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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

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