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Your True Risk for Cardiovascular Disease: The Blood Tests You Need

functional medicine heart labs

Heart health is everyone’s business. Consider these staggering statistics: 

  • 44% of American women currently have heart disease, which is almost an incomprehensible percentage of us.1
  • 22% of deaths of women in America are due to heart disease.2
  • Heart disease kills 40% more Americans each year than all cancers combined. 
  • The generations being born right now, are more likely to die younger than our current generation, and unfortunately CV disease is on the rise since 2017 in the US

WHAT IS HEART DISEASE?

When we talk about heart disease, we are referring to people with coronary artery disease (blocked arteries in the heart usually from cholesterol), those with heart failure (the heart stops pumping properly), and those with arrhythmias like atrial fibrillation (abnormal electrical activity). It’s a huge concern that the fastest growing population affected by heart disease is 25-44 year olds. This highlights the importance of early intervention, so that we can help reduce the length of time that the body is exposed to all the things that cause heart disease, like “bad” inflammatory cholesterol (for example a lipid particle called ApoB), and environmental toxins.  

This is the classic definition of prevention:  Before the disease manifests, you can make changes that prevent you from getting that disease. For example, lifestyle changes (exercise, diet, targeted supplements and lowering toxin load) have the power to lower your risk of heart disease.  And the prevention power gets even stronger when you add our favorite blood tests for early detection and screening.  We can see if you are heading down the wrong path, and need to make a course correction! 

HOW WE WORK TOGETHER 

Most doctors who think about heart health will focus on optimizing hypertension, cholesterol, and diabetes with prescription medications, risk factors that when managed well can have life-saving benefits for many people. We work closely with local cardiologists and internists, and join your team to add additional Functional Medicine support for getting to the root cause of your heart disease.  We focus on Lifestyle Medicine, and also offer advanced testing, assessments and treatments for oxidative stress, inflammation and disorders in your blood sugar and stress systems. 

By using advanced testing alongside one’s medical conditions, family history and lifestyle, we can get an accurate understanding of your risk for heart disease. Some of the advanced tests we offer here at Blum Center are below. Ultimately these specific blood tests help us create a personalized and comprehensive treatment plan for you. 

Specific cardiovascular risk factors we like to assess include:  

  • LDL particle size: While traditional lipid panels will tell you your total LDL, HDL, and triglyceride cholesterol quantities, a more advanced and detailed risk assessment will give us a size profile and particle characteristics of someone’s LDL.  We can see if your LDL is light and fluffy, or small and damaging to the arteries, and this gives us information about how dangerous your individual LDL cholesterol number is. 
  • Lp(a) quantity:  this is a risky and largely inherited subclass of LDL that is particularly atherogenic (plaque inducing).
  • ApoB level: the most common carrier protein for LDL, this may be an even more relevant predictor of heart disease than LDL quantity. 3
  • Lanthosterol and desmosterol vs beta-sitosterol and campesterol– these numbers are markers of the level of cholesterol absorption from the GI tract vs cholesterol production from the liver, and guide both lifestyle and medication and supplement treatment plans  
  • LP-PLA2 activity, myeloperoxidase level, hs-CRP,  and fibrinogen levels- these tell us about inflammation in the arteries and help us see if there is an increased risk for blockages forming or breaking. With this you can better understand how at risk you are for making plaque and therefore heart disease, and helps determine how aggressive we need to be. We also monitor these to determine whether a particular intervention is helping you. 
  • fasting insulin, adiponectin, glycated serum proteins, Hgb A1c- these types of measurements can give a good sense of your metabolic health, a very important risk factor.
  • F2 isoprostane, oxidized LDL- these are measured in the serum, and are markers of oxidative stress, a precursor to inflammation, and both are markers of atherosclerosis and significant risk factors for heart disease,4,5 
  • Oral microbiome- Because of the strong association between high-risk oral pathogenic bacteria and heart disease, we can perform oral DNA testing to assess for pathogenic vs beneficial oral flora. If indicated, we can refer you to dentists who provide specialized periodontal treatments to encourage a healthier oral biome. 6   
  • Genetics- We can provide genetic testing specific for cardiovascular disease, which indicates whether you are at risk for blood clots, statin-induced myopathy, or the ApoE gene, which is a risk factor for both cardiovascular disease and Alzheimer Disease. Genes like KIF6 predict statin response and heart attack risk, while others like 4q25 predispose to atrial fibrillation. Genetics can provide much information about modulating one’s individual risk. 7
  • Omega 3 index: By looking at the fatty acids in your blood, we can advise you how to rebalance your fatty acid profile towards a lower risk one. 8
  • Radiology tests: A coronary artery calcium score, which is a visual test performed by CT (computed tomography), can assess whether you have calcified plaque in your coronary arteries currently. A Cleery scan is coronary computed tomography angiography that visualizes soft plaque and blockages and can avoid the need for invasive imaging. The Cleerly ischemia scoring system was shown to outperform true angiography in one study in determining risk for heart disease. It is an encouraging option, particularly for those seeking to avoid invasive testing. 9 

Once we figure out what your risks are, now we get to do the fun part of using the best science has to offer to lower risk in a preventative way. Our plans at Blum Center always focus on lifestyle, and you will certainly leave with a prescription for stress, sleep, exercise, nutrition, but at the same time we are going to look for the root causes for your oxidative stress and inflammation. We address metabolic health, and look for environmental toxins and contaminant metals, which have been shown to impact coronary plaque.10  Our ability to address oxidative stress and inflammation and address root causes makes us an optimal partner to help you reduce your risk of heart disease.  You can change your health trajectory!  While we have many strategies, knowing your personal data and risks is often the way to start. 

Schedule an appointment with Dr Jane Andrews for a complete heart health assessment.  914.652.7800 or click here

 

Dr. Jane Andrews is a Functional Medicine doctor with a background in internal medicine physician doing both inpatient and outpatient clinical medicine for 12 years prior to joining Blum Center. Dr. Andrews received her MD from the Johns Hopkins School of Medicine, her MPH at Johns Hopkins School of Public Health with a concentration in biostatistics and epidemiology, and is a graduate of the NIH-funded Predoctoral Clinical Research Training Program. She completed residency at Tulane University and was faculty at Tulane, followed by Yale School of Medicine, and finally at UT Health where she was an Associate Professor. 

 

  1. https://www.cdc.gov/heartdisease/women.htm
  2. https://www.cdc.gov/women/lcod/2017/all-races-origins/index.htm
  3. Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, et al.  Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol 2019;4:128795.
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686621/
  5. https://pubmed.ncbi.nlm.nih.gov/18625445/#:~:text=Oxidized%20LDL%20(oxLDL)%20represents%20a,formation%20of%20macrophage%20foam%20cells
  6. https://pubmed.ncbi.nlm.nih.gov/17645769/
  7. https://pubmed.ncbi.nlm.nih.gov/27277824/#:~:text=ApoE2%20and%20apoE4%20increase%20the,to%20downregulation%20of%20LDL%20receptors)
  8. https://pubmed.ncbi.nlm.nih.gov/25720716/
  9. AI Evaluation of Stenosis on Coronary CT Angiography, Comparison with Quantitative Coronary Angiography and Fractional Flow Reserve. Journal of the American College of Cardiology. Published February 2022.
  10. https://www.dropbox.com/scl/fi/myzk4vzmgk941zbp77rp8/lamas-et-al-2023-contaminant-metals-as-cardiovascular-risk-factors-a-scientific-statement-from-the-american-heart.pdf?rlkey=ju0veckl8b4yazha9vyz0iw42&dl=0
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How Ketamine is Helping Patients with Chronic Stress and Trauma

Ketamine Infusions at Blum Center for Health

In functional medicine, we see trauma as more than just emotional distress; it has a tangible impact on both your physical and mental health. Picture your body as a well-coordinated orchestra, each section representing a different system. Trauma throws off this balance, affecting everything from hormones to digestion. 

The stress response triggered by trauma can lead to inflammation, impacting your immune system and overall well-being. Our goal as practitioners is to address these interconnected factors, restore balance and support healing. 

The Biology of Trauma

In recent years, there has been a growing interest in understanding the biological mechanisms underlying trauma and exploring innovative treatments. Dr. Stephen Porges introduced the Polyvagal Theory, a groundbreaking framework for understanding the autonomic nervous system’s role in responding to stress and trauma. According to this theory, the autonomic nervous system consists of three branches: the ventral vagal, sympathetic, and dorsal vagal systems.

  • Ventral Vagal System: Associated with social engagement and relaxation, this branch promotes feelings of safety and connection.
  • Sympathetic Nervous System: Known for its “fight or flight” response, the sympathetic system activates during stressful situations, preparing the body for action.
  • Dorsal Vagal System: Linked to immobilization and shutdown, this branch activates when an individual perceives a life-threatening situation, leading to a state of dissociation or freeze.

Understanding the interplay between these systems provides insight into how trauma can impact an individual’s physiological responses and overall well-being.

Trauma’s Impact on the Nervous System: 

When an individual experiences trauma, the autonomic nervous system may become dysregulated. Chronic exposure to stressful or traumatic events can lead to a heightened sympathetic response and an impaired ventral vagal system, hindering the ability to regulate emotions and navigate social interactions effectively. 

Additionally, trauma may result in an overactive dorsal vagal system, contributing to symptoms such as dissociation, anxiety, and depression. 

Understanding these neurobiological changes is crucial for developing effective interventions. Here’s several examples of patients* who’ve who’ve come to me for treatment:

  • The middle-aged patient with depression, who finally connects his dissociation and inability to focus, constipation, and recurrent sinus infections to the stress of his childhood-being raised by an alcoholic mother.
  • The 21 year old college student  who has diarrhea, difficulty tolerating foods, eczema and painful periods- who also lives in a state of fight or flight that she experiences as ADHD and anxiety.
  • The perimenopausal small business owner who is starting to have night sweats, weight gain, change in her bowels.
  • The sleep deprived mom of 3- shuffling kids from activity to activity, managing a household, cooking, who has difficulty finding time to exercise, meal prep, and meditate and who experiences chronic HIVES and cannot clear toxins like mold from her system.
  • The retired patient who has long haul covid after years of reflux symptoms, a short fuse and anger management issues, recurrent sinus infections, and a history of insomnia.  

Ketamine and Trauma Treatment

Ketamine, traditionally known as an anesthetic, has garnered attention for its potential therapeutic effects on trauma-related conditions. 

Recent research suggests that ketamine may influence the N-methyl-D-aspartate (NMDA) receptor,  a receptor in the brain leading to neuroplasticity and the formation of new neural connections.  

What this means is that the brain is literally rewiring itself, allowing faulty connections (synapses) to reconnect stronger and with more integrity. And what we experience physically is less anxiety and depression and the somatic manifestations of those states of being. 

Moreover, ketamine’s impact on glutamate transmission may play a role in dampening hyperactive neural circuits associated with trauma. 

Studies exploring the use of ketamine-assisted psychotherapy indicate promising results in alleviating symptoms of post-traumatic stress disorder (PTSD) and depression.  

I’m brought to my 20-something  patient who came to me, unable to work, in chronic pain, almost bed bound and with suicidal ideations.  After only 2-3 months of treatment, he is starting graduate school, his pain well integrated and understood, and walking with a new found confidence in himself.   Both having rewired the neural-circuits and integrated his experiences during his sessions into his daily life and conscious awareness.  

Ketamine, with its potential to modulate neural circuits and promote neuroplasticity, emerges as a novel avenue for trauma treatment. As research in this field continues, integrating biological insights with innovative therapeutic approaches holds promise for advancing chronic stress and trauma care and improving the lives of individuals affected by trauma.

As a practitioner, having a cutting edge tool like ketamine has been one of the most profound ways I have helped patients heal their physical body. If you’d like more information about Ketamine treatments at Blum Center for Health contact our team at 914.652.7800 or on our website www.blumcenterforhealth.com 

*distinguishing characteristics have been removed to protect patient identity.

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5 Ways to Make Your Health Goals A Reality

Functional Medicine Health Coach

Let’s jump to the chase: New Year’s Resolutions don’t work.

Thanksgiving hits and all through December we say to ourselves, “Come January 1st all this is going to change.” Year in and year out. 

But, does it?

Does everything change?

The answer for over 95% of us? A big, fat NOPE.

The reality is, that every single day is a “clean slate” opportunity. 

We put a tremendous amount of pressure on the first day of the year. 

But think about this: Putting all your eggs in the basket once a year gives you only ONE OPPORTUNITY. 

Thinking about everyday as a clean slate gives you 365 OPPORTUNITIES!

Regardless of whether you’re into New Year’s Resolutions, there are ways you can make your goals achievable any time of year. 

 

5 Ways to Make Your Health Goals a Reality

Focus on one goal at a time: Trying to change multiple aspects of your life at once can be overwhelming. Concentrate on one resolution until you feel confident in your progress before adding another one.

Make realistic and specific goals: Setting vague and unachievable goals sets you up for failure. Instead, be clear about what you want to achieve and ensure it is within your capabilities. For instance, don’t commit to getting washboard abs, start with “I’ll workout for a minimum of 10 minutes, three times a week.”

Break it down: Breaking your goal into smaller, manageable steps makes it easier to achieve. This way, progress can be easily measured, keeping motivation high.

Celebrate milestones: Recognize and celebrate the small victories along the way. These milestones serve as positive reinforcement, helping you maintain motivation and continue striving towards your goal. Take a vacation day, get a massage, do something that makes you happy. (Ummm, not a food reward – that creates another habit to break!)

Find support: Share your goal with friends and family (not frenemies who undermine your goals) or join a support group – both can provide encouragement, advice, and accountability. For the ultimate in support, though, hire a coach! A top-notch coach (ahem, like me) will help you identify the habits and behaviors that hold you back from progress, and help you “rewire” them. 

 

Want to learn more about working with Melissa? Make an appointment with our team to answer all your questions. Yes, I want support now

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What it’s Like to Experience a Ketamine Infusion

Launching the Ketamine Program  at Blum Center for Health with Dr. Danielle Greenman has been one of the most profound and exciting moments in my career as a Nurse Practitioner. When Dr. Greenman brought up the idea of bringing ketamine to Blum Center, I instantly became excited because I knew how life-changing ketamine can be.

We have seen some incredible results in our patients and overwhelmingly people have had a positive or productive experience. Ketamine is a wonderful option for so many reasons:

 

  1. Rapid Onset of Action: Ketamine is known for its rapid onset of action, often providing relief from symptoms such as anxiety, depression, rumination, low self-esteem etc. within hours or days, as opposed to weeks or months it can take for traditional antidepressants to become effective.
  2. Different mechanism of action: Ketamine acts on the glutamate system in the brain, which is different from the mechanisms of action of most other antidepressants (which primarily affect serotonin and norepinephrine). This unique action makes ketamine a great alternative or add-on for those who do not feel optimized on their current treatment.
  3. Neuroplasticity: Ketamine enhances neuroplasticity, which is the brain’s ability to adapt and reorganize itself. This can help people form new, more adaptive neural pathways and thought patterns.
  4. Greater mind body connection: The altered state of consciousness during the infusion leads to a heightened sense of introspection and self-awareness. This leads to a deeper connection to thoughts and emotions. Ketamine opens the door to the unconscious mind and allows people to explore what is lying beneath the surface. Emotions, thoughts, or memories that are difficult to reach in everyday life or an ordinary state we often don’t connect to are easier to grasp and process during a ketamine infusion. This can facilitate a deeper understanding of your emotional or past experiences and promote a more profound connection between your emotional and physical states. Ketamine can create a deeper self-awareness of thoughts, emotions, and bodily sensations that contributes to a stronger mind-body connection and a deeper sense of self.
  5. Reduction of suicidal thoughts: Ketamine has demonstrated the ability to rapidly reduce suicidal ideation. This could potentially be life-saving for those at high risk of self-harm or suicide.

 

It truly has been an honor to administer the ketamine infusions and walk alongside people on their journeys–a task that I do not take lightly. It is my mission to create as comfortable of an environment as possible to give people the safety they need to feel vulnerable and open to embrace anything that comes up in a non-ordinary state of consciousness similar to that of a deep meditation or hypnosis.

Before each infusion, I take a moment to set the intention of the experience with gentle reminders to start the journey off in a good headspace, where you are anchored to your body and have guidance for navigating the experience. Everyone is different and has different needs during the infusion and I honor whatever those needs may be. I take the time before someone starts their ketamine journey to make sure I understand how to best support them. 

There are things you can do to prepare to have the best experience during a ketamine infusion. 

How to prepare for a Ketamine Infusion at Blum Center for Health: 

  • Use the bathroom before you start the infusion
  • Wear comfortable clothes
  • Eat a light meal before
  • Bring an eye mask and blanket
  • Curate a playlist (we have a playlist for you if you need)
  • Communicate all needs 

Many people fear a “bad trip”. Dr. Greenman would say there is no such thing as a bad trip but rather our experience is shining a light on an area of the psyche that needs attention. What feels scary or dark to one may be exciting for another. That being said, when uncomfortable experiences present during a session either Dr. Greenman or myself will support you and help you find safety. Oftentimes what may have felt scary at first becomes enlightening. That being said, most people have joyous and happy experiences and do not experience anything uncomfortable at all. I am always amazed by the profound insights that people share at the end of the infusion and notice positive shifts in energy from when they first came in.

Every single person has dealt with something challenging in their lives and those are things we usually carry with us, whether we realize it or not. Ketamine leads to a greater understanding and connection to ourselves. We all have an organic inner healing intelligence and throughout the process, ketamine can help create a deeper sense of connection and understanding of this part of ourselves.  

Learn more about Ketamine Therapy and our offerings at Blum Center for Health.  If you’re curious about Ketamine Assisted Therapy and if it ‘s right for you, set up a consultation call with Michelle Levins, NP: call or text 914.652.7800.  

 

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Why You Can’t Lose Weight and Keep It Off

As a Functional Medicine Health Coach, I frequently hear these weight loss concerns:

  • I’m really trying to lose weight and just can’t seem to get the scale to budge.
  • I feel like all I do is eat vegetables and exercise to no avail. 
  • My metabolism has changed. I used to be able to lose weight just by reducing my food. Now it’s impossible. 
  • Ever since I started perimenopause my weight has been creeping up.
  • My body just seems to be working against me. 
  • There are so many diets, and I’m just so confused about what’s right for me. 

Do you relate?

If so, don’t despair. It does not have to be this way. There is usually an underlying reason behind stubborn weight loss.

Food-Related Reasons You Can’t Lose Weight

  1. Food Triggers – You have an argument with a friend or family member; you get a promotion at work; you go to a friend’s birthday party; you’re home alone for a weekend. What do all of these have in common? They can bring up feelings or emotions that are tied to eating. Easy example: a child is given chocolate every time they fall down and cry. Soon enough every time they feel badly, chocolate is their go-to soothing strategy. The stimulus (feeling bad) and the response (eating chocolate) become associated. You can’t have one without the other. Fortunately, these can be “re-wired” so to speak.
  2. Portion Distortion — You might find it hard to believe but portion size alone is often a culprit, particularly in the United States where portion sizes have grown over the years. Researchers have found, for instance, that meal sizes at restaurants have tripled in size since the 1970s¹ and the plates we serve our meals on have also increased in size.2 At every turn, we are encouraged to eat more than we need.
  3. Overdoing It With Healthy Foods – Here’s a prime example: Nuts are a healthy addition to your diet — they are a healthy fat, a good source of protein, fiber and have anti-inflammatory properties. But, one serving of Brazil nuts, for example, is two nuts. Yes, one serving is only 2 nuts! One serving of almonds is six nuts. If you’re eating nuts like popcorn, you’re not going to lose weight.
  4. The Right Mix of Nutrients — Beyond the amount you are eating, is what you are eating. Are you living on rice cakes and cottage cheese, thinking that low-calorie diet foods are going to help you reach your goal? That strategy is likely undermining your weight loss objective. Weight loss is often about moving away from processed foods and into a whole foods, anti-inflammatory food plan that includes increased fats, ample protein and unlearning the reliance on empty carbs, even the so-called “healthy” ones like gluten-free bread and “nutrition” bars. This will ramp up your metabolism, jumpstart weight loss and teach you to eat for life, rather than going on and off diets continually.
  5. Inflammation — Do you unknowingly fill your body with foods that create systemic inflammation, a slow, quiet disturbance that never seems to shut off? Systemic inflammation is our body’s immune response to substances it sees as a foreign invader. For those struggling to lose weight, inflammation makes you, well … inflamed. You see, there is a very important hormone, called Leptin, that regulates your body’s level of fat by controlling your appetite and metabolism. In healthy people, the production of leptin signals the brain to suppress appetite and speed up metabolism—leading these people to feel less hunger, burn more calories and lose the excess fat. Chronic inflammation, however, impairs the brain’s ability to receive leptin’s appetite-suppressing message.
  6. And inflammation Can Lead to Leaky Gut – Leaky gut syndrome refers to a condition where the digestive tract lining becomes permeable, allowing toxins and undigested food particles to leak into the bloodstream. This disruption impairs insulin sensitivity, promotes fat storage, and makes it more challenging to shed those extra pounds.

 

Lifestyle Reasons You Can’t Lose Weight

 

  1. Chronic Stress — Stress is a major player in stubborn weight loss. We live stressful, fast-paced lives. Stress elevates cortisol and adrenaline, hormones responsible for “fight or flight” in what your body perceives as an emergency — something as serious as jumping out the way of a careening car, or something as nerve-wracking as public speaking. Once the event is over, our cortisol and adrenaline levels return to normal. This is a healthy stress response.Chronic stress, however, creates havoc in the body. Cortisol levels, which spike during a stress-inducing event, remain elevated. Think … a stressful job, a stressful relationship or even the everyday stress of “getting everything done.”This rise in cortisol puts a damper on weight loss. In fact, chronically elevated cortisol can cause weight gain!3
  2. Lack of Consistent Quality Sleep — Research4 demonstrates that even slight sleep loss boosts cortisol levels and can accelerate the development of insulin resistance. In fact, one study found that getting just 30 fewer minutes sleep than you should per weekday can increase your risk of obesity and diabetes.5 Not getting enough sleep is related to a host of other issues including heart disease, high blood pressure, accidents, mood disorders, depression and decreased productivity.

 

Medical Reasons You Can’t Lose Weight

  1. Thyroid Dysfunction — The American Thyroid Association7 estimates that 20 million Americans have a thyroid problem, and that up to 60% are unaware of their condition.  Whoa, that’s jaw-dropping! Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone, is characterized by unexplained weight gain and/or difficulty losing weight. To find out if your thyroid gland is functioning properly, you will need a blood test ordered by your doctor. I highly recommend working with a functional or integrative physician who will look beyond whether or not your numbers are “in range,” including lifestyle and mind-body medicine.
  2. Insulin Imbalance — If your blood sugar levels and insulin are off, you can experience carb cravings, difficulty losing weight and excess belly fat. Insulin resistance means your cells can’t absorb the extra blood glucose your body keeps generating from the food you eat, and your liver converts the glucose into fat. Processed foods, including beloved foods like pasta and bread, sugary drinks, and even foods marketed as “healthy,” like granola bars, play a role in insulin resistance. Insulin imbalance can give rise to Type 2 diabetes so it is important to get those numbers under control. Again, I recommend working with a functional or integrative physician who will also address lifestyle factors that contribute to insulin issues.

 

Losing weight can feel difficult but it does not have to be impossible. Your hard work can pay off. It’s a matter of figuring out the underlying challenges. 

Not sure where to start? Consider checking out our new Weight Loss Program. Our director of weight loss, Macaulay Kerr, and I have banded together to create a program that incorporates Semaglutide therapy (you’ve probably heard of Ozempic) with an allied coaching that focuses on helping you get on track and stay on track. No more losing weight and then gaining it all back. 

Want to learn more? 

 

Already a Patient at Blum Center?

To learn more about the program and whether it would be right for you, simply message your provider or call the office to make an appointment with the director of the weight loss program, Macaulay Kerr, PA, who will review the program with you and help determine your next steps. 

New to Blum Center?

Inquire about our Weight Loss Program by calling 914.652.7800 or request a phone or Zoom appointment with our New Patient Coordinator, to learn more. Once you are ready to move forward, the first step is to schedule your 60-minute consultation with our Weight Loss Director to ensure this is the best fit for you. 

 

About Melissa Rapoport: A skilled listener, Melissa empowers her clients to achieve their goals by working together to create tools and strategies that are unique to each person that walks through her door. Her passion is to look at the whole person and, like a detective, find their keys to success, incorporating health goals with topics as diverse as dealing with stress, eating healthy while managing a busy life, increasing joy and creating powerful self-care practices.

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Are You Blood Sugar Curious? A Continuous Glucose Monitor May Help

Have you noticed that circular disc on someone’s arm, or read an article about how Continuous Glucose Monitors (CGM) help people understand their blood sugar patterns, and wondered if it can help you? Continuous Glucose Monitoring is a technology that allows individuals to track their blood glucose levels in real-time or near real-time throughout the day and night. While CGMs are commonly used for people with diabetes to manage their blood sugar levels, more and more non-diabetics are using these devices to help them get smarter about their health and nutrition habits.

CGM technology consists of a small sensor placed under the skin that measures glucose levels in the interstitial fluid. The sensor transmits this data to a receiver or a smartphone, allowing users to track their glucose levels throughout the day. For individuals who are curious about their blood sugar levels, using CGM can offer a comprehensive understanding of how their body responds to various factors such as diet, exercise, and stress. It can provide insights into how different foods impact blood sugar levels and help identify patterns and trends in glucose fluctuations. 

While use of Continuous Glucose Monitors is currently approved for insulin dependent diabetics, there is a growing interest in its application for many other situations.

A Continuous Glucose Monitor can help with:

  • Pre-diabetes and Insulin Resistance: Has your doctor told you that you are prediabetic, or have metabolic syndrome or insulin resistance?  CGMs can be used to monitor glucose trends in people who are at risk of developing type 2 diabetes, which can be as many as 1 out of every 3 people in the US.  By closely monitoring glucose levels, individuals can make necessary lifestyle changes to prevent the onset of diabetes.
  • Metabolic Health Optimization: Poor glucose regulation is linked to many chronic diseases and long-term health challenges, A CGM can be used to gain insights into your body’s response to various foods and lifestyle choices. This data can be used to optimize overall metabolic health, even in the absence of a specific diagnosis.
  • Weight Management: CGM can help individuals understand how different foods impact their blood sugar levels, assisting in weight management strategies.
  • Menopause and perimenopause: Blood sugar regulation and hormone balance are intimately linked. As a woman experiences the hormone changes that come with menopause,  a CGM can help her modulate her diet and exercise in response.
  • Fitness and Athletic Performance: Some athletes and fitness enthusiasts use CGM to monitor their glucose levels during training and exercise to optimize their performance and understand how their bodies respond to different workouts and diets.

It’s important to note that the use of CGM in non-diabetic contexts is still an emerging area, and the interpretation of the data in these situations may differ from its use in diabetes management.  Wearing a CGM means you are getting 24/7 feedback about your blood sugar which can be overwhelming.

Without a knowledgeable guide to help you navigate your results, you can feel anxious about or misinterpret the feedback, end up over-restricting your intake, or otherwise negatively impact a healthy relationship with food. If you’re curious about your blood sugar levels and are considering using CGM, it’s essential to have a professional to guide you on how to interpret the data and make appropriate lifestyle adjustments based on the insights gained from a CGM.

To learn more, speak to our Patient Care Coordinator by calling 914.652.7800 or visit www.blumcenterforhealth.com

 

Vicki Kobliner, MS RDN is a Registered Dietitian/Nutritionist with over 20 years of expertise applying a Functional Nutrition approach to the care of children and adults. She utilized her wealth of experience with both traditional and integrative modalities, incorporating the power of food, herbs and targeted nutrition support for both prevention of and healing from both acute and chronic illnesses.

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Weight During the Holidays

Halloween is the official start of the holiday season. Yep, that’s right … Halloween!  This is often the trigger where someone thinks, consciously or unconsciously, “Well, I’ve never been able to stay on track before, so why even try. I’m just going to eat whatever I want and deal with it in January.”

Enter guilt, shame, weight gain … 

Listen up! You can enjoy the holidays, AND curtail weight gain with strategies that eliminate the all-or-nothing approach to food and self-care. After all, when the holidays kick in, you have less to take care of yourself, right? When you put more time into one thing (preparing for the holidays), that time has to be taken from somewhere. The most common places? Your own self care – sleep, eating nutritiously and relaxing your boundaries. 

And you know where that’s headed: Burn out!

  • Stick to your routine and schedule your priorities first – Do you usually workout on Monday, Wednesday and Friday? Go to your book club on Thursday evenings? Do something special on Friday nights? Go! Put these on your calendar in pen!
  • Define your “bare minimum” – While you might typically go for a 4-mile walk several times a week, what is the smallest amount you can do, no matter what during this busy time? 10 minutes? Great! You can apply this to exercise, meditation, your morning routine … anything that needs a holiday revision. 
  • Take a daily time-out with no phone, no agenda – Unplug from the world. Ten minutes every morning makes a huge difference in how you face the day. Could be a walk, meditation, drawing, a crossword puzzle. 
  • Cut down on emotional eating – Identify exactly what you’re feeling before you take the first bite. Are you hungry? thirsty? tired? stressed? sad? happy? Give it a name, and then choose to eat it. Choose each bite. It takes the “power” away from the food.
  • Eat more often – Yep, more often! If you find yourself skipping meals, craving carbs and overindulging in goodies, your blood sugar likely needs to be balanced. Every few hours have something with healthy fat, protein and complex carbs, such a nutrient-dense smoothie, avocado with a sprinkle of olive oil and sea salt, or hummus with your favorite raw vegetables. You could even eat leftovers as a mini meal.
  • Don’t skip your grocery shopping – have food in the house. An empty fridge leads to unhealthy grab and go foods. Don’t have time to cook? Take shortcuts – buy veggies already cleaned and trimmed, make easy soups that will last for several days (lentil soup is my go-to), batch cook to intentionally create leftovers.
  • Eat your veggies! — Rather than thinking about all the foods you’re trying to avoid, focus on adding as many vegetables as possible to your day! That will naturally “crowd out” the foods you’re trying to minimize.
  • Create a nightly tranquil self-care routine rather than plopping in front of the television. Consider taking a hot bath, and surround yourself with fragrant candles and your favorite music. You might even “unplug” from all electronics. Gasp, I know!

What we’re really talking about here is …. Slowing down. Slowing down enough to honor your needs. Slowing down enough to eat “good enough” and slowing down enough to breathe. 

And, if you really want to lose weight, the coach in me says, “Don’t wait until the New Year. Make it your best holiday season ever. Make it about you.”

Consider checking out our new Weight Loss Program. Our director of weight loss, Macaulay Kerr, and I have banded together to create a program that incorporates Semaglutide therapy (you’ve probably heard of Ozempic) with coaching that focuses on helping you get on track and stay on track. No more losing weight and then gaining it all back. 

Want to learn more? 

Already a Patient at Blum Center?

To learn more about the program and whether it would be right for you, simply message your provider or call the office to make an appointment with the director of the weight loss program, Macaulay Kerr, PA, who will review the program with you and help determine your next steps. 

New to Blum Center?

Inquire about our Weight Loss Program by calling 914.652.7800 or request a phone or Zoom appointment with our New Patient Coordinator, to learn more. Once you are ready to move forward, the first step is to schedule your 60-minute consultation with our Weight Loss Director to ensure this is the best fit for you. 

 

About Melissa Rapoport: A skilled listener, Melissa empowers her clients to achieve their goals by working together to create tools and strategies that are unique to each person that walks through her door. Her passion is to look at the whole person and, like a detective, find their keys to success, incorporating health goals with topics as diverse as dealing with stress, eating healthy while managing a busy life, increasing joy and creating powerful self-care practices.

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Your Comprehensive Guide to Semaglutide

It was the summer of Semaglutide; in the media, medical offices and all over Hollywood and the fall continuing to buzz as people see the remarkable results from these popular weight loss drugs. So, is it worth the hype? You may have heard of Semaglutide under the brand names Ozempic and Wegovy, so let’s unravel the science behind this popular peptide. 

The Science Behind Semaglutide

Semaglutide is a GLP-1 agonist, which stands for Glucagon Like Peptide 1. This peptide is naturally produced in our gut and serves a vital role in regulating our body’s insulin response and insulin sensitivity, ultimately leading to lower blood sugar levels. It’s a key player in the delicate balance of our metabolic health.

Initially approved by the FDA in 2017 for diabetes management, Semaglutide made headlines again in 2021 when it earned the green light as Wegovy, a groundbreaking treatment for obesity without diabetes. But what’s the secret behind its dual action on blood sugar and weight?

The Weight-Loss Magic of Semaglutide

While we’re still uncovering all the mysteries of Semaglutide, two key mechanisms have captured our attention:

  • Central Action on the Brain: Semaglutide works its magic centrally, in the brain. By acting as a GLP-1 agonist, it helps reduce hunger and suppress appetite. Think of it as turning down the volume on the constant “food noise” in your mind. This can be a game-changer, especially for those who battle emotional and genetic factors contributing to weight gain. Quieting that noise allows you to reconnect with your body’s hunger and satisfaction cues, a liberating experience for many.
  • Local Effects on the GI System: Semaglutide doesn’t stop at the brain; it also influences your gastrointestinal system. By slowing down the transit of food through your digestive tract, it ensures that food lingers in your stomach longer, making you feel full sooner and for an extended period.

The synergy of these central and local effects leads to weight loss and improved glycemic control, helping you achieve your health goals.

Are Semaglutide Right for You? 

This once-weekly injectable medication can be administered conveniently at home or in our office, depending on your preference. Our approach is to start low and advance slowly, tailoring the dosing to your unique needs. The goal? Achieve your desired weight with minimal side effects.

Maintaining Your Weight Loss

The million-dollar question: “Will I regain the weight after stopping Semaglutide?” Well, it’s a possibility, but not all hope is lost. Data from Semaglutide trials show that some patients did regain weight post-treatment, but they never returned to their pre-Semaglutide weight.

Our mission is to help you find your body’s “set point,” a weight that feels optimal and healthy for you, as this varies based on your genetics. As you get closer to your set point, weight loss might slow down.

Here’s where the functional medicine difference shines. At Blum Center for Health, your journey with Semaglutide is just the beginning. We embark on a 12-week exploration to uncover the root causes of your weight gain. We dive deep into intensive testing for blood work abnormalities, hormone imbalances, toxic load, nutrient deficiencies, and dysbiosis, among other factors. Our dedicated health coaching supports you in correcting these imbalances, ensuring that your weight loss is not just temporary but lasting.

Semaglutide is a groundbreaking tool, offering hope for those seeking to manage diabetes, combat obesity, and achieve lasting weight loss. Our approach goes beyond the prescription, addressing the root causes of weight gain and empowering you to maintain your newfound vitality.

Macaulay and Melissa will be with you every step of the way. Are you ready to embark on your journey to better health with Semaglutide? Book an appointment by calling 914.652.7800 or visiting www.blumcenterforhealth.com

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How To Tell If You Have SIBO or IBS?

Irritable bowel syndrome, also known as IBS, is the most common gastrointestinal diagnosis.

How common is IBS?  Scientific tests show that 10%-15% of Americans suffer from IBS. IBS is more common in women with almost twice as many women having it than men.  IBS is characterized by a cluster of symptoms, including recurrent abdominal discomfort, as well as a change in the frequency and/or consistency of bowel movements. Diagnosis is based on these symptoms; there is no official test for IBS. 

Due to this broad definition, at times ‘IBS’ is considered a catch-all term for anyone suffering from digestive symptoms who does not have inflammatory bowel disease. When assigned too broadly, it can provide a diagnosis without adequate investigation into the root cause of symptoms, and treatment may focus solely on providing temporary symptom relief rather than permanent resolution. Additionally, IBS is often falsely determined to be solely psychogenic, denying patients access to further investigation while reducing the cause of their suffering to ‘all in their head’. 

Changing Tides in Digestive Health

 Thankfully, our understanding of gut health – and gut disease – is changing rapidly.  Recent research indicates that the development of IBS is multifactorial, and is largely influenced by the health of the gut microbiome, the complex microbial ecosystem that houses fungi, viruses, and bacteria within the gastrointestinal tract. This is most evident when chronic IBS symptoms begin following acute gastroenteritis due to exposure to a pathogen. The introduction of a pathogenic microbe can create both the acute symptoms associated with acute gastroenteritis, such as vomiting, diarrhea, and fever, while creating a long-term shift in gut motility that sets the stage for chronic IBS.  

Alterations to the microbiome also appear to underlie the two main categories of IBS: diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C). IBS-D has been associated with increased levels of hydrogen-producing bacteria, while IBS-C has been associated with increased levels of methane-producing bacteria; both of these microbial imbalances are collectively known as small intestinal bacterial overgrowth (SIBO).

Does IBS = SIBO?

The gold standard for diagnosing SIBO is small intestinal aspirate, though it is rarely used clinically. Instead, lactulose breath tests are utilized to measure both hydrogen and methane levels; these measurements are indicative of bacterial levels within the small intestine. Research values vary but indicate that anywhere from 33-78% of patients diagnosed with IBS actually test positive for hydrogen and/or methane SIBO.  There is now a trio-smart test that also tests for sulfate gas.  An additional study of patients who tested positive for SIBO found a 7-8 fold increase in both Escherichia/Shigella and Klebsiella bacteria compared to non-SIBO patients.  An additional study in patients with IBS-like symptoms showed roughly 25% of them had an excessive number of fungal organisms within the small intestine, known as small intestinal fungal overgrowth or SIFO.   Recently, a large-scale study at Cedars Sinai has identified elevations of a third gas, hydrogen sulfide, in cases of IBS-D, indicating elevation in hydrogen sulfide-producing bacteria as both an additional type of SIBO, and another possible root cause of IBS.  Several therapeutic trials that aimed to treat gut microbes with antibiotics have shown favorable improvements in IBS-symptoms, further supporting the theory that microbial imbalances play a key role in the development of IBS.

All of this research indicates that for a huge percentage of IBS-sufferers, microbial imbalances, either in levels and/or locations of bacteria (as in SIBO) or fungi (SIFO), or a combination of both, are largely to blame for their symptoms. These findings are essential in providing relief for IBS patients, as these complex imbalances in the microbiome will not be corrected simply by following the typical treatment recommendations for IBS, such as stress management, increased fiber intake, laxatives or anti-diarrheals, or pain medications. 

IBS: A Way Forward To Healing

The diagnosis of IBS simply labels the symptoms as a syndrome, without providing any answers as to why a patient may be experiencing those symptoms. Without a root cause, it is difficult to provide the correct treatment methods. But with a correct diagnosis, the correct treatment methods can be applied.

Depending on symptomatology, it may also be helpful to test for Celiac disease, lactose intolerance, and food sensitivities, in addition to completing imaging to evaluate for inflammatory bowel disease such Crohn’s or Ulcerative colitis. While we have yet to gain access to testing methods for SIFO or hydrogen-sulfide SIBO, a comprehensive stool analysis can provide insight into the body’s ability to breakdown and absorb nutrients, as well as the health of the gut microbiome.  It is through these testing methods that specific imbalances in the gut can be identified; once they are identified, targeted treatments can be applied. For patients previously diagnosed with IBS, particularly if they have seen no resolution in their symptoms following the standard IBS treatment methods, identifying the root cause of their symptoms can be life-changing.

At Blum Center for Health, our team of practitioners and health coaches can work with you to heal your digestive distress. Whether you have an existing condition, are experiencing symptoms, or simply want to prevent future complications we are here to support you on the journey. Book an appointment by calling 914.652.7800.  

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What are Adaptogens?

Adaptogens are the wellness industry’s latest buzzword – adaptogenic lattes are popping up in salad bars and blends are finding their home on the shelves of apothecaries. Some adaptogens, like ashwagandha, can be taken in a powdered form. While others, like Lion’s Mane mushroom, can be a nice dinnertime side dish. So, what are they?

Adaptogens are a category of herbs and mushrooms that help balance your body’s reaction to stress by modulating its hormonal and physiological functions. Adaptogens improve adrenal function, protect you from disease, boost immune function and improve overall well-being. Adaptogens help your body handle stress. They are meant to bring us “back to the middle.”

Top Adaptogenic Herbs and Mushrooms

Ashwagandha

What it is: Ashwagandha, also known as “Indian Ginseng,” is a powerful Ayurvedic root that can help your body manage stress.

How it’s consumed: You can add ashwagandha to smoothies and teas. You can buy ashwagandha in powder, capsule, or tincture form.

What it tastes like: In Sanskrit, ashwagandha means “smell of the horse”, which refers to its interesting smell, and supposed ability to increase strength. It tastes slightly bitter, with herbal undertones, but pairs very well with creamy, cocoa flavors.

What it does, according to science: This Ayurvedic root helps reduce long-term stress and alleviate the hormonal imbalances that result from chronic stress. All without inducing a sense of fatigue, ashwagandha helps you build up tolerances to stressful situations, and relaxes an anxious mind. Some research suggests that Ashwagandha helps combat stress-induced weight gain.

Eleuthero Root (Siberian Ginseng)

What it is: Eleuthero root, also nicknamed “Siberian Ginseng,” has been part of the herbal repertoire of Traditional Chinese Medicine for centuries. There are more published scientific studies on eleuthero root than any other herb – and when you dig into the research it’s easy to see why so many scientists have been fascinated by this stringy, beige root. Not only has it been shown to decrease stress, but it has immune-boosting properties to boot.

How it’s consumed: People usually take the root and stem extracts of the eleuthero plant either as a tincture or as a powder. Either way, it can be added to smoothies, lattes, or other drinks and tonics.

What it tastes like: We’ll tell it to you straight: Eleuthero root is bitter, and not exactly a pleasant taste. This is definitely not a herb you’ll be downing with water (unless you’re super hardcore).

What it does, according to science: Siberian Ginseng decreases fatigue by increasing your work and exercise capacity without the “crash” that comes with a morning cup of coffee. With this herb, you’ll also recover faster from acute stress and intense workouts. Some preliminary research also suggests that eleuthero can protect against cognitive decline and reduce DNA damage.

There is abundant scientific research confirming their adaptogenic properties such as the ability to help the body resist a stress response in a non-specific way and the ability to help the body maintain homeostasis. Primary adaptogens directly influence the hypothalamic-adrenal-pituitary (HPA) axis in response to stress.

Reishi Mushroom

What it is: Reishi is an adaptogenic mushroom that has been a staple of holistic wellness and herbal medicines for decades — over 200 to be exact. As a species of the “woody” mushroom family, the fan-shaped ‘shroom boasts orange to reddish-brown hues and can be found in the forest areas of Asia, Europe, South America, and the United States. Reishi’s effects on the body are widely ranging – it’s been shown to have anywhere from anti-depressant qualities to anti-fatigue effects on the body.

How it’s consumed:Reishi mushroom has a tough, thick form that is hard to bite into – it’s definitely not a mushroom that you can just cut into and stir fry with your dinner veggies. Most consume it as a dehydrated mushroom powder, or in a liquid tincture form. Though, some cut the mushroom into long strips, then steep it in hot water to make tea.

What it tastes like: This isn’t the most delicious mushroom you’ll taste. Reishi has an earthy bitterness that has been compared to tree bark.

What it does, according to science: Reishi mushroom’s positive effects on the body are widely ranging. It’s been shown to decrease depression and work as an anti-fatigue agent in a population of breast cancer patients. There’s also ongoing research into whether the trace amounts of cytotoxins found in Reishi could be used in targeting cancer cells.

Maca Root

What it is: Maca is a plant native to Peru that has been traditionally used to improve energy and stamina, while also improving sex drive and fertility. It looks like a cross between a turnip and a radish, with thick rosemary-like leaves. Different varieties come in different colors: red, pink, black, and yellow.

How it’s consumed: For most, maca root is supplemented as a dried powder. The caramel-like taste mixes very well into smoothies, lattes, and even the occasional oatmeal bowl.

What it tastes like: It has a delicious caramel-like flavor, with a subtle earthy aftertaste. Out of all the adaptogens, some vote for maca root as the best tasting.

What it does, according to science: This Peruvian root, long used by Spanish royalty, helps improve memory recall ability and overall learning ability. This super root is also known for its ability to protect against depression and age-related cognitive decline.

Rhodiola Rosea

What it is: Also commonly called “Golden Root” and “Arctic Root”, Rhodiola typically grows in the cold, mountainous regions of Europe and Asia, as well as high altitudes in the Arctic region, such as Finland, Norway, and Russia. Historically, people in northern regions of Scandinavia and the Nordics have used Rhodiola for anxiety, fatigue, and depression, People also have used it to increase physical endurance and to improve resistance to high-altitude sickness.

How it’s consumed: Typically it’s taken as an extract that confers both 3% rosavin and 1% salidroside.

What it tastes like: It actually tends to taste somewhat sweet with only a slight bitterness, which allows it to mix very well with many drinks and desserts.

What it does, according to science: It has been shown to help with physical performance in non-athletes by modulating cortisol levels after exercise-induced stress, and to reduce general anxiety as well. Note: it is not recommended in high amounts for pregnant women or those taking Warfarin.

Schisandra Chinensis

What it is: Known also as “Omija”, it is a bright red berry that is natively found in China, where it has been used to make medicine, tea, and wine for centuries.

How it’s consumed: Normally it’s taken in the form of dried powdered fruit, although can also be found in the form of whole dried fruit, juice, or part of a tea blend.

What it tastes like: Called “the five flavor fruit” in Chinese, it has an interesting mixture of flavors described as sweet, salty, bitter, pungent, and sour.

What it does, according to science: It possibly reduces anxiety, and could affect cortisol levels, although most of the research from numerous human trials that were done in Russia have been kept secret. New research is still being currently done however and shows promising possibilities, and the fruit itself is high in beneficial lignans which can aid in maintaining a healthy bacterial gut biome.

Angelicae Sinensis

What it is: Natively referred to as Dong Quai (which translates to female ginseng), this antioxidant-rich, adaptogenic root has long been cultivated in Traditional Chinese Medicine for its health effects in women. Although most likely first widely cultivated in Asia for medical purposes, this nomadic herb canalso be found in the middle east and eastern Europe, and possibly originated in modern-day Syria. It is also very commonly used as a botanical in many popular gins.

How it’s consumed: The root is normally dried and/or powdered and can be found in loose powdered form or with the powder encapsulated into pills.

What it tastes like: Bitter and earthy, but with a very subtly sweet and flowery undertone.

What it does, according to science: The polysaccharides in Angelicae Sinensis have been shown to cause hematopoietic effects in both animal models and in humans, meaning it aids in the formation of new red blood cells and thus could aid in the bioavailability of other compounds in the bloodstream, as well as having anti coagulative effects. There is also some evidence that it does indeed affect the female reproductive system with a kind of hormone regulation and is, therefore, advised to not take it if pregnant.

 

In Closing….

Adaptogens can have a wide array of benefits to the human body due to the balancing effects they can bring and have properties that can truly aid against the added stresses and anxieties of a modern lifestyle. Adding adaptogens into your diet or taken as an added nutritional supplement could bring some health benefits – at least based on current research – and they are similar in their role against stressors as antioxidants are to oxidizers.

 

Jennifer L Jennings, DNP is a board-certified Family Nurse Practitioner with a doctoral degree in nursing practice (DNP), an IFM Certified Practitioner, and a diplomate for the American Academy for Anti-Aging Medicine (A4M). She explored functional medicine for her own health journey and observed her body healing through dietary changes, stress management, GI healing and key supplements as well as bioidentical thyroid management. She knew in that moment that the foundations of functional medicine were the comprehensive medicine that she wanted to discover, learn and deliver to her patients. Book an appointment with Jennifer through Blum Center for Health by calling 914.652.7800