Saturday, February 13, 2021

Happy Valentine's Day and Heart Health Month!

I was going to write this last weekend but it seemed like a futile exercise to try to talk about heart health on Super Bowl weekend! I myself indulged in some chips and dips (because no parties over Christmas and New Year's meant I missed out) and some non-dairy ice cream called Revolution (and it is!).

Since heart disease is the top killer of both men and women over 50, everyone should know the risks and how to minimize the likelihood of a life-ending event like a heart attack or stroke. If you have one or more of these risk factors, you owe it to yourself and your loved ones to heed the advice of experts on how to lower your chances of heart disease - and by heart disease I mean atherosclerosis (plaque build-up in your blood vessels) which causes heart attacks.

TOP RISK FACTORS:

Smoking
Diabetes
High blood pressure - Hypertension
High cholesterol - especially LDL cholesterol
Obesity
Sedentary lifestyle (lack of exercise)

Those are the main risk factors but insulin resistance and inflammation (particularly if your hsCRP, or highly sensitive C reactive protein, is elevated) are also major risk factors.

Amazingly, some of our major medical institutions don't say much about diet and how it relates to reducing incidence of heart disease but there are indications that the right nutrients, including polyphenols, antioxidants and anthocyanins, can help lower inflammation and improve cellular function - including endothelial cell function. Endothelial cells line your arteries so when they are healthy, your blood vessels will be healthy. 

For an amazing documentary on why some medical authorities don't advise on dietary changes to improve health, watch What the Health, currently on Netflix. I don't agree with everything that is said in this film but it does reveal what the food industry's impact on large health organizations has been.

That said, a whole foods, mostly plant based diet is definitely helpful in reducing the likelihood of arterial damage. When followed with a low glycemic focus, to prevent elevations in blood sugar and keep your average blood sugar less than 100, a mediterranean type diet can be the best diet for most people trying to prevent heart disease. There are multiple other diets that may be better for your particular situation so consult with your provider to get the best fit for you.

The traditional Mediterranean diet allowed for liberal use of healthy fats like olive oil and nuts (almonds and walnuts mostly) and seeds, lots of fresh fish, locally grown seasonal vegetables and fresh fruit when available. When you get lots of vegetables and fruits in your daily diet you will likely get lots of potassium which is important for heart health. 

The Mediterranean diet, tailored for someone with blood sugar issues, should limit starchy vegetables to one or zero servings a day and fruit servings to one or none daily. If you are going to consume grains make sure they are organic whole grains, sprouted if possible. Consult with a nutritionist to make sure your food combinations are low glycemic - we know that high blood sugar is undesirable for heart health.

For meat eaters, pastured poultry can be consumed 4 times a week, grass fed red meat rarely and pastured eggs up to 4 times a week or less. Pastured animals that have not been fed pesticide laden grains are much less inflammatory to our bodies so try to only consume these and avoid factory raised meats. Watch the documentary Food, Inc on Amazon for a taste of how inconvenient fast foods and agribusiness grown meat products really are.

If you have had Covid then you know it is associated with heart disease. This wasn't obvious at first but as more people recovered we discovered that some people have a persistent disease state that may involve the heart. Follow these heart healthy guidelines to support heart health.

Besides the above diet, exercise or just daily movement is also very important for maintaining heart health. 

If you work at home particularly, set a timer to remind you to get up and move hourly. If possible, do a HIIT circuit at least 4 mornings a week. HIIT is High Intensity Interval Training. I do a 10 minute routine 4 times a week to protect and improve heart health. Along with the HIIT, regular cardiovascular training (walking, jogging, swimming) and strength training are also beneficial to improving and protecting heart function.

Supplements can also support your heart's cellular function and help with post-Covid heart issues. The following are my top choices for supporting heart health now:

Quercetin 500mg 2-3 times daily
Selenium 200mcg daily
Magnesium 800mg daily (citrate or glycinate)
Hawthorn (I drink the tea shown above) 500mg 3 times a day
CoQ10 300-400mg daily
Vitamin C 2000mg daily
High EPA fish oil 2000mg a day
Nattakinase 150mg daily
Lycopene 15-30 mg a day
Vitamin K2 100mcg or more a day
Vitamin D3 5000IU daily
L-Citrulline 3 gm a day (precursor of L-arginine and improves nitric oxide status and blood flow)

Check here for my heart health protocol supplement list.

One last thing that most people need to do to prevent heart attacks - manage their stress! 

When you are stressed your cortisol goes up along with your blood pressure and puts a strain on your heart function. Regularly taking time to lower the demand on your adrenal glands (where cortisol is produced) can help lower cholesterol and cortisol output and improve blood pressure and endothelial function. 

Most people don't realize that cholesterol is the parent steroid hormone that is the building block for all of the other steroid hormones, principally cortisol, but also pregnenolone, progesterone, DHEA and testosterone as well. If your stress level rises, your body will naturally make more cholesterol to meet the demand for cortisol so develop a strategy to manage stress. I recommend a daily mindfulness practice.

The simplest practice to begin with is taking deep belly breaths. Begin by inhaling for a count of 5 slowly then hold a couple of seconds and slowly exhale for a count of 5. Repeat for a total of 5 breaths. 

It is easier to start a new habit if you link it with another activity so try beginning by doing this practice on waking, each time you eat a meal and just before bedtime. Taking mindful deep breaths helps to diminish the threat mode in which we often find ourselves.

Another option is Insight Timer. I use this free app as a meditation timer or for guided mindfulness meditations. There are literally thousands of meditation options from which to choose on this app. If you are short on time, click on the guided meditation icon and select 0-5 minutes for some short stress busting exercises. Just a few minutes a day, done consistently over time, is enough to decrease adrenal stress.

Last but definitely not least - if you smoke then you are exposing yourself and loved ones to over 50 different carcinogens which are carried around your body on your LDL cholesterol, literally scraping up your blood vessel walls and damaging them. Damaged blood vessels create an environment favorable for plaque formation. 

If all you do is quit smoking (or avoid smoke exposure), you will reduce your relative risk of mortality from coronary artery disease by 36%. Lent is just around the corner - give up smoking for your lenten observation. 

Back in the day, when I was young and foolish, this is how I stopped smoking. I gave it up for Lent then on Easter weekend I smoked two packs of cigarettes in one day. I was so sick after overdoing it with the cigarettes that I never wanted to smoke again. Be strong, protect your heart - you can do it!

Namaste.
























Thursday, October 29, 2020

Sending out an SOS - Save Our Sleep

Insomnia impacted millions of people before the coronavirus, but now sleep has become such a huge issue that experts have coined a new term, "coronasomnia", to refer to the stress and sleep loss attributed to the pandemic.

Sleep is a critically important component of overall health, and when we are deprived of quality sleep, many other aspects of our health suffer including immune, hormonal, and metabolic functioning.


There are a variety of reasons why people are struggling with sleep right now.

1. Stress & Anxiety - There seems to be a never ending barrage of bad news that we are exposed to this year, all while living isolated from loved ones and working to maintain a new normal that is anything but.

This year the threat of falling ill to the coronavirus is only one of several major threats to our sense security. We have also dealt with:
  • social isolation
  • grief over everything from missed plans to loss of loved ones
  • the pain associated with police brutality and increased awareness of systemic racism
  • clashes between protestors and police
  • burnout in helping professions like police officers, teachers and health care workers
  • navigating educating our kids during a pandemic
  • natural disasters ranging from forest fires to hurricanes
  • political divisions
When our nervous system perceives so much potential threat for so long it becomes overly activated. The signal the brain sends the body goes a little something like, "DANGER HERE! NO TIME FOR REST! MUST SURVIVE." The result is a feeling of being tired all day and wired at night, unable to ever full rest and recover.

2. Depression - Rates of depression have surged during the pandemic. There is a well established connection between depression and insomnia. We are social beings that require safe connection with other human beings to thrive, and arguably to stay alive. The lack of both safety and connection during the pandemic, along with a reduced sense of control over many of the perceived threats has had a devastating impact on our mental health and sleep.

3. Loss of a Regular Schedule - Human beings are creatures of habit and sleep can be negatively impacted by a loss of routine. The pandemic has lead to wide variations in our usual schedules since we no longer even have to get dressed or leave the house to go to work, take the kids to school or even get food. Many parents are trying to navigate working from home while trying to keep kids on task with online learning. Changes to our normal schedule have increased our stress and effected our sleep.

4. Increased Screen Time - Screens have been a huge part of the pandemic survival strategy for many. Americans are getting by on Netflix binges, "connecting" through social media and Zoom meetings. When we are exposed to screens before bedtime it interferes with our body's natural sleep clock. The reason why our sleep suffers from increased screen time is the short-wavelength, artificial blue light that is emitted by these device can lead to being more alert when you should be winding down for rest. It can also reduce the quality of sleep, reduce the total amount of REM sleep, and decrease alertness in the morning. 


So what do we do about our coronasomnia?!?!

We may not be able to change what is going on in the news but that doesn't mean we can't turn our sleep troubles around. Here are a few practical tips that can get you started:
  • Set a sleep schedule. Set an alarm in the morning and get up even if you don't have to leave the house. Establish a consistent bedtime and start to wind down 1-2 hours before. Notice how your sleep is impacted if you stay up too late at night or hit snooze too many times in the morning.
  • Develop a relaxation ritual. Pay attention to practices that really help you to feel relaxed and incorporate these things into a regular evening practice designed to help you prepare for sleep. If you are clueless about relaxation because you are always go-go-go, try some things and see what works for you. You may involve things like a stretching routine, diffusing lavender essential oil, listening to relaxing music, soaking in a hot bath or reading a relaxing book before bed. Try using the free app Insight Timer which provides thousands of free guided meditations and relaxing sounds to help you sleep.
  • Reserve your bed for sleep only. Set a rule that the bed is for sleep (and sex) only. Avoid bringing your laptop into the bed for work because it brings the stress energy of work into your sacred area for rest.
  • Mind your light exposure. Resetting our circadian rhythm is possible and understanding how light impacts it is key. During the day try to get outside and have light exposure. At night avoid screens and consider getting black out shades or wear a sleep mask to inform the body it is time for rest.
  • Try supplements. There are tons of natural sleep aids that can help you to improve insomnia. One of my favorite natural sleep support supplements is MindYourMind. This blend of herbs and nutraceuticals encourages an easy transition to sleep and a restful nights sleep. Another staple in my sleep supplement protocol is magnesium. I recommend Natural Calm powder taken right before bed. Hemp oil containing cannabinoids like CBD, has also shown promise in helping to support sleep by helping with anxiety.
  • Watch your beverages. Drinking too much, too late can interrupt sleep for bathroom breaks, regardless of what it is. Alcohol and caffeine are notoriously bad for sleep. Try to go without and watch how your sleep is effected.
  • Avoid eating before bed. Laying down to rest after a large meal is not a great sleep strategy. This can lead to indigestion and reflux, as well as disrupted sleep. Try to avoid eating 3 hours before bedtime.
  • Prioritize safe connection and healthy relationships. We need each other and we do better when we are loved and supported. In order to have the best sleep of your life, your nervous system must experience safety and connection. Staying in touch with loved ones may not look like it always has, but we can and must connect, whether through zoom calls or distanced gatherings, in order to feel and function at our highest level.
  • Support hormone balance. A variety of hormone imbalances can impact sleep. Melatonin, estrogen, progesterone, testosterone, oxytocin, cortisol, thyroid, and insulin are all hormones that when imbalanced can cause insomnia. Bringing hormones into balance can have a tremendous impact on sleep.
Try the tips above and then share what's working to save your sleep in the comments below!

If you still need help, connect with Elevate Functional Medicine to help you identify and correct the root cause of your sleep disorders.


Rabia Vaughns, MMS, PA-C is a certified physician assistant who specializes in functional medicine, integrative medicine and lifestyle medicine, helping people overcome chronic illness using a personalized approach to healing. She is also a co-owner of Elevate Functional Medicine.
Resources:



https://drarielleschwartz.com/polyvagal-theory-unlocks-symptoms-of-ptsd-dr-arielle-schwartz/#.X5a2jUJKjJ8

Sunday, October 4, 2020

Heavy Metal Series: Get the lead out!

 As we head into Breast Cancer Awareness month, Elevate Functional Medicine is focused on helping our patient community to strengthen their immune systems and improve their detox pathways.

The obvious reason is the ongoing pandemic combined with the approaching flu season but supporting your immune system is also key to cancer prevention and treatment.

In the course of our daily lives, our bodies are making cancer cells nearly every day and one of the immune system's roles is to detect these abnormal cells and kill them.

You may be wondering why your body might make a cancer cell and that is a good question to ask! 

Remember Erin Brockovich? (worth watching or rewatching)

Exposure to environmental toxins in our water and air is one reason our bodies may have cells transforming into cancer cells. DNA damage and dysregulated cell signaling are pathways to cancer for a cell. It is toxins that put us at risk and they can be eliminated naturally if our detox mechanisms are working properly.

Erin B. was dealing with hexavalent chromium in ground water. Hopefully none of you readers live on ground contaminated with industrial waste! Incidentally, according to data cited in the 2019 Clinical Environmental Medicine textbook (Crinnion & Pizzorno), over 4400 public water systems in the U.S. have hexavalent chromium levels above the EPA recommended minimum reportable level. 

If you would like to get your water tested, I like Doctor's Data. I also use them for heavy metal testing.

You may need to email or call them to get the kit for testing your household water. 

But today, I am continuing my series on heavy metal toxins with my fourth and last installment - lead. There are more than 20 possible toxic heavy metals that can cause illness in humans and I've tried to cover the ones I see most often. That is why we're covering lead to round out the series.

Also, fall is a good time to try a detox program, fresh produce is in abundance and the holidays haven't begun yet!

So 50% of our population have blood lead levels associated with disease, according to Crinnion and Pizzorno's textbook. Exposure to lead is associated with cognitive decline, mood disorders, neurodegenerative disorders, cardiovascular disease, kidney disease, respiratory problems and reproductive problems. 

One big problem with lead is that up to 80% or more of the lead gets stored in our bones and remains there because it has a half-life of 30 years or more in bone. The half-life is the amount of time (with no new exposure) to get rid of half of the element/chemical.

So where does the exposure come from?

The two biggest non-occupational sources of exposure are leaded gasoline (banned in the 70s but still used by private planes) and lead in house paint (used until 1978). 

Lead may also be in our water (from house pipes), painted ceramic dishes, cigarette smoke, and particles attached to dust in the home. PVC contains some lead, so vinyl mini-blinds, power cords, artificial Christmas trees, lunchboxes and toys may all contain lead.

Another concern is bone broth, popular component of the Paleo diet. There is evidence that bone broth has lead levels associated with disease.(1)

There are a few other common exposures - persons who make lead bullets, fishing weights and toy soldiers have higher lead levels. Also, shooting lead bullets in an indoor shooting range will result in higher blood lead levels. 


So what do we see when children (and adults) are exposed to lead? I think of Flint, MI, where the entire population has been exposed to high lead levels in their water. Truly a tragedy and failure of government.

In children exposed to lead, we see lower IQs, higher risk of ADHD, ODD and CD. Adults have higher risks of Parkinson's disease and Alzheimer's disease. There is also an increased risk of heart attack and kidney damage (especially in diabetics) with lead exposure.

We also see increased risk of male infertility with lead exposure and if there is lead in seminal fluid then there may be an increased risk of failed infertility treatments (artificial insemination and IVF).

I will also point out that as women go through peri-menopause and menopause, their estrogen levels decline and they can have significantly increased bone loss with the leaching of lead at the same time.

So what to do to actively get the lead out?

I start with testing to get an idea of the body burden (amount not just in blood but in the body). Then I make sure there is not ongoing exposure. If there is recent exposure, we work to figure out where the exposure originated and on avoiding additional exposures. Then we do metabolic testing and decide the safest way to chelate the lead while supporting the elimination pathways. 

Removing the lead and lowering the body burden will gradually allow the return of normal function and lowering of the disease states (if any are already present). I most frequently have seen brain fog but there are many other potential disorders that could be corrected with careful chelation.

Metals can also be assisted out of the body, along with other toxins, with a detox program.

The chelation of lead should be done under the guidance of a knowledgeable functional medicine provider. That being said, my top 3 favorite supplements to help with metal detox are N-acetyl cysteine, Alpha Lipoic Acid and Vitamin C

These also happen to be very helpful for bolstering the immune system.

Also, we have a very basic Detox program available. It includes dietary support, daily cues, recipes, menus and recommended detox supplements. If you are in fairly good health then you may attempt a basic detox. For those of you with multiple chronic issues, please contact us for a consult before doing the program. Message me if you would like to get signed up, mention the blog post to get $20 off. karenfmillermd@gmail.com

So does lead have anything to do with breast cancer?


A recent study from China showed a significant elevation in Cadmium levels in breast cancer patients (15 fold) and also noted elevated levels of chromium, arsenic and lead.(2).

So it is highly likely that testing and removing heavy metals can help to restore better metabolic function and lower the risk of damage to cell function that leads to cancer.

If you'd like to find out whether heavy metals are an issue impacting your health, give us a call at Elevate: 470-266-1380 or contact us through the website.

For supporting your immune system in a fundamental way, you can now sign up for our Immune Boost Program.

Namaste.

Karen Miller, MD is an OB/GYN and Certified Functional Medicine provider who specializes in integrative women's health and complex medical illness. She is medical director and co-owner of Elevate Functional Medicine.



1.Clinical Environmental Medicine. Crinnion, Pizzorno. 2019. p.162.

2. Oncol Lett. 2020 Apr; 19(4): 2925–2933. Heavy metals interfere with plasma metabolites, including lipids and amino acids, in patients with breast cancer. Ling, Meihua, Yuhao, Wei, Weidong. Published online 2020 Feb 17. doi: 10.3892/ol.2020.11402 

* These statements have not been not been evaluated by the FDA and are not intended to diagnose, treat, mitigate, cure or prevent any disease.