Immune Health - Carolina Total Wellness

March 17, 2023March 19, 2023

How to Talk About Food

Erica Nelson, MSPH, NBC-HWC

Here, at Carolina Total Wellness, we often recommend dietary adjustments to treat a wide variety of symptoms. Many of our patients come to us for guidance, asking ‘What is the healthiest diet?’ And the truth is, the ‘healthiest diet’ is unique to the person eating it.

One patient may get itchy and congested when they eat and need to reduce or eliminate foods that may increase or contain histamines like leftovers and peanuts. Another patient may have intestinal permeability and need to eliminate identified sensitives to gluten, oats and eggs. Yet another may be concerned about their family history of Alzheimer’s disease or cancer and need to make a variety of other adjustments.

Regardless of health status and dietary needs, most of us prefer sharing meals with our friends, family and coworkers over dining alone. Sometimes even a simple lunch can be a source of concern when a well-meaning aunt or friend asks about your ‘crazy diet.’

Over and over again, patients tell me that eating with their families is a barrier to successfully making the adjustments necessary to improve their health. Here are some strategies to enjoy eating the food that nourishes your body with the people that nourish your soul (and even some people that don’t):

Know your why. Get clear on why you are making the changes. And practice your responses ahead of time. When you know exactly what you are trying to accomplish with your food, it is easier to make good choices and much harder for someone else to convince you otherwise.

Have a short ‘elevator pitch’ prepared. Something like, ‘I wasn’t feeling my best recently and, after talking to my doctor, I am focused on eating foods that nourish my body and soul like (name a few key foods you’re enjoying eating.)’ And then mention a positive outcome like. ‘You wouldn’t believe how much better I am sleeping!’

Have at least one person fully in your corner. As part of your preparation for making these changes, make sure you talk to a trusted friend or partner that will be your support-person when the going gets tough. No matter how committed you are to health changes, there will be days when you don’t get enough rest or you have a bad day at the office. On these days, even strong-willed, prepared ‘you’ can have a tough time remembering your ‘why’ and the ‘Can’t you have just one bite?’ question may be coming from inside your own head. On these days, call this person and tell them that you are considering deviating from your plan.

Project confidence. Add a big smile to your ‘No thank you’ and you’re less likely to get pushback or hear ‘Can’t you have just one?’ Know your restaurant order before you go and say it confidently. ‘I’ll have the burger, no bun, no cheese, extra lettuce and the spinach salad on the side, please.’

“Girl (or boy,) stop apologizing.” Rachel Hollis made this phrase famous with her book by the same name. She was right, though. There is no need to apologize for doing what is right for your health and/or sanity. Try replacing ‘I’m sorry’ with ‘Thank you.’ For example, instead of ‘I’m sorry to inconvenience you,’ try ‘Thank you for accommodating for my gluten/dairy/egg/sugar sensitivity.’

Boundaries. Some people have no trouble with the sentence ‘no.’ But for many, it is easier to please the people around you and silently suffer your own consequences later. This can be exhausting and lead to difficulty knowing what you wanted in the first place. Know where your line is and don’t let anyone tempt you to cross it. Remember that everything you say ‘yes’ to is a ‘no’ to something else.

It is okay to make inappropriate people uncomfortable. If, for example, someone makes a comment about your body composition or fertility, it is not only okay to make them uncomfortable, but also brave and good. Saying ‘That’s inappropriate’ could keep them from bestowing their judgement on another undeserving person.

The health coaches at Carolina Total Wellness are here to support you in your personalized health care journey.

Your Partner In Health,

Erica Nelson, MSPH, NBC-HWC

March 3, 2023March 19, 2023

Hormesis: The Beneficial Type of Stress

Sara Yadlowsky, FMHC

What doesn’t kill you makes you stronger. We’ve all heard the saying before. Science has revealed it is surprisingly accurate when it comes to our health and longevity.

Hormesis is the idea that short, intermittent bursts of certain stressors can start a cascade of cellular processes that slow aging, improve overall health and make you more resilient, both physically and mentally. It is a hot topic in longevity research right now.

We all know that chronic stress caused by relationship issues, financial problems and working too many hours is detrimental to our health. However, hormetic stressors are controlled and acute, triggering healthy adaptive responses.

What does all this mean in real life? Hormesis is the common thread found in some popular health and fitness trends such as HIIT (high intensity interval training), cold exposure, heat therapy and intermittent fasting. Prolonged doses of these behaviors are not healthy or sustainable. For example, if you spend too much time in a sauna you will become dehydrated. But, in short bursts, the bodily stress caused by these practices are enough to bring about health benefits such as reducing inflammation, supporting elimination of toxins, repairing DNA, combatting oxidative stress, repairing cellular damage and reducing risk of cancer.

Here are three ways to strategically stress your body and reap the rewards:

HIIT – Do a HIIT workout 1-3 times a week. HIIT workouts are intermittent bursts of intense effort for 30 seconds, followed by 15 seconds of rest. These workouts are usually short, around 15-20 minutes. You can easily find these HIIT videos on YouTube.
Hot or Cold Therapy – Infrared sauna is a great way to heat up and sweat out some toxins. It also reduces inflammation and pain. In contrast, ice baths, cold showers and the new cryotherapy chambers that are popping up everywhere will cool you down quicky. Cold therapy is also known for reducing inflammation and pain. Both types of therapies may help strengthen the immune system.
Intermittent Fasting – Fasting triggers a cellular “clean up” response called autophagy. Autophagy results in several health benefits such as lowered cholesterol, reduced blood pressure and reduced inflammation. For many, a 16:8 intermittent fasting schedule (16 hours of fasting followed by an 8 hour feeding window) works well. However, we recommend that you experiment with the timing to see what works best for you.

Be aware that adding stress (even the good type!) to our lives can backfire if done at the wrong time. When life is already very stressful, it is best to wait until a better time when you are more relaxed to try out these new practices.

Your Partner In Health,

Sara Yadlowsky, FMHC

January 24, 2023January 24, 2023

Autoimmunity: Why is my immune system attacking me?

Frances Meredith, MD

All of us either have a family member or friend who suffers with autoimmunity, a condition where our immune system wrongly targets us. Perhaps you yourself are part of this very popular club, affecting people at younger and younger ages. Generations ago there might have one uncle with “rheumatism” in your family, or a grandmother whose “joints hurt when it rains”. Today these cases are commonplace, as are the many other faces of autoimmunity from Hashimoto’s hypothyroidism, to lupus, to multiple sclerosis. So what is autoimmunity, why is it affecting so many of us, and what can we do to stop the “self-attack”?

Autoimmunity occurs when our finely tuned immune system, designed to defend against foreign invaders ranging from food borne bacteria to pandemic viruses, turns against us. Unfortunately, many with autoimmunity are frustrated with lack of a clear diagnosis. Traditional medicine looks to fit us into neat diagnostic boxes, which frequently do not apply. It is clear to those who see many autoimmune patients that the majority of those who suffer from chronic illness over years, feeling unheard by their providers, searching for answers from multiple doctors who scratch their heads, represent this type of self-attack.

Why would such an intelligent immune system turn against us? Imagine the confusion of your protective army as it heeds the call to attack its own castle. And how do we bring our defense system back to its original function: to make decisions as we interact with our environment, deciding what is friend vs what is foe and mounting an appropriate response, but not to attack us?

A more esoteric view of autoimmunity emphasizes that we are not separate from our immune systems. You are your immune system. You are creating it, and impacting its ability to function optimally every day by the choices you make. The salient question is “If I am my immune system, where did the communication go wrong? What messages am I sending to make me turn upon myself?”

The answers to these questions are complex, and very individual. Autoimmunity, first, requires susceptible genetics. These genetic vulnerabilities are then activated by certain lifestyle triggers. Your Functional Medicine provider assesses this by creating a “Personal Autoimmune Trigger Blueprint”. These triggers range from reactive foods to infections, toxins, vaccines, childhood trauma, concussion, blood sugar, high stress, lack of sleep such as with sleep apnea, and low levels of key nutrients for optimal immune function. Addressing these triggers while optimizing immune nutrients and plant based supportive supplements allow the immune system to regain balance. The goal is to get our autoimmunity into remission. We see patients achieve remission every day as they address their triggers, support their body, and see the results in declining antibody levels and, more importantly, in feeling better.

We at Carolina Total Wellness are experienced in a broad range of autoimmunity, not only the ones with names you recognize, but also those not yet defined by a lab test from a Rheumatologist. We would be honored to walk with you on this journey of understanding and regaining immune balance.

Your Partner In Health,

Frances Meredith, MD

December 16, 2022December 16, 2022

Leaky Gut

Susan Denny, MD, MPH

Do You Have Leaky Gut?

If you suffer from a chronic health condition and have been researching how to improve your health, you may have heard of leaky gut. If that conjures up an unpleasant image of gut materials leaking in to your bloodstream, you are not far off. Leaky gut happens when contents from the small intestine spill into the sterile bloodstream from a damaged or “leaky” gut wall. This contamination of the bloodstream by digested foods as well as bacteria, yeast, and other pathogens is often the foundation for chronic inflammatory and autoimmune health disorders.

Leaky gut is referred to as increased intestinal permeability in scientific research and is increasingly being recognized as a common underlying factor in most inflammatory symptoms and disorders. As our body’s largest immune organ, the gut powerfully influences the rest of the body. Importantly, this includes the brain. Current scientific studies link intestinal permeability with inflammatory bowel disorders, gluten sensitivity, celiac disease, Crohn’s disease, type 1 diabetes, depression, anxiety, psoriasis, and many other chronic conditions.

Given what we know about the connection between gut health and immunity, it is vital to include a gut repair protocol in the treatment of inflammatory and autoimmune disorders. Repair of leaky gut begins with understanding why it developed in the first place. Reasons for leaky gut can include over the counter or prescription medications, antibiotic use, toxin exposure, hormonal changes, food intolerances, poor diet and others. After root causes are identified, a leaky gut protocol can help you improve your health, relieve symptoms, boost energy, make you happier, and clear your brain fog. Ask our office for advice on improving your overall health through a personalized leaky gut evaluation and treatment plan.

Your Partner in Health!

Susan Denny, MD, MPH

September 30, 2022November 28, 2022

Fall Detox

Susan Denny, MD, MPH

Hello Fall! It’s Time to Detox!

While consistent Fall weather arrives a little later in our area than the Autumnal Equinox, the lower temperatures and falling humidity have thankfully begun to emerge. This is one of my favorite times of year and one in which I reflect on the past year and look forward to the year ahead. In many cultures this changing of seasons is a time for celebration and reflection. It is also a great time for detoxification to help cleanse our bodies of unwanted toxins and prepare ourselves for the year ahead.

I have completed many different detoxification regimens over the years but one of the easiest and most effective ones I have tried is the Mung Bean Detox. This simple detox was shared with me by one of my favorite local chiropractors, Dr. Thomas Mitchell. Dr. Mitchell practices Ayurvedic medicine as well as chiropractic medicine at Mitchell Chiropractic Healing Center in Raleigh. The following information, instructions and recipes are from Dr. Mitchell and his wife, Lisa.

If you have questions about whether or not this diet or another detoxification program is right for you, please contact us at Carolina Total Wellness.

Yours in health,

Susan Denny, MD, MPH

The Fall Detox Plan:
By: Tom Mitchell, DC

Detoxification is one of the pillars of Ayurveda, the ancient medical system of India that is more than 5,000 years old. Whole mung beans are a legume that is common in Asia but is also widely available now in the US. Whole (green) mung beans. Whole mung beans have a scraping action, which supports the detoxification process. More specifically, they cleanse the colon, liver, kidneys, and lymph system. Mung beans are also much easier to digest than other legumes such as lentils and hard beans, which include pintos, black beans, and chickpeas.

The Benefits of a Mung Soup Food Plan

Improved digestion
Reduced inflammation
Pain reduction
Strengthened metabolism and weight loss
Improved energy, enthusiasm, and stamina
Reduced congestion
Greater mental clarity
You never go hungry!

Many patients lose 6 to 8 pounds in one week. Follow-up labs often show measurable improvement in cholesterol, triglycerides, and blood sugar/insulin resistance. Many patients experience lowered blood pressure as a result of the program.

The Food Plan

The simplest form of the food plan is to make a pot of Mung Soup daily cooked with vegetables right in the same pot. You can make this dish in a standard pot, standard pressure cooker or Instant Pot. Eat this food for five to seven days, at least two times a day (lunch and dinner) but preferably three times. (If you don’t enjoy a savory breakfast, it’s fine to have some organic cooked oatmeal, but not the instant variety.) Focus on easy-to-digest foods such as squashes and greens of all kinds. A little bit of green beans and a little sweet potato is also fine. A small amount of white basmati rice is considered better for a detox than brown rice; just eat enough to complete the protein of the beans and ensure that you feel adequately fed.

During the detox it is essential to avoid gluten, dairy, and refined sugar as well as all animal foods. The major emphasis is staying on a plant-based diet (except for the use of ghee, clarified butter). Plant-based meals are easier to digest, which supports the detoxification process. We also recommend that you avoid inflammatory vegetables such as nightshades (tomatoes, eggplant, peppers, chilies, white potatoes) and gassy vegetables such as the cruciferous vegetables and okra.

For people who can make a little extra time to cook—and who want a more diversified diet—we offer some delicious vegetable soup and side dish recipes to complement the mung soup. You can make Quick Sauteed Asparagus in about 5 minutes, or a luscious Asparagus Soup with leeks and fresh tarragon. One of our favorites is a Vegan Collards recipe with smoky salt. You will find all these recipes on Lisa’s Sacred & Delicious Blog. You can also buy a copy of her cookbook Sacred & Delicious: A Modern Ayurvedic Cookbook, with 108 gluten-free recipes at Amazon, only available today in Kindle (reprint date TBA). The book won five national book industry awards in 2019. You can sign up for Lisa’s blog to receive new recipes at www.sacredanddelicious.com/blog.

September 9, 2022November 28, 2022

ANTIBIOTICS AND THE GUT MICROBIOME

Didem Miraloglu, MD, MS

Since their discovery, antibiotics have been a godsend in terms of eradicating infections and saving millions of lives. Without antibiotics, common infections and minor injuries used to be life-threatening, and surgeries and chemotherapy were nearly impossible. Today the tables have turned on us, whereas, 50 years ago we were reaping the benefits of antibiotics, in the past 2 decades antibiotic resistance has become one of the leading causes of death in the world for people of all ages.

To comprehend the weight of this problem, we must first understand what the gut microbiome is and the role it plays in human health and disease. The gut microbiome is comprised of almost 40 trillion bacterial cells and has anywhere from 500-1000 bacterial species comprising nearly 2 million genes. The gut microbiome contributes to human body functions such as digestion, metabolism, protection from pathogenic microbes, production of vitamins, as well as the regulation of the immune system and inflammatory reactions.

A healthy gut microbiome has high diversity, and any kind of disruption may lead to dysbiosis, an imbalance between the commensals (those bacteria which normally reside in and on us without harming us) and the pathogenic bacteria. Antibiotic use can reduce the diversity of the species in the gut microbiome, alter their activity and select and breed antibiotic-resistant organisms. Short term effects of antibiotic use include diarrhea, Clostridium Difficile infection, and antibiotic resistance, whereas long terms effects can be the development of allergic conditions, such as asthma, food allergies, and obesity.

The problem of antibiotic overuse and misuse does not only stem from treatment of human infections but mainly from their use within the animal industry. The amount of antibiotics used for human infections is four times less than the quantities used for breeding livestock. Antibiotics in the animal industry are added to the feed of animals to improve their growth. They accomplish this by inhibiting the growth of microbes in the gastrointestinal tract which triggers immune responses in the host. This in turn is cost-effective to the producer since more meat can be produced with the usage of less feed.

Antibiotic misuse in both animals and humans has led to a significant increase in antibiotic-developed resistance. This is where a particular antibiotic is no longer effective in treating an infection. The consequences are anywhere from increased human illness, suffering and death, increased cost and length of treatments, and increased side effects from the use of more powerful medications.

There are many suggested solutions to alleviate this ongoing health crisis. Some things you can consider to prevent further antibiotic resistance are:

Don’t rush to treat your runny nose or cough. Be sure that the antibiotic is necessary and not just convenient to use for shortening the duration of the infection. In up to 95% of the cases, bronchitis is viral and there is no cure for the common cold, it gets better on its own with over-the-counter remedies.
Consume antibiotic-free dairy and meat products, pasture-raised farm animals rather than factory-farmed animals
Ask your doctor to use a narrow spectrum antibiotic if possible to treat the most common organism causing that particular infection rather than a “shotgun” approach, using an antibiotic that kills all
Shortest effective duration of antibiotics (this does not mean discontinuing the antibiotics once feeling better, there are specific guidelines for a minimum duration of use for certain infections)
Adhere to the antibiotic prescription
Take a high-quality daily probiotic while on an antibiotic

Taking a high-quality probiotic as soon as you start antibiotics is another way to counteract the side effects of antibiotics. If you are able to, start taking probiotics a week before taking the antibiotics. Separate them out by two hours while on the antibiotics and continue for 3-4 weeks from the start of the antibiotics. After a month you can decrease the dose to your minimal effective dose for your optimal health outcomes. The probiotics help to restore some of the healthy gut microbiomes lost through antibiotic therapy. Strains of Lactobacillus and Saccharomyces (a beneficial yeast) can help mitigate antibiotic side effects. This in turn contributes to better adherence to antibiotic prescription thereby reducing the evolution of resistance.

Generating and maintaining diversity in the microbiota is a new clinical target for health promotion and disease prevention.

Fecal Microbiota Transplantation FMT) is a therapy and is one of the main treatments against antibiotic-resistant infections. This is whereby stools either from the same individual before the antibiotic use or from a healthy donor are introduced orally or via enema or probiotics. This stems from the premise that the gut microbiota in healthy donors is dominated by a large number of probiotics. Many studies have shown that FMT restored both the gut microbiota composition and function in patients who suffered from recurrent Clostridium Difficile-associated diarrhea. Some studies have shown that the worldwide mean cure rates of FMT for diarrhea are approximately 91%. To date, this is better than any other treatment we have for antibiotic-associated C.Diff colitis.

We can envision in the not too distant future, antimicrobials and therapies which will be prescribed for their direct anti-pathogen benefit while simultaneously limiting collateral damage to the microbiome. Until then it is essential to keep our bodies healthy by taking good care of our gut microbiome.

Contact our office to schedule an appointment to learn more about optimizing your health.

Your Partner in Health!
Didem Miraloglu, MD, MS

August 26, 2022November 28, 2022

The Vagus Nerve: Not All Who Wander are Lost

Erica Nelson, MSPH, NBC-HWC

Practical Strategies for Managing Anxiety and Improving Digestion

Who’s the Boss?

They say the mind is a wonderful servant but a terrible master. Are you in charge of your mind and body? Or do you feel like you are at the mercy of your thoughts and feelings (physical and emotional)? This article shares cost-free and drug-free practical strategies to take back control of your physical and emotional feelings and make your mind your servant.

Your nervous system is complicated but you do not need to know all of the details to have a significant impact on its function. In this article you will find a very simple description of how one specific nerve, the Vagus, connects your physical and emotional feelings. You will also learn practical things you can do to reduce anxiety, improve digestion and overall wellbeing.

A (Very) Brief Neuroanatomy Lesson

Starting from the top, the brain branches out from your skull through 12 cranial nerves (and their branches) known as the peripheral nervous system.

Starting from the ‘bottom’ the gastrointestinal ‘mind’ is called the enteric nervous system (ENS.) The ENS has more nerve cells than the rest of the entire nervous system combined (more than 100 million!) and is capable of functioning independently of the rest of the nervous system.

The Vagus nerve is one of the 12 cranial nerves. It connects your brain to your digestive system and vice versa. It sends and receives both motor (movement) and sensory (feeling) signals. Beyond the digestive system, it touches nearly every major organ and plays a role in heart rate, respiration, facial expression, inflammation, sweating, reproduction and more.
Photo courtesy:
www.drarielleschwartz.com

The word ‘Vagus’ comes from the Latin for ‘wander’ but, as Tolkien wisely said, ‘Not all who wander are lost.’ This nerve, and its branches serve as the information super highway in your body and provide the early warning system for threats, internal and external.

Most of these functions are reflexes that happen without you thinking about them to keep you alive. Can you imagine if you had to decide to shunt blood supply from your stomach to your heart and lungs to run from danger? But sometimes the reflexes are not actually helpful in the moment and we are left feeling like our stomachs have minds of their own – because they kind of do. But when we know what the reflexes respond to, we can take steps to trigger a more desirable response.

Toning the Vagus for Stress Resilience

Have you ever felt your mouth go bone dry just as you are about to begin a presentation or performance? Or worse, maybe you feel like you are going to throw up? Or need to go to the bathroom RIGHT NOW. This is your reflexive response to stop bodily secretions and smooth muscle contractions in your GI tract so you can spend your resources elsewhere.

When you perceive a threat, your brain and body make preparations to respond and additional resources – oxygen, fluids, etc. – are diverted from digestion and reproduction until you are physically and psychologically safe again. Your heart rate, blood pressure and breathing increase, your pupils dilate, your mouth may go dry, your muscles may begin to tremble all of these are signs of activation of your sympathetic nervous system.

It is the job of the parasympathetic nervous system, including the Vagus nerve, to restore resources to ‘rest and digest’ once the threat (perceived or real) is passed. Depending on the duration and intensity of the threat, it may take 20 minutes or 20 years to return to a healthy resting state. When left unattended, chronic stress or PTSD can have long-term effects on your physical, cognitive and emotional health.

Techniques to Build ‘Stress Resillience’ and Facilitate the Job of the Vagus Nerve

Daily Habits to Support Stress Resilience:

Cat/Cow stretching with a Lion’s Roar

This exercise lengthens and contracts the Vagus nerve to activate it. Get on your hands and knees on the floor. Begin with a neutral spine and then press down through your hands and knees to arch your back upwards like a cat. Inhale while doing this. Then drop your belly down towards the floor and lift your breastbone forward and up. Exhale loudly while you do this, sticking your tongue out and even roaring like a lion.

Laugh

Laughter really is one of the best medicines. Real laughter is best but even fake laughter will engage the Vagus nerve through contraction of the diaphragm.

Hugs

A warm embrace, ideally 20 seconds or longer, will stimulate the part of the Vagus nerve that runs down your back and can trigger the release of a hormone called oxytocin, known as the feel-good hormone.

Singing, humming, chanting, gargling

The Vagus nerve is connected to your vocal cords and the muscles at the back of your throat. All of these activities activate the muscles around the nerve and can stimulate it. Choose one or more and find time for it each day.

In-the-Moment Strategies to Get Back to Rest and Digest:

4-7-8 breathing

Place the tip of your tongue against the ridge of tissue just behind your upper front teeth, and keep it there through the entire exercise. Exhale completely through your mouth, making a whoosh sound. Close your mouth and inhale quietly through your nose to a mental count of four. Hold your breath for a count of seven. Exhale completely through your mouth, making a whoosh sound to a count of eight. This is one breath. Now inhale again and repeat the cycle three more times for a total of four breaths.

Go outside for a walk

This works for a couple of reasons. First, when you are walking, your eyes naturally move side-to-side and trigger a response in your brain that distracts it from threat. Second, you are using up some of the ‘energy hormones’ that were dumped into your system to respond to the threat and may be making you feel ‘jittery.’

Self-massage

Stroke your neck from your ear to your clavicle 10 times on each side. Again, your Vagus nerve is connected to these muscles. Moderately intense massage to the area will stimulate the nerve and help to restore a resting state.

You do not have to be at the beck and call of your body’s reflexes. Choose one or two of the strategies above and integrate them into your day to improve your ability to respond the way you want to – instead of simply reacting – the next time you are faced with a stressful situation.

Call our office and schedule an appointment with one of our health coaches to learn more healthy strategies to reduce and respond to physical, emotional and cognitive stress.

Your Partner in Health!
Erica Nelson, MSPH, NBC-HWC

May 20, 2022August 25, 2022

Heart Rate Variability

Didem Miraloglu, MD, MS

DO YOU KNOW HOW TO MEASURE YOUR WELL-BEING?

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

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

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

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

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

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

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

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

Apple Watch – Uses an optical sensor (green light) to record heart rate automatically, however, you need to obtain the Health app on iPhone to look at the data.

Oura Ring – A sleep tracker, takes the mean of all 5-minute samples measured while you are sleeping. The changes in your HRV are accounted for every 5 minutes throughout the night which makes it one of the most accurate devices out there to measure HRV. This is in comparison to other wearables that only take HRV measurement at a single point during the night.

Fitbit – Heart rate tracker automatically measures the HRV and sends stats to the Fitbit app. The only problem is that the technology used in Fitbit does not accurately record or report heart rate.

AIO (All in One) Smart Sleeve – It is a sleeve you wear that can measure your EKG real time. It also does sleep analysis, workout optimization and stress level monitoring.

Frontier X – Worn directly over your heart, like a chest belt, provides continuous ECG monitoring.

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

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

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

Marcus Aurelius – Roman Emperor and Stoic philosopher (161-180 AD)

Didem Miraloglu, MD, MS

May 16, 2022May 16, 2022

Welcome to Tick Season

Frances T Meredith, MD

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

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

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

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

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

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

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

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

Your partner in health,
Frances T Meredith, MD

April 3, 2022April 3, 2022

Nasal Cleansing Using A Neti Pot

Breathing is a necessity of life. Keeping the nasal passages clear is an important part of the body’s immune defense system.

As we breathe, we inhale various pollutants, allergens, mold, and dust into our nasal passages. The nasal passages are designed to protect us by filtering out these airborne particles. Unfortunately, this filtering system can become overloaded by inhaled irritants, resulting in congestion, inflammation, or infection. Additionally, certain foods can promote inflammation and mucus formation, further clogging of the nasal passages and sinuses.

Nasal cleansing can help keep sinuses clear and improve the ability to breathe freely. The practice of nasal irrigation (also known as neti) has been around for thousands of years. Water, and in some case herbs, are used to gently open and stimulate the nasal passages. Using a neti pot or similar device makes this process easier.

Basic Nasal Cleansing/Neti Pot Protocol

Materials needed:

8 oz water—distilled, sterile, or boiled for at least 3 minutes and then cooled (note: do not use water directly from the tap)
½ teaspoon uniodized (or Kosher) salt, or botanical glycerate/tincture as has been recommended
Nasal cleansing (neti) pot

Directions:

Prepare the saline solution and fill the nasal cleansing pot
Lean over a sink and tilt your head to one side so that your forehead and chin are at approximately the same level. (This can also be done easily when taking a shower.) This prevents water getting into your mouth.
Place the spout of the pot into your upper nostril. While breathing through your mouth, pour half of the solution through the upper nostril so that it drains through the lower nostril. It may take a few tries to get the hang of it. Persevere.
Blow the nose to clear both nostrils.
Turn head and repeat on opposite side with the remaining solution. When finished, wash the nasal cleansing pot.
Repeat once or twice a day as recommended.
Note that for 15-30 minutes following a session you may find you need to blow your nose as the stimulatory action of the salt or medicated solution result in additional ‘flushing.’ These recommendations should be followed under the supervision and guidance of a qualified healthcare professional.

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

In health,

Clarissa A. Kussin, N.D., FMHC, ERYT-500

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