Kussin Clarissa - Carolina Total Wellness

May 20, 2019May 20, 2019

Depression is a Disorder of Inflammation in Many Cases

849 depression and inflammation

Depression is one of the most common mental disorders in the United States, affecting more than 16 million people. As such, antidepressant use has jumped by 65 percent in the last 15 years, with one in eight Americans over the age of 12 taking antidepressants.

These statistics are alarming considering the root causes of depression are going unaddressed. Like pain or injury anywhere in the body, depression is a warning flag from the body that the system is out of balance. Stamping out the root causes of depression is like removing the engine light in your car instead of investigating what’s wrong with the car.

In functional medicine we look at the body as an integrated whole, with all parts working together and influencing one another. If you understand human physiology, it doesn’t make sense to isolate and treat one part of the body — such as the brain in depression — without including the overall health of the body.

Many factors can play into depression, including blood sugar imbalances, hormonal imbalances, immune dysregulation, gut health, and gut microbiome dysfunctions.

All of these factors can lead to brain inflammation, which scientists are increasingly finding is the most common cause of major depressive disorder. This type of depression does not respond to antidepressants.

Antidepressants target brain chemicals. called neurotransmitters, that govern mood, motivation, behavior, and mental activity. Some natural remedies, such as 5-HTP or Saint John’s Wort, also target neurotransmitters.

However, this model does not take into account newer research that shows depression is usually due to inflammation. Inflammation in the brain disrupts brain function in several ways that leads to depression.

Brain inflammation slows firing between neurons

Your brain operates through communication, or firing, between neurons. However, when the brain becomes inflamed, the inflammation slows down conduction between neurons. Slowed firing between neurons in the frontal and limbic lobes of the brain leads to depression.

Brain inflammation prevents the production of neurotransmitters

Feeling happy and content instead of depressed depends on proper neurotransmitter production and activity in the brain. Brain inflammation has been shown to sabotage the synthesis of dopamine and serotonin, the two neurotransmitters most associated with depression.

Dopamine is called the “pleasure and reward” neurotransmitter. Symptoms of low dopamine include:

Inability to handle stress
Inability to self-motivate
Inability to start or finish tasks
Feelings of worthlessness
Feelings of hopelessness
Short temper over minor upsets
Isolating oneself from others
Unexplained lack of concern for family and friends

Serotonin is the “joy and well-being” neurotransmitter. Symptoms of low serotonin include:

Feelings of depression
Feelings of inner rage and anger
Difficulty finding joy from life’s pleasures and favorite activities
Depression when it is cloudy or when there is lack of sunlight
Not enjoying friendships and relationships
Not enjoying favorite foods
Unable to fall into deep restful sleep

As dopamine levels drop, you lose your motivation and drive. As serotonin drops, you lose your mood, sense of happiness, and satisfaction with things you used to love.

While this may look like a neurotransmitter problem, antidepressants typically have no effect because they do not address the brain inflammation causing it.

Brain inflammation prevents neurotransmitter receptor sites from working well

Brain inflammation also inhibits the function of receptor sites on neurons for neurotransmitters. Even if there is enough dopamine or serotonin in the brain, brain inflammation will prevent receptors from responding to them appropriately. This prevents neurons from communicating with one another efficiently and depression results.

Brain inflammation and depression are signs the brain is degenerating too fast

The brain is made up of two types of cells: neurons and microglia cells. Microglia cells are the brain’s immune cells and facilitate healthy neuron function, respond to foreign invaders, and clean up plaque and debris.

However, the brain’s immune cells don’t have an off-switch like the body’s. When they are triggered by a brain injury, an inflammatory food, unstable blood sugar, a chronic infection, poor gut health, infectious bacteria in the gut, chronic stress, alcohol abuse, and other insults, they become over-activated in an effort to protect the brain. Unfortunately, they don’t necessarily turn off afterward and can stay in a “primed” over active state indefinitely if constantly triggered by poor dietary and lifestyle choices. This is what causes brain inflammation and depression.

I hope you can see now why so many people don’t respond to antidepressants and why it’s so important to address the root causes of depression. Failing to do so allows brain inflammation to continue unchecked, raising the risk of dementia, Alzheimer’s, Parkinson’s, and other brain degeneration diseases. Ask my office how functional medicine can help you tame brain inflammation and overcome depression.

May 13, 2019May 20, 2019

Exercise and Autoimmune Disease : A Balancing Act

848 exercise and autoimmunity

Although autoimmune disease symptoms can vary depending on the tissue the immune system is attacking, most people with autoimmunity struggle with bouts of fatigue, energy “crashes,” brain fog, inflammation, and pain. These symptoms can throw a frustrating wrench in your exercise habit. Or if these reoccurring symptoms have prevented you from starting an exercise routine, take heart. Regular exercise can be one of the most effective ways to manage your autoimmune condition — you just need to heed your body’s fluctuating needs and tolerance levels.

Autoimmune disease is a condition in which an immune imbalance causes the immune system to attack and destroy tissue in the body. It is a chronic inflammatory condition that many people successfully manage through functional medicine protocols that include dietary and lifestyle strategies as well as helpful nutraceuticals.

Regular exercise is paramount in managing an autoimmune condition for the following reasons:

Done correctly, it produces anti-inflammatory compounds, such as endorphins and endothelial nitric oxide.
It improves circulation, which helps oxygenate body tissue, deliver nutrients to tissues, remove debris, and facilitate detoxification.
It produces chemicals that enhance brain function, such as brain-derived neurotrophic factor; a healthy brain facilitates a healthy body.

How exercise may be different for the person managing autoimmune disease

Although autoimmune disease can feel like a burden, especially when you’re having a flare, many people report it has also forced them to live more balanced, healthy lives.

With autoimmune disease you typically don’t have the privilege of abusing your body to be more productive, to sleep less, to give too much, to say yes too often, and so on.

This also means you don’t always have the option of pushing yourself as hard as you’d like when you exercise. This can be hard on the ego, especially when it comes to exercising in a group situation. For instance, if you are involved in a team sport, group exercise class, or other situation that invites a competitive drive, your ego may want to do more than your body can deliver.

It’s important to pay attention to your body because while exercise has profound anti-inflammatory potential, over exercising will make inflammation worse and could trigger an autoimmune flare.

Likewise, if you’re new to exercise and afraid of triggering a flare, you may feel too intimidated by a group exercise class and looking “weak” or “lazy.”

Rest assured that’s just your ego talking and it’s best not to take orders from it if you want to prevent an autoimmune flare or excessive inflammation. Also, other people are too absorbed in their own workouts to notice yours.

Challenge yourself enough to release anti-inflammatory compounds but not so much you can’t comfortably return the next day

Many people with autoimmune disease find optimal results managing their autoimmunity by maintaining a consistent exercise schedule most days of the week.

Pulling this off means tuning in to your body to find the exercise sweet spot for autoimmune management — not too little and not too much.

Science shows using high-intensity interval training (HIIT) provides the most benefits for managing inflammation, boosting circulation and oxygenation, and improving brain function.

HIIT involves exercising at your maximum heart rate for short bursts of 30 seconds to 2 minutes, followed by a rest and recover phase, and then repeating.

If you’re new to exercise, even just a few minutes a day can start to deliver HIIT’s benefits. If you’d like to improve your fitness level, incorporate HIIT into a longer workout that also includes weight training and some endurance training.

It can be confusing knowing how to safely exercise to maximize its anti-inflammatory effects without going too far. Some great online resources exist that can help you figure out safe ranges using a heart rate monitor. Gyms such as Orange Theory Fitness also use heart-rate tracking, in addition to motivational coaching, to help you dial in your sweet spot.

The beauty of HIIT is that you can adjust it to your fitness level. One person’s HIIT may be sprinting up some stadium stairs while another person’s HIIT may be doing some push-ups from the knees. Both people benefit.

Keep these tips in mind when exercising with autoimmunity:

Find an exercise that is fun and enjoyable. Positivity is anti-inflammatory while dread and negativity are pro-inflammatory. Making it fun will be part of the health benefits. A group class or social setting may be healthy for the same reason.
Challenge yourself enough to get your heart rate up.
Don’t challenge yourself so much you trigger a flare. The key is to be able to do it again the next day. A consistent exercise schedule will deliver the most health benefits.
Pay attention to your body. If you are feeling so run down you can hardly get out of bed, that is probably not a good day to go work out. If you are feeling a little run down but can function, dial back the intensity of your exercise but see if you can still perform. Sometimes a light workout helps you recover faster than not working out.
If you are feeling really run down while working out, it may be better to quit early than to push through.
Capitalize on the days you feel good to challenge yourself a little more than normal, being cautious not to overdo it.
Remember, this is a lifelong condition that requires lifelong attention. Make each day of exercise about the long-range journey as much as that day’s session.

Ask my office for more information on managing autoimmune disease and chronic health symptoms.

May 7, 2019

Streaming Documentaries about Chronic Illness

847 streaming docs on chronic illness

One of the hardest things about dealing with a chronic health or autoimmune disorder is how isolating it can be. Because it’s an “invisible” illness, you look healthy and normal to people when, in fact, you may have periods where you suffer profoundly from the symptoms of your illness along with fatigue, brain fog, and depression. Many people with chronic health disorders are disbelieved by doctors and family members or told they are being lazy or whiny. You are not alone, and you can even find validation and comradery in a few streaming shows on the topic.

Below are a list of streaming shows that take you inside the world of chronic and autoimmune health disorders. Even if you don’t have the same disorders as the subjects in these documentaries, chances are you can relate to their journeys.

Afflicted

This 2018 Netflix docuseries follows the lives of several people with mysterious chronic health disorders as they bounce from one treatment to the next in their search for healing. Afflicted drew considerable criticism from the subjects of the film for being edited in a way that makes their disorders look psychosomatic — the biggest stigma people with chronic and autoimmune disorders struggle against. So, keep that in mind if you watch this series, but otherwise the subjects are very open and vulnerable about their struggles.

Under Our Skin

This 2008 Amazon Prime documentary chronicles the disabling effects of long-term Lyme disease and the endless search for effective remedies. Under Our Skin reveals the emotional and psychological journey of despair with debilitating symptoms, the ongoing search for remedies, and medical denial and neglect that is still systemic today.

Brain on Fire

Brain on Fire is a 2016 drama based on a true story about a young woman who suddenly begins to experience a range of neurological and psychiatric symptoms that progressively worsen. Doctors run multiple tests and insist nothing is wrong with her until one doctor diagnoses her with neurological autoimmunity.

My Kid is Not Crazy

My Kid is Not Crazy follows the struggles of parents whose children suffer from neurological and psychiatric disorders triggered by a strep infection, a condition known as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.) Parents must navigate not only the frightening and tragic symptoms their children face but also medical skepticism, controversy, and ridicule. It is now established in the research that infections can trigger neurological autoimmunity in both children and adults.

Living Proof

Living Proof is a 2017 documentary that chronicles one man’s diagnosis with multiple sclerosis and his battle not only with this autoimmune disease but also conventional medicine, pharmaceutical companies, and the drug-funded Multiple Sclerosis Society. Filmmaker Matt Embry and his family turn to the science for answers when doctors fail him, and as a result he emerges as an advocate for a diet and lifestyle approach he uses to successfully manage his condition.

Gaga: Five Foot Two

Although Gaga: Five Foot Two is primarily a look into Lady Gaga’s life, she talks about her struggles with chronic pain, body-wide muscle spasms, fibromyalgia, and a search for relief. Viewers are also allowed into Gaga’s life as she suffers through a pain flare in this 2017 film. Gaga said she chose to portray her struggles with chronic pain and fibromyalgia because she is tired of people thinking it’s not a real condition.

Unrest

Unrest, 2017, was created by a Harvard PhD student who was two months away from marriage when she became bedridden with ME/CFS, also known as chronic fatigue syndrome. No longer able to work, write, or read, the filmmaker begins chronicling her disease through her iPhone and then including footage of other people from around the world. She and the others in her film suffer not only from the disease but also from ridicule and dismissal from both conventional medicine and society at large. Unrest is available on Amazon.

Functional medicine for chronic health and autoimmune disorders

One common thread that runs through these documentaries is the disbelief, disregard, and ridicule that patients with chronic health and autoimmune disorders run into in the insurance-based health system. Patients are accused of making up their symptoms, of needing psychiatric help instead of medical attention, and repeatedly told nothing is wrong with them.

In functional medicine, we take your symptoms seriously and do not accuse you of attention-seeking. We run tests that look for underlying causes of your symptoms and help you revamp your diet and lifestyle to support recovery and remission.

Ask my office for more information about managing a chronic health or autoimmune disorder.

April 30, 2019May 20, 2019

Autoimmune Disease Considered Epidemic Today

846 autoimmunity today

Although few doctors know how to successfully manage autoimmune disease — a condition in which the immune system attacks the body — researchers say it has become a modern epidemic, affecting more people than heart disease and cancer combined. Conventional medicine also argues autoimmune disease has mysterious origins and is primarily genetic, but again research paints a different picture — autoimmune disease has largely been traced to the tens of thousands of toxic chemicals in our environment.

It takes the average person five years and visiting at least five different doctors before they receive a diagnosis for autoimmunity. Despite many published and peer-reviewed scientific studies about autoimmunity, rare are medical doctors who know how to identify symptoms of autoimmunity, properly screen for it, or appropriately treat it.

Most autoimmune patients are prescribed antidepressants or anti-anxiety medications, told they need to exercise more or lose weight, or told they are making up their symptoms. More than 75 percent of patients with autoimmunity are women, which suggests the sexism shown to exist in medicine stands in the way of better treatments.

If medical doctors do diagnose autoimmune disease, it is typically only after the disease has almost completely destroyed the targeted tissue, whether it’s parts of the brain, the thyroid gland, or the sheaths that coat the nerves. At this point they can offer invasive treatments such as steroids, chemotherapy drugs, or surgery.

Examples of popular autoimmune diseases include Hashimoto’s hypothyroidism, lupus, multiple sclerosis, psoriasis, type 1 diabetes, rheumatoid arthritis, Crohn’s disease, celiac disease, and vitiligo. Although about 100 autoimmune diseases have been identified so far, the truth is the immune system can attack any cell in the body and researchers believe there are probably more than 100.

Why autoimmunity is becoming so common

Autoimmunity rates are skyrocketing. Consider the following:

Type 1 diabetes rose 23 percent between 2001 and 2009 in the US
Crohn’s disease rose 300 percent in 20 years in the UK
Inflammatory bowel disease has risen more than 7 percent every year in Canada
An Israeli study showed autoimmune rates are rising worldwide
Studies show autoimmune rates rise the most in developed nations and in countries that are developing while they are lowest in the least developed countries.

“Developed” has become synonymous with “toxic.”About 80,000 chemicals that haven’t been tested on humans are in our environment in the US and about 5,000 new ones are added every year. Random blood sampling studies show that we all have dozens, if not hundreds (depends on how many they test), of these chemicals in our bloodstream. One study of fetal cord blood found almost 300 different chemicals in newborns around the country.

Other studies link different chemicals to different autoimmune diseases. For instance, mercury has been shown to trigger lupus and pesticides are linked to rheumatoid arthritis.

Rising autoimmune rates are also traced to poor diets high in processed foods and low in plant fiber. This compromises the gut microbiome, or gut bacteria diversity, which has been linked to poor immune function.

Low vitamin D levels, high chronic stress levels, hormonal imbalances, high sugar consumption, and sedentary lifestyles are some of other common reasons for the autoimmune epidemic.

A functional medicine approach to autoimmune disease

When it comes to autoimmunity, functional medicine shines.

For one thing, we listen to you. We know you are not crazy, making up your symptoms, or attention seeking. Autoimmunity is frustrating and confounding in its wide variety of symptoms and mysterious nature. We understand how demoralizing this can be.

Although symptoms vary depending on the tissue being attacked, common symptoms among all autoimmune sufferers include fatigue, malaise, pain, brain fog, depression, and periods where you “crash,” or have such low energy you can’t function.

In functional medicine we use lab tests that screen for multiple autoimmune conditions at once. This allows us to identify an autoimmune reaction taking place that may not be advanced enough yet to cause extreme symptoms. This allows us to halt or slow its progression.

We also can test for the triggers in your environment, such as certain foods you may not be aware are sending your immune system into a tailspin, such as gluten, or specific chemicals, such as benzene. Avoiding these triggers can help you feel better.

Successfully managing autoimmunity is not necessarily about managing the part of your body that is being attacked. Instead, it’s about addressing your hyper zealous and misguided immune system. The immune system is very complex and always in flux, but thankfully new research is continually helping us learn new strategies to balance immunity, dampen inflammation, tame autoimmune flares, and prevent autoimmunity from progressing and devastating the body.

In fact, some autoimmune patients say their autoimmune disease has taught them how to live more balanced and healthy lives than they would have otherwise.

Ask our office for more information about how to manage your autoimmune condition.

April 23, 2019May 20, 2019

Black Women Harmed by Toxins in Hair Relaxants

845 hair relaxants toxic

Chemicals to straighten and relax hair are a part of life for many black women, for reasons that range from societal expectations to ease of care. But our society’s discomfort with black women’s natural hair comes with a cost — these products contain chemicals associated with early puberty, obesity, asthma, and increased cancer risk.

True, the majority of hair, body, and makeup products aimed at all women contain multiple toxic compounds. However, researchers believe that some health disparities that exist between black and white women may be due to the use of more toxic hair chemicals among African American women.

This was demonstrated in a 2016 study that showed black women’s bodies contained more of these toxic chemicals than in women of other ethnicities.

Relaxers, root stimulators, and anti-frizz products contain almost 70 chemicals identified so far that are known toxins to the human body.

For instance, parabens and phthalates have been shown to disrupt hormone function and are linked to early puberty in girls and pre-term births.

Nonylphenol is associated with obesity and increased cancer risk.

Formaldehyde increases the risk of miscarriage and respiratory issues.

Many of these products also cause eye and skin irritation, burning and blistering the scalp, damaging hair follicles, and causing hair loss. They also cause respiratory disorders.

One product can contain as many as 30 different toxic chemicals and we don’t yet know how these chemicals react in combination with one another.

It’s no wonder black women are shown to suffer more health disorders related to these chemicals compared to other ethnicities.

Black women are more likely than white or Hispanic women to suffer from disorders related to the endocrine system, or their hormonal system.

In fact, hair relaxers have been linked to uterine fibroids in black girls and women at a rate that is two to three times higher than in other women. It’s estimated uterine fibroids affect up to 80 percent of black women during their lifetime.

Other studies have shown that cosmetologists exposed to these products during pregnancy experienced twice the rate of miscarriages.

Breast cancer is a leading cause of death among black women, who generally experience more aggressive forms of the cancer compared to white women.

Additionally, studies show a link between the use of these hair products in girls and early puberty.

Although the black hair care market is an industry estimated to account for $500 billion in sales, very few products are tested for toxicity or the effects they have on human health. In the few cases when they are tested, they are found to be the most toxic hair products on the market.

The Black Women for Wellness Report addresses the complexity around the harmful and toxic nature of black women’s hair products, cultural expectations for black women’s hair, and the positive role of hair salons in black communities.

Other factors that cause early puberty and disrupt hormone function and balance

Although scientists have established a clear link between the synthetic toxic compounds and hormonal imbalances such as early puberty, other factors play a role as well.

One of the most common is consistently elevated blood sugar from a diet high in processed carbohydrates (such as pasta, bread, pastries, etc.) and sugars. These foods raise the incidence of obesity, insulin resistance, and diabetes, which in turn raises the risk of early puberty and other hormonal disorders.

Excess body fat and high insulin stimulate the production of estrogen. Both diabetes and obesity are prevalent among African Americans. Genetics play a role in this, as does the fact that many black people in the US do not have access to healthy foods, nutritional education, or safe outdoor spaces to exercise.

Also, compounds in common foods are estrogenic. One study showed infants fed soy formula had estrogen levels 13,000 to 22,000 times higher than normal (soy is a known estrogen mimicker). Also, sex hormones are given to beef and dairy cattle, and the antibiotics given to animals may be a factor.

Puberty also begins earlier in populations who live further from the equator and more prone to vitamin D deficiency. Studies show black people and people with dark skin in the US tend to be deficient in vitamin D due to insufficient exposure to the sun. Taking 10,000 IU a day of vitamin D can be helpful.

A whole foods diet that restricts sugar and limiting exposure to chemicals can help prevent hormonal disorders.

Ask my office for advice on how to reduce the toxic burden on your body, support the organs that help remove toxins, and how to reduce your risk of chronic and serious health disorders.

April 15, 2019May 20, 2019

Integrating Fiber Needs (Prebiotics) Into a Modern Diet

Although the produce section at the grocery store may look vast, it only represents a fraction of edible, nutritious, and tasty plant foods. It’s estimated there are more than 20,000 species of edible plants, and that we only eat about 20 to 50 of them. As a result, this may be playing a significant role in the rapidly declining health of westerners. Our gut bacteria, or gut microbiome, is a foundation to our health, and healthy gut bacteria depend on a diverse and ample array of vegetables.

Ancient humans harvested wild fruits, nuts, and seeds that varied with the seasons. They also dug up underground roots and stems. Studies of the Hadza people, in Tanzania, one of the last remaining hunter-gatherer populations left on the planet, gives us additional insight into the human microbiome and health.

The Hadza have one of the most diverse gut microbiomes on the planet; Americans have the worst. The Hadza gut microbiome diversity is about 40 percent higher than that of the average person in the United States.

Americans consume an average of 15 grams of fiber a day, most of it coming from grains. The American Heart Association recommends eating 25 to 35 grams a day. Some microbiome authors suggest even higher amounts — at least 40 grams of fiber a day.

In contrast, the Hadza consume about 100 to 150 grams of fiber a day, with the average Hadza person eating almost 600 species of plants that vary with the seasons. They suffer almost none of the same diseases that have come to characterize the average American — obesity, diabetes, autoimmune diseases, and cancer.

Studies show fiber also lowers heart disease risk by binding with “bad” cholesterol to remove from your body. A high-fiber diet also lowers high blood pressure and thus the risk of stroke.

They type of fiber you eat matters too. What gut bacteria need for optimal function are “prebiotic” fibers mixed in with a diverse array of produce.

Prebiotic fibers best feed the healthy bacteria in our guts, thus improving overall health. Good sources of prebiotics include all vegetables but especially:

Garlic
Jerusalem artichokes
Jicama
Dandelion greens
Onions
Peas
Broccoli
Brussels sprouts
Fruits
Beans

Not only do prebiotic fibers help with bowel regularity, they also change the composition of the gut microbiome in a favorable direction. They help strengthen intestinal walls, improve absorption of important nutrients, produce hormones that control appetite, reduce anxiety, and help protect you against chronic disease.

If you’re not used to eating high amounts of plant foods loaded with fiber, don’t double or triple your intake overnight. Your gut may rebel with constipation, diarrhea, pain, bloating, and gas. It takes your digestive system and gut microbiome some time to adapt and be able to adequately digest large amounts of fiber. Gradually increase the amount of fiber you eat by 1 to 2 grams a day over several weeks to give your system time to adjust.

Also, you may have noticed legumes, or beans, are especially high in fiber. It’s tempting to make those a staple in your diet as a result, and if they don’t disturb your health then go for it. However, many people cannot tolerate the lectins in legumes — they trigger inflammation or autoimmune flare-ups. For people with SIBO, small intestinal bacterial overgrowth, they also cause intense digestive issues and inflammatory responses.

Also, some people need to avoid nightshade vegetables because they trigger inflammation, particularly in relation to arthritis. These include eggplant, potatoes (but not sweet potatoes or yams), peppers, tomatoes, tomatillos, hot pepper products (cayenne, Tabasco, etc.), and pepper-based spices. Simply removing nightshades from the diet has brought relief from joint pain for many, especially those with rheumatoid arthritis.

Lastly, some people have gut or immune disorders that make a high-fiber diet inappropriate until they resolve those. Ask me for more information if eating fiber makes you miserable.

What does a high fiber paleo diet look like?

Most people with chronic inflammatory and autoimmune disorders fare best on a paleo diet that eliminates grains and legumes. As grains and legumes are sources of high fiber, what does a high-fiber paleo diet look like?

The recommended produce consumption is seven to 10 servings a day. That may sound like a lot, but one serving is a half-cup of chopped produce, or a cup of leafy greens. Because sugary foods can be inflammatory, aim for veggies and fruits that are low in sugar and unlikely to destabilize your blood sugar.

Therefore, shoot for at least three to four servings of produce per meal – that’s 1.5 to 2 cups of chopped veggies or 3 cups of leafy greens. Or break that up into five meals if you eat more frequently to stabilize low blood sugar.

Ask our office for more ways to support your gut microbiome.

April 11, 2019May 20, 2019

Staying Thin is Harder Than in the Past

843 weight loss harder these days

If you feel like you have a harder time staying slim than your grandparents did at your age, you are right. We are about 10 percent heavier than people in the 80s, even when we eat the same foods and exercise just as much. This may be due to changes in lifestyle and environmental factors that impact our BMI, or body mass index.

Recent research by York University’s Faculty of Health shows it’s harder to maintain the same weight at a certain age than it was for someone 20 or 30 years ago. Even if you eat exactly the same macros (protein, fat, and carbs) and do the same amount and type of exercise, you are likely to be heavier than they were at your age.

In fact, with all factors accounted for, the predicted BMI has risen 2.3 points between 1988 and 2006.

According to study author Jennifer Kuk, “Our study results suggest that if you are 40 years old now, you’d have to eat even less and exercise more than if you were a 40-year-old in 1971, to prevent gaining weight. However, it also indicates there may be other specific changes contributing to the rise in obesity beyond just diet and exercise.”

Specific factors contribute to our increased BMI

Historically we tend to look only to dietary and exercise habits when we consider our weight or BMI (body mass index).

However, weight management is much more complex than watching what you eat and how much you work out. Our BMI is affected by many factors such as:

Medication use
Environmental toxins
Genetics
Meal timing
Stress level
Gut bacteria populations
Nighttime light exposure

While the study’s authors admit we need more research to determine exactly how these factors play into the changed BMI picture, they suggest three main players:

Increased environmental toxins. Compared to 30 years ago, we are exposed to a higher level of environmental toxins such as pesticides, air pollution, heavy metals, flame retardants, plastics used for food storage, and more. These toxins put a heavy burden on the endocrine system, altering the hormonal processes that affect metabolism and weight management.

Increased use of prescription drugs. Since the 1970s our use of prescription drugs has risen dramatically. Many antidepressant drugs are linked with weight gain and are the most prescribed drugs in the US for people between 18 and 44.

Our gut microbiome has changed. The gut microbiome, or the community of good and bad bacteria that naturally inhabit the digestive tract, have changed dramatically since the 80’s.

Americans eat differently than they used to. The products we eat are more filled with antibiotics, pesticides, and other toxins; we eat more artificial sweeteners; and we eat more junk food. All of these factors may negatively affect our gut bacteria populations.

A hot topic of research, the gut microbiome is linked to more and more aspects of health and disease. We now know that some gut bacteria are linked with weight gain and obesity. In fact, doctors are even using fecal implantation — insertion of gut bacteria from a healthy slim patient into the gut of an unhealthy obese patient — to reduce chronic obesity.

Support your microbiome with SCFA

In functional medicine we consider the gut microbiome to be a foundation of health. An imbalanced gut microbiome can prevent you from healing from many health disorders, so it makes sense to do everything you can to support yours.

One important factor is oral tolerance, or the body’s ability to properly recognize food proteins. When we lose oral tolerance, the immune system mistakenly thinks more and more foods are pathogens, and we begin to have more food sensitivities, increased hormonal issues, increased autoimmunity, and imbalanced metabolism and weight gain.

You can support oral tolerance by fixing leaky gut, supporting liver function, taming histamine reactions, reducing stress, and balancing blood sugar. But one of the best ways to support it is by providing your body with plenty of short-chain fatty acids (SCFA).

Your gut bacteria not only make SCFA, they also need them as fuel to produce more SCFA. The more you eat them, the more your good gut bacteria can outweigh the bad.

Three main SCFAs include:

Butyrate
Propionate
Acetate

SCFA bind to cell receptors that control your hunger and appetite, turn off insulin resistance, and burn body fat more efficiently.

When you are low on SCFA you will:

Have a larger appetite
Be prone to insulin resistance (think pre-diabetes)
Store body fat better than you burn it

When gut diversity is ruined, SCFA can’t signal properly and you end up with what we call an “obese microbiome.”

How to support SCFA

To support healthy levels of SCFA, adopt the following habits:

Eat abundant and varied produce. Eat plenty of diverse vegetables so your gut bacteria stay adept at recognizing many different food proteins. Aim for 7 to 9 servings a day. One serving consists of a half cup of chopped vegetable or one cup of shredded greens. Go easy on high-sugar fruits to keep your blood sugar stable.

Supplement with SCFA. You may benefit from also supplementing with butyrate, the main SCFA. Start with one capsule a day and work your way up to two capsules twice a day.

Boost glutathione levels. Glutathione is the master antioxidant that helps dampen inflammation, a main factor in loss of microbiome diversity. Take absorbable glutathione such as liposomal glutathione, s-acetyl glutathione (regular glutathione isn’t absorbed well), or its precursors such as n-acetyl cysteine.

There are many other helpful ways to support a healthy microbiome. Contact our office to determine your microbiome health and how to improve it, so you can maintain a healthy weight.

April 1, 2019May 20, 2019

How to Support Optimal Stomach Acid for Good Digestion

842 stomach acid

When we go to the doctor with symptoms of acid reflux, gas, bloating and heartburn, typically the diagnosis of high stomach acid is based purely on symptoms — not a lab test for stomach acid levels — resulting in a prescription for antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery.

For many people, these drugs only worsen the problem.

Antacids reduce stomach acid temporarily, then more acid is automatically produced to bring the stomach back to its intended pH level. This only treats the temporary symptoms and does nothing to fix the actual problem.

H2 blockers block a substance in the body that encourages acid production in the stomach. They work more slowly than antacids and are intended to last for longer periods of time. On the down side, they stop production of pepsin, a digestive enzyme necessary for breaking down protein.

Proton pump inhibitors permanently block an enzyme that tells your stomach to produce acid.

All of these methods are linked to serious side effects and can even contribute to the root causes of continued chronic low stomach acid and other serious health conditions.

5 Ways to test stomach acid levels

Because hypochlorhydria isn’t well known to most patients, many never trace it back to their chronic health condition and they continue to suffer.

The good news is multiple options exist for testing stomach acid levels, which will help you create a clear game plan for remedying the situation at its foundation.

1. Gastric acid secretion test. Highly invasive and expensive, this test is typically done if a patient is diagnosed with a stomach ulcer. It can be helpful to track if anti-ulcer medication is working and to see if material from the intestines is coming back into the stomach.

2. The Heidelberg Stomach Acid Test. Considered the gold standard test for hypochlorhydria, a small capsule with a radio transmitter is ingested to measure the pH of the stomach as you drink a solution with baking soda (reduces acidity). The baking soda will naturally neutralize the HCL in the stomach. If the body does not return it to normal, it’s a sign of hypochlorhydria.

This test provides a graph showing your specific stomach response to the baking soda challenge, and can help determine if you have hypochlorhydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid). At a cost of about $350, this test is not covered by most insurance plans.

3. CBC and CMP. These are common factors on a metabolic blood panel, typically covered by insurance. A skilled clinician can diagnose hypochlorhydria by taking into account these lab results in combination with your symptoms.

4. Betaine HCl challenge. An at-home test considered to be quite reliable, however false positives are possible, so it’s recommended to repeat the test three times. The betaine HCl costs about $20. If you have low stomach acid, you can then take it to help restore your HCl levels.

Buy Betaine HCl with pepsin.
Eat a high-protein meal containing at least 6 ounces of meat (veggies are allowed with this).
In the middle of the meal (not the beginning) take one betaine HCl pill.
Finish the meal and observe what happens.

Possible outcomes:

1. You notice no symptoms. This is likely a sign of low stomach acid.

2. Indigestion. Burning, heat, or heaviness in your chest likely indicate adequate stomach acid levels.

It is recommended to repeat the betaine HCl challenge two or three times to confirm your results. Three positive tests are a good indication of low stomach acid.

False positives are possible if:

You consume too little protein. A low protein meal doesn’t require much acid, so the betaine HCl can cause too much increase in acid.
You took the capsule before the meal, which can cause indigestion.
You have esophageal sphincter dysfunction. A hiatal hernia or poor esophageal sphincter tone can cause increased indigestion symptoms. Rule this out with a medical exam if you suspect it.

5. Baking soda stomach acid test. While not as accurate as the above tests, this is a free at-home test you can use to get an indication of your stomach acid levels. The results can vary from person to person depending on interpretation of the results. Some use it as a baseline measure and to track changes over time.

First thing in the morning, before eating or drinking anything:

Mix ¼ tsp baking soda in 4 to 6 ounces of cold water.
Drink the baking soda solution.
Time how long it takes for a burp to occur. Time it for up to 5 minutes

If you have not burped within five minutes, it may be a sign of insufficient stomach acid. Early and repeated burping may be due to too much stomach acid (do not to confuse this with small burps from swallowing air when drinking the solution). Any burping after 3 minutes is an indication of low stomach acid levels.

Associated tests

Low stomach acid can be associated with other health issues that have far-reaching consequences. If you suspect low stomach acid, ask our office about testing for the following:

B12 levels: Intrinsic factor is a glycoprotein in the stomach necessary for absorption of vitamin B12. When stomach acid is too low, intrinsic factor can’t do its job. This results in vitamin B12 deficiency, which is a serious health concern.

Homocysteine levels: Stomach acid is important for proper absorption of vitamin B12, a key factor in methylation that keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine elevates.

Supporting healthy stomach acid

Eat protein foods at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein.

Chew thoroughly. This is one of the most important parts of digestion. Food proteins need to be broken down to be properly digested.

Limit liquid intake during meals until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilization, and protein metabolism.

Stay hydrated between meals to support proper gut motility; this pushes the contents of the intestines out of the body instead of back into the stomach. This is very important for those who are prone to SIBO.

Betaine hydrochloride supplements help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)

Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may create a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol, or aspirin.

HCl with pepsin. Add these to your diet when you consume protein. When you feel warmth in your stomach, that means you are taking enough. Then back it down a notch and monitor your response. Some people need one capsule, others need more as everyone is unique.

Pepsin. Typically used in conjunction with HCl, pepsin is considered very safe when administered to assist digestion.

Digestive enzymes help to break down food proteins. Make sure to get a high-quality blend.

Apple cider vinegar. One tablespoon in a bit of water right before a meal can help with digestion.

Fermented foods such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. pylori, arch enemy of stomach acid production.

Taking the time to improve your stomach acid levels will make a huge difference in your symptoms and quality of life. Please contact my office for more help.

March 25, 2019May 20, 2019

Statins Raise Diabetes Risk: What to Do Instead of Drugs

841 statins raise diabetes risk

You’ve been told you need to lower your cholesterol, but did you know taking a statin could raise your risk of type 2 diabetes? A recent study of almost 9,000 people in their 60s showed that statin use increased the risk of diabetes by almost 40 percent. Statin use was also associated with a higher risk for elevated blood sugar and insulin resistance (pre-diabetes). While the brand of statin subjects took didn’t seem to matter, risk was higher in overweight and obese subjects.

Given the risks associated with high blood sugar, insulin resistance, and diabetes, this study highlights further problems with statin use for a condition that is typically well managed through functional medicine protocols. High blood sugar and diabetes raise your risk for many chronic health disorders, including dementia and Alzheimer’s.

This isn’t the first study to link statins with an increased risk of type 2 diabetes. Previous research has found a 50 percent increased risk of diabetes in female users.

Statins most commonly prescribed drugs

Statins are among the most commonly prescribed drugs, accounting for more than $20 billion of spending a year. About one in four Americans over 40 takes statins, with that number having increased by almost 80 percent in the last two decades. Side effects include muscle weakness and wasting, headaches, difficulty sleeping, and dizziness.

Statins do not address the underlying cause of high cholesterol

Although statins lower cholesterol, they do not address the underlying cause of high cholesterol in most people, which is typically inflammation (some people have a genetic disorder that causes very high cholesterol). The body uses cholesterol to patch up damage in the arteries caused by inflammation. In fact, research shows inflammation is the primary cause of heart attacks and strokes, not high cholesterol.

Considering the following facts about cholesterol and heart disease:

75 percent of people who have heart attacks have normal cholesterol.
Older patients with low cholesterol have a higher risk of death than those with higher cholesterol.
Populations in other countries with higher cholesterol than Americans have less heart disease.

Hypothyroidism, a condition estimated to affect more than 20 million Americans, raises cholesterol. Many find a gluten-free diet lowers cholesterol, as gluten is inflammatory for so many people.

Research also shows diets low in fat and high in carbohydrates increase the “bad” form of LDL (there are two to look at) and decrease the protective HDL.

Lowering cholesterol through functional medicine

Using functional medicine is a highly effective way to lower cholesterol naturally. This is because functional medicine identifies and manages the root cause of a problem versus using a drug to block symptoms.

Management includes an anti-inflammatory diet, exercise, nutritional support, and finding out causes of inflammation. These may include low thyroid function, autoimmune disease, bacterial or viral infections, leaky gut, poor blood-sugar handling, or other chronic health issues.

In fact, high cholesterol is more often tied to a diet too high processed carbohydrates and sugars, not fat. Sugar and refined carbs, including processed white foods, drive good cholesterol down and triglycerides up. It causes low density small particles that encourage the dangerous buildup of arterial plaque. This can lead to not only heart disease but also insulin resistance or “pre-diabetes.” Sugar, not dietary fat, is the bigger cause of most heart attacks.

However, the type of fat you eat matters too. Trans fats, or hydrogenated fats, promote dangerous types of cholesterol, while omega-3 fats and monounsaturated fats improve the healthy types of cholesterol.

Measuring cholesterol players

Cholesterol is found in every cell and helps produce cell membranes, vitamin D, and hormones. It’s also necessary for good neurological function.

When we measure cholesterol, we are measuring LDL and HDL. These are small packages of fat and protein that help move cholesterol throughout the body.

High-density lipoprotein — HDL

This is considered “good” cholesterol. It helps removes excess arterial plaque.

Low-density lipoprotein — LDL

This is considered “bad” cholesterol. It can form plaque that narrows the arteries and makes them less flexible (atherosclerosis).

Triglycerides

High levels of this dangerous fat are linked to heart disease and diabetes. Levels rise from eating too many sugars and processed carbs, as well as from smoking, physical inactivity, excessive drinking and being overweight.

Lipoprotein (a) or Lp(a)

Lp(a) is made up of an LDL part plus a protein (apoprotein a). Elevated Lp(a) levels are a strong risk for heart disease.

When testing cholesterol, please pay attention to:

Levels of HDL “good” cholesterol versus LDL “bad” cholesterol
Triglyceride levels
The ratio of triglycerides to HDL
The ratio of total cholesterol to HDL

Inflammation promotes heart disease

Systemic inflammation is a primary factor in heart disease and most chronic health disorders. A diet high in sugars and processed carbs, a sedentary lifestyle, smoking, excessive drinking, chronic stress, gut infections, unmanaged autoimmunity, and chronic infections are all causes of chronic inflammation. People with elevated systemic inflammation, which is measured by a blood marker called C-reactive protein (CRP) have a higher risk for heart disease than those with high cholesterol. Also, normal cholesterol is not protective for those with high CRP.

By addressing the cause of high cholesterol not only do you avoid the dangerous risks and unpleasant side effects of statins, but also you journey into your golden years with improved energy and well being.

March 18, 2019May 20, 2019

Pregnancy and Postpartum can Trigger Hypothyroidism

840 pregnancy and Hashimoto s

For many women, the onset of their hypothyroid symptoms began either during pregnancy or just after. Most of these women went on to be diagnosed with Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland. Pregnancy often triggers Hashimoto’s due to normal shifts in immunity that cause an already beleaguered immune system to tip out of control and begin attacking the thyroid gland.

Factors that can contribute to developing Hashimoto’s around pregnancy or childbirth include shifts in immune function during the third trimester, shifts in immune function postpartum, the dramatic shifts in hormone function, genetic tendency, and the exacerbation of existing disorders such as blood sugar imbalances, food intolerances, gut infections, and other autoimmune diseases (which may or may not be diagnosed).

How pregnancy can trigger Hashimoto’s hypothyroidism

Women make up the vast majority of people struggling with autoimmune diseases, about 75 percent. Researchers suggest this is because women have more complex hormonal systems that involve more fluctuations; hormone and immune function are closely tied. Hormone imbalances are a major contributor to chronic inflammation that can trigger autoimmunity.

Pregnancy simply exacerbates these fluctuations and underlying imbalances.

Shifts in immune function during and after pregnancy can trigger autoimmune disease

Women experience major immune shifts towards the end of pregnancy and then again immediately after birth. These are natural shifts designed to help protect the baby.

During the third trimester, a pregnant woman’s immune system becomes more heavily weighted toward what is called the TH-2 system. This arm of the immune system is the delayed immune reaction that produces antibodies that identify a foreign invader a short while after it enters the body. This response allows the body to recognize the invader in the future.

After the baby is born, a woman’s body then becomes more TH-1 dominant. This is the arm of the immune system that reacts immediately to a foreign invader, such as with swelling and pus around a splinter.

Most people who either already have an autoimmune disease or are at high risk of developing one are overly dominant in either the TH-1 or TH-2 arms of the immune system.

The immune swings that pregnancy and childbirth cause tip an already imbalanced immune system into full expression of an autoimmune disease such as Hashimoto’s hypothyroidism.

Pregnancy and pituitary function

Although about 90 percent of hypothyroid cases are caused by Hashimoto’s, some cases are caused by chronic stress. As any mom can tell you, pregnancy and childbirth can bring inordinate amounts of stress.

Extreme or chronic stress depresses function of the pituitary gland. The pituitary gland is a small gland at the base of the brain that is like a control tower for the body’s hormones, telling the various glands throughout the body how much hormone to secrete in response to external and internal cues.

Chronic stress overwhelms the pituitary gland and depresses its function. As a result, the pituitary falters at its job of telling the body’s hormone glands to secrete hormones. In the case of the thyroid gland, this means it doesn’t tell it to release enough thyroid hormone.

This not only causes tiredness and other hypothyroid symptoms, but it can also explain postpartum depression in some women.

It’s important to understand that stress doesn’t just mean bad traffic or a demanding job. Many women enter into pregnancy already under enormous stressors they may not be aware of:

Leaky gut or gut infections
Blood sugar that is either too low (hypoglycemia) or too high (insulin resistance)
Undiagnosed food intolerances such as gluten sensitivity or celiac disease
Hormonal imbalances
Undiagnosed brain dysfunctions, such as from an old brain injury, brain inflammation caused by poor diet, or PTSD or CPTSD
Sensitivity to chemicals or over exposure to chemicals
Poor liver detoxification
Undiagnosed chronic bacterial, viral, parasitic, or fungal infections

Are you at risk? Check your TPO and TGB antibodies before pregnancy

It’s not a bad idea to screen for risk for Hashimoto’s before conceiving. You can do this by testing TPO and TGB antibodies. Many people have autoimmune mechanisms already in place that not advanced enough to cause symptoms. However, a big shock to the body such as pregnancy can be the tipping point to send you over the edge into autoimmune expression.

If you have Hashimoto’s in your family, other autoimmune diseases in your family, or you suffer from other inflammatory conditions, it pays to screen for your risk before pregnancy. This gives you an opportunity to use functional medicine strategies to slow down or send into remission your autoimmune condition.

Studies show that women with no thyroid symptoms but positive blood serum TPO antibodies have a 25 percent higher risk for developing an autoimmune response to their thyroid.

Reducing the risk of autism, allergies, eczema, and more in your baby

Using functional medicine to manage autoimmunity or heightened risk for autoimmunity is not only good for the mother’s health, but also for that of her child. Children born to mothers with autoimmunity such as Hashimoto’s show increased risk for varying health disorders, including autism spectrum disorder, eczema, asthma, food allergies, and food intolerances.

Researchers have increasingly found that autoimmune disorders underlie many cases of autism, which is caused by an autoimmune attack against the brain in these children. Whether it’s autism or other immune disorders, children born to mothers with imbalanced immune systems may be more vulnerable to environmental triggers that can tip them over into full blown autoimmunity.

Triggers can include food intolerances, blood sugar imbalances, or toxic chemicals introduced into the bloodstream.

Of course, no one willingly or knowingly brings these hardships onto themselves or their children, but in today’s world the modern immune system faces significant burdens. Going into pregnancy knowing how to manage and minimize the impact of those burdens on the body can help minimize the risk. If you already developed Hashimoto’s during pregnancy or after childbirth, understanding why you did can help you better manage it.

Ask my office for help addressing the root cause of your Hashimoto’s hypothyroidism.