Sunday, December 30, 2018

What to do about the flu

Not just Christmas season, this is also flu season and the vaccine makers are not sparing any expense to convince all humans that they must have a flu vaccine or risk death.

As a Functional Medicine doctor my patients are a little more wary than the average citizen and have a lot of questions about whether they should get a vaccine.

My story is that I'm allergic to most of the components of the vaccine so the last time I got a flu vaccine was in 1993 and that was also the only year I've ever had the flu. It was awful.

Vaccines are supposed to stimulate your immune system and help you create antibodies against a potentially harmful infection. Many vaccines helped our society immensely when communicable diseases like smallpox and measles were rampant and we didn't have tools to help sick people get better. I think when vaccines were first created that our immune systems were not as compromised as they are today.


My hypothesis is that our environment and water and food are now so contaminated that our immune systems are already overly challenged and that is why we are seeing dramatic rises in the rates of cancer, autism and autoimmune diseases.

But this post isn't about how to safely give vaccines, there are lots of books about that topic. This post is about flu prevention.

If you are required to get a flu shot for your job and know that it doesn't harm you then do a little research and decide for yourself whether you'd like to get one. Read this before you give yourself or your children the flu shot.

Since I am allergic to almost every ingredient in the flu vaccine I elect not to get it. My flu prevention starts with the vitamins you see in the photo. Taking a high quality multivitamin helps by giving your cells the nutrients they may not be receiving in our nutrient deficient food supply. I also don't use hand sanitizer because of allergies but recommend hand washing and making sure not to drink or eat after others. Don't share utensils or dishware!

Remember during the holidays that excess sugar, alcohol and processed foods also compromise your immune system. Try to celebrate the season in moderation and treat yourself with whole foods and vegetables - your immune system will function better and you'll be less likely to get sick.

If you aren't living at the equator and out in the sun daily your immune system probably could use some extra vitamin D. See a Functional or Integrative physician to have your vitamin D, thyroid, zinc, folate and B12 levels checked. You could also get a functional nutrient assessment that will show whether you have any other vitamin deficits or heavy metal toxicity.

I take 50000IU of vitamin D3 every week and if someone around me gets sick I take an extra D3 the first day of exposure  and the next day just for good measure. Vitamin C (1000mg per capsule in the Ascorbplex example above) is also necessary to help your immune system fight off a viral attack.

I recommend taking at least 3000 mg a day if you suspect exposure or begin to have symptoms of a viral infection. Zinc is also necessary so make sure your multivitamin has 30mg of zinc or get a good zinc supplement. I also like the Elderberry and zinc lozenges by Sambuca to help with fighting off a virus.

Mushrooms like Shitake, Maitaki, Cordyceps and Turkey tail will help give your immune system a boost. If you don't like the taste or can't get a steady supply of mushrooms there are supplements made from these species of mushroom to help strengthen your immune system's defenses.

Last but not least, your immune system will be compromised if you are overly stressed and don't take time out to manage your stress levels. Regular activities that are relaxing and let your adrenal gland (main organ of stress management) have a break will help your immune function.

I really enjoy yoga and reading books so I make time for those. I also recommend a good meditation app like Stop, Breathe and Think. A few minutes of meditation daily has been shown to increase mental clarity and focus and help reduce the effects of stress. Lowering the effects of stress will help your immune function.

Take charge of your health in 2019 and have the healthiest year yet.

Happy New Year!




Sunday, December 16, 2018

Phthalates and why you care



These products have phthalates. They don't mention fragrance but there are phthalates in fragrance.

As a Functional Medicine doctor I spend a lot of time explaining how our every day lives and the things to which we are commonly exposed are hazardous to our health. In this busy Christmas season I've noticed many stores have increased the number of products with fragrance.

My journey began with a severe allergic reaction to fragrance.

In 2004 I was visiting a friend and awoke in the middle of the night covered in hives. My friend is a nurse practitioner and as soon as she saw me she asked if we should go to the Emergency room. I suggested I take a Benedryl and write myself a prescription for a steroid taper and remove myself from the room in which I was sleeping. The sheets on the bed were very fragranced and she admitted she had just laundered them prior to my arrival.

The rash and itching seemed to subside over the next 24 hours and I finished my steroid taper and returned to work the next week. I was in surgery, performing a very difficult hysterectomy, when I began to have a return of my symptoms along with severe burning in my hands. I was already using a specially formulated glove that did not contain latex.

That event led to my skin being in a constant state of itchiness and irritation (called dermatitis) for the next month. The dermatologist prescribed steroid creams and moisturizing shampoos, both of which only made the condition worse. He finally threw up his hands and sent me to the national expert in contact dermatitis in Louisville, Kentucky.

After patch testing I was told I was allergic to many different chemicals, especially to chemicals in surgical gloves and to fragrances. I had to stop working because there were no surgical gloves that were safe for me to use to deliver babies and do surgery. I had to walk away from a job that I loved doing and figure out how to live safely. Luckily I eventually was introduced to Functional Medicine.

In Functional Medicine we search for the root cause of disease and environmental exposures are a huge cause of disease. There are hundreds of articles related to phthalate exposure and thousands related to environmental exposure causing harm to humans. Phthalates have been implicated as endocrine disrupting chemicals. If you've been reading this blog then you know that an endocrine disruptor wreaks havoc on your hormones and can be the root cause of many different hormone issues.

Here is just one list of ways you can be unwittingly exposed to harmful chemicals in candles. I personally only use beeswax candles in my home and rarely a soy votive candle. If you have small children you should think twice before exposing them to fragrances and other chemicals that can disrupt their hormones.

The fact that we are seeing girls go through puberty at the ages of 8-10 is a direct consequence of environmental exposures and can be the cause of many hormonal issues in life, including increased probability of reproductive cancer.

I hope by shedding some light on this issue that I can help others to create a healthier environment for themselves and their families.

Peace.


Sunday, December 2, 2018

What you eat may be killing you

I have basically two types of patients that I commonly see at my Functional Medicine practice - those who are willing to do anything - even change their diet - to live longer healthier lives, and those who flat out refuse to even think about changing their diet or lifestyle to better their health.

For those of you who don't think food is connected to disease, the science is out there but the medical community isn't keeping up with it very well so you may be suffering from disease and receiving medications and thinking the medications 'fix' things but in reality the medications may be making things worse.

In my Functional Medicine training, we learn about the 'Standard American Diet' or SAD diet that frequently contributes to disease. When I'm consulting with patients, I always explain to them the impact that food has on our health.

Our bodies need nutrients to function at their best and unfortunately the current American food supply (even if all you eat is organic fruits and vegetables and pasture-raised animals) has lost its nutrient-density over the last 75 years due to over-farming and over-use of pesticides and chemicals on the soil.

If the contents of your refrigerator currently look like this picture then you are doing better than the majority of your neighbors at improving your health and preventing disease but I find when I ask patients to keep a diet diary that they are frequently eating food from restaurants and fast food places which contain the most inflammatory substances and the least nutrient content.

Another major issue with our diets is the emphasis on refined carbohydrates. That includes sugar, white rice and white flour. These are all very inflammatory as is dairy and animal fat.

If you have any kind of cancer or metabolic disorder such as diabetes, hormone imbalances like PMS or endometriosis or infertility, high blood pressure or heart disease, hypothyroid or hyperthyroid, autoimmune issues like rheumatoid arthritis or Multiple Sclerosis, then what you eat may be killing you, especially if you diet is mostly carbohydrates, dairy and animal fat (from chicken skin, beef or pork).

If you are suffering from any of the above conditions, you would benefit from trying a plant-based diet (you can also have fish that is clean and without high levels of mercury a couple of times a week) and seeing how you feel over time.

New research from a doctor who studies fasting and longevity has been published this year and shows that a Fasting Mimicking Diet (FMD) can slow down or reverse these disease processes when done along with a pescatarian diet.

The researcher, Dr. Valter Longo, also recommends taking a high-quality multivitamin and a omega 3 supplement every day that you follow the FMD. His initial research shows that the FMD can decrease the side effects of chemotherapy and improve the effectiveness of chemo for cancer. He has shown that while following the FMD, stem cell production increases and diseased cells are disposed of at a more efficient rate.

If you have a metabolic disorder you should not undertake a self-prescribed fast without consulting a health care provider. A good integrative or Functional medicine provider can help you incorporate a regular FMD into your lifestyle to promote health and help reverse disease. If you are a science nerd like myself, you might enjoy reading about all the health benefits of FMD in Dr. Longo's book The Longevity Diet.

If you would like to find out whether the FMD could help you reverse disease, contact me for a consultation at KarenFMillerMD@gmail.com.

As we are transitioning to winter this month we can take the opportunity to be more reflective. I invite you to start a mindfulness practice. Mindfulness can help improve your brain function (memory and clear thinking) and reduce the deleterious effects of stress. Mindfulness is simply being present and aware in the current moment.

A PRACTICE:

Begin by sitting or lying in a comfortable position, if sitting bring your spine erect to allow deeper breathing and make sure your head isn't craning forward but situated directly between your shoulders with the crown parallel with the ceiling or sky. Imagine a string pulling the crown of your head upward so your head doesn't droop.

Close your eyes or bring your gaze to a point on the floor in front of you and notice your breath. Bring your attention to the sensation of your breath moving through your nostrils and down into your chest and expanding your belly. Try not to control the breath but merely to observe the effects of the breath on your body.

If your mind wanders away from being present, gently bring it back without judgment. You can use rosary or mandala or bodhi beads to track your progress. One circuit around a string of beads is a good place to start. If you don't have beads, set a timer for 10 minutes. There is a free app called Insight Timer that you can put on your phone and set for any length of time you wish.

Peace be with you.




Sunday, November 11, 2018

Hormones, Bones & Brains

As a Functional Medicine physician, I see lots of patients who are aging more rapidly than they expected and two of their main concerns are Alzheimer's and osteoporosis. This week I want to focus on how hormone imbalance or hormone deficiency can impact your aging body.

Did you know that up until age 30 your body builds more bone than it breaks down? Your body is constantly 'remodeling' bone by breaking it down in a process called resorption and building it back up which is called bone formation. Before age 30 bone formation occurs at a higher rate than bone resorption and after age 30 the process of bone resorption becomes more and more dominant.










<---Appearance of normal bone



                     Appearance of osteopenic bone -->



As women go through menopause, the hormone shifts cause a dramatic increase in bone loss and thinning of bone which is called osteopenia. For women, the fastest bone loss occurs in the five years after menopause so taking steps to prevent bone loss should being before menopause and you should work with your doctor to correct your hormones as you go through menopause and beyond to prevent bone loss.

Bone loss occurs for both women and men but let's talk about women first.

Three problems arise at menopause that will hinder your bone health. The major problem is declining estrogen. There are estrogen receptors on bone so without adequate estrogen our bones will begin to thin out which increases your fracture risk. Besides fractures, the thinning of your spine bones (vertebrae) results in compression of those bones by the weight and activity of your body so that you lose height and become 'hunched' (medically known as kyphosis).

The second, less common issue, is hypothyroidism which increases in incidence as women age. Thyroid hormone is essential to bone formation and the incorporation of needed minerals (selenium, boron, magnesium and calcium) into bone.

Thirdly, bone formation requires testosterone and many women experience a decline in testosterone as they go through menopause. Loss of testosterone with aging is also the mechanism by which men develop osteoporosis. Men can also develop hypothyroidism but it is less common in men.

So to sum up - women need to replenish their natural estrogen (not to pre-menopausal levels but just to a functional post-menopausal level) and testosterone and balance or replenish their thyroid hormones to prevent excessive bone resorption. Men need to replenish testosterone and thyroid hormone. Both sexes need to increase calcium-rich food intake and supplement with the minerals needed for bone formation: calcium, magnesium, boron, strontium.

If you are dairy-free like me then you can get a decent amount of calcium from chia seeds, almonds, white beans, collard greens, kale, edamame, tofu, rhubarb, amaranth and canned salmon and sardines.

Vitamins and phytonutrients that help absorption and incorporation of minerals are essential to increasing bone formation. I take a supplement called OsteoVegan Rx from NuMedica that contains all the recommended vitamins and nutrients in two bottles - one for the calcium, magnesium and boron and the other for the strontium because you get better absorption if you take it separately from the calcium.

If you are concerned about bone loss the NuMedica program guarantees to increase your bone density. It costs about 69.95 for a one month supply but if you are like me and forget to take it (or only take half the dose every day due to being busy) then it may last two months! If you would like to get it from Fullscript (a reputable supplement website which partners with supplement makers who are known for their quality and purity) then let me know and I can send you an invitation. You must work with a practitioner to access their site because many of the supplements are therapeutic doses (not the much lower RDA in the over the counter stuff you find at Walmart or Target).

Next month I'll tackle hormones and Alzheimer's - between now and then the number one thing you can do to increase brain health is eliminate sugar - added sugar - to decrease brain inflammation. I know Halloween just happened and the holidays are upon us but you brain deserves some TLC so be nice to your brain and EAT LESS SUGAR.

Here is a good calcium rich recipe to enjoy on a cold Fall day:

Cajun sausage, white bean and kale soup -

1/2 to 1 pound smoked Cajun sausage (I used mixed beef and pork), sliced into 1/4 inch slices
1 - 2 cans organic low sodium white beans
2 bunches organic kale, washed and stripped from stems
3 T grapeseed oil
2 medium organic onions, chopped
2-4 garlic cloves, minced (or garlic powder if you are sensitive to fresh garlic)
home made bone broth or organic chicken broth - 4 cups
1 can organic diced tomatoes (I like the no salt added option)
Italian flat leaf or curly parsley - 1/4 c chopped
shaved organic parmesan, Romano or asiago cheese (to top off the soup)
sliced baguette bread (or GF bread)

In a medium stockpot heat the oil and add the chopped onions and garlic. Once wilted (4-5 minutes) add the sliced sausage to brown. Add stock and enough water to equal about 8 cups of liquid and add canned tomatoes and bring to low boil. Add chopped kale and canned beans and let greens wilt (only takes a few minutes) and turn down to simmer. Simmer about 15 minutes and taste for seasoning. If you used the low salt options you may want to add a sprinkle of Himalayan salt and some fresh cracked black pepper to taste.
Serving options - toast slices of gluten free or baguette bread (brushed with olive oil and sprinkled with garlic powder) and serve soup with shaved dry Italian cheese and a side of bread. My son likes pasta so I sometimes boil some gluten free rotini pasta and add a serving to his bowl and top with soup.

Happy Veterans Day!





Sunday, October 21, 2018

Fall Detox Y'all

It seems like it took a really long time but finally it feels like Fall! As promised, I started a structured Detox the first week of October. Following a Detox food plan, adding a Detox meal shake and using fiber and supplements that improve Detox pathways - all of these adding up to help move toxins from my body and decrease inflammation and things that can increase the rate of cellular aging. (That's your cells that make up your bodily tissues - not your cell phone- when they last longer, your body functions better.)


I've posted before about why to do a Detox(here) and also posted a simple outline of how a medical detox works (here).

This post is to reflect on the experience of doing a detox. It's hard, I'm not going to lie.

To prepare for my detox, I pulled out all of my detox supplements (some shown here) and decided which ones I would use. Then I went shopping and bought lots of cruciferous vegetables, one of the main food categories that help your liver detox. I bought cabbage, cauliflower, brussels sprouts and broccoli.

I also got salmon and sardines and pastured chicken because the first part of the detox allows all of these plus unlimited therapeutic vegetables. I picked out a Detox shake and a fiber supplement to help increase my number of bowel movements daily. I bought alkaline water to help me hydrate during the process.

Once I had all the things I needed, I planned out the 12 days I would be doing the Detox. Advance planning is the key to success because there will be challenges, especially on long days when you are tempted to just grab some food from a restaurant. Most restaurant foods are heavily processed - meaning they are going to cause inflammation and have ingredients that decrease your ability to detoxify - and they are not organic, so they have toxic pesticide residues and will slow down your ability to detox.

The first two days involved drinking one detox shake daily, taking my detox supplements, drinking extra water and trying to eat as many organic vegetables as I could. I decided to use a binder that binds heavy metals and biologic toxins (like mold) and that had to be mixed daily and had to be consumed at least an hour away from any other supplements so that got tricky when my daily schedule varied from one day to the next.

The next few days I increased the detox shake to two servings a day and ate no meat, only fish or vegetables.

Then I moved on to the 'peak' of the detox, where I was using homeopathic drops to increase my detox pathways, drinking lots of water and using the detox shake mix three times a day.

I found when I got to the third serving for the day, I just decided to make half of the shake and have it as a dessert after my dinner because I was really tired of drinking the shake - even though it was pretty tasty. I encourage my patients to listen to their bodies. My body was saying it didn't want the full serving at dinner so I had half a serving.
                                                           
I drank a lot of tea! These are a few teas that can help during a detox. The Cleanse and Detox Pukka teas help improve detox functions, the Relax tea helps you to let go of stress at the end of the day, especially since you are not supposed to do strenuous exercise during the detox so your energy can be directed toward detoxing. The Super Slim tea is a Senna-based tea to help you move toxins out through the digestive track (in other words - poop).

Drinking tea is also helpful as a replacement for adult beverages! I carried tea bags with me so that if I met a friend for an after work 'stress management' session, I could just order hot water and drink my tea. Sometimes during the detox, the hardest part is altering your habits to accommodate the detox.

After the intense - 3 shake a day - phase of the detox, I tapered back to two servings a day of the detox shake and added back meat. I was getting tired of fish! This part lasted a couple of days and then I had two final days with one shake a day.

The last part of my detox was an ionizing foot bath. This involved using an ion generating motor in regular water in a foot bath. The ions generated will attract oppositely charged ions from your feet and draw them out into the water. Some of the ions are already in the water but many will be drawn from your feet, as the company has shown in their product research. Here are pictures of the before and after appearance of the water:



Pretty gross, right? I did the detox foot bath the night before I started the detox, then 5 days later, in the middle of the detox and then the evening of the last day of the detox. These are from the first day and the water pretty much looked the same each time so I plan to continue doing the foot detox at least once a week. We are constantly breathing in toxins, eating them, getting them in drinking water or showers (at hotels, friends' homes, etc), so an ongoing detox plan is essential.

Lastly, but definitely not least, is taking time for meditation, walking in the woods or doing whatever relaxes you and speaks to your soul. You can't detox when you are stressed.

I leave you with a forgiveness meditation to open your heart. (adapted from Luminous Mind by the Leveys) 

...Awareness is the light by which we see the world..
                   -Stephen Levine

Sit comfortably in your seat and bring your awareness to your breathe. Place a hand over your heart and become aware of your heart beating. Think of an action, thought or deed that you did that may have hurt someone or caused them emotional pain or distress. Bring that person to mind and extend the sincere heart-felt plea to them for forgiveness. Imagine asking for their forgiveness and receiving their forgiveness. 

Forgive yourself whole-heartedly for the harmful words or deeds that you have done in haste or irritation or some other circumstance. Release them and open your heart up to yourself to receive your forgiveness.

Now bring to mind when someone you care about who may have done something to hurt you. Realize that they too may have been acting out in haste or irritation or some other circumstance. Bring them to mind in front of you and extend forgiveness to them with all of your heart. Imagine them receiving your forgiveness and accepting it.

If you are ready to extend the exercise, forgive someone to whom you have negative feelings towards. Once you have done that, you may also extend forgiveness to those towards whom you are neutral who may have injured you or caused you pain or distress. Remember that you may have caused injury to some bystanders and casual contacts and forgive yourself from the heart for your thoughtless actions or words. 

At the conclusion, release any guilt you may have felt about your harmful words or actions and open your heart to be free from negative emotions and free to love yourself and others more fully.

Love is that flame that once kindled burns everything,
    and only the mystery and the journey remain.
                    --Rumi







Sunday, October 7, 2018

Estrogen - what is it good for?

Estrogen - the hormone that makes women female, is found in women and men. There are actually three estrogens but the main estrogen, responsible for promoting ovulation and genital health, is estradiol. Estradiol is the most potent of the three 'estrogens' and controls the thickness of the lining of the uterus during the menstrual cycle. It also plays a role in thousands of other processes in the body. For women, it also controls vaginal moisture and lubrication, enhances libido and sexual enjoyment and thickens the vaginal wall to support the bladder and prevent urinary tract infections and incontinence.


These images of coral kind of remind me of a 'plump' uterine lining and a 'scanty' uterine lining. The plump one might results in heavy painful periods and the scanty may result in skipped periods or short, spotty periods. These types of issues with menstrual cycles result from an imbalance in your hormones, usually between estradiol and progesterone, but insulin resistance and adrenal gland problems can also throw off your hormone harmony.

The other estrogens in play are estrone, often thought of as the 'danger' estrogen because excess estrone can promote abnormal growth in the breast cells and uterine cells, increasing the risk of cancer in those tissues. Your ovaries, liver and fat cells make estrone prior to menopause and after menopause it is predominantly made in your fat cells. 

If you are overweight going through menopause you will have estrone 'dominance' which can be worsened by alcohol consumption. Estrone can block the beneficial actions of estradiol, especially in the brain (where estradiol can promote memory retention and protect nerve cells). It can also increase risk of blood clots, weight gain, gallstones and can stress your main organ of detoxification, the liver.

The third estrogen is estriol, also the weakest in potency. It can be produced when estradiol and estrone are convert into estriol. It is thought of as beneficial because it may block the harmful effects of estrone on breast cells. It may also have positive effects on autoimmune processes like multiple sclerosis (MS). In a 2003 study it decreased the size and number of MS-related brain lesions and increased protective immune functions. It has also been used extensively in Europe for vaginal health. It is also mixed with estradiol in bioidentical hormone replacement.

So how do hormones get out of balance? 

In our toxic environment, toxins called Endocrine Disrupting Chemicals (or Xenoestrogens) are getting into our bodies from our food, water and air. They mainly come from dairy and beef in our food supply but can also come from herbicides, pesticides, plastics, toys, personal care products and cosmetics. Check here for more info on cleaning up your internal and external environment.

Stress can throw your hormone balance off when high demand for cortisol diverts progesterone into the cortisol pathway, as shown in this previous post. Poor liver function, from alcohol consumption, use of multiple medications which require increased processing through the liver, fatty liver disease (likely from too much sugar consumption) can all increase the amount of circulating estrogens.

Digestive issues from a poor diet can lead to dysbiosis (imbalance in the bacterial environment in the colon) which can lead to increased recycling of estrogens. High saturated fat consumption can increase the amount of estrogen produced. Being overweight also increases the amount of estrogen produced (in men and women). Lack of exercise can also increase the amount of available estrogen, as can sleep deprivation. 

Too much estrogen in women can lead to PMS, difficulty losing weight, gallstones, varicose veins, fibroids, cervical dysplasia, endometriosis or ovarian cysts. In men it can result in low libido, lack of motivation, depression, loss of muscle mass, breast development and belly fat. In both sexes increased estrogen is linked to increased risk of cancer.

So this week I'm detoxing to balance my hormones, cleaning up my internal and external environments and promoting hormone balance with stress management and sleep. Next week I'll blog about the specifics of the detox since I'm in the thick of it now and want to finish it before I report on how it went. 

So I leave you with a meditative exercise. Get out and walk if weather permits and notice nature. Look for something to speak to you: a plant, tree or bird. Expect to see something unusual and when you do, give it your full attention for at least 15 seconds (count one-mississippi, two-mississippi, etc). Be grateful for your 15 seconds of WOW. 

Shalom.





Sunday, September 30, 2018

WOW - October is tomorrow!

So Fall is here already! (How?) I went to two conferences in September and my brain is jam-packed with new information that I now need to sort out and digest BUT - this week I think we need to talk about WOMEN and our hormones and our dignity.

As an Obgyn who was trained at Emory I worked in the rape clinic at Grady Memorial Hospital in downtown Atlanta. I was 'on duty' for the month of August in my third year of training and saw 50 cases of sexual assault in that month. Most of those women had obviously been assaulted but only a small percent decided to pursue assault charges.

As someone who has suffered sexual assault myself (and has never spoken out) I think it is time to make space in our society for women to be heard, to be treated with the dignity they deserve, and for men to be brought to justice. As we heard eloquently from Dr. Ford this week, a traumatic experience imprints indelibly into the hippocampus (the part of your brain that records memories) and you never forget the person or the event. Recovery is a long process and your stress hormones and female hormones can be thrown off balance, causing all sorts of long term health issues.

For those of you over 40, you may be approaching menopause, going through it or well past it but your hormones still can help you feel better and look younger and healthier (also your brain to think more clearly and remember things). When your ovaries shut down or you have adrenal dysfunction and your estrogen, progesterone, DHEA and testosterone are non-existent or out of balance, it may be time to consult an integrative or Functional Medicine doctor.

As a Functional Medicine (certified through IFM) doctor, I use evidence-based medicine in a holistic way to help women regain hormone balance but also emotional and mental balance. The most common type of hormone imbalance in younger women is decline of progesterone (which can be due to increased stress and demand for cortisol) which can lead to irregular or heavy bleeding. In women who have stopped having cycles, I frequently see loss of libido, problems with lubrication or terrible pain when attempting intercourse. I use bioidentical (molecularly identical to the hormones we produce) replacement or supplemental hormones to help resolve these issues.

On top of enduring the hormonal roller coaster that we ride in our later years, women need to heal emotionally and mentally so they can fully live their best lives on a daily basis. Assault victims have fractured hearts and difficulty with intimacy and trust. Even after counseling, the work of becoming whole is an ongoing endeavor. I'm attending a free online 'Emotional Clearing' webinar series this week. I leave you with this exercise from the first lesson -

LETTING GO OF HURT:

Part 1. Write down your recollection of the event. Recall your feelings during and after the event. Write down any wisdom you would share with your younger self after the event.
Part 2. Write down the event from the perspective of the person who hurt you. Consider what their feelings and motives may have been and write those down.
Part 3. Become a reporter and write a description of the events as an observer reporting the facts only as one reporting for a newspaper.
Part 4. Perform a ritual that allows you to discard the emotional disturbances that go along with the memory by either shredding the papers, burning them, or otherwise destroying them. End with a short compassion meditation, extending compassion to yourself first, then to someone you love, then to a neutral person and finally - if possible - to the person who hurt you.

Namaste.

Sunday, September 23, 2018

Autoimmune thyroiditis - what can you do?

Just like the glimmer of a rainbow you can see in this cloud, we have a glimmer of hope in the quest to figure out how to address autoimmune problems.

For those of you not familiar, an autoimmune process means that your body is making antibodies that are attacking one or more of your tissues. This includes diseases like Hashimoto's and Grave's when it happens to the thyroid gland.

If you have one of these issues and it goes untreated, you are more likely to develop other autoimmune diseases like Rheumatoid arthritis, Lupus or Multiple Sclerosis. By treatment I don't mean drugs, which just try to stop the symptoms but don't address the Root Cause of an illness.

Since most of your immune system is in your gut (along your intestines), it makes sense that one of the triggers of the autoimmune process can be food.

As a Functional Medicine physician I see many patients with autoimmune thyroiditis. The first thing we do is an elimination diet to remove possible triggers. Many times, after the elimination diet is done we see antibody titers coming down. The most common food triggers are gluten and dairy.

Food is not the only possible trigger, though. Medication can also be a trigger. I have a patient whose antibodies were fairly low and she was put on one of the new anti-coagulation drugs and her antibodies went through the roof - into the thousands - and when I wrote to the Cardiologist to ask them to change her medication, the nurse practitioner (not the doctor to whom I had written) sent a response that the patient needed that particular medication. For those of you unfamiliar with anticoagulants, that statement is false. There are other options.

If your thyroid isn't functioning as it should then work with a Functional Medicine doctor to see if it may be an autoimmune problem. Many conventional doctors don't look at thyroid antibodies and if you don't look, you won't know whether you are dealing with autoimmunity. I routinely check thyroid antibodies if a patient is having symptoms of thyroid dysfunction. I mentioned the symptoms of thyroid dysfunction in my previous post.

If your antibodies remain high after consideration of food and drug triggers then you may want to take a closer look at other things your body comes into contact with.

This slide from my conference this weeks shows some of the other triggers. Heavy metal toxicity can come from exposure to contaminated air, water, toys and food. Heavy metals can interfere with multiple metabolic processes. There is research that shows a link between mercury exposure and thyroid antibodies and persons treated for heavy metal toxicity have had improved thyroid function after treatment.

The other area where we get huge exposures is personal care products and household cleaning or air freshener products that contain dangerous chemicals. Check out EWG.org to see if your makeup, shampoo, lotions, dishwashing liquids, etc. may be making you sick.

I have seen patients who successfully eliminated many possible triggers from their life and brought their antibodies down almost to the 'reference range'. Some of these had many nodules on a thyroid ultrasound which were no longer there after they searched for root causes and got rid of them.

So there is a glimmer of hope. We don't have all of the answers but many pieces of the puzzle are falling into place. Since unmanaged stress can also be a trigger, I leave you today with a stress-busting exercise.

ALTERNATE NOSTRIL BREATHING (Nodi Sodhan)

Use your thumb and ring finger to close one nostril at a time. You can either bring the index and middle finger to your forehead between your eyes or bend them.

First close the left nostril and breathe in through the right, then close the right nostril and breathe out through the left. Then breathe in through the left, close that nostril and breathe out through the right. This is one 'cycle'. Complete 10 cycles then relax and take 5 deep cleansing breaths, paying attention to the movement of air and how it moves through your airways, down into your lungs and expanding your belly as you inhale and how your chest and abdomen fall and draw in as you exhale.

Benefits of Nodi Sodhan:

- Inhale left, exhale right: Helps to make you calm and integrates unwanted negative emotions and stress. Excellent by itself before bed.

- Inhale right, exhale left: Gives clarity, and positive mood. Helps us to focus on what is important.

Namaste.









Sunday, September 16, 2018

Thyroid hormones - a primer

I attended a conference last week on Integrative Medicine and Mental Health and there was a lecture on the thyroid gland. As a Functional Medicine physician I see many people with thyroid disorders, mostly hypothyroid, so I chose that lecture (they offered concurrent sessions) to hear the latest scoop on the thyroid. The thyroid is a complex little gland that sits at the base of your windpipe just above the jugular notch. It is often described as being shaped like a butterfly but I think it looks like upside down angel wings.


The graphic shows a schematic of how the hormones from the region of the brain called the hypothalamus signal the pituitary gland to then signal the thyroid to make more hormone. Like I said, it's a tricky gland. So the most interesting part of the lecture to me was that conventional thyroid testing has been shown in studies to miss thyroid dysfunction and that a thyroid gland that is underperforming may be associated with mood disorders, particularly depression.


How might you feel if your thyroid is sluggish? 
  •  You might notice that you rarely sweat or that you seem to be cold when everyone else is warm. 
  • You may be constipated
  • If you are female you may have menstrual irregularities or infertility problems
  • You may notice hair loss 
  • You might have difficulty losing weight or notice you gain weight easily
  • You may lose the outer third of your eyebrows
  • You may be feel fatigued
  • You may have difficulty concentrating
  • You may be depressed



If you two or more of the above symptoms, you may want to get your thyroid checked. Your doctor can examine your thyroid gland and see if it is enlarged. Most physicians were taught that the best screening test for thyroid function is TSH. This is incorrect! New studies show that up to 80% of thyroid dysfunction will be missed with just a TSH level. Ask you doctor to get a Free T3 level and a reverse T3 level along with the TSH. They may want to get a T4 or free T4 but these are secondary in importance to the Free T3 and reverse T3.

Conventional doctors may not realize that optimum levels of hormone are in the upper ranges of the 'reference range'. For example, if the reference range at your lab for Free T3 is 2.1 - 4.4, then your Free T3 should be around 4.0 for best function. Most people feel better once the Free T3 is above 3.2 but in Functional Medicine we think of a reference range as analogous to the normal range of shoe sizes. One size does NOT fit all and your 'fit' may be different from mine.

If you are already taking a thyroid medication it is likely that you were given a synthetic form of thyroxine or T4. Synthetic thyroxine is designed to act like T4 - the main hormone your thyroid gland makes. Unfortunately, sometimes things like stress, trauma, infection, inflammation and extreme dieting can cause the conversion of T4 into active T3 to be diverted. This diversion, shown on the graphic below, results in the T4 being converted to REVERSE T3 (which the lecturer dubbed the 'evil twin' of T3). 



Reverse T3 acts like a brake on the thyroid and prevents some of your T3 from gaining access to the cell nucleus (so it can't do it's job). It's a double whammy. The T4 can either turn into T3 OR reverse T3 so every time it converts to reverse T3 you have less T3 to work with AND the reverse T3 blocks the T3 from doing its job! You can see why it might be important to check the reverse T3 level.

If you think your thyroid may be dysfunctional - stay tuned! Next week I am at a conference but hope to post more about thyroid disorders, including autoimmune thyroiditis (Hashimoto's), and how they can be managed.

Today's De-stress meditation -
    'The more and more you listen, the more and more 
      you will hear. The more you hear, the more and more
       deeply you will understand.' -Khyentse Rinpoche

This is adapted from Luminous Mind by Joel and Michelle Levey:

Sit quietly and pause in your thinking and relax. You may want to set a timer for 3 - 5 minutes once you are ready to begin.

Take a comfortable posture, either sitting upright with feet on the floor and hands resting in your lap or lying down. Relax your forehead, soften the eyes, close the eyes and relax your jaw muscles and neck. Notice your body moving in rhythm with your breath. Begin to notice the sounds in your environment. Imagine your mind is an antenna, picking up all the arising sounds around you. In this state of receptivity, your mind is a place of awareness of sounds rising and falling into silence. Without thinking about the sounds, just let them come and flow. If your mind wanders off into thinking, just smile at yourself and mentally say, "Listen.." without judgment.
Notice how the sounds dissolve back into silence and how your listening mind is like the vast, clear sky that can contain limitless sounds without any getting in the way of the other. Breathe, listen and smile. 
When the timer sounds, if you used one, bring your awareness back to your breath for a few moments then open your eyes.

Namaste.

Sunday, September 2, 2018

Healthy Adrenal glands - Why we can't live without them

I hope this long holiday weekend is allowing everyone some time to rest and rejuvenate!  I see a lot of patients in my Functional Medicine practice that have adrenal dysfunction and regular down time is essential to preventing adrenal meltdown and self-care is part of the restoration plan when the adrenals are already in trouble.

These two tiny glands sit on top of the kidneys and are divided into the cortex and medulla. The adrenal cortex makes your steroid hormones. In a previous post, I displayed a chart of these hormone production pathways. Glucocorticoids like cortisol and corticosterone, mineralocorticoids like aldosterone and the sex steroids - progesterone, DHEA, testosterone and estrogens - are all produced by the adrenal glands, although the majority of testosterone and estrogens are produced in the reproductive organs.

When overly stressed, the 'raw material' (cholesterol) used to make the steroid hormones will be allocated primarily to make cortisol. Long-term overproduction of cortisol can lead to weight gain, diabetes, high blood pressure, lowered immune function, difficulty sleeping or a host of hormone imbalances.

Eventually, if chronic overproduction continues, some people develop a deficiency in cortisol which leads to chronic fatigue, low blood sugar, salt craving, low blood pressure or the inability to cope with even the smallest amount of stress. Along with low cortisol, most of these people also suffer from low DHEA which is an important precursor to testosterone and estrogen.

Research is ongoing to find out all of the ways DHEA impacts our functioning but one way that is emerging is to decrease inflammation that promotes the loss of neurons in the brain. DHEA may also be an important source of hormones for women after menopause. I always check DHEA levels in my patients and don't recommend taking a supplement of DHEA unless you have been tested and know you are deficient.

Your functional provider should also assess your levels of estrogen and testosterone and progesterone if adrenal dysfunction is suspected. If there are any memory issues, pregnenolone (precursor to progesterone) should also be assessed. After we finish hormones I will post on memory loss and how to reverse or avoid it! For now, let's focus on how to preserve your adrenal glands.

I wrote about developing a mindfulness practice in a previous post and want to also mention meditation. I think of meditation as an exercise for the brain. While the brain is developing the ability to focus on something mundane and non-threatening, the adrenal glands are having some 'down time' which builds resilience. I recommend a free app like 'Stop, Breathe and Think' or 'Insight Timer' to get started.

You can also use magazines or books like these pictured to help you keep it interesting and grow your knowledge of the various ways to engage in meditation. Some think because they pray they don't need to meditate but I remind them that praying is actively engaging in an activity that might bring more worries and is a way of asking instead of receiving. I think of mediation as listening and receiving wisdom, along with being a mini-vacation for the adrenal glands.

One of the most important ways to preserve the adrenal glands is to get enough sleep. Having a routine and getting to bed and to sleep allows your body to replenish and restore itself, particularly the brain and adrenals. If you've burned the candle at both ends for too long you may need to get 8-10 hours nightly for a minimum of two weeks before you begin to feel rested after a good night's sleep.

If you fall asleep but are awakened throughout the night you may need to have your adrenal function assessed to see if you need to take supplements to help your adrenal glands and improve your ability to stay asleep.

Having good 'sleep hygiene' will help you get better quality sleep. This means setting a certain time to wind down and prepare for bedtime. I have an app on my laptop called 'f.lux' that reminds me when my bedtime is 3 hours away and blocks the blue light from the screen that can stimulate the pineal gland and impair it's ability to make melatonin, a hormone essential to good sleep.

I have patients who benefit from having a certain bedtime ritual. This can mean taking time to soak in Epsom salts, journaling, using essential oils in a diffuser or listening to soothing music. My ritual includes reading something that won't stimulate my brain too much. Right now I'm re-reading the Harry Potter series - non-stimulating because I know what's coming - but sometimes I read meditation magazines.

So in summary, to keep your adrenal glands humming along you will need to meditate regularly, develop good sleep hygiene and get at least 8 hours of sleep each night, practice mindfulness and self-care and find activities you like and do them regularly and identify those things that bring you negative energy and avoid those things. If you are struggling then don't delay in getting your adrenal glands tested so you can begin the process of repairing them. There are herbal teas like 'Stress-Ease' from Traditional Medicinals that can help, along with adaptogenic herb supplements to prop up your adrenal function but they should be part of an overall plan to pamper your adrenals.

I leave you today with a Sabbath Meditation:

Take a comfortable seat and close your eyes. Take five deep cleansing breaths - focus on the air movement and the way the body expands during inhalation and draws in on the exhalations. Begin to relax your face, neck, jaw and move down your body until all tension is released.

After the five breaths, begin to focus on the concept of a day of Holy Rest. Release any need to 'do' something to be worthy and realize that just 'being' in the Presence of your Maker is enough. Let your soul relax. Contemplate letting go of doing, letting go of acquiring, letting go of making, letting go of expectations. Allow yourself to sit in the Divine Presence and just be. Receive the Divine Qualities that are being offered to you. Feel Divine Unconditional Love showered upon you. Open up to Forgiveness, Lovingkindness and Compassion. Receive Peace.

As you become full to overflowing extend these Qualities to those in your life, blessing them with the Blessings you have received. Once you have blessed your loved ones, extend those blessings to your community, then to your country and then to the entire world and out into the Universe.

End your meditation by returning to the breath. Take five deep cleansing breaths, focusing on the movement of the air and the way the body expands during inhalation and draws in on exhalation. Bring your awareness back to your body and slowly open your eyes.

Namaste.






Sunday, August 26, 2018

Medical Detox - the basics

If you've followed this blog so far, I have been writing about hormone balance and the health consequences of being out of balance. I've covered the why of detoxing in a previous post. Today I will explain the basics of working with a Functional Medicine doctor (or Integrative practictioner) like myself to do a guided medical detox.

 As you can see in this photo, there are lots of different detox supplements out there. How do you choose one that will work for your situation? That is one of the reasons for getting medical guidance.

It is especially important to get help with doing a detox if you have any metabolic disorders (high blood pressure, diabetes, high cholesterol, overweight, menopause, autoimmune disorders, hypothyroid, etc.) precisely because your individual set of circumstances will impact the way you should proceed and a Functional or Integrative practitioner can make recommendations to individualize the process for you so that you don't suffer any bad side effects.

After an initial physical exam and laboratory evaluation, your practitioner should be able to suggest a detox that will work for your lifestyle, motivation and goals. It is important to note that most toxins are stored in fat tissue and you should do a detox before you lose weight so you don't release all the toxins into your body and move them around to your brain or bones!

 There are 'detox kits' that usually include a medical shake mix like the one pictured and a detox supplement to improve your detox pathways. These kits include suggestions of how to best utilize the shake and supplement to achieve the maximum results. Your practitioner can tailor the suggestions to meet your needs.

To move toxins out of your body efficiently your practitioner can help you improve the performance of your kidneys, liver and lymph systems - the main pathways by which toxins are removed. You may also need to use a fiber supplement to increase the frequency of your bowel movements.




Since many toxins are secreted into the colon for elimination, if you don't have at least two bowel movements a day during the detox you may be reabsorbing the toxins and storing them away in various body tissues, including your bones and brain! You definitely do not want to do that.

Your practitioner can help you find the right fiber supplement for you. I have a sensitivity to oats, which are an ingredient in many fiber supplements, so I found this one from Vital Nutrients that doesn't have oats in it.

When I prescribe a detox I always recommend taking a few days to plan meals and get groceries since the therapeutic foods that help the detox pathways are the key to getting the best results. If you eat inflammatory foods or foods that slow down the metabolic pathways that need to work at full capacity to move toxins, then you will not get good results and may even do damage to your health.

I also recommend picking a time frame that will allow you to follow the detox plan without getting into situations that will defeat you. Most detox programs require a commitment of 10-28 days, depending on how much you want or need to achieve. It would not be a good choice to start a detox the week before vacation or a holiday or travel.

You will get the best results when you can cook your own meals and eat organic foods, so you should plan ahead and choose wisely. I think it is good to do a short detox at least once a quarter and plan a longer detox in January just after New Year's. I'll be doing another short detox in early October and blogging about it.

Meanwhile, we have covered several ways to help balance hormones - reducing inflammation, detox and practicing self care and mindfulness. Next week we will talk about the adrenal glands because if they aren't functioning properly all of your other hormones can be thrown out of balance.

I leave you with my organic arugula salad. Yesterday was a day when all the stars aligned and I was able to get to the Farmer's Market early enough to snag some hydroponic arugula before it sold out and one of the vendors had fresh picked figs. I had just bought a new goat cheese to try and some organic walnuts and so a salad was born.

Arugula Salad with goat cheese, figs and walnuts:


The goat cheese was Vermont Creamery 'smoked pepper jelly'. I dressed it with himalayan salt, fresh cracked black pepper and organic olive oil and white wine vinegar. It was yummy!

Sunday, August 19, 2018

Unexpected Detour

My plan was to post about working with an Integrative or Functional Medicine practitioner to do a supervised detox this week. In last week's post, I wrote about the basic principles of a detox and why you might benefit from an occasional detox. BUT - sometimes Life gets in the way and our best laid plans go by the wayside. This was one of those weeks!

I work in a fairly busy Integrative/Functional Medicine/Chinese Medicine clinic and we are transitioning to an EHR (Electronic Health Record) for the first time from paper. Paper is very inefficient so eventually, once we are all familiar with the system and have customized it for our purposes, we will be able to store the paper charts and just work on the computer but right now our charts aren't scanned in and it has been a little crazy to say the least!

So I realized on Friday, when we were having a Team Building day (and I had to go back to the office afterwards to finish my digital 'Task list') that I had not mentioned one of the most important components of ongoing detox - Self Care.

In our hectic modern society, we tend to work overtime during the week and overextend ourselves on the weekends. This leaves our adrenal glands - tasked with handling day-to-day challenges - without any reserves and sometimes just depleted to the point of exhaustion.

Taking time for self-care by literally stopping to smell the roses or reading a book or just hanging out with a friend doing nothing can allow you to put some 'money' back in the adrenal 'bank'.

SO - instead of researching my post and writing it yesterday, I went with a friend to Gibb's Gardens near Ball Ground, Georgia, which is just northwest of where I live in Alpharetta. Around every bend in the garden path is a new delight to appreciate, if you take the time to notice and be in the moment - a practice called mindfulness.

I recommend developing a mindfulness practice as part of an ongoing self-care regimen. Mindfulness allows you to connect with what I like to think of as your 'primordial self' - the you that you were before you were born and Life happened to you. This self doesn't have an Ego to tend but is perfect in every way and connected to the Source of all Being. When you connect to this Self, you can be more grounded, more compassionate, more loving, more present - you can receive from the Giver of all things whatever you need to be content.

When I first got started practicing mindfulness, I read some of Jon Kabat-Zinn's books.  I like Mindfulness for Beginner's and Full Catastrophe Living but he has many from which to choose. I also recommend Search Inside Yourself by Chade-Meng Tan which was written to explain both the personal and corporate benefits of mindfulness. I like it because each chapter is short and sweet and usually has a mindfulness exercise to try.

I also recommend to patients that they combine movement and mindfulness in some way to improve brain health. This could be yoga, tai chi, mindful walking, qi gong or visiting a garden and stopping to notice butterflies like the one above. So I was practicing what I preach by taking a break when my body was telling me I needed a break and so our discussion of a medically supervised detox will have to wait until next week.

Meanwhile, get out there and be mindful so your brain and adrenal glands can be healthier! That will help you have more balanced hormones and help your body avoid the possible diseases that result from being over-stressed.

Peace.


Sunday, August 12, 2018

Detox to balance hormones

In last week's post I began to discuss hormones and how imbalances can contribute to the development of diseases. The first step we covered to help improve hormone balance was reducing inflammation. This week I want to talk about the second step to help improve balance - detox. If you are unfamiliar with detox, this post will be a primer. 

I should explain that when I speak about detox I am talking about a metabolic detox, not getting off drugs or alcohol! 

Why do we need to detox? Glad you asked.

Our environment has been polluted by harmful chemicals, many of which directly affect our hormones to induce imbalance and disease. These are commonly referred to as endocrine disrupting chemicals - EDCs.

You may have heard about BPA (bisphenol A) in plastic bottles and packaging. The ZRT hormone assessment mentioned last week includes an assessment for BPA because it mimics estrogen in the body. If you think you are safe because you don't use plastic, think again. BPA is used to line cans containing food and it coats cash register receipts. 

Here is a list of the top ten EDCs as researched by the Environmental Working Group (EWG). If you read through each hazardous chemical group in the publication (download the pdf), you will see that our air, water, soil, personal care products, our bodies and food are all contaminated. THAT is why you need to detox.

<- Detox teas

If you've never done a detox or have a lot of metabolic problems like diabetes, high blood pressure, heart disease, autoimmune disease or cancer, you should first work with a Functional Medicine practitioner like myself to prepare yourself for a detox.

If you aren't able to work with a doctor, you can encourage gentle detoxification with teas like these made by Pukka or an organic dandelion tea and by eating cleaner foods to help lower the toxic load in your body. If you message me, I can send you a detox food list to help your detox pathways work better. Eating colorful foods and being strategic with your food choices can improve your ability to detox.

Your liver is your main organ of detoxification. It is in the liver that substances are transformed, in what is called Phase I of the detox process, mainly by enzymes in the Cytochrome P450 family, into polar molecules that are then either moved into bile for excretion or further changed via the Phase II detox pathways.

Your hormones are metabolized via the Phase II pathways - after having been changed in the Phase I system - by conjugation with moieties that allow your body to then excrete the conjugated molecules. Estrogens end up conjugated through glucuronidation and are then moved into the bowel for elimination.

If you don't have good bacteria in your intestines, some non-beneficial bacteria (like the families that thrive on sugars and carbs) can uncouple the estrogens from the glucuronide moity, which allows the uncoupled estrogens to be reabsorbed and go back into circulation. This is one of the ways you can end up with excess estrogens and hormone imbalance.

Your body also moves toxins out through your kidneys and lymphatics via urine and sweat. Lymph can also move toxins into your intestines for elimination so having regular bowel movements is very important for detoxification.

Help your kidneys work better by drinking water. Hydration is another important way you can help your detox pathways on a daily basis. Your minimum daily water requirement can be calculated by taking your weight in pounds and dividing by two. If you weigh 140 pounds, drink 70 ounces of water a day minimum.

You can help your lymphatics by exercising to improve lymph flow and increasing your sweat production. Getting a massage also improves lymph elimination and using an infrared sauna can help you detox with increased sweat.

So to sum up:

  • Find out where you are being exposed to toxins in your food, water and environment and remove toxins as much as possible by eating clean foods (use the Environmental Working Group list to know which foods have the highest pesticide burdens).
  • Know where Endocrine Disrupting Chemicals come from and get rid of them to help balance your hormones.
  • Hydrate adequately every day.
  • Drink green tea and detox teas 
  • Eat colorful foods and plenty of fiber to have 1-2 bowel movements daily
  • Exercise regularly
  • Sauna to increase sweat and get a massage if possible to improve lymph flow
Next time I'll cover doing a doctor-supervised metabolic detox. Meanwhile, here's another detox shake you can make:

Pear Detox Shake

1/2 - 1 cup greens (kale, spinach, chard, red butter lettuce)
1 frozen or fresh pear, in chunks
10 frozen cherries
1 T ground flaxseed
2 T MCT oil
dash cinnamon
2-4 peppercorns
Vegetable protein to provide 15-22 grams protein
1 shot organic aloe (if available)
8-12 ounces hemp milk or cashew milk
ice

You can make this a chocolate shake by adding 1 T organic cacao powder, 2 T organic cacao nibs.

Blend in a high speed blender and enjoy. Add extra liquid if needed to get the right consistency.

Happy detoxing!









Sunday, August 5, 2018

Hormonally speaking..

What do you think of when someone mentions hormones? Most of us think of the sex steroid hormones. For women, this translates mostly to estrogen and progesterone and for men, mostly testosterone. Here is one of the teaching tools I use in practice (not an exhaustive list) when addressing the sex steroid hormones:

<- Steroid Hormone Cascade


This flow sheet is from a ZRT urinary metabolites report, just one of the options for assessing hormones.

You might notice (sorry for the tiny print) that cholesterol is at the top. It is the backbone of all of the other steroid hormones. Most patients are surprised to hear that.

I recently had a very stressed patient whose cholesterol had gone up in the last six months, despite her efforts to control it with diet, lifestyle and supplements.

If you look down the line flowing second from the left you will see cortisol. Cortisol is the main hormone from the adrenal gland that helps your body manage any stressors. Stressors can be good or bad, happy or sad. Divorce, moving, a new baby, death of a loved one - all are stressors. In the metro Atlanta area traffic is a stressor! Just making a Target run can add a little stress to your day.

So, I explained to my patient that her body may be making more cholesterol in order to meet the demand for cortisol. As I told her, cholesterol is the brick and when you need to build a house you will need more bricks. So if you experience daily stress for a prolonged period of time, you can see that the demand for cortisol might throw the other columns out of balance.

Hormone imbalance is the root cause of many symptoms, like PMS, PCOS, fibroids, ovarian cysts, irregular menses, weight gain, mood changes and libido changes. Since I get questions about managing hormone imbalances and see patients every day that are suffering from one or more imbalances, I thought maybe over the next few weeks we could cover hormones and how imbalances impact your health and what you can do about them.

There are hundreds of other hormones in the body but a few that will be important in this discussion, besides the sex hormones already mentioned, are the thyroid hormones that regulate our metabolism, melatonin, the hormone that regulates sleep, and the hormones that impact appetite and blood sugar control, leptin and insulin.

One very important factor in hormone imbalance is inflammation. We become inflamed because our food is inflammatory and our environment is inflammatory. Foods are either intrinsically inflammatory (containing too much sugar or omega 6s) or become inflammatory through processing or cooking methods or overconsumption.

One of the tools I get from IFM is a chart developed by nutritionists called the Phytonutrient Spectrum. It illustrates the positive effects of eating a rainbow of colors. The foods that are listed as anti-inflammatory include red foods - apples, red beans, beets, blood oranges, strawberries, rhubarb, tomatoes and watermelon (the actual handout has many more examples), yellow foods like apples, bananas, corn, ginger, pineapple and summer squash, green foods including (again not an exhaustive list) apples, asparagus, broccoli, celery, greens, okra and zucchini, and purple foods like bell peppers, berries, cauliflower (yes, it comes in purple), eggplant, figs, prunes and purple or black rice.

Just adding color to your diet will add natural anti-inflammatory properties to help lower your overall inflammation and balance your hormones. The best way to eat many of these foods is raw but some actually deliver more anti-inflammatory properties when lightly steamed or baked (broccoli's impact is increased with light steaming, tomatoes increase their lycopene content when baked but have more vitamin C raw).

The worst way is to blacken foods. The blackened parts are called Advanced Glycation End products or AGEs and they increase oxidative stress and inflammation (which accelerates the aging process).


<- Red, Yellow, Green & Purple!

Most people don't realize that dairy and animal fat are the most inflammatory foods because of the high omega 6 content. Most omega 6 fatty acids convert to arachidonic acid, which is mostly inflammatory in the body. There is a great book called The China Study that follows the adventures of a cancer researcher who set out to find out why children overseas in food impoverished areas suddenly began having liver cancer. I highly recommend it to anyone wanting to know the impact of what we eat on our risk for disease, including cancer. He also covers how corporate influences affect governmental agencies like the FDA, which was originally created to protect the health of the public but with corporate interests involved, not so much.

Besides adding color to your diet, you can take anti-inflammatory supplements like turmeric, ginger, boswellia, fish oil and resveratrol. Work with a Functional Medicine (like myself) or Naturopathic or Integrative doctor to determine the right doses for you. In general, you won't get therapeutic doses at a Target, Walmart or GNC and those cheaper supplements may contain contaminants so don't waste your money.

Exercising is another good way to lower inflammation, if you don't overdo it. Start slow and gradually work up to 30 minutes at least 5 times a week. I usually have patients start with some stretching and work up from there, incorporating breathing to also help lower stress.

So to sum up - lowering inflammation is one way to help balance your hormones. Avoid dairy and beef and pork (meats with the most animal fat), avoid processed foods (tend to have a lot of omega 6 fatty acids), eat more colorful foods, avoid sugar (or foods that turn into sugar like white bread, white rice and white potatoes), take anti-inflammatory supplements and get off your rump and move!

I'm doing a detox this week to help my body get rid of unwanted endocrine disrupting chemicals and other environmental toxins that can cause inflammation and hormone imbalance so next week will be a primer on detox. I like detox shakes so am sharing my watermelon shake recipe today. You will need a vegetable protein shake powder. There are formulations made specifically for detoxing, which I'll cover next week.

Watermelon detox shake:

Watermelon, chopped, approximately 2 cups
1/2 frozen pear (if you use fresh you'll need more ice)
1 ice cube of pomegranate juice, frozen
1/2 c spinach
juice of 1/2 lime
3 T MCT oil
1 tsp flax oil
Protein shake powder to provide 15-22 g protein(unflavored or vanilla)
8-12oz coconut water
ice

Place all into the carafe of a high-speed blender and blend.

I use a Vitamix but any high-powered blender will do. Enjoy!