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.

 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

Functional Fertility

Blair Cuneo, PA-C
Functional Fertility: Basics and Beyond for Pre-conception

Whether trying to conceive naturally or going through advanced reproductive options, there are lifestyle, nutritional, nutraceutical and botanical interventions to support optimal fertility.

We need balanced hormone communication and low levels of inflammation for a woman’s body to create and nourish new life. There are major leverage points for understanding your body’s baseline of communication and inflammation. These include the Basics: checking in with your sleep quality and daily nutrient intake; and Beyond: testing for personalized understanding of your hormonal health, nutrient needs and inflammatory status.


Some quality Zzzs…
Good sleep hygiene is important for our general restoration, healing and detoxification. Our daily circadian rhythm should be an appropriate balance of our stress hormone cortisol, and our restorative hormone, melatonin. Related to healthy menstrual cycles, chronic low overnight melatonin impacts hormone signaling between the brain and ovaries. Hormones necessary for conception include luteinizing hormone (LH), estrogen and progesterone. Production of these hormones is decreased in chronic low melatonin levels.

Melatonin is an important antioxidant in the follicular fluid ovarian eggs are swimming in. It acts as a strong scavenger of free radicals, protecting egg cells from cellular damage. Melatonin is also anti-inflammatory, turning down cranky messengers like NF-KB and turning up calming ones like IL-4 and IL-10. Studies with IVF patients taking even 3mg of melatonin nightly days 5 until mid-cycle showed a 4-fold increase in follicular melatonin, which resulted in decreased oxidative damage of these eggs and higher pregnancy rates.

Regular sleep is key for fertility. Aim for 8 hours nightly and turn off screens at least one hour before bedtime. This is to address not only the blue light impact on wakefulness, but also to limit the cognitive and psychological stimulation from texting and scrolling through feeds, for example. Use the later hours in the day to turn your attention inward and cultivate, rather than demand, sleep. Consider breathing exercises, calming herbal teas including chamomile and lemon balm, gratitude journaling and yoga nidra.

Step away from the chicken fried biscuit….
When examining your nutrient intake, if you need a template to guide changes, I recommend the Mediterranean food plan. It has shown to improve markers of fertility for females and males.  Its major principles include:

Emphasis on fruits and vegetables, providing great phytonutrient and antioxidant diversity

Higher content of omega 3 fatty acids, which are anti-inflammatory, support cell membranes and improve blood viscosity which ensures good blood flow to the uterus

Mediterranean foods are rich in B6 and folate – fertility boosting nutrients!

Dietary fiber from vegetables and grains – keeps bowels moving regularly to support healthy detox to mobilize toxins and hormone metabolites like high estrogen, high cortisol.

How’s my thyroid doing?
Low thyroid function affects fertility. Around 1/3 of women experiencing subfertility have thyroid disease. The ovaries and egg cells have receptors for thyroid hormone. Thyroid testing includes TSH, free T4, free T3. TSH levels <3 are associated with better ovarian reserve. It’s important to also consider antibodies to the thyroid. Even in a patient with normal thyroid levels, presence of thyroid antibodies is correlated to increased rates of miscarriage and pregnancy-related complications. 

What’s my Vitamin D level?
Vitamin D deficiency is linked to a number of reproductive issues, including gestational diabetes, endometriosis and PCOS. Vitamin D levels >30ng/mL are associated with greater rates of pregnancy. This is likely due to higher levels of anti-mullerian hormone (AMH) when vitamin D is sufficient. The more AMH, the more eggs in the ovarian reserve, the more changes for successful pregnancy. Vitamin D is also involved in helping create endometrial docking sites to help an embryo attach and hold on tight!

What’s my iron status?
Iron deficiency is common in subfertility. Iron’s job is to deliver oxygen to tissues throughout the body, including the uterus and ovaries. Chronic oxygen deprivation can take a toll on egg quality and result in anovulation. Adequate iron levels build a nice, fluffy endometrium…a cozy place for an embryo to attach.

Am I inflamed, you ask?
A balanced immune system is important in order to conceive and carry pregnancy to term. One’s general level of inflammation can be assessed with the blood test, hs-CRP. Contributors to systemic inflammation include gum disease, food sensitivities, insulin resistance and imbalances in gut microbiome. Nutrients and botanicals to help reduce inflammation include omega 3s (fish oil) and curcumin. Additional testing is available to further investigate these areas of potential inflammation if needed.

Help your cup “run-eth” over
With all things, give yourself grace and start from a place of fullness. Know that you are enough! By integrating supports to reduce inflammation and balance communication, your internal supports will overflow to support the life of another. Fill your body with adequate sleep, nutrients, love, support and confidence!

Your Partner In Health!
Blair Cuneo, PA-C

HORMONES! A Balancing Act

Blair Cuneo
By Blair Cuneo, PA-C

Sister Act: The Story of E&P

We are all trying to seek balance and the systems in our body are no different, particularly our hormonal system. The differences between the many hormones in our bodies and the roles they play are meant to balance each other. This ying and yang is beautiful and important! Sure, there may be an appropriate time for one hormone to be in abundance, but not all the time. The consequences of imbalance are felt in our bodies, brains and by our loved ones sometimes! And unfortunately, when we do reach out for help, there can be misunderstanding, misdiagnosis and totally missing the mark on root cause.

Today we focus on the dance between estrogen and progesterone in our menstrual cycles and what happens when balance is lost. There is a natural shift over time, but the way we live, what we eat, the products we use in our home, and imbalance in our microbiome and detox health can speed up and intensify the process.

Mood changes, sleep disruption, menstrual cycle changes, nothing’s off limits. Today we hope to empower you with the knowledge of understanding the typical hormone timeline, recognizing signs your body may be sending to warn you and what tools to implement to find your balance again.

Your providers at CTW like to think of Estrogen and Progesterone as sisters with different personalities. Estrogen is exciting, loud, provocative, and loves with all her heart (while protecting yours)!  Progesterone is calm, steady, grounding, healing and gives you an inner glow.

Specific to your menstrual cycles, the first half of your cycle is ruled by Estrogen. She’s out there as a mover and a shaker, stimulating the ovaries to create and release an egg, encouraging the lining of your uterus to grow lush and large. After all of that hard work she *should* take a break and pass the baton to Progesterone.

Progesterone maintains that lining to welcome a potential very special guest… a fertilized egg. Hoping to turn this quick visit to a longer engagement, she’s sending out calming, grounding vibes and remaining present. But alas if this is not the way, with either no visitor or the wrong kind of visitor, she steps aside, the lining gives way, leaves the body in menstruation and the process starts again with big sis, E.

This is the healthy pattern in our child-bearing years, but as dysfunction becomes more common in our society, this may not be the “normal” pattern. We intentionally labeled Estrogen as the big sister, because she is the more dominant force between the two. If Estrogen is having too much of a good time, she is loud, lingering and can get kind of annoying.  Progesterone is quiet and waiting off to the side, not able to provide her needed support and countermeasures.

Estrogen is produced not only by our ovaries, but also our adrenals and stored fat. Additionally it can enter our body in the form of fake estrogens, chemicals called xenoestrogens. These chemicals are estrogen wannabes and do as E does. They can be found lurking in our water, our food, even our personal care and household products. Gross.

When we want the party to be over, our body tries to reduce estrogen by breaking it down in our liver and sending it away via the toilet in a healthy bowel movement. Good bacteria in our gut are also trying to breakdown and escort out this fiery one, but only if good bacteria is in adequate amounts. Otherwise, non-beneficial bacteria act as estrogen promoters, sending out little enzyme agents to keep the party going.

Now let’s talk about the two times the female body will experience internal decline of progesterone beyond our monthly cycle. One, is very dramatic and the other, slow and steady.

During pregnancy, progesterone is sticking around and plays the lead role in maintaining a beautiful, lush environment for a thriving pregnancy. After pregnancy, progesterone dramatically decreases and that’s a big shift after 9 months! Mentally, we can experience this as postpartum mood changes like anxiety or depression.

A more subtle change over time is related to our bodies natural decline in progesterone production, which begins around age 35. From 35-50 years of age, Progesterone decreases 75%, while estrogen is only decreasing about 35%. And chances are, estrogen was already in abundance before this began.

So what might YOU be feeling if the sisters aren’t taking turns?

Again, we think of Estrogen as exciting, aka stimulating and things are more intense:

Breast tenderness
Pain with periods
Heavier and/or longer bleeding days
Irregular cycles
Mood swings
Brain fog
Sleep disturbances

What can YOU do to reduce estrogen?

At least one soft daily bowel movement is necessary! We are what we don’t poop!
You can help this lovely process and support healthy microbiome by eating prebiotic foods, rich in fiber and probiotic foods, rich in bacteria.

Eat Clean food! Limit processed foods, avoid artificial flavors and colors. Eat organic when you can, especially if it’s on the “Dirty Dozen” list, distributed annually by the Environmental Working Group.

Drink Clean water! Use a water filtration system, either countertop or whole home to reduce toxins.

Plastics….reduce your use! Plastic has softeners that are major Estrogen wannabes. Ditch those plastic water bottles, plastic food storage containers and microwaved plastic meals.

Check your makeup, personal hygiene products, cooking and cleaning supplies products for hidden xenoestrogens: parabens, phthalates, BPA, nonstick coatings.

Essential oils: rosemary

What can YOU do to increase progesterone?

Eat vitamin B rich foods! Salmon, leafy greens, organ meats, eggs, oysters, mussels…

Wild Yams are also progesterone enhancing foods, but not sweet potatoes.

Essential oils: thyme

Above just scratches the surface on two of the players involved in hormonal balance. While there are many things you can initiate on your own, there are also options for evaluation and support that a well-trained health care provider can offer. These tools and supports help you understand the needs of your unique system and implement successful, sustaining strategies to maintain your balance for many years to come!

We are honored to be your partners in health! Let us know if you would like to schedule an appointment to discuss your “Sister Act” personally by calling 919.999.0831. 

Hair Dyes and Relaxers Linked to Significant Cancer Risk

926 hair dyes cause cancer

It is hard being a woman in a society that disapproves of aging women and favors straight hair. In fact, coloring and straightening hair is regarded as “professional,” “good grooming,” or “taking care of yourself.” But at what a cost — a new study shows hair dyes and relaxers are significantly associated with breast cancer…especially for black women.

The Journal of Cancer article showed the results of a study that tracked more than 45,000 women over eight years. Black women who regularly used permanent hair dyes had a 60 percent higher chance of developing breast cancer than black women who did not. White women had an 8 percent higher chance.

Women who used chemical hair straighteners were 30 percent more likely to develop breast cancer. While some white women straighten their hair, in the study three quarters of the black women straightened their hair.

Why the cancer link? The researchers pointed to toxic compounds in hair dyes known as “endocrine disrupters.” This means these compounds mimic hormones and interfere with normal hormone function, thus causing imbalances and an increased risk of cancer.

The chemicals used in products geared towards black women may be more “hormonally active,” according to researchers.

Women are increasingly being encouraged to choose health and longevity over toxic cosmetic options. For instance, a movement is under foot to embrace silver and gray hair and black women are encouraged to embrace their natural hair, with one state so far banning discrimination against black people who wear their hair naturally (many employers discriminate against black women who forgo chemical straightening).

Black women bear the brunt of toxic hair products

Although most commercial women’s hair and body products are laden with toxins, hair products aimed at black women contain a disproportionate amount of chemicals linked with early puberty, obesity, asthma, and cancer.

A 2016 study showed black women’s bodies contained higher burdens of the toxic chemicals found in hair products than in women of other ethnicities.

Researchers have so far identified more than 70 harmful chemicals in relaxers, root stimulators, and anti-frizz products.

Toxins in these products (and in other beauty products in general) have been shown to have the following impacts on health:

  • Parabens and phthalates disrupt hormone function and are linked to early puberty and pre-term births.
  • Nonylphenol is linked to obesity and cancer.
  • Formaldehyde is linked to miscarriage risk and respiratory issues.
  • Various compounds irritate the eyes and skin, burn and blister the scalp, damage hair follicles, cause hair loss, and cause respiratory disorders.
  • Hair relaxers are linked to uterine fibroids in black girls and women at a rate two to three times higher than in other women. Uterine fibroids affect up to 80 percent of black women during their lifetime.
  • Cosmetologists exposed to these products during pregnancy experienced twice the rate of miscarriages.
  • Breast cancer is a leading cause of death among black women; they generally have a more aggressive forms of cancer compared to white women.

Just one product alone can contain 30 different toxic chemicals. How these chemicals affect human health when in combination with one another has not been studied.

Toxic hair products could help explain why black women suffer from more endocrine disorders than white or Hispanic women.

While these products harm black women, the Black Women for Wellness Report also points to the complexity and conflict between harmful hair products and the positive role of hair salons in black communities.

Ask my office for advice on how to lower your toxic burden, buffer your body from the effects of toxins in our everyday lives, and improve your overall health and well being.