Food and Mood

Blair Cuneo, PA-C

I think about many things this time of the year with seasons changing and holidays approaching. As a functional medicine provider, I consider how changing landscapes not only affect my patient’s physical health, but also their emotional health. This landscape or “environment” of less direct sunlight, more time indoors, increased celebratory food and drink and increased holiday stress has a major impact on mental health for many of us.

Our relationship with food is complex, as is our body’s response to our culinary selections. We hope that our bodies can effectively digest food and absorb its nutritious content, but how do we know if it doesn’t? We hope the foods we are eating are contributing to healthy neurotransmitter production, healthy immune system messaging, but what does it feel like if that’s not the case?

You’d think that your stomach would definitely let you know if any of the above was amiss, but consider this: approximately 30% of us will have a gastrointestinal/gut symptom if there are imbalances in digestion or immune activation, while the majority of us will have a “beyond the gut” symptom first, such as headaches, mood changes, sleep disruptions, fatigue and pain. Thus, the majority of people may not be thinking of a direct relationship between green bean casserole and their anxious or sad days.

Several things need to happen when we eat a meal. First, we need to be in a “rest and digest” state. This signals to the body it’s time to produce digestive acids, enzymes and bile to sterilize the food, break it down and absorb it well. Next, we need healthy proteins that can be broken down by these digestive supports to become the basic amino acids that our body will use as the building blocks to create neurotransmitters like dopamine and serotonin. Neurotransmitters are signaling molecules, providing communication between nerves. The balance of neurotransmitter production, absorption and clearance, affects mental and physical health. Further, this building of neurotransmitters requires cofactors of several micronutrients like zinc, vitamin B6, magnesium and vitamin D.

To cap things off, there can be immune system reactions to foods, allergies and/or sensitivities that are contributing to inflammatory messaging that starts in the gut, but travels “beyond the gut”, affecting our emotional state.

In my practice, I regularly see low levels these cofactors, low levels of digestive enzymes and gastric acid, high stress and of course, the daily challenge in regularly making healthy eating and drinking choices.

In order for a body and mind to be healthy, each of these areas needs to be considered, evaluated and addressed.

While there are objective tests available for providers to check your nutrient and digestive status, there are also excellent lifestyle supports to begin making a shift in your wellness today.

-Eat at regular intervals. It is less stressful for the body when it knows it can count on you to feed it. This also helps the timing of the digestive acids/enzymes release where there are patterns in meal timing.

-Whole foods. Limit processed foods. Head to the refrigerator, before you head to the pantry. Each meal should contain a protein, small amount of fat, and colorful fruits and vegetables.

-Mindful eating, not distracted eating. Try to avoid multitasking while eating. As often as you can, eat at a table, focused on your food and the company that you share. Look, smell, taste and chew well! Even the process of chewing is signaling release of enzymes.

-Connect with your healthcare provider to review your micronutrient and vitamin status. You might discuss multivitamin, magnesium and/or zinc supports and also test your vitamin D to help assign dosing recommendations.

Remember, Food can be medicine! Make sure you use it wisely!

Your Partner in Health!

Blair Cuneo, PA-C

Magnificent Magnesium

Frances Meredith, MD

In the times of COVID, so many nutrients seem to be in the news these days from quercetin to Zinc, to Vitamin D.  Overlooked I believe is the nutrient essential for every cell and every process in our body including immune readiness: Magnesium!

Magnesium is a cofactor for over 300 enzymatic reactions, supporting DNA and RNA synthesis, cell growth and reproduction. Magnesium enters the energy cycle as a cofactor in at least 12 different steps in the process, and is essential for the little batteries in every cell, our mitochondria, to transport electrons and create energy. It is necessary for bone growth and strength, stabilizing the cell membrane, and maintaining normal nerve and muscle function.

Magnesium sits within the cell, balancing all of our cells, keeping calcium outside the cell from overstimulating cellular activity in all parts of the body. For example, Mag balances Calcium in the NMDA glutamate receptor, controlling its opening, avoiding “neuroexcitation”.  Thus, lack of Magnesium sets the stage for nerve overactivation, hyperexcitability (think chronic anxiety, chronic pain, chronic states of inflammation created by lack of Magnesium). When we are Mag deficient this NMDA glutamate receptor activates. This is good for survival when we are under intense stress, but not something we want to live with on a day in and day out basis.

Low Magnesium can express itself in so many ways including fatigue, muscle cramping/tension, PMS, headaches, especially migraines, constipation, insomnia, tinnitus, brain fog, heart arrhythmias, anxiety and depression, TMJ, ADHD, and blood sugar issues. Sound familiar?  If that’s not enough, Magnesium deficiency is implicated in diabetes, osteoporosis, and hypertension. It is a natural “calcium channel blocker” (think drugs that do this such as amlodipine used for hypertension). The lower the Magnesium levels the greater the progression of Alzheimer’s. Fibromyalgia improves with Magnesium treatment. Increasing Magnesium intake is correlated with a decrease in stroke, diabetes, heart failure, fracture risk and all-cause mortality. Sounds like we all need more, yes?

Why are we so deficient? The answer lies both in the disruption of our food chain and the breakdown of our food choices. The soil is now deficient in Magnesium due to lack of crop rotation, pesticide use and overproduction; in addition, the use of fertilizer heavy in nitrogen and phosphate blocks the plants’ ability to absorb Magnesium.  Further, as foods are processed, Magnesium is leached out. The end product: less for us.

Testing for Magnesium is easy, with red blood cell levels being the most accurate form of testing. Body signals, however, are much more important than a test result. Symptoms such as myofascial and muscular tightness/tension/cramping, sluggish bowels, and low energy point to low Magnesium and a trial of Magnesium is warranted even without checking a blood level.

So how can we optimize Magnesium for all of the cells in our body to “sing”? It is clear that plant-based Magnesium is much more effective than the mineral in supplement form. This is due to the fact that Magnesium is at the heart of chlorophyll, responsible for the green pigment in our green foods. Plant based Magnesium is very absorbable and is already charged, essential for its function. The big winners for high magnesium are pumpkin seeds, spinach, almonds and cashews. This great link from Cleveland Clinic lists the magnesium content of many foods.

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 Magnesium in supplement form can be very helpful, and must be attached to a “chelator” to get across the intestinal border. They are best taken with food to improve stability. Magnesium comes in forms including glycinate, citrate, theonate, asparate, orotate, and oxide, with different benefits associated with the specific chelators.

For example, the Mag oxide form is only minimally absorbed and very unstable, drawing water into the intestinal tract, helpful for severe constipation or impaction but not helpful to get Magnesium into cells elsewhere in the body. In contrast the Magnesium glycinate is more stable, better absorbed and better for anxiety or insomnia. Mag citrate is helpful for intestinal motility/constipation as well as energy as it plugs directly into our “Krebs cycle” to create energy.

In addition, optimal intestinal absorption is necessary, with Magnesium absorbed mostly in the ileum of our small intestines. Therefore, if things go awry in the ileum, our ability to absorb Magnesium (as well as other nutrients) will be impacted (think leaky gut, small intestinal bacterial or fungal overgrowth).

Sounds like most everyone would be better off with a little more Magnesium! If any of the above-mentioned symptoms or conditions apply to you, your functional medicine provider at Carolina Total Wellness would be most happy to discuss this with you.

Your Partner In Health

Frances T. Meredith, MD

5 Strategies For Stress Eating

Stress eating occurs when we eat in response to a stress signal instead of a hunger signal.  It is reaching for food to calm our nerves, soothe our sadness, chase away boredom or buffer against other emotions we are uncomfortable with.
 
When we stress eat we are usually reaching for sugary and/or salty foods.  It’s often food we eat with our hands.  Hand to mouth eating frequently occurs without much awareness or mindfulness.

 
Tips to Help Decrease Stress Eating:
 

1) Being Body Aware – This means getting in touch with your body.  Get back into your body, get grounded, get centered.    Are you truly hungry?  Pay attention to what sensations are going on in your body.  Has your heart rate increased?  Do you have butterflies in your stomach?  Are you feeling fragmented and disassociated in your body?  Feeling out of sync between body and mind?
 
You can bring yourself back to center by concentrating on your breath.  Put one hand on your chest and one on your belly and breathe in deeply.  Is the breath going to the upper chest area or the belly?  You want the breath to go into the low belly.  By doing this you engage the parasympathetic system (aka rest and digest) and reduce the sympathetic system (aka fight or flight).
 
2) Exercise your emotional muscle – Emotions are energy in motion.  Don’t be afraid to show your emotions.  We need to let emotions flow and we need to express them.  When we don’t do this we “eat our emotions” with food.  Emotional eaters tend to eat foods that are nutrient poor (junk food) instead of nutrient rich (veggies, fruits, healthy fats, lean proteins).
 
Keep a check on your feelings.  One way to do this is to check in with family and friends.  Be real about your emotions as this allows others to feel comfortable to open up with you as well.  Journaling is also a great tool for expressing your emotions. 
 
3) Developing alternatives – Rather than engaging in stress eating come up with alternatives.  Make a list of 5 things that you can do instead of eat when you are not really hungry but are craving food due to emotions.  Some ideas:  call a friend, physical movement, journaling, nap, read a good book, organize a drawer in your kitchen or bathroom.
 
4) Having healthy foods available – If you can’t fight the urge to eat, make the best choices with the cravings you have.  Ideas:  avocado for someone who craves fat, fruit for someone that craves sugar, cacao powder in water for someone who craves chocolate, olives for someone who craves salt. 
 
5) Fueling your body with real food – Be sure you are getting lots of nutrients so you are not vulnerable to the effects of stress.  Food modulates our mood and if we stick with whole unprocessed foods our mood will be better and we won’t feel as stressed.


Your Partner In Health!
Sara Yadlowsky, FMHC

Tips To Slow Down

Clarissa A. Kussin, ND, RYT-500

It has never been easier to connect with someone on the other side of the world, yet it’s so easy to feel disconnected from the people closest to us.  We have more tools than ever to simplify tasks and accomplish more things quickly, yet our to-do lists have never been longer. Life is short, and time flies, especially in today’s fast-paced world.  

These exercises are meant to help you slow down, enjoy life, and focus on the most important parts of your day.  Take the time to prioritize daily objectives.
 By focusing on the most important tasks to get done, we eliminate the hustle and stress of trying to accomplish everything at once. 
Cut personal Internet use by half.
Technology has become a major element in most of our lives. Social networking, email, and web-surfing can occasionally cause our minds to lose focus and wander through hundreds of topics, thoughts and ideas.
Try to use half your designated Internet time to explore new hobbies, exercise, or meditate.

 Enjoy nature.
When time permits – take a five to ten minute break to step outside and breathe in some fresh air. Disconnect from the rest of the world and concentrate on the beauty of nature.

Eat slower.
A lot of us tend to speed through meals – missing the chance to appreciate different textures and flavors. Start to chew foods slower and distinguish new tastes, aromas, and consistencies. 
 
Connect and make time for yourself.

Acknowledge and consciously thank yourself for taking care of YOU.  When did you last spend valuable time with yourself? Take a night to find a new book, watch a favorite movie, try yoga, meditate, or cook a new recipe.

Give yourself more time.
Some of us like to stick to a tight schedule and plan all our daily events. Next time you’re jotting down new tasks in your planner, try to factor in a few extra minutes when estimating how long things will take. This will help you not rush through daily tasks.

Take the scenic route.
Next time you’re driving a somewhat long distance – try taking the scenic route. Driving through open fields, mountains, or viewing a city skyline can be very relaxing.

Sit for a moment with your eyes closed when you start your computer. Even just a few moments of meditation can set the tone for the rest of your day. Try to empty your mind and take deep breaths before jumping into your day’s tasks.

Remember your goals and aspirations.
Each morning when you wake up, take a few moments to think about your life goals and aspirations. Try to recall the milestones you’ve already made in your life, and your drive to achieve new ones. Try doing this for about five minutes before getting out of bed to start your day.

Take the time and share this with someone you love that may need some support in slowing down…

 
Your Partner in Health!
Clarissa Kussin, ND, RYT 500

Health Benefits of Napping

Susan D. Denny, MD, MPH
“No day is so bad it can’t be fixed with a nap.” — Carrie Snow

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting a few less hours for even a few nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, chronic sleep debt can contribute to fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Nap Duration  and  Potential Health Benefits

10-20 minutes:
 Reduces sleepiness; improves cognitive performance; increases alertness, attention, and energy levels; improves mood; improves motor performance; reduces stress levels

20-30 minutes:
Enhances creativity; sharpens memory

30-60 minutes:
Sharpens decision-making skills, including memorization and recall; improves memory preservation

60-90 minutes:
Rapid eye movement (REM) sleep, which is critical for problem solving; helps make new connections in the brain; enhances creativity; reduces negative reactivity; promotes happiness

  The following is a list of tips and tricks to help you make the most of naptime:

Choose a dark, quiet, comfortable place where you can relax. Try to limit the amount of noise and light in the room, and make sure the temperature is comfortable. Choose a time that works for you, and aim to nap at that time each day to establish a routine. You may find that restricting your naps to early afternoon (between 1:00 pm and 3:00 pm, or an hour or two after lunch) is less likely to interfere with your nighttime sleep patterns. Set an alarm on your cell phone, watch, or computer so you don’t sleep for too long. If you’re napping at the office, try closing your door and hanging a sign that says, “will return in 20 minutes.” Alternatives to this are napping in your car or on an outdoor bench.

Wherever you nap, bring along something that you associate with sleep. Some ideas include a sleep mask, neck pillow, relaxing playlist and headphones, cozy blanket, warm socks, and lavender essential oil to dab on your pulse points.

Keep in mind that longer naps may be accompanied by sleep inertia, or a period of grogginess that sometimes follows sleep. Give yourself time to wake fully before returning to any activity that requires a quick or sharp response. 

Your Partner In Health!
Susan D. Denny, MD, MPH

Regular Crafting Helps Undo Damage From Screentime

927 crafting improves health and brain

If you’re like most people today, you spend hours a day in front of a screen. Americans now spend at least half their lives in front of a screen, five times as long compared to 50 years ago. This excessive screen time has been linked with neurodevelopmental issues in children and “digital dementia” in adults, not to mention depression, isolation, sleep disorders, and anxiety.

While the answer is to spend less time using screens, the problem is screen time also appears to be uniquely addictive for us all.

Is there an antidote? Studies show spending time working with your hands crafting, building, gardening, etc. can provide unique qualities that boost your physical and neurological health. If you’re working to manage a chronic condition such as autoimmune disease of gastrointestinal disease, regular craft time can be a fun and beneficial tool in your health toolbox.

For instance, knitting, crocheting, sewing, and other textile crafts have been shown to have the same neurological benefits as meditation and mindfulness.

Regular knitters have reported knitting makes them feel happy and they are drawn to the craft for its stress relief and anti-anxiety effects. People who knit three or more times a week reported more benefit than those who knitted less frequently.

What’s more, people who knitted in a group or did some other type of group craft activity were even happier than those who knitted solo, thanks to the proven health benefits of socialization.

About three quarters of patients with anorexia nervosa reported knitting distracted them from obsessive, ruminating thoughts about food and weight and helped them feel more relaxed.

Oncology nurses reported knitting reduced compassion fatigue and stress in one study, and another found people with chronic fatigue, depression, and other chronic health disorders experienced increased positivity and well being engaging in textile crafts.

While these crafts are associated primarily with women, research has also found traditionally male crafts, such as woodworking, repair jobs, and “tinkering” impart the same benefits.

The benefits of crafting are believed to be derived from the “flow state” of repetitive mindful action crafts require.

Working with your hands is good for the brain

Although crafting delivers psychological benefits that translate into biochemical mood boosts, there is another important aspect of crafting — working with your hands is great for the brain.

In an era when many of us use our hands primarily for texting, typing, and swiping, handiwork and crafting can activate long dormant areas of the brain. And healthy brain activity in one area, such as the “hands” area, will help improve activity throughout the rest of the brain, contributing to overall improved brain health.

Working with your hands on something physical boosts reward circuits in the brain in ways working abstractly only with your brain doesn’t. This in turn triggers a cascade of neurochemical reactions that improve motivation and self-esteem and relieve depression.

The repetition, memory, and learning required when engaging in a task keeps the brain engaged in a mindful manner while freeing up the “thinking” centers of the brain that are engaged for knowledge tasks. This is not only calming and therapeutic for anxiety and obsessive thoughts, but many people report that this cognitive brain break allows problem solving and creative solutions to spontaneously arrive while crafting.

Knitting, woodworking, scrapbooking, and other crafts may seem like an odd recovery tool when you’re working to manage autoimmunity, gastrointestinal disease, or other chronic health disorders, but once you understand their physical and mental benefits, it makes perfect sense to ditch the screen for some handiwork on a frequent basis.

How To Avoid Autoimmune Flares During Holiday Travels

920 staying healthy while traveling

As if managing an autoimmune condition isn’t hard enough, traveling and holiday schedules can make it downright daunting. Staying with relatives, life on the road and in airports, trying to prepare a good meal in a hotel room, and constantly being offered foods that will throw your autoimmune symptoms into a tailspin all present constant challenges. However, sticking to your autoimmune protocol and diet as much as possible will help prevent flares and relapses so you don’t spend the holidays crashed in bed.

So how do you manage? First, check in with your stress levels. Stress is one of the most potent triggers for flare ups, so commit to a no-stress, can-do attitude. You simply need to invest in a little advance planning and strategic thinking.

Following are tips to stick to your autoimmune protocol and diet while traveling.

Don’t let yourself get too hungry! Letting yourself get overly hungry is the biggest saboteur of the best laid plans. It’s only natural to want to eat when your energy is flagging and you’re starving. This will make you more likely to eat trigger foods, such as gluten or dairy.

Map out your options at your destination before you arrive. Is there a Whole Foods or other health food market in the area? Will your hotel room have a fridge?

You can also travel with frozen food you have insulated to heat up at your destination. Some people even bring their own hot plate and cookware.

Also, make sure you have plenty to eat on long flights, such as beef jerky, celery, sardines, olives, coconut meat, and other filling snacks.

Pack plenty of anti-inflammatory support. Traveling during the holidays is stressful. As much as we love them, sometimes our family members can be stressful. Make sure to save space in your check-in luggage for your go-to anti-inflammatory supplements, such as liposomal glutathione, resveratrol, and turmeric. Glutathione is the body’s most powerful antioxidant and essential for preventing and taming autoimmune flares. Liposomal resveratrol and turmeric in high doses are also great.

Early morning flights, long travel days, overstuffed flights, Aunt June’s air freshener, uncomfortable guest beds, and so on — these stressors can deplete glutathione and raise inflammation, so have your arsenal handy.

Effective anti-inflammatory supplements include glutathione precursors such as N-acetyl-cysteine, alpha-lipoic acid, cordyceps, and milk thistle. You can also take s-acetyl-glutathione, or an oral liposomal glutathione. Note that taking straight glutathione is not effective. You also may want to bring a bottle each of a powerful liquid liposomal resveratrol and turmeric — ask my office for more info.

Search ahead for unscented hotel rooms. Sadly, some hotel rooms can knock you over with the sickly perfume stench as soon as you walk through the door. Or the rooms are dusty and stale. Look for hotels that offer scent-free, allergy-friendly rooms with hypoallergenic bedding, air purifiers, and windows that open. Or at least ask them to air out the room for you before you arrive.

Carry a mask to avoid inhaling triggers. Sometimes you’re simply trapped in an environment that is overly scented, smoky, or potentially triggering in some other way. Just in case the woman next to you on the plane reeks of perfume, keep a face mask with you so you can breathe safely. Invest in a quality face mask that allows you to breathe comfortably. If you wear glasses look for one that won’t fog them up. Some companies also make face masks for children.

Schedule in alone time, time away, and time to rest. It’s too easy for a vacation to feel like an overbearing job. Make sure you take naps, read, meditate, or go for peaceful walks. Stress is one of the most powerful inflammatory toxins, so create and enforce boundaries to keep yours as low as you can.

What Leaky Gut Is and Why Should You Care

919 why you should care about leaky gut

If you have been researching how to improve your health, you may have heard of leaky gut, also known as intestinal permeability. If that conjures an unpleasant image of your gut contents leaking into the rest of your body — that’s not too far off the mark.

Leaky gut happens when contents from the small intestine spill into the sterile bloodstream through a damaged and “leaky” gut wall. This contamination of the bloodstream by not only partially digested foods but also bacteria, yeast, and other pathogens begins to create a foundation for chronic inflammatory and autoimmune health disorders.

Symptoms and disorders linked to leaky gut include fatigue, depression, brain fog, skin problems, joint pain, chronic pain, autoimmune disease, puffiness, anxiety, poor memory, asthma, food allergies and sensitivities, seasonal allergies, fungal infections, migraines, arthritis, PMS, and many more. Basically, your genetic predispositions will determine how leaky gut manifests for you.

Leaky gut is referred to as intestinal permeability in the scientific research. It means inflammation has caused the inner lining of the small intestine to become damaged and overly porous. This allows overly large compounds into the small intestine. The immune system recognizes these compounds as hostile invaders that don’t belong in the bloodstream and launches an ongoing attack against them, raising inflammation throughout the body. Also, some of these compounds are very toxic (endotoxins) and take up residence throughout the body, triggering inflammation wherever they go.

At the same time, excess intestinal mucous and inflammation from the damage prevents much smaller nutrients from getting into the bloodstream, which can lead to nutrient deficiencies and poor cellular function.

Leaky gut is increasingly being recognized as a common underlying factor in most inflammatory symptoms and disorders.

Medicine finally recognizes leaky gut

Conventional medicine has long ridiculed leaky gut information and protocols as quack science and alternative medicine folklore, but newer research now establishes it as a legitimate mechanism. In fact, pharmaceutical companies are even working on drugs to address leaky gut.

Research has established links between leaky gut and many chronic disorders. It’s good this long-known information is finally being validated in the dominant medical paradigm as the gut is the largest immune organ, powerfully influencing the rest of the body, as well as the brain.

Current studies link intestinal permeability with inflammatory bowel disorders, gluten sensitivity, celiac disease, Crohn’s disease, type 1 diabetes, depression, psoriasis, and other chronic and autoimmune conditions. Given what we know about the connection between gut health and immunity, it’s vital to include a gut repair protocol in overall treatment of inflammatory and autoimmune disorders.

How to mend leaky gut

Sometimes, repairing leaky gut can be as simple as removing inflammatory foods from your diet. Other times it’s more complicated. Most importantly, you need to know why you have leaky gut. Either way, however, your diet is foundational.

Many cases of leaky gut stem from a standard US diet of processed foods and excess sugars. Food intolerances also contribute significantly, especially a gluten intolerance. A leaky gut diet, also known as an autoimmune diet, has helped many people repair intestinal permeability. Keeping blood sugar balanced is also vital. If blood sugar that gets too low or too high, this promotes leaky gut. Stabilizing blood sugar requires eating regularly enough to avoid energy crashes. You also need to prevent high blood sugar by avoiding too many sugars and carbohydrates. Regular exercise is also vital to stabilizing blood sugar and promoting a healthy gut.

Also, failure to eat enough fiber and produce leads to leaky gut by creating a very unhealthy gut microbiome, or gut bacteria. Our intestines (and entire body) depend on a healthy and diverse gut microbiome for proper function. A healthy gut microbiome comes from eating at least 25 grams of fiber a day and a wide and rotating variety of plant foods.

Other common things that lead to leaky gut include antibiotics, NSAIDs such as ibuprofen, excess alcohol, hypothyroidism, and autoimmunity.

A leaky gut protocol can help you improve your health, relieve symptoms, boost energy, make you happier, and clear your brain fog. Ask my office for advice on improving your well being through a leaky gut diet and protocol.

Do You Have Autoimmunity or Brain Inflammation and Suffer from Exercise Intolerance?

917 exercise intolerance

If there were just one magic bullet to feel and function better, it would probably be exercise. Countless studies show the numerous benefits of exercise. Our bodies and brain were designed for constant physical activity and perform at their best when we provide that. Exercise releases chemicals that boost your overall energy and dampen inflammation.

But what to do if exercise actually makes you feel worse? Some people battling autoimmunity or brain inflammation suffer from exercise intolerance and see their symptoms worsen after physical activity.

Many autoimmune and brain inflammation patients see multiple doctors before receiving a diagnosis. Most of these doctors will tell a severely compromised patient they just need to exercise more. This advice can actually worsen a patient’s symptoms until they start bringing their inflammation under control.

What is exercise intolerance?

In the conventional medical model, exercise intolerance is most often associated with heart disease, particularly from the heart not filling adequately with blood. As a result, insufficent blood is pumped out to the rest of the body.

However, in functional medicine we frequently see exercise intolerance in people struggling with autoimmunity and brain inflammation.

It’s normal to feel sore or tired after a tough workout, but people who suffer from exercise intolerance experience more severe and unusual pain, fatigue, a flare up of their autoimmune symptoms, nausea, vomiting, or other negative effects that go beyond normal muscle tiredness. Some “crash” for a day or more with flu-like symptoms, feeling unable to get out of bed or function normally.

Exercise intolerance can be very emotionally distressing for people who care about their health and are working to improve it. Afterall, we are constantly bombarded with images of uber athletes and messaging about intense workouts.

What causes exercise intolerance?

When exercise intolerance is related to autoimmunity or brain inflammation, exercise intolerance is a result of compromised mitochondria.

Mitochondria are known as the “energy factories” insde each cell, as their role is to take nutrients and oxygen and turn that into energy.

Unfortunately, mitochondria are also very sensitive to inflammation and will under function when the body is struggling with intense inflammation. This means the cells don’t function well, the brain under functions, and you generally feel crappy and fatigued.

How to exercise if you have exercise intolerance?

One of the most common mistakes people make is to push themselves too hard and over exercise. Over training spikes inflammation and can make an autoimmune or brain inflammation condition worse.

Also, when you have an inflammatory condition, you must realize your immune system is never at a constant. Stress, viruses, diet, and myriad other factors keep our immune systems in a constant state of fluctuation.

People with autoimmunity or brain inflammation must always tweak and adjust their activity level to not overburden their immune system or neurological health.

If you are used to working out a certain level and then suddenly notice your workout make you feel worse, it could be an outside factor flaring up inflammation. So you need to dial it down or even take some time off. Listen to your body.

For instance, someone who does high-intensity interval (HIIT) and weight traning four or five days a week suddenly feels fatigued and lethargic the day after each class. They may need to reduce the duration, the intensity, or the frequency of those workouts, or substitue in something that doesn’t push their inflammation over the edge, like a brisk walk.

Forget about cultural messaging around fitness

Managing autoimmunity and brain inflammation is highly individulaized; no two people will have the same protocol. You must always be tuned in to what your body says. This can be difficult in our hyped-out fitness culture.

After all, for some autoimmune or brain inflammaton folks, the mildest workouts can be triggering. The goal is to find what works for you and makes you feel good. When we stimulate blood flow through movement, it sends more oxygenation to our bodies and brains and triggers the relase of beneficial chemicals. If it feels good, it’s lowering inflammation and helping you manage your autoimmunity and brain inflammation.

Autoimmune appropriate exercises for building exercise tolerance could be walks, light weight training, gentle yoga or stretching routines, water aerobics — explore and find what works for you. You are the ultimate expert on what’s right for your body. As you start to feel better you will naturally feel inclined to take on more.

Start low and slow so that you are able to stay consistent and keep it up on a daily basis. Once you have established that, then gradually increase intensity and duration.

Ask my office for more advice on managing autoimmunity or brain inflammation.

How To Avoid Toxic Positivity

914 negativity important too

If you are working to manage your Hashimoto’s hypothyroidism or other chronic or autoimmune disorder, you may have heard a positive attitude is good for your health. And it’s true — positive thinking, gratitude, and healthy socialization have all been linked to better health outcomes. However, chasing a positive attitude can have a dark side.

It’s common to hear, “just think positive,” “focus on the good,” “don’t dwell on the negative,” and so forth. But the truth is, sometimes life circumstances are awful and sometimes people do horrible things to others.

The demand for a positive attitude when it’s not appropriate is known as toxic positivity. Avoiding or denying negative emotions only makes them bigger and more persistent — and hence more inflammatory for your system if you have an autoimmune condition such as Hashimoto’s hypothyroidism.

Also, negativity exists as a survival trait. It alerts you to danger, or if something isn’t right.

In fact, telling someone who is suffering that they just need to be positive is referred to as spiritual bypassing or gaslighting. Spiritual bypassing is an attempt to use false positivity to bypass a difficult issue, and gaslighting occurs when someone tries to make you feel like you’re crazy when you express uncomfortable thoughts or feelings.

Many autoimmune patients have felt gaslighted by doctors who insinuated they were making up their symptoms or just seeking attention.

Practice mindfulness, not just positivity

It’s normal to want to avoid negative and unpleasant emotions because they are uncomfortable and distressing. As such, we think of them as “bad.” But they are not there to be banished us but rather to guide us through life and help us make decisions that protect and support us.

Instead of denying them through forced positivity or drowning them out through whatever addiction or bad habit is our go-to, psychologists say we should listen to what they reflect about a current situation.

For instance, if you’re frustrated and angry about your health, it means you care about yourself and being able to participate in life. Allowing and accepting our negative thoughts and feelings can help us understand who we are and make good choices.

Resilience and self-care are the bedrocks of positivity

In self-help circles some tout the theory that bad things happen if you think negative thoughts, but the truth is bad things happen to everyone on a regular basis. Positivity isn’t about feeling good all the time, but rather about practicing resilience and positive self-talk in the face of adversity.

Do you practice these negative self-talk habits?

  • You filter out the good parts of an experience and dwell on the bad.
  • You think you are to blame for when things go wrong, or that it’s only happening to you and other people are luckier.
  • You catastrophize and make problems out to be much bigger than they really are.
  • You polarize things into very good or very bad and fail to see that most things in life have a grey area.

Practicing positivity through bad things means avoiding the temptation of despair and hopelessness and instead becoming your own cheerleader and coach.

Positivity is a practice, not a destination

Perhaps the most important thing to understand is that positivity is something that takes ongoing practice and application. It is like playing an instrument or a sport — you have to keep up with it to be proficient.

This is the concept of neuroplasticity in how the brain works. By applying yourself regularly to the practice of positivity, you hardwire new neural pathways into your brain, which makes you more efficient at positivity over time. And if you have a chronic autoimmune condition such as Hashimoto’s hypothyroidism, every time you practice positivity you also release anti-inflammatory chemicals in your body that help tame inflammation and modulate immunity.

Try these tricks at learning how to be a more resilient, positive thinker who can also handle the negative aspects of life:

  • If an area of your life is constant major stressor, whether it’s a job or relationship, start strategizing on how to change it.
  • Check yourself throughout the day to see if your thoughts are negative or positive.
  • Seek out humor. Laughing at life reduces its weight and lowers stress.
  • Follow a healthy diet to lower inflammation. Many studies now prove what we eat affects how we feel. Eat food that feeds a good mood.
  • Exercise at least 30 minutes a day. Generating feel-good endorphins through exercise beats any addictive substance or habit. It makes it easier to practice positivity and weather the storms.
  • Surround yourself with positive people. Although we all have down days and need to vent, incessantly negative people can make it hard to stay positive. Seek out and cultivate friendships with other people who also practice positivity.
  • Pay attention to how you frame things. We all say things that can be reframed more positively. For instance, if you make a mistake, instead of saying, “I’m such an idiot,” reframe it to something like, “Whoops, I’ll see if I can get it right next time.”
  • Talk to yourself the way you would talk to someone you care about. Chances are you would never talk to someone you love the way you talk to yourself. Make self-respect and self-care a priority in your self-talk.

Some people were taught healthy positive self-talk in childhood by their parents and teachers. Others have to learn it later in life. Either way, it’s a skill that simply takes awareness and practice in order to develop the resilience to see you through the tough times of dealing with an autoimmune or chronic health disorder such as Hashimoto’s hypothyroidism.