Sunday, December 8, 2019

Better health through better food

Yesterday I went to the Alpharetta Holiday Market and the best part was visiting with this lady. Follow her on Instagram @CherokeeMoonMixology. Buy her stuff. It's amazing!

As you can see, I have sampled all of these (and bought up seven different kinds of her tonics, shrubs, vinegar and bitters!)

The tall bottle is a culinary vinegar - all organic and SO flavorful it will inspire you to invent recipes!

So last night while watching LSU dominate Georgia (condolences to my Georgia friends), I made a marinade for ribs. And not just any ribs - I had a half rack of ribs from Iverstine in Baton Rouge.

If you haven't tasted the difference between mass-produced meat and small farm pastured heritage breed meat you are definitely missing out! Their pork is so yummy I won't cook with anything else.

So I had my defrosted ribs and concocted the following marinade:

1/2 c organic safflower oil
1/4 c Bourbon & GA Peach vinegar(in the photo above)
1 T organic blue agave
1 tsp garlic powder
1 tsp onion powder
1/2 tsp red pepper flakes
2 T Smokehouse shandy (see picture above)
I whisked all these together and then placed the ribs(meat side down) in a ceramic dish and poured the marinade over them and covered them with foil. They marinated overnight in the fridge.

I am trying to be more intentional about the integrity of all of the ingredients in my food and the safety of the containers I place my food into and the safety of the cookware I use. Remember that everything our food touches can contaminate (or enhance) the food.

If you use cast iron to cook with you could get some traces of iron in your food each time you cook (not a bad thing!) but if you use aluminum then you could get aluminum in your food which is not necessarily a good thing as excess aluminum (not just from cookware, it is also in your deodorant and other personal care products) is linked to Alzheimer's disease.

That being said, I am cooking the ribs on a stainless steel rack in the oven on 245 degrees for at least 3 hours. I made an aluminum foil tent over them instead of wrapping them in foil so they are not in direct contact with the foil.

The Zen Vin in the photo above is a tonic designed to help you 'chill' after a stressful day of Christmas shopping (or just life). It has lovely lemongrass, Holy basil, lemon balm, passionflower and other auspicious herbs which all work to raise your calming neurotransmitters and settle down your overactive sympathic (excitatory) neurotransmitters (the chemical messengers that make you anxious).

Since the Zen Vin is a tonic you can place a dropperful directly under your tongue or several droppers into a shot glass and top it off with a splash of sparkling water and shoot it (as I did). Ahhhh - just what I needed before going to Target on a weekend before Christmas.

If you get a chance this weekend, consider going to see Dark Waters with Mark Wahlberg. He did an excellent job bringing a very important subject to the big screen. It will make you mad and make you want to raise your awareness about how much our environment is contaminated and how dramatically it impacts our health and the health of our children. See it! You may need some Zen Vin afterwards. Or some Pukka Relax tea (if you aren't able to get the Zen Vin).


Sunday, October 27, 2019

Testosterone - the sequel

This post will be short and sweet as I am packing to go to the ILADS conference in Boston. Woohoo!

This graphic is from Spectracell labs and covers almost everything I'm discussing today - how nutrients affect hormone production, specifically testosterone.

Some of these nutrients you would expect to get in your regular diet but the 'Standard American Diet' or SAD is dramatically void of the required nutrients because of over processing and soil depletion from over-farming.

In my Functional Medicine practice I test for vitamin and mineral levels and frequently see many deficiencies. Most common is vitamin D deficiency. The reference range is usually around 30-100 ng/ml (very wide) but optimal levels are above 50, which I rarely see in people who do not supplement. Vitamin D regulates the production of testosterone (acting like a hormone) so low vitamin D means low production of testosterone.

Vitamin K2 (there are two main forms of K - K1 and K2) is necessary for the enzyme which drives testosterone production to work so a deficiency in K2 will result in lower testosterone. There are now some high quality supplement manufacturers that are offering vitamin D3 and K2 in a combination form since both are also needed for maintenance of strong bones by helping move calcium into your bones. Talk to your integrative or functional medicine doctor about what dose might be right for you.

Most people do not need to supplement vitamin E as it is found in olives, olive oil, avocados, almonds, shrimp, squash, sunflower seeds, spinach and broccoli. Doses above the minimum recommended amounts for a long period of time may lower testosterone.

Folate and B6 are important B vitamins that support healthy testosterone levels. Here is a report on an association between low folic acid levels and erectile dysfunction. Leafy green vegetables like spinach, oranges and other citrus fruits and whole grains are good sources of folate.

B6, or pyridoxine, is found in pork, poultry, fish, grains, eggs, soy beans, peanuts and vegetables so you likely get enough in your regular diet. Don't take more than 10mg daily unless instructed to do so by a doctor.

Zinc and Magnesium are two important minerals that affect testosterone. Both are commonly deficient in my patients. I usually check RBC levels of both, as well as serum levels. Zinc should be around 90-110 mcg/dL optimally and is found in meat, shellfish(oysters!crab!yum!), legumes (like chickpeas and lentils), nuts, seeds, dairy, eggs and whole grains.

Magnesium levels should be about 2 mg/dL You can get it by eating spinach, almonds, tofu, dark chocolate, bananas, avocados and quinoa. A deficiency in either of these important minerals may cause low testosterone. If you supplement with magnesium you should get either glycinate or citrate chelates for better absorption, Magnesium threonate crosses the blood brain barrier and can support brain health. Magnesium sulfate (Epsom salt) is nice for sore muscles, twitchy muscles and detox.

Carnitine is found in red meat, poultry and dairy. beans and avocado. It may prevent the loss of testosterone after strenuous activity and may increase dopamine levels which usually correlate with testosterone levels. If you are vegan you may need to supplement with acetyl-l-carnitine.

Last but not least, vitamin C may be protective of the prostate in the presence of testosterone related tumors. A good maintenance dose of vitamin C is 1000mg daily. I recommend 2000mg daily in flu season for the immune boosting benefits. Vitamin C is found in broccoli, cauliflower, kale, oranges, kiwi, strawberries, cantaloupe, papaya, red, green and yellow peppers, sweet potatoes and tomatoes.

Lifestyle also matters - exercise, especially weight lifting, and eating a diet without sugar or alcohol and keeping blood sugar in the normal range helps to improve testosterone levels. If you or a loved one has noticed low energy, loss of sex drive, loss of muscle mass, 'man boobs', depression or moodiness, have your/his testosterone levels checked and help him get his mojo back with lifestyle and dietary modifications and supplement support.


Sunday, October 6, 2019

Testosterone - the nitty gritty

Whole books are written just about the male hormones so I'm going to try to cover the basics of testosterone for men and women.

<--------ORGANIC FOOD - helps keep hormones in balance!

Testosterone is the determining hormone of male external sexual characteristics. If an XY embryo has a defect that doesn't allow the production of testosterone then the external genitalia will be female by default.

Testosterone is secreted by the ovaries in women, testes in men and by the adrenal gland in both sexes. It will provide a healthy libido, help maintain bone density, prevent loss of muscle mass (common in aging), increase muscle strength, contribute to motivation, allow you to remember by maintaining the neural pathways that affect memory, increase fat burning and improve skin tone.

In men testosterone influences sperm production, health of the prostate gland and is an important contributor to mood and motivation.

So how can we balance this important hormone? First let's look at symptoms of imbalance:

Women might notice the following issues if they have too much testosterone -

  • Hirsutism (unwanted hair, especially on the face and chest)
  • Increased abdominal fat
  • Acne
  • Scalp hair loss
  • Irritability
  • Rage or increased anger
  • Sagging breasts or decreased breast size

If they have LOW testosterone, women might notice -

  • Loss of muscle mass
  • Fatigue
  • Low or absent libido
  • Low bone density
  • Increased body fat
  • Decreased motivation
  • Depression
  • Hair loss
  • Dry skin or poor elasticity
  • Loss of vitality
Men usually suffer from low testosterone as they age for various reasons and may experience

  • Increased abdominal fat
  • Loss of muscle mass
  • Erectile dysfunction
  • Low libido
  • Impotence
  • Fatigue
  • Bone density loss
  • Prostate problems
  • Sleep disruption
  • Loss of vitality
  • Increased risk of heart disease and death
  • Depression
  • Hair loss
  • Dry skin and/or poor elasticity
Occasionally men taking exogenous testosterone will have too much testosterone and have

  • Increased agressiveness
  • Acne
  • Increased temporal or scalp hair loss
  • Prostate enlargement
  • Increased hemoglobin and red blood cell numbers
  • potential for increased chance of cancer

So how can we keep it in balance? Most importantly both men and women should remove xenoestrogens (hormone disrupting chemicals) from their lives as much as possible. Most of the exposure comes from increased use of pesticides (another reason to eat organic) and other agricultural chemicals. Phthalates (see here for more info) found in cosmetics, soaps, some plastics (including sex toys) can cause suppression of testosterone production.

Since the adrenal gland is involved, stress management (discussed here) is key to balancing testosterone production. I also recommend doing an adrenal stress test to see if you need adrenal support supplements. Some of these supplements increase cortisol production (which could be bad if you already overproduce) and some decrease or balance cortisol production (which you don't want if you are already too low) so testing is critical to getting the right adrenal support.

The third 'pillar' of testosterone balancing is eating a LOW glycemic diet. Keeping your A1c below 5.7 will improve your hormone balance by lowering insulin. Regular exercise will also lower insulin and improve hormone balance.

For men, exercise can actually raise testosterone levels back to normal if insulin is in the normal range. For men worried about heart disease, exercise is important to improving cholesterol and the lowering the risk of heart disease. Men should try natural methods of cholesterol management before statins as they have been found to lower testosterone production.

To sum up - the following will help improve testosterone balance:

  • Clean up you diet and environment to avoid EDC (endocrine disrupting chemicals)
  • Practice stress management (including getting enough sleep)
  • Have your adrenal gland function tested by a Functional Medicine or Integrative health practitioner
  • Eat colorful organic foods in a Low Glycemic way
  • Exercise at least 150 minutes weekly
  • Have sex regularly
  • Eat enough healthy fats and complex carbohydrates and protein
  • Get exposure to morning sunlight
These are just the basics of keeping a healthy testosterone level. See a Functional Medicine or Integrative practitioner for help if you are doing these things and still experiencing symptoms.

Hope you are having a break from the heat today - get outside and enjoy it!

Dr. M

Sunday, September 1, 2019

Change happens

IT'S ALREADY SEPTEMBER - how did that happen?

The month of August was a whirlwind - lot's of change happening. We went to New York to celebrate my son's graduation from high school (late, I know) and then my birthday was squeezed in between the trip and leaving 7 days later to help him move into his dorm in New Orleans. Go Wolf Pack!

I'm just now finishing unpacking from that trip and washing the stinky clothes he left behind!

So now I'm an empty nester.

The photo is our dog, Max, looking very gray now as he is almost 11 years old. I got him a new toy because he seems a little down since I came back without his best buddy. Change is hard on pets, too.

Meanwhile, I handed in my notice at my current job and am going to be working with other Functional Medicine providers nearer to my house in Alpharetta. I'm excited about helping women and men with their hormones and their overall health.

So big change is happening and all change, good or bad, is stressful. I've got tons of supplements to help with stress but the first step to handling change well is to build up and support your adrenal gland.

The main way to do this is SELF CARE. Women are the worst at this because we spend so much of our existence taking care of others. I've outlined some of the steps to good adrenal health in a previous post. So today I am focusing on facing and embracing change.

When faced with change we all get a little nervous because of the uncertainty. When there are areas of our lives that we are comfortable with and those begin to shift we get uncomfortable. Resistance to change is a natural reaction but to paraphrase a famous saying - nothing in life is certain except that change happens.

Last week one of my yoga instructors provided the metaphor of pulling weeds. Sometimes you look outside and wonder - where did all of those weeds come from? The same thing can happen in our lives - all of a sudden we are aware of things becoming uncomfortable and realize that we've allowed things to slide and we need to change - we need to do some internal weed pulling (or some actual weed pulling).

Maybe we need to forgive ourselves or others. Maybe we need to be more thankful. Maybe we need to be more compassionate or kind to others. Maybe we need to let go of grudges or judging others. Maybe we need to let go of beliefs that no longer serve us.

To grow requires change and sometimes change happens and we realize we need to grow. So in order to embrace change I offer two practices to help you through it.

The first is contemplation or mindfulness practice. This involves taking a scripture or affirmation and repeating it with each breath. I take a comfortable seat and close my eyes and focus on my breath, noticing the air moving in and out of my airways and the expansion of my belly on the inhale and contraction of my diaphragm on the exhale.

After a few breaths of focusing I say the scripture or affirmation while breathing in and repeat on the exhale. An example would be 'I am thankful for all of my blessings'. As I inhale I say to myself silently 'I am thankful for all of my blessings' and I repeat that on the exhale. I have rosary beads and bodhi beads that I will sometimes use to help with counting the breaths.

A common yogi mantra is 'Om Mani Padme Hum' repeated with each breath or counted on mala beads. This mantra expresses our desire to be as One with our Source of Being by receiving wisdom and enlightenment. It is said that reciting it regularly will help you pull the weeds of pride, jealousy, ignorance, greed and aggression.

The second practice is a breath practice from Ashley Neese called Letting Go.

She describes doing it standing but if you have blood pressure issues or are pregnant you can do it sitting down. If standing, stand with your feet hip distance apart and let your arms rest down by your sides. Don't lock your knees.

Set an intention to let go of whatever is not serving you.

Take a few breaths in and out through your nose and repeat the intention.

Inhale deeply while raising your arms up over your head.
Hinge at the hips as you lower your arms toward the ground and bend into a forward fold as you exhale with a great big sigh through your mouth.

Repeat this ten times, inhaling and sighing as deeply as possible.

Rest and take a few breaths and notice how you feel. Close your practice and journal if you wish.


Sunday, July 21, 2019

Prevent cancer one plate at a time

Some of you may not be aware that our bodies make cancer cells all the time. Every day. Don't go into a spiral about it - your immune system is designed to kill the cancer cells and keep you healthy.

But in this crazy world we are exposed to lots of chemical toxins which are poisons and the poisons keep our immune systems VERY busy so it is more and more likely that the cancer cells will escape notice and be able to grow.

So one way to help reduce the chances of cancer growth is to eat clean food - organic food, pasture raised meats (beef, chicken, turkey and pork that haven't been fed pesticide laden grains or genetically modified grains)and wild caught or sustainably raised fish - and to avoid inflammatory foods.

I went to the Farmer's Market yesterday and got hydroponic lettuce, organic tomatoes and cucumbers, figs (not shown here because I ate them before dinner!) and various other vegetables (like asparagus and okra).

When I got home there was a Williams-Sonoma catalog in the mailbox with all kinds of cool cooking utensils and grilling paraphernalia and I got the idea for this post because HOW you cook your food and WHAT pans you use can also impact how healthy the food will be for you.

The bad news is that the char you love from grilling food is carcinogenic.There are dangerous chemicals in the smoke from smoking and grilling and it gets into the food and can cause cancer (has been shown to cause cancer in lab animals!). One study out of China has shown that when you are exposed to barbecue fumes you actually absorb more of the harmful chemicals through your skin than through inhalation.

BUMMER, right?

So you can do a few things to reduce your exposure to the harmful chemicals - use leaner cuts of meat (fat dripping onto the grill and releasing smoke increases the production of the carcinogens) - and marinate the meat to break down some of the proteins (the amino acids and creatine when heated to high temperatures can produce harmful chemicals). Take the skin off of poultry to prevent fat drippings from creating carcinogens. Trim the char off of the meat and don't eat it!

Also you can wrap meats, fish, fruits and vegetables in aluminum foil (not as exciting, I know!) to put on the grill and prevent some flame/smoke exposure. You can cook at a lower temperature for a longer period of time to reduce production of harmful chemicals.

So my plate above doesn't have any grilled items but I did caramelize the onions which increases the amount of Advanced Glycation End-products (called AGEs) which increase oxidative stress and accelerate aging and can contain harmful chemicals.

What will protect me from these AGEs?

Well the rest of the plate - hydroponic Bibb lettuce, organic cukes and tomatoes, the roasted okra that you can't see because I ate it all while preparing the liver - Grass-fed beef liver - natch.

Yep - that's pan fried liver with caramelized onions in the middle of the salad. I used a cast iron skillet and coconut oil. I soaked the liver in hemp milk (lots of omega 3s which are anti-inflammatory) and dredged it in sprouted gluten free baking mix with a little bit of coconut flour added for flavor and a lot of seasoning (paprika, ground chipotle pepper, garlic granules, and onion powder).

The dressing was olive oil and white balsamic vinegar with Himalayan salt and ground pepper.

When cooking inside, be aware that not all pans are created equal. Pans with Teflon or other non-stick coatings contain chemicals (PFOAs and PTFEs) that have been shown to cause cancer (which is why Teflon removed PFOAs from their pans in 2013). These chemicals have been shown to increase infertility, cause hormonal changes, decrease immune system function, increase cancer risk, increase cholesterol and cause growth and learning delays in young children.

Safer choices are stainless steel and cast iron and enamel coated cast iron. Read more about cookware safety here.

So eat more fresh, organic food this summer while it is available. Colorful foods contain antioxidants which protect you from cancer. And please (please please please) avoid processed and 'fast food'.


Sunday, May 26, 2019

Vaginal mummification - there is help!

True confession - I never watched Sex in the City - mainly because at the time I was a poor starving just out of residency doctor who couldn't afford cable TV and also because I'm a gynecologist and didn't think sex made for TV could top what I was already learning from my patients.

Boy, was I wrong.

I recently saw a patient who was brought in by her husband because she is becoming more 'forgetful' and while that is their number one concern, each time she comes in she laments about how she 'is dead from the waist down' and how she is 'drier than the desert down there'.

I don't have a picture of a desert, therefore the mummy image.

Our last conversation went something like this:

"I'm concerned about my poor husband" (patting him on the knee), "I never feel like having sex. Is there something to be done? It is very painful and I feel bad because when we do have sex it gets so bad I am telling him to just hurry up and get it over with. And I never have an orgasm anymore so what's the point?"

Me - "I agree with you. Isn't that what makes you want to have sex in the first place? If you can't have an orgasm then what's the point?"

At this juncture her husband interjected, "You ladies are cracking me up." as he shifted uncomfortably in his seat.

So we talked about some options (which I will get to later) but it got me thinking later - what other  reasonable options will help her?

Then I watched Sex in the City and realized that maybe seeing a TV show about sex would help her discover things about sex that she hasn't tried or learned about yet. Maybe Sex in the City is another option for her. I saw things I never saw before and let me warn you - you can't un-see that stuff!

One episode was all about vibrators! But I digress.

SITC is definitely pornographic - like pornography with classy storylines and characters you can befriend and learn from (and develop shoe envy). And for some people, seeing other people having sex can increase the desire to have a satisfying sex life. So for this patient, once she can 'feel down there' again, she may also need some visual aid to get the fires burning (so to speak). Until then, it may just cause frustration!

So ladies, if you find yourself 'never wanting to do it' or going 'dead down there', let's chat.

First, have your doctor check your anatomy. If you aren't getting adequate hormone support then your vagina and vulva (skin and 'lips' around the vagina and clitoris) will begin to lose connective tissue and thickness, resulting in a pale shadow of it's former self.

This translates to dryness and pain with intercourse.

As a Functional Medicine doctor, I also check hormone levels and try to find out if there are other hormones involved (i.e. stress hormones) which can alter normal hormone metabolism. Traditional Obgyns don't check hormone levels because they are usually not familiar with how to translate the levels into physiology, so find an integrative, Functional Medicine or naturopathic doctor who is familiar with bioidentical hormone therapy and start there.

Estradiol is the main hormone that keeps the urogenital area (vagina and vulva) maintained with blood supply and growth factors that keep the architecture of the area from collapsing and that translates to a thicker vaginal wall, 'fluffy' but not flabby vulva and a clitoris that has enough nerve and blood flow to be stimulated by touch. Estriol (another estrogen) has been found to also encourage blood flow and tissue thickness in the vaginal area.

So the first thing I offered her (after checking her hormone levels) was a vaginal cream or suppository compounded with bioidentical estriol (safer than estradiol).

I also offered her 'scream cream'. There are several different variations but each formulation is designed to increase blood flow and heighten sensitivity. It is applied to the clitoris just before sex.

If these don't work for her she may consider a procedure to rejuvenate the vagina and clitoris. There are two currently that involve a medical device, the Mona Lisa (laser) and the ThermiVa (radiofrequency heat). These are done in your doctor's office or outpatient procedure room and may need to be done multiple times to get results. The underlying issue (loss of collagen support and blood supply) will revert back to it's shrunken state if the procedure isn't repeated at regular intervals - usually every 12-18 months - so it is not a permanent fix.

Another procedure that can help is an injection with platelet rich plasma (PRP). This technology was developed for thoroughbred race horses to repair joint injuries but has expanded to be used by professional athletes and now can be found in many clinics (including the one where I currently work). The platelets bring in growth factors and stimulate collagen formation and repair wherever the injection is placed.

So the clitoris and upper vagina can be numbed and PRP (harvested from your own blood) can be injected to increase sensation and orgasmic quality is improved (or regained if it was lost). I recommend some hormone treatment prior to this procedure if there is currently no ability to orgasm.

In fact, tailored hormone support will help maintain the area along with any other therapy that works for you. That requires checking levels and rechecking while you are on therapy.

I've had patients come in and demand testosterone, saying that they have a friend, cousin or sister who got some and got her freak back on. I say that if your doctor gives you testosterone and doesn't check levels then find yourself another doctor.

I've had patients who thought they needed testosterone to solve all their sex and libido issues and they had high levels of testosterone without any being added so more is definitely not better! So if you decide to use hormones, make sure you are only adding hormones that you lack.

So to sum up:
1. Check hormone levels
2. Topical hormones in the vagina
3. Stimulant creams to the clitoris
4. Medical procedures
5. Ongoing hormone support (appropriate to your needs)
6. Maybe a little SITC - you know, as a visual aid, if you like that sort of thing. Or a vibrator.

And remember - 'if you don't use it, you lose it' applies to the vagina.

Keep it juicy.
Dr. M

Sunday, May 5, 2019

Strong Bones - do you have to drink milk?

May is National Osteoporosis Month. So let's talk about bones again.

I get a lot of questions from patients about preventing osteoporosis so I'll cover that today. The word osteoporosis means porous bone. All bone is porous but strong bones are much less porous then weaker osteoporotic bones.

This image is showing enlarged spaces between bone structure that weakens the bone progressively until it is easily broken. This is important because as we age we naturally lose more bone mass and this can increase our risk of hip fracture (or other fracture) with a fall.

Menopausal women are especially at risk as their estrogen levels fall with age and their rate of calcium absorption goes down. When your body doesn't get enough calcium in the diet it breaks your bones down to get some because calcium is essential to your metabolism!

It has been reported that the one year mortality rate (rate of death from an injury at one year after the injury) from a hip fracture is somewhere between 14-58%. So you definitely want to protect your bones and decrease your chances of a fracture from a fall!

So how can we best protect our bones? For women that means considering estrogen replacement as we go into menopause. I found one resource from the National Institutes for Health written in the mid-90s that recommended 1000mg of calcium a day for menopausal women on estrogen and 1500mg a day for menopausal women not on estrogen. I think that's huge! This recommendation just shows how important adequate estrogen is to bone health.

Of course, if you can't take estrogen for whatever reason you can still protect your bones. The first place to focus is on foods that contain calcium. I will add a caveat before I get into the specifics. Calcium absorption is very low when conditions for absorption are not ideal. Here and here are some of the factors that can hinder absorption. Some of the nutrients that need to be adequate for better absorption include vitamin D3, vitamin K2 and magnesium. Vitamin C is also critical to absorption.

So when you look up calcium rich foods dairy is usually mentioned as if it is the only option - in fact, the National Osteoporosis Foundation - advertising National Osteoporosis Month - has a video on their website that draws a huge picture of a glass of milk and a piece of cheese and other options are minimized. So what's a dairy intolerant person to do?


1. Seeds - make chia pudding (chocolate chia pudding in the photo) or sprinkle chia seeds into smoothies. Sprinkle sunflower seeds or pumpkin seeds onto salads.

2. Beans and lentils - sprinkle black beans on a Taco Salad or make black bean salsa by mixing canned (organic!) black beans into either prepared or homemade salsa. Make dal with lentils or add cooked lentils to your hummus recipe to add extra calcium.

3. Almonds or almond butter - add 2 tablespoons to a smoothie recipe and get a little protein, fat and calcium boost.

4. Soy - choose organic, non-GMO soy beans or tofu and enjoy edamame or a good tofu stir-fry.

5. Leafy greens - choose low oxalate kinds for best absorption but most leafy greens provide good amounts of calcium. Make a chopped salad or a soup with added greens. I even add chopped greens to my spaghetti sauce.

6. Broccoli rabe - I just had a bunch of this Thursday night since it is in season and I was fortunate enough to get a bunch from a local grower. I just steamed it and ate it but I also have a good recipe for Ginger Sesame Soy Rabe with asian noodles that amps up the calcium content.

7. Oranges - I'm allergic to orange peel but if you peel it and break it into wedges I'll enjoy it with you!

8. Dried fruit - especially dried figs - enjoys whole or chop into smoothies. Other dried fruits with calcium include raisins, prunes, apricots and dates.

9. Okra! I love it roasted in a pan, drizzled with olive oil, but you can smother it or add it to soup or a pot of beans (double bone whammy).

10. Fortified non-dairy milk - check your non-dairy almond or other milk and see if they've added calcium.

So the bottom line is this - dairy does have a lot of calcium but the absorption of calcium from plant sources is higher. If you tolerate dairy don't rely only on diary as your source of calcium. If you do consume dairy make sure it is grass-fed organic dairy so you don't expose yourself to pesticides, antibiotics, hormones and other substances in industrial-based cow dairy products.

What about supplements? There are lots of options to make sure you get adequate calcium and other essential nutrients for bone health.

See a Functional Medicine provider like myself to make sure you have adequate levels of the nutrients (like K2 and vitamin D3 and vitamin C) needed to absorb and use calcium from your diet. You can also discuss with your provider when to test for bone density, what to do about osteopenia and whether supplementation with calcium is right for you.

Chocolate Chia pudding:

Mix together 2 tablespoons of organic cacao powder and 3/4 c. warmed hemp, almond or soy milk to dissolve the cacao. While whisking add in 3 tablespoons agave or maple syrup. I also added a packet of powdered monk fruit. Add in 1 tsp organic vanilla extract and a pinch of salt. Once it is well mixed pour in 1/4 cup of chia seeds and whisk. It should begin to thicken after about a minute. Pour into ramekins and place in fridge for 4 hours or overnight. Enjoy. Makes 2 small ramekins - may double if needed to make 4 servings.

This is nice sprinkled with cacao nibs or wild blueberries and a dash of cinnamon. Have it as a light dessert after your fajita feast today! Happy Cinco de Mayo!

Sunday, April 7, 2019

Candor in Medicine

The theme of my meditation this morning was candor/honesty. While pondering candor and honesty I wondered if people really want to know the truth when they consult with a doctor. Maybe they just want to be placated and given a magic pill that will allow them to avoid taking responsibility for their health. Or to be told that everything will be alright even when that is far from the truth.

I chose this breaking dawn photo today because I want it to 'dawn on' my readers as it dawned on me that our current system of healthcare is beyond broken. How healthy is it for medical students to be taught that their job as doctors is to 'diagnose' a disease so they can 'treat' it with a drug?

I recently saw a patient in consultation who had seen a few doctors before he came to me (a common occurrence). One of them was a Rheumatologist (specializing in autoimmune disorders) because in his initial lab work he had a positive ANA. When I saw him he had many seemingly disconnected symptoms but I could see a pattern evolving and thought he needed further testing and treatment.

He wanted to wait until he had had followup appointments with the other doctors he had seen and by the time he was seen in followup many of his initial symptoms were better. When he saw the Rheumatologist that doctor concluded that the positive ANA must be a false positive. 

This would mean that the lab test shows an antibody to his own tissue but that the result is an erroneous result due to lab error. The doctor concluded this solely based on the fact that the symptoms were subsiding as if it were impossible for symptoms to wax and wane. This conclusion was probably also because now the patient doesn't meet diagnostic criteria that would allow him to prescribe a drug!

Being candid with my readers I have to ask - do we honestly think a chronic disease like lupus (diagnosed with positive ANA and other autoantibodies) or diabetes (diagnosed by having an average blood sugar over an arbitrary amount) just pops up in your body one day for no reason?

The answer is NO - these processes take time to develop in the body. I have multiple patients with autoantibodies either ANA or thyroid antibodies that don't yet have symptoms. If your immune system is running amok due to some process that might be able to be controlled or reversed with lifestyle changes shouldn't that be the first line of investigation and treatment?

Unfortunately for most people, they aren't provided with the opportunity to reverse their diseases because most doctors aren't trained to detect early signs and symptoms of future diseases. Functional medicine doctors are trained in sleuthing for early signs and helping patients reverse those by changing their diets and improving their nutrition. (As I explained to my son yesterday when he was making poor dietary choices - all medicine was originally functional/nutrition/herbal based until pharma came along and decided to make selling legal drugs a big business.)

I think the most exciting area where early detection can make a huge impact is in the area of Alzheimer's disease. As many of you are aware my mother passed away four years ago this month due to end complications of Alzheimer's disease. When I first took her to see a doctor for her memory issues she was 61 years old. He said she 'didn't meet criteria' for diagnosis of Alzheimer's so he didn't prescribe any of the drugs in use at the time (Aricept, Namenda). He also didn't offer any suggested treatments.

Now there are thousands of patients who are being treated with a pre-emptive protocol from Dr. Dale Bredesen (an Alzheimer's researcher) who authored The End of Alzheimer's in 2018. By searching for possible metabolic 'switches' that can be turned off or on and making sure they are being optimized to promote neuronal growth, regeneration and repair we can assist patients in improving their cognition (ability to think clearly and form memories). There are also environmental toxins that can harm neurons and break their ability to connect properly and those must be identified and dealt with.

Another very exciting area is cancer research. I am finishing a book right now by a research doctor who I blogged about in March. She has discovered a connection between a retrovirus, chronic fatigue and cancer. Explaining the research would require rewriting the book but it is enlightening to see outlined in her book the difference between research doctors who want to answer the big questions and those who are just posturing for credit and glory.

The bottom line is that one of your immune system's jobs is to identify new born cancer cells (that form in your body on a daily basis) and squash them like a bug (actually I think they chew them up and don't spit them out).

So wouldn't it be a good idea to have regular 'pre-emptive' checkups? Peek under the hood and see what's cooking? Or maybe we really don't want to know the truth?

Personally I want to look for any early signals and head off any developing issues before they get out of control. If this describes you then find a certified Functional Medicine doctor near you on this website. Ask them a lot of questions before you go as some FM doctors specialize (in cancer or autism or Lyme or autoimmune issues) and make sure they are a good fit for you.

I'm sad I had to cut my trip to Louisiana short this past week - I wanted to meet with some of my readers to have a Q&A. I hope to set one up online in the near future and will keep you posted once it is all arranged. If you have a question please send an email to You may not get an answer the same day (work taking precedent sometimes) but I will answer.


Sunday, March 10, 2019

So much worse than Radium girls!

I wasn't going to post this week because I have so many other things on my plate but then I came across this video: (click the link!)

If you've been reading my blog you may remember that I have referenced the book Radium Girls more than once as a thrilling historical fiction (but really a true story) chronicling the lengths that industry will go through to deny that they are causing harm or to take responsibility for it.

Please watch the video. You may not understand all of the science-y jargon but it boils down to our government and pharmaceutical companies and scientific journals colluding to keep us from finding out that they are poisoning us unnecessarily. While y'all are watching I'm going to get her book and read it so I can get the full story.

After you've watched the interview with Dr. Mikovits you may need to watch Food Matters on Amazon Prime. They further explain why actual useful scientific information that would help greatly reduce all disease (including cancer) in the United States is not being provided to the public.

I'll be drinking my water and taking my vitamins while you watch.


Sunday, March 3, 2019

Eat Adventurously & Nutritionally

Functional medicine is all about healing the body using our knowledge of normal biochemistry and pathophysiology to restore health - mainly using nutrition. So today I'm thinking about food choices.

I grew up in south Louisiana and know how easy it is to get into a food rut. Rice is a staple in our town and it seems we had it with every meal. Rice is a grain and some would argue that we don't need grains (those who go Paleo) and some who would argue that grains should always be part of a healthy diet (FDA, the author of The Longevity Diet and others). So how do we decide?

First, in consideration of rice (which is a gluten free grain). I would consider the type of rice to eat. White milled rice (with hull, bran and germ removed) is what I grew up on but there are lots of other options - Brown rice, Basmati rice, Jasmine rice, sprouted wild rice. For starters, I found a nutritional comparison of white versus brown here.

To summarize that article - brown rice has more fiber so is better as a prebiotic for gut bacteria and we are finding out that gut bacteria play a huge role in health maintenance (both physical and mental). I didn't see it mentioned in the article but all rice has arsenic in it (the soil is contaminated so even organic rice has this issue) and should be soaked to remove the arsenic before cooking. Also the higher fiber content in brown rice makes it harder to digest so it doesn't raise your blood sugar as fast as white rice so brown is the better choice for those with blood sugar issues.

I've tried all different sorts of brown rice and so far my favorites are brown Jasmine rice and sprouted wild rice. In my quest to eat different foods I made a sprouted wild rice grain bowl last night which included stir fried daikon radish, celery, watermelon radish and broccoli along with hydroponic butter lettuce and a homemade olive oil and rice vinegar dressing. I didn't have any pea sprouts but those would have made the bowl perfect. It was still pretty awesome.

I don't have a picture because I scarfed it down but here is a picture of the rice - so pretty and delicious:

So sometimes you have to get out of your rut and eat something new (and maybe more nutritious and better for your overall health). If you want to live longer and stay healthy for all those extra years, start by choosing foods that are closer to there natural state (whole foods, not processed foods) and try different foods, especially those with more color in them.

Color is frequently a protective mechanism for the plant and by consuming the colors we get the benefit of those antioxidant chemicals which help prevent free radicals that cause cancer, trigger cell death (which accelerates the aging process) and are generally harmful.

So I encourage you to eat adventurously and nutritionally for better health and leave you with this quasi-recipe for a collard green wrap - feel free to embellish and make it your own:

Collard Green Wrap

Shave the stem on the back of a collard green leaf (after washing and patting dry). Lay it out flat and add fillings. I used shredded carrots, sliced mushrooms, balsamic caramelized onion hummus (Cedars brand) and sliced watermelon radishes for my filling. Roll it up, tucking in the sides to make it like a burrito, and cut in half and chow down.
So yummy.

Sunday, February 3, 2019

OOOh! What a world, what a world!

I was going to post about expanding your eating horizons today but my child is sick and I'm still unpacking from the move so I thought I would share on one of my favorite topics - toxins.

Check this out (especially my peeps down in my home state of Louisiana). Makes me want to move to Vermont (at least in the summer!)

The booklet in the photo is just a brief overview of environmental medicine.

Dr. K

Sunday, January 6, 2019

New Year - Now What?

Happy New Year! My hope is for happiness and well-being for myself and for all my patients and followers. This year snuck up on me because I was busy buying a home (finally) after renting for 2 1/2 years in Alpharetta. I had a dental appointment on January 2 and the technician asked whether I had any resolutions and I just had that deer in the headlights look!

So instead of resolutions I thought about what areas to be intentional about so that my health (and by extension my life) could be better and happier. These will work for everyone so feel free to steal.

Here are my Top 5 things to be intentional about in 2019:

1. Environmental exposures - these mostly come from inside your living space. I want to make sure I get the cleanest air, water and food inside my body. That means air filters, water filters, trying to join organic coop farms and making sure my cleaning and personal care products are non-toxic. I recommend this website as a resource to see if any of your household products could be harming you or your family.

2. Diet - I wrote a (very long, I realize) post about why your diet matters to your over all well-being. I want to be intentional about eating to improve my health this year. If there were only one thing you could accomplish this year to improve your diet I would recommend eliminating sugar. Sugar causes inflammation which is the root cause of lots of disease processes, including heart disease, cancer and diabetes. If you want to go further, talk to your Functional Medicine practitioner about doing some form of detox diet or elimination diet to improve your health - you may add years of better health to your life.

3. Movement - I always recommend yoga because it incorporates breath and movement which helps your adrenal glands handle stress (which is also a root cause of many diseases). Even if you have bad knees and hips or low back issues, you can still do yoga to stretch and gain better balance and help your brain work better! If yoga doesn't float your boat pick a movement that can help you with balance and strength and one that doesn't raise your stress level.

4. Sleep - Be intentional about getting quality and quantity here. Sleep is necessary for our bodies to repair and regenerate our brains and vital cell functions. If you have sleep apnea or restless sleep get help to address these issues and improve your sleep quality. You need 7-8 hours nightly at a minimum to get the job done. Your best repair work happens early in the sleep cycle so don't stay up late - whatever is enticing you to stay awake, it can wait!

5. Stress - Our lives are inherently stressful. Stressors come from our environment, our work habits (Americans in general work too many hours), our lifestyles, our families and even our vacations can be stressful (flying in a plane - being exposed to other people's illnesses and air space for example). Build a mindful practice to help alleviate some of the bad side effects of too much stress. I previously posted here about the benefits and nuts and bolts of being mindful. Set an appointment on your calendar for self care and mindfulness.