while a genuine concern for many service members, is simply too often used as a blanket diagnosis when underlying conditions for mental-health issues might be physical.
“You can’t fix a problem unless you frame and identify the problem,” he says. “If you’re a person who has all these things going on and you’re just told you have these four letters [PTSD], well, what the heck are these four letters?”
Chronic stress is itself inflammatory. When the body’s sympathetic nervous system is in fight-or-flight mode, the pituitary gland signals the adrenals to release cortisol. It’s a healthy hormone in the right dose; the body needs it for energy, alertness, and inflammation control.
But when the nervous system gets stuck in the sympathetic mode, as it does for a lot of service members, the rest-and-rebuild parasympathetic system never kicks back in. The adrenals eventually quit their high alert and stop producing cortisol. Energy flatlines and inflammation skyrockets.
Chronic inflammation is usually a central feature of chronic pain. For Henri Roca, MD, who treats pain patients in the VA hospital in Little Rock, Ark., addressing inflammation is really a key tenet of his protocol. Also, he strongly emphasizes the importance of self-care for patients and empowering these to heal themselves.
“Self-care skills give the greatest chance of pain resolution,” Roca says. His patients learn to drink anti-inflammatory bone broth, which will help reduce the need for pain medication. They discover brightly colored vegetables reduce inflammation, which it’s important to avoid sugar, fast food, and other inflammatory fare. They’re taught gentle stretching techniques to address musculoskeletal issues.
And, crucially, they learn to give and receive support with others in group medical appointments, a strategy that is central to Roca’s approach. The best motivator for a disengaged patient, he says, is “the stories of other patients who've successfully reengaged with their lives and accomplished a degree of pain resolution and acceptance.”
Each One Teach One
Marine Corps veteran Elijah Sacra is a such pain patient, and that he has dedicated his postmilitary life to helping other injured service members recover their own health.
He and his fiancée, Clarissa Kussin, run Warrior Wellness Solutions (WWS) in Durham, N.C., where they offer functional-medicine health coaching to active-duty service members and veterans. This includes dietary strategies to improve gut health and reduce inflammation, rehabilitative exercise, and restorative yoga and mindfulness practices.
Sacra learned the value of a lifestyle approach to managing chronic pain firsthand in 1993, as he fractured three vertebrae in his neck. “The culture from the Marine Corps at the time was ‘try taking some Motrin and let’s go.’ I continued to complete exercises with my arms being numb,” he recalls.
Like many service members, he powered through it. But when he was honorably discharged and took a desk job in 1996, his spinal pain grew more severe. He soon changed course, pursuing a new career as a rehabilitative exercise physiologist.
As luck might say, his first client included a list of complex health issues that compelled Sacra to understand more about all the factors that contribute to a healthy recovery. That path eventually led him to review at the Institute for Integrative Nutrition (IIN) in Nyc. The first military veteran to sign up there, he found himself inside a strange new world.
“I’d never heard of smoothies; I’d never heard about wheatgrass,” Sacra recalls. He was still being eating fast food at the time. But that started to change when he met Kussin, an IIN health coach, holistic personal chef, and meditation teacher.
In 2009 Sacra launched WWS with fellow Marine Corps veteran Alvaro Matta, and Kussin soon joined their team. “I was teaching juicing, smoothies, and some rehabilitative exercise and yoga,” he states. Sacra and Kussin attended the Functional Medicine Coaching Academy on scholarship.
The nonprofit has since provided health coaching to countless service members, as well as their families and caregivers. Clients have routinely weaned themselves using their meds, lost weight, and even returned to active duty, with the help of the dietary and lifestyle interventions they learned from WWS’s health coaches.
The team remains open to coach its clients throughout their lives, should they end up struggling with weight gain or medication. Healing complex illnesses is definitely an ongoing process.
Dardia in 2021, serving in Chad.
The Right Tools
The Pentagon already recognizes that whole-person care is a good fit for service members. The army’s 2021 Move to Health and the VA’s Whole Health for Life initiatives place the patient in the center of the treatment model and emphasize the significance of nutrition, sleep, exercise, mindfulness, and social support. Sacra serves on a VA research advisory panel and a chronic-pain and opiate-addiction study committee.
More than 50 Department of Defense clinicians are currently certified in functional medicine. A range of integrative treatments — including acupuncture, chiropractic, biofeedback, yoga, and mindfulness — are actually available to service members and veterans inside the military healthcare system. Battlefield acupuncture has become a standard form of treatment for acute and chronic pain.
Still, functional and integrative services aren’t popular at this point, and many service members aren’t aware of the available resources. Dardia, Stepanenko, and others will work to change that.
Dardia volunteers with TFD like a VA-certified recovery care coordinator to assist connect people with unfamiliar integrative services. With Hyman, he’s made a pipeline for SOF to get treated at the Center for Functional Medicine. He and Stepanenko have presented on root-cause medicine to clinicians and military leaders.
Stepanenko continues to blend functional medicine in to the care he provides for patients on post, and he counsels soldiers on how to protect their health during service.
“I give probiotics to guys once they go on deployment. I let them know, ‘Take your doxycycline and this. When you go over there and start breathing the air, drinking the water, and eating the local meat, take detoxifying chlorella, ascorbic acid, and modified citrus pectin. Stay well hydrated and make sure you’re having bowel motions daily.’”
Dardia now deploys with what he calls his “force field” supplements: glutathione to support detoxification, fish oil for inflammation, n-acetyl cysteine to support lung health, and vitamin D to enhance the immune system. He also packs their own high-quality paleo protein bars as one alternative to the Meals, Ready-to-Eat (MRE) rations served in the field. “I haven’t eaten an MRE since 2006,” he says.
That doesn’t mean Dardia’s immune to new health challenges. He returned from a recent deployment with severely inflamed lungs and strange skin growths. But while he understands how his body interacts with his environment, he had the team and the tools he needed to recover. (This time around they included a course of antibiotics and intermittent fasting.) Nothing surprises him anymore. He’s ready for which comes.
“Everyone I know who's resilient has always were built with a contingency plan,” Dardia explains.
If the military’s present curiosity about whole-person health continues to grow, such contingencies — with nutrition, lifestyle, and social components — may eventually become one of its best defense strategies.
Dardia anticipates seeing it. He knows that staring at the “operational environment” is vital to solving any complex problem, including complex illness. In survival situations, knowledge isn't just power. It’s protection.
Pictured left to right: Bryan Stepanenko, Elijah Sacra, and Geoff Dardia at the 2021 Annual Conference for the Institute for Functional Medicine in San Antonio, Texas, where they presented on chronic pain within the military healthcare system.
WEB EXTRA!
Get More Support
For more details about functional-healthcare resources for service members, visit:
Task Force Dagger
This link has more functional medicine-related health resources for service members:
https://www.taskforcedagger.org/resources/
On Instagram:
@sof_health_initiative
Warrior Wellness Solutions
Health coaching services for service members and veterans:
https://www.warriorwellnesssolutions.org
Center for Functional Medicine at Cleveland Clinic
https://my.clevelandclinic.org/departments/functional-medicine
Institute for Functional Medicine
To find a functional medical physician or coach in your area, use their “find a provider” link:
https://www.ifm.org