COVID-19 UPDATED

Blair Cuneo, PA-C
While there are questions and uncertainties in our evolving understanding of COVID-19, its variants and vaccination options, there are many things we have learned. We continue to see reduced severity of COVID-19 illness in patients with less chronic inflammation and with healthy immune support.

The CDC website reviewing preventative recommendations for vaccinated and unvaccinated patients is below, including guidelines for mask wearing, social distancing and information on vaccinations.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

In addition to those guidelines, the providers at Carolina Total Wellness recommend the following lifestyle and supplement supports to optimize immune function, decrease viral transmission, reduce viral activity in the body and support the body’s immune response.

LIFESTYLE:
For adults and children, focus on eating foods that are organic and rich in antioxidants.  Try to eat 5 to 7 servings of vegetables and 2 to 3 servings of fruit every day.  Drink filtered water, avoiding plastics as much as possible. Improve ventilation, air flow and utilize quality air filters indoors, including home and work. Ensure adequate sleep for healthy immune and detox response.
Integrate mindfulness and stress lowering practices each and every day.
 
SUPPLEMENTS: (Bold items are available in online patient portal supplement store)

Adult Prevention Supplement Options:
1. Vitamin C: 500-1000mg daily to twice a day (Complete Vitamin C)
2. Vitamin D: 2000IU -5000 IU per day (Liquid D3, Vitamin D3, Ortho Force)
3. Zinc: 15-30mg daily (Zinc glycinate or Zinc Drink)
4. Quercetin 400 mg daily (Allergy Ease, BetaQ Immune, D-Hist Jr)
5. Melatonin 3-6 mg at bedtime (Melatonin CR or Quick Dissolve Melatonin)
6. Biocidin LSF mix 10 pumps into Xlear or a bottle of over the counter nasal saline spray: 2 sprays per nostril after possible exposures to virus.  
Additional options to discuss with your provider include curcumin, NAC, Andrographis, Vitamin A, Resveratrol and Immune Adaptogenic Mushrooms.
 
Pediatric Prevention Supplement Options:

1. Vitamin C (CTW Complete Vitamin C), Seeking Health Liposomal Vitamin C (liquid):3-5 years: 125-250 mg daily6-12 years: 250-500 mg daily 
2. Vitamin D (CTW Liquid D3 or CTW Vitamin D3):3-6 years: 1,000 IU daily7-12 years: 2,000-3,000 IU daily 
3. Zinc (Zinc Drink, Zinc Glycinate):3 years: 5-10 mg daily4-12 years 10-25 mg daily 
4. Quercetin (CTW Allergy Ease, D-Hist Jr chewables):3-4 years: 50-100 mg daily4-8 years: 100 mg daily8-12 years: 100-200 mg daily 
5. Xlear nasal spray: 1-2 sprays per nostril daily and after potential exposures. 
6. Elderberry:<7yo: 250mg daily>7yo: 500mg daily 
Additional options to discuss with your provider include curcumin and glutathione
 
The following therapeutic options are started at first signs of illness, positive exposure, and/or positive testing. Please notify your provider so that we can further personalize support.

Adult Therapeutic Supplement Options:

Vitamin C: increase to 1000mg four times a day. Reduce dosage to 500mg if loose bowels. (Complete Vitamin C)

Vitamin D: 2000-5000IU per day (Liquid D3, Vitamin D3, Ortho Force

Zinc liquid or lozenges: 15-20mg four times a day. Swish liquid before swallowing. If using lozenge, do not chew, instead suck on lozenge until done. (Zinc Drink)

Quercetin:  800 mg two times a day (Allergy Ease, BetaQ Immune, D-Hist Jr

Melatonin 3-6 mg at bedtime (Melatonin CR or Quick Dissolve Melatonin

Biocidin LSF mix 10 pumps into Xlear or a bottle of over the counter nasal saline spray: 2 sprays per nostril two times a day. 

Curcumin 500-1000 mg four times a day (Meriva or Turmero liquid) N-acetylcysteine: 600mg twice a day (CTW Liver Support or Trizomal glutathione

Andrographis: 375 mg twice daily (Viragraphis

Pediatric Therapeutic Supplement Options:

1. Vitamin C (CTW Complete Vitamin C), Seeking Health Liposomal Vitamin C (liquid)3-5 years: 125-250 mg four times a day, reduce dose if loose bowel movements.6-12 years: 250-500 mg four times a day, reduce dose if loose bowel movements. 
2. Vitamin D (CTW Liquid D3 or CTW Vitamin D3):3-6 years: 1,000 IU daily7-12 years: 2,000-3,000 IU daily 
3. Zinc liquid or lozenges (Zinc Drink or Zinc Glycinate)3 years: 5-10 mg four times a day4-12 years: 10-15 mg four times a day 
4. Quercetin (CTW Allergy Ease caps or D Hist Jr chewables):3-4 years: 50-100 mg two times a day4-8 years: 100 mg two times a day8-12 years: 100-200 mg two times a day 
5. Melatonin (Quick Dissolve Melatonin 3mg) or Source Naturals Melatonin lozenge, 1mg3-5 years: 1mg at bedtime6-12: 3mg at bedtime 
6. Biocidin LSF: 5 pumps into Xlear or nasal saline spray: 1-2 sprays per nostril two times a day.
 
7. Curcumin (Meriva or Turmero liquid)3-4 years: 125 mg three times a day4-8 years: three times a day8-12 years: 325 mg three times a day 
8. Glutathione (Trizomal Glutathione):3-5 years: 50mg two times a day6-12 years: 100mg twice a day


   
 

ADULT COVID-19 Vaccination prep: supporting resiliency
 
Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:
 
1. Clean water: 8–10 glasses a day or ½ body weight in ounces
2. CTW Complete Vitamin C: 1 cap (500mg) two times a day
3. CTW Daily Multivitamin or MitoCore 2 caps two times a day
4. Daily Probiotic
5. Vitamin D3 4000IU daily
6. Zinc Glycinate 15mg daily
7. SPM Active 2 caps daily
 
In the days leading up to your vaccination, fuel your immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Rest when you need to rest and aim for quality sleep the two nights before the vaccination.
 
*Day of and day after vaccination, increase vitamin C:
CTW Vitamin C: 2 caps (1000mg) twice a day
 
After your vaccination, think muscle, immune and lymphatic system support:
 
Engage your deltoid, the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, push-ups, resistance shoulder pressing exercises.
 
Go on a walk! Perform some light cardio and exercise after your vaccination to provide a healthy stimulus for your immune system for optimal response and reduce side effects.
 
Stimulate your lymphatic system! Right after the vaccine, begin gentle skin brushing of the vaccinated arm, encouraging lymphatic flow toward center of body. Whole body lymph support options: whole body dry skin brushing, gentle rebounding, deep breathing. 
 
   

PEDIATRIC COVID-19 Vaccination prep:
 supporting resiliency for children 12 years and older
 
Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:
 
1. Clean water: ½ body weight in ounces
2. Vitamin C: 250-500mg two times a day (CTW Complete Vitamin C caps, Seeking Health Liposomal Vitamin C (liquid)
3. Daily Multivitamin (ActivNutrients chewables or CTW Daily Multivitamin caps)
4. Daily Probiotic (Ther-biotic complete chewables or CTW Daily Probiotic)
5. Vitamin D 2,000IU – 4,000IU daily (CTW Liquid D3 or CTW Vitamin D3)
6. Zinc 15mg daily (Zinc Drink liquid, Zinc Glycinate caps)
7. SPM Active 2 caps daily
 
In the days leading up to your vaccination, fuel your child’s immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Stick to sleep schedules/healthy sleep hygiene and aim for quality sleep the two nights before the vaccination.
 
*Day of and day after vaccination, add extra C to above protocol:
Vitamin C: 1000mg two times a day
 
After your vaccination, think muscle, immune and lymphatic system support, refer to instructions above.
  
Please contact our office for an appointment to further support and personalize your path to wellness.
 

Your Partner In Health!
Blair Cuneo, PA-C
 

References:
https://www.drkarafitzgerald.com/2020/03/16/covid19-traditional-chinese-medicine-and-western-options-for-the-non-tcm-trained-clinician/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3
https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/
https://www.drkarafitzgerald.com/2020/03/12/covid-19-preserving-your-familys-health-and-sanity-in-the-face-of-a-pandemic/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3
https://www.sciencedirect.com/science/article/pii/S1550830720301130?fbclid=IwAR0ZjInhMGulFrfnMHVL_uITY5EYuGNccwRII03as8NSVn_EeqRGvi8DgXY
https://healthykidshappykids.com/2020/04/04/pediatricians-pandemic-immune-support-plan/
https://info.ifm.org/covid-19?utm_campaign=covid-19&utm_source=website&utm_medium=popup&utm_content=resources_learn_more
https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/your-vaccination.html
 
 

 

TOXINS… Mercury, phthalates, and lead, oh my!

Frances T Meredith, MD

We are swimming in toxins every day from the water we drink, the air we breathe, the food we eat, and the products we use on our bodies, and in our homes and yards. We have all heard the story of Flint Michigan. But lead exposure is just the very tip of the iceberg of our daily toxin exposure.

Toxins now are well established to impair the ability of our mitochondria, the batteries in every cell, to create energy. That has downstream effects in every organ system. Many studies clearly establish that toxins underlie many chronic diseases including neurogenerative disease (think Parkinson’s, Alzheimer’s, ALS), autoimmunity, hormone disruption (think thyroid and endometriosis) and > 50% cases of gout. Did you know toxins often lurk beneath depression, anxiety, and ADHD?

There are simple things we can all do to both decrease our exposure and assist our body in moving out toxins. The first step is a good look at where the toxins are coming from. Stop the inflow! Environmental toxins include chemicals, metals, mold, particulate matter in the air, ozone, radiation, and EMF. And don’t forget those ever-present psychic toxins that have escalated in the past few years: toxic relationships, social media, and news. Toxins also can come from within, in the byproducts created by intestinal bacteria, our own hormone processing, and our own natural detox pathways. Then we often “choose our poisons”, drinking that evening wine to wind down, vape, diets that are too acidic, or choosing non pure forms of hemp, and often using them for the wrong reasons.   

I’d like to take a bit of time to dig into environmental toxins. First, metals. We all know about lead exposure, but did you know that our city water has arsenic? Kale is often filled with thallium? Do you have mercury fillings? If so, are they stable or are they leaking low level mercury into your body every day?

Next, a bit more focus on chemicals. Many chemicals are known to be “gender benders”, disrupting our hormone pathways, plugging into the estrogen receptors and not letting go, decreasing fertility in women, sperm counts in men. The big offenders on the “gender bender” list are phthalates, bisphenols, parabens, triclosan in antibacterial soap, and PCBs. Below is a list of chemicals to which we are frequently exposed, creating buildup over time.

  • Polycyclic aromatic hydrocarbons (PAHs): burning of tobacco, oil, coal, gas, garbage
  • Plastics (phthalates): from plastics and from anything with “fragrance” or “parfum” not labelled as organic (think Bath and Body Works); microplastics are also in our water
  • Phenols, particularly bisphenol, (BPA); found in hard plastics, sippy cups, linings of beverage/food containers, transferring through the skin of your hands on your Publix receipt.
  • Parabens: in many cosmetics, creams, medications etc
  • Organochloride pesticides: DDT is still  in soil from use 1940s-1960s
  • Organophosphate pesticides: RoundUp etc
  • Polychlorinated dibenzo-dioxin and furan (dioxins): exposed in high fat dairy/meat/FISH
  • Polychlorinated biphenyls (PCBs): illegal 1979, but we are still exposed in high fat dairy/meat/FISH
  • Polybrominated diphenyl ethers (PBDEs): flame retardants, FATTY FISH     
  • Polyflourinated compounded (PFCs): stain, grease, water resistant products

So how can we help our body deal with this onslaught of chemicals? First, stop the inflow:

  • Clean Air: Create a “scent free zone” in your home. Avoid living near highways if possible. Add plants that absorb toxins (ficus, mums, gerber daisies). Leave shoes at the door. Just 2 days with clean air improves health
  • Clean Water: Quality water filtration is essential, such as Aquasana, or Zero Water
  • Clean Food: Organic where possible using Clean 15 Dirty Dozen list; grow your own food where possible; wash chemically grown food in acidic solution such as vinegar, no plastic for food storage, no perflouride based nonstick pans
  • Clean up household, lawn, personal hygiene products using www.ewg.org and the Think Dirty Shop Clean app to guide product choice. No RoundUp.
  • Clean frequently, especially with crawling children in the home.

Then we can get the body ready to move toxins out. This will take guidance from your Functional Medicine provider and will include essential nutrients, balancing the intestinal bacterial microbiome, an “oil change” to remove and replace damaged oils in cellular membranes where toxins reside, adding binders to catch and remove toxins as they are excreted by liver/gallbladder into the intestinal tract. The “prep” also includes many pieces to get liver and kidneys ready. Then, and only then, can we proceed to escort the toxins out without creating further damage. “Detox” without this prep is very dangerous.

Once we move into the process of escorting out the toxins, we choose supplements, foods, and sometimes medications to grab and move toxins out of tissues. At the same time, we use many modalities including lymphatic massage, infrared sauna, castor oil packs, and CranioSacral therapy to support the lymphatic system whose job it is to move those toxins through and out.

Unfortunately, we no longer live in an organic world as did our predecessors. We are swimming in toxins every day and all have a role to play in the cleanup and healing of our planet. As we set this intention, we must support the beautiful creation that is our body in order to survive and thrive in this toxin filled world.

“Detox your mind, body, AND your contact list”

-Supa Nova Slom

Your provider at Carolina Total Wellness would be happy to discuss strategies to better optimize your body’s ability to thrive in this world of toxins.

Your partner in health,

Frances T Meredith, MD

Toothpaste: What should I use?

Caroline Wilson, M.Ed., FMHC


Do you ever wonder if the toothpaste you and your kids are using is toxic?  Let’s take a look at some ingredients of concern that are in most conventional toothpaste brands.

Artificial Colorings – Linked to ADHD & hyperactivity in children.


Titanium Dioxide – It’s just there to make toothpaste white.  EWG has a list of safety concerns, including possibly a carcinogen when ingested.


Sodium Lauryl Sulfate (SLS) – Causes canker sores for many people.


Triclosan – A pesticide and hormone disruptor.


Glycerin – It isn’t toxic, but ideally has no place in the mouth as it’s a soap that can strip your body’s natural oral mucosa and leaves a film. This could alter the microbiome in the mouth.

Ingredients we love:
Hydroxyapatite (HAp) – is a naturally occurring mineral that makes up 97% of our tooth enamel and has been scientifically-proven to strengthen and protect your teeth without fluoride. While Hydroxyapatite is not as well-known in the US, it’s been the gold standard in Japan for over 40 years.
TIP – Don’t rinse your mouth after brushing with HAp.

Bentonite Clay – A natural polisher that is rich in minerals and not too abrasive.  It’s alkaline and helps reduce acidity in the mouth. 
TIP – Make sure it’s “lead-free” clay.

Xylitol – Reduces cavity causing bacteria in the mouth. 

Approved Hydroxyapatite containing toothpaste: Boka, Risewell, Wellnesse, Karex

Find these approved non-toxic brands in our clinic: Dentalcidin and Hyperbiotics Probiotic Toothpaste. 




Call our office and schedule and appointment with one of our Health Coaches to learn more about non-toxic personal care products. 
 

Your Partner in Health!
Caroline Wilson, M.Ed., FMHC

Travel Tips

Sara Yadlowsky, FMHC

Summer is in full swing, which means weekend getaways and road trips. While for some a trip to the beach can help deter the stress associated with day-to-day life, for others it might spark a pang of anxiety. One of the most common questions we get as the weather gets warmer is: “how do I stay on track with my wellness goals while I am on vacation?” For so many of us, the excitement of being on a much-needed vacation coupled with an environment of food options that we do not usually indulge in creates a perfect storm of bloat, fatigue and overall unhappiness.

Here are some tips on how to stay on track while on vacation while still be able to enjoy yourself.

 
Bring Along Some Food From Home
Stay on track with your diet by bringing some food from home. Whether that mean fresh veggies and fruit, gluten-free bread, your favorite protein powder or organic meat, make sure that you are sticking with your routine from home to not only encourage healthy eating while away, but also to avoid temptations of food items that may cause unpleasant side effects.

 
Drink Lots of Water
Drinking lots of water daily is critical to your wellbeing and it’s even more important while you’re on vacation. Making sure that you are staying hydrated can help aid in digestion and prevent constipation while you are traveling.   If you are indulging in alcoholic beverages while on vacation, this tip is even more crucial. It’s an excellent idea to alternate between alcohol and water in order to avoid dehydration.
 
Prioritize Whole Foods
Eating an adequate amount of vegetables and fruit while on vacation will keep your fiber intake up during vacation. An easy way to get lots of whole foods is to make a superfood green smoothie for breakfast with plenty of fruits and veggies added in. Continue to prioritize whole foods throughout the day by getting veggies and/or fruits at every meal.
 
Get Plenty of Sleep
Being on a vacation always couples with being out of your normal routine; which is typically a good thing unless it interferes with your sleep. As tempting as it is to stay out later, getting a couple hours of sleep in before midnight will provide you with enough restorative sleep to help maximize your sleep and, in turn, stay on track with your wellness goals.
 
Don’t Stress
You’re on vacation after all! After navigating through the stress of daily life, this is your chance to lower your cortisol levels and spend quality time with loved ones. Don’t let your fear of losing traction on your goals interfere with your ability to truly enjoy yourself. If you backtrack a bit take it easy on yourself.  Rather than beating yourself up for indulging in dessert the night before, celebrate yourself for going on a run the following morning.
 
Wherever your travels make take you this summer, I hope that these insights give you peace of mind to relish in the calm and come back feeling rejuvenated and ready to continue your wellness journey. Safe travels! 
 
In health,
Sara Yadlowsky, FMHC

Back To School Checklist

Blair Cuneo, PA-C

While the family is enjoying the downtime from school break, the upcoming school year is in the back of my mind. I’m slowly starting to make lists for updating lunch boxes, checking clothing sizes, gathering school supply items, all the while wondering what the next grade level will be like for my kids. 

“Preparation clears a pathway for success.”  ~ Ron Kaufman

As a pediatric functional medicine provider, I recognize that each child has unique needs to optimize their mental and physical wellness. However, there are several general recommendations from which many children and families can benefit.

Specific to academic performance, here are some fundamentals for your “Back to School” checklist:

– Honor the importance of sleep for body and brain.

Lack of sleep impacts production of neurotransmitters like dopamine, crucial for its role in attention and focus. School aged children should be getting 10-12 hours of restorative sleep. Restless sleep, teeth grinding, snoring, and waking up tired after adequate hours, are all signs that the sleeping hours are not “quality”. Without quality sleep, the body has not had the restorative opportunity to repair, heal and learn.

– Check in on screen time.

Prolonged screen time is associated with increased difficulty in attention, focus, emotional regulation and anxiety. Take into account screen time needed for school and set boundaries for when and what type of screen time is allowed in the home.

– Clean up the pantry, stock the fridge.

Artificial foods and dyes have a direct, negative relationship to behavioral health and cognitive performance. When hungry, go the fridge first, aim for rainbow whole foods, read labels and avoid eating what you can’t pronounce.

Many patients and families notice improvement in mood, energy, digestion, pain and school performance by integrating the above considerations.  If needed, there are more areas to investigate with a pediatric functional medicine provider.

In the functional medicine approach, we evaluate metabolic, nutritional, environmental and genetic contributors to your child’s symptoms or medical conditions. We want to understand “root cause” and not rely solely on band-aids to suppress or mitigate symptoms. We want to support the body and mind in need, while also shifting towards fundamental healing and prevention.

Some major contributors to impaired school performance include nutrient needs, like zinc and magnesium. If nutritional needs are found, we can directly support, but let’s also consider why the needs are there! Is the diet lacking? Does the digestive system have trouble absorbing nutrients adequately?

Speaking of the digestive system, the gut-brain axis is a recognized, bidirectional communication mechanism between the gut and brain. The gut microbiota affect the production and breakdown of neurotransmitters like dopamine, serotonin and GABA. These neurotransmitters are responsible for mood and academic performance. Dopamine is a key neurotransmitter for attention and focus.

When the body is under stress, dopamine production is hindered. Areas of stress include poor sleep, inflammatory foods/chemicals, food sensitivities, nutritional needs, yeast overgrowth, inflammatory bacteria.

Objective testing can be helpful in creating a personalized plan for our young patients. Less guessing, with more targeted interventions and support, can help you and your child experience enjoyment and success in their academic programs.

Call Carolina Total Wellness to schedule with our pediatric functional medicine provider.

Your Partner In Health!

Blair Cuneo, PA-C

Lithium

Blair Cuneo, PA-C

Lithium…a little goes a long way in cognitive and emotional health

 
Popular nutrients that make the major headlines for supporting cognitive wellness include magnesium and zinc, but how’s your lithium?

Lithium is an essential micro-nutrient with chemical properties similar to calcium and magnesium. It is present in all organs and tissues of the body.

The US Environmental Protection Agency estimates the daily lithium intake of an average adult ranges from 0.65 mg to 3 mg. Foods higher in lithium include grains, vegetables, eggs and milk. The most frequent source of lithium is tap water. Depending on where you live, there can be lithium deficiencies in your soil and with increased bottle water and home filtration use, we are filtering the lithium right out of our water.

Supplementing with low-dose lithium aims to support the body’s daily nutritional need for lithium. This is very different than the dosage of lithium as medication. Lithium carbonate is a well-established, effective medication therapy for mood disorders like bipolar disorder. Whereas lithium carbonate dosing can be in the hundreds of milligrams, low-dose lithium can range from micrograms to low milligram amounts.

How does lithium benefit brain health?

It is NEUROPROTECTIVE, shielding neurons from biological stress and toxins.

It promotes NEUROGENESIS, leading to increased numbers of neurons and brain volume.

It regulates NEUROTRANSMITTERS, helping to balance the mood.

Studies continue to accrue demonstrating improvement in mood and cognitive performance for patients with ADD, depression and Autism Spectrum Disorder. More recently, studies highlight the role lithium can play in prevention and treatment of Alzheimer’s disease, by inhibiting plaque formation and aiding in growth and repair of damaged neurons.

Screening for nutritional lithium deficiencies can be performed by hair trace mineral analysis, as blood testing is not sensitive enough to detect nutritional levels.

Talk with your functional medical provider about your cognitive and emotional health and find out if low dose lithium can further support your wellness goals.
 

Your Partner In Health!

Blair Cuneo, PA-C

Health Coaching

Erica Nelson, MSPH, NBC-HWC 

The legendary basketball coach, John Wooden once said, “A good coach can change a game. A great coach can change a life.”  At Carolina Total Wellness, our coaches help our patients change their lives every day.Every patient at Carolina Total Wellness that sees a doctor or physician assistant is paired with a health coach. Some patients may also choose to work solely with a health coach to achieve their dietary and lifestyle goals. This article will help you know what to expect when you work with a health coach.

Here are 3 key aspects of the health coaching experience at Carolina Total Wellness:

The Space Between
Health coaches hold space for you to pause… and decide how you want to respond to your circumstances. The world today is a seemingly relentless onslaught of stimulation, and it can feel like there is an urgency to react to all of that stimulation.

George Mumford, meditation coach to Michael Jordan, LeBron James, Kobe Bryant and other world-class athletes offers another way, ‘Think about the eye of a hurricane.’ He says, ‘No matter how intense the storm or what’s swept up in its gale-force winds, that calm, blue center is always there. We all have this quiet center within us.’  Your CTW coach will help you respond from that quiet center within, rather than reacting from the chaos of the storm.

In our office, health coaches hold space for you to make sense of what is going on in your world and in your body and decide how you want to respond. Health coaches always honor the fact that you are the expert on your own life and display unconditional positive regard for you and whatever lifestyle decisions you choose. They pay attention to what matters to you and may offer suggestions for adjustments that fit into your life.

Translator
The science of the body and its systems are the physician’s expertise. Science of behavior change is the coach’s expertise. Our coaches help you translate medical science you discuss with your doctor or PA into evidence-based behavioral change strategies to optimize your health. When you combine the medical knowledge of our physicians and PA with your coach’s expertise in the science of motivation, habits, and change, many of the barriers to experiencing health fall away.

Each of the coaches at CTW has at least a bachelor’s degree from an accredited university and training in coaching from either the Functional Medicine Coaching Academy or Duke University. Some of them also have master’s degrees and other specialized training in nutrition, exercise, counseling, and other relevant fields. Unless otherwise specified, CTW coaches are not registered dietitians, licensed mental health professionals or certified fitness professionals.

Guide
In the words of Michael Jordan, ‘A coach is someone that sees beyond your limits and guides you to greatness!’ CTW coaches come to the table with empathy for whatever you are facing and feeling and confidence in your ability to overcome. Each coach has faced their own struggles in life and knows what it is like to work hard to overcome. However, coaches never replace you as the expert on you; they serve as your guide on your journey to health. Coaches can help you understand all the different ways you can try intermittent fasting or yoga or what, exactly, is ‘glycemic index.’ Maybe our most important job, though, is to help you get very clear on your vision of the healthiest version of you. Once you decide where it is you want to go, coaches provide education, support and accountability to knock down any stumbling blocks that may come up along the way.
 
Call us today to schedule your appointment with one of our health coaches.
 

Erica Nelson, MSPH, NBC-HWC 

Heart Rate Variability

Didem Miraloglu, MD, MS

DO YOU KNOW HOW TO MEASURE YOUR WELL-BEING?

Ever heard of Heart Rate Variability (HRV)? Exactly as its name states, heart rate variability is a measure of the variability between heartbeats. Your heart beats a specific rate, anywhere from 60-100. There is a variation in this rate, depending on whether you take a deep breath, exercise, are under stress or are at rest. HRV is dependent on our nervous system to pick up cues from our environment.  In order to understand how these cues are translated into physiological response, we first need to understand how the nervous system works.

Our nervous system controls our heart rate in two opposing directions.

One is the sympathetic nervous system, “fight or flight.” It is responsible for increasing the heart rate when we are stressed, like running away from a saber tooth tiger. In our present world since we are not normally faced with tigers, sympathetic drive kicks in during other emergency situations. This is exactly when you want more blood pumped from the heart to your muscles so you can fight or run. The blood pressure and heart rate increase as a normal response to the feedback from our environment.  

Its counterpart is the parasympathetic nervous system, which is the “rest and digest” system. When our senses detect the emergency is all clear, our parasympathetic system takes the lead and tells our heart rate to slow down and lowers the blood pressure. Our body starts to relax.

This is the normal sequence of events that occurs by increasing and decreasing the heart rate appropriately according to the environmental cues. Studies have shown people with high heart rate variability are usually less stressed and are happier.

The problem occurs when there is low heart variability. This means the nervous system is not responding adequately to the environmental cues and hence your body is less resilient and struggles to handle changing situations. This may occur with diabetes, asthma, anxiety, depression and high blood pressure. This is also seen as we age.

You can improve your heart rate variability by taking care of your body and mind. Regular exercise along with a healthy diet, staying hydrated, avoiding alcohol, getting a good night sleep, being exposed to natural light, taking a cold shower and mindfulness, all help with reduction in HRV.  Controlled breathing has also been shown to boost HRV and help fight stress which can decrease HRV.

The gold standard for measuring HRV is an EKG. But you don’t have to buy an EKG, since there are smaller and more affordable gadgets on the market with which you can measure HRV in the comfort of your home.  Here are some of those:

  • Apple Watch – Uses an optical sensor (green light) to record heart rate automatically, however, you need to obtain the Health app on iPhone to look at the data.
  • Oura Ring – A sleep tracker, takes the mean of all 5-minute samples measured while you are sleeping. The changes in your HRV are accounted for every 5 minutes throughout the night which makes it one of the most accurate devices out there to measure HRV. This is in comparison to other wearables that only take HRV measurement at a single point during the night.
  • Fitbit – Heart rate tracker automatically measures the HRV and sends stats to the Fitbit app. The only problem is that the technology used in Fitbit does not accurately record or report heart rate.
  • AIO (All in One) Smart Sleeve – It is a sleeve you wear that can measure your EKG real time. It also does sleep analysis, workout optimization and stress level monitoring.
  • Frontier X – Worn directly over your heart, like a chest belt, provides continuous ECG monitoring.

There are also apps that help you increase your HRV. They do this thru teaching breathing techniques via biofeedback, which changes the heart rhythm to create a physiological balance in physical, mental and emotional systems. Some of these include HeartMate, HeartRate + Coherence Pro and HeartMath. HeartMath is the gold standard in the industry for coherence and the one with the most science behind it.

So, how do you measure your well-being? Mainly with tools that provide feedback on your heart rate variability. But remember, your well-being does not have so much to do with what is going on in your environment, as it does with how you perceive and react to your environment. And working on those factors will in long term help with your well-being.

“You have power over your mind – not outside events. Realize this, and you will find strength.”

 Marcus AureliusRoman Emperor and Stoic philosopher (161-180 AD)

Didem Miraloglu, MD, MS

Welcome to Tick Season

Frances T Meredith, MD

Prevention is the best medicine

We are all familiar with Lyme disease and likely know someone who has had to deal with this incredibly complex, and sometimes debilitating disease. Lyme, caused by multiple species of the Borrelia bacteria,  is not new, the Borrelia bacteria having coexisted with humans for thousands of years. What is new is that our immune systems are increasingly compromised by the stressful and no longer organic world in which we live. In addition, ticks that most often carry Lyme disease are now all over the United States. Lyme is now endemic EVERYWHERE in the US, though the species of the Borrelia bacteria vary in different areas of the county. And thanks to global warming, tick season is now all year round in many areas, though certainly numbers increase as temperatures warm in the spring.

To make things more complicated, Lyme disease, most often spread by hard Ixodes ticks, is also carried by other ticks as well including several soft ticks. Lyme bacteria are also found in mites, fleas, mosquitoes, biting flies and in tick feces (and those little suckers poop continuously while feeding; think bite, itch, scratch, I’m in!). Other infections often travel along with Lyme including Babesia and Bartonella. These little suckers are smart and know how to evade our immune systems to become “baggage for life” and create havoc all over our bodies.

 Prevention is indeed the best medicine with avoidance and early detection of tick bites the goal. According to Stephen Buhner, an internationally renowned expert on Lyme and coinfections, a blend of essential oils is about 99% effective for repelling the major tick species that carry the many Borrelia species that carry Lyme and coinfections (Healing Lyme, 2015)

Here is his recipe: Take ½ teaspoon of each of the below essential oils, add the oils (4 tspn total volume) to 8 oz pure grain alcohol (95%), blending well and storing in a brown glass bottle out of sun. Subdivide this into 1-2 oz brown herb bottles with spritzer/spray attachment, using this to apply liberally and often during tick season when going outdoors.

-Rhododendron tometosum (Labrador tea; NOT Rhododendron anthopogon)
-Tagetes minuta
-Chamaecyparis nootkatensis
-Artemisia absinthium
-Myrica gale (bog myrtle)
-Juniperus Virginia
-Eucalyptus citriodora (lemon eucalyptus)
-Origanum majorana (marjoram)

I have just ordered these myself, most of them very cheap on Amazon, though several more expensive and coming from Canada. The bottles are also available on Amazon. The total price was $152 which should provide a family with several seasons of protection.

In addition Stephen Buhner suggests Andrographis tincture applied to tick bite site, covering with a “moistened glob of bentonite clay, cover with thin cotton, and leave on for 12-24 hours)”. This tincture is also easily available on Amazon.

This will make for a fun and fragrant home chemistry session! Time to get out there and enjoy some gorgeous spring weather, safely.

Your partner in health,
Frances T Meredith, MD

How to Ground Your Energy When Feeing Anxious

The last couple of years have been hard on everyone.  The pandemic has caused so many disruptions in our lives – lost jobs and income, friends and loved ones becoming ill, children home from school and missing socialization, feeling more isolated and less connected.  It’s no wonder that an even greater number of people have reported feeling anxious. 

Talk therapy, supplements, exercise and medication are beneficial solutions for curbing anxiety.  There are also practical strategies you can utilize when experiencing anxiety.

1)  Box Breathing – If you’ve ever practiced meditation then you know how helpful mindful breathing can be to calm your nervous system.  Close your eyes and then breathe slowly in for four counts.  Hold your breath for four counts and then exhale slowly for four counts. At the bottom of the exhale count to four while doing nothing.  Repeat this process for a total of four times.  Once completed you should feel much more relaxed and centered.

2) Name Objects in Your Line of Vision – If your thoughts are spiraling out of control you can change your state of mind by simply naming objects that you see.  Keep doing this as long as you need to until you feel your energy begin to mellow.  This works because you are changing which hemisphere of your brain is being used, moving from the emotional side to the logical side. 

3) Mantras – Taking the time to recite a mantra is valuable for grounding feelings of anxiety.  Some examples are “I am safe”, “I am peaceful”, “I am loved” or “With every breath I feel myself relaxing”.  Write down your own affirmations that resonate with you the most and then say them repeatedly when you’re feeling anxious.

4) Gratitude – We cannot be in a state of fear or anxiety and be in a state of calm or peace a the same time.  Pausing to “count your blessings” will transition your energy into a more relaxed vibration. Write down five things you are grateful for or if you can’t write them down, list them in your mind.

The next time you find your heart beating fast or your mind racing, try practicing these strategies to ground your energy.

The next time you find your heart beating fast or your mind racing, try practicing these strategies to ground your energy.

If you or someone you know can benefit from working with our health coaches please contact our office to make an appointment. 

In health,
Sara Yadlowsky, FMHC

How To Choose A Safer Sunscreen

Caroline Wilson, M.Ed., FMHC



Summer is coming and while sunlight is vital for health AND is an important way for us to obtain Vitamin D, it is important to practice safe sun exposure and prevent sunburn, which is a risk factor for skin cancer. A recent study in JAMA found that chemical ingredients from sunscreen were detected in the bloodstream after one use, sometimes for days after. These ingredients are also detected in breast milk, and have been associated with lower testosterone levels in teenage boys.
Recently Johnson and Johnson voluntarily recalled 5 of their sunscreens due to the presence of benzene, a carcinogen in these products. 
Using a safer sunscreen without known harmful chemicals is important.  EWG, the Environmental Working Group, is a non-profit, non-partisan organization dedicated to protecting human health and the environment. They score products based on safety data. EWG scores 0-10, 0 is the cleanest and 10 is the worst. Here is a list of ingredients to avoid with the EWG ratings:

  • Oxybenzone(EWG 8), sometimes called benzophenone-3, is banned in Hawaii due to its harm on aquatic life, and yet still found in around 40% of non-mineral based sunscreen. In animal studies, it is an endocrine disruptor and there is some evidence it has a similar impact in humans too – In an evaluation of CDC-collected exposure data for American children, researchers found that adolescent boys with higher oxybenzone measurements had significantly lower total testosterone levels. It is also a contact allergen, may cause systemic toxicity, and be harmful to aquatic life.
  • Octinoxate(EWG 6) – (aka OMC or methoxy-cinnamate) linked to endocrine disruption as well as reproductive toxicity in animal studies. Harms coral reef.
  • Homosalate(EWG 4) – linked to reproductive and developmental toxicity. 
  • ParabensPhthalates – endocrine disruptors, can hide under the guise of ‘fragrance’, so avoid the word Fragrance on that ingredient list. 

Lowest Risk Ingredients: Zinc Oxide (EWG 2), Titanium Dioxide (EWG 2), Avobenzone(EWG 2).

Some recommended brands that use the better ingredients are Babo Botanicals, Earth Mama, 365 Clear spray, Think Sport, Blue Lizard and Badger. For a complete list of safer sunscreens you can go to www.ewg.org.

For more information on using safer products for your skin, contact our office and schedule an appointment with one of our Health Coaches.   

Your Partner in Health!
Caroline Wilson, M.Ed., FMHC