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I discovered the exact steps needed to help thousands of people treat and heal every type of arthritis. Now, I want to help you live pain free with the Healing Arthritis Challenge.

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What You Need to Know About the Slow Burn: GERD

Nothing like a slow burn in the middle of your chest or the back of your throat to wake you up at night in a panic!  Or at least in a lot of pain. The most common cause for this experience is gastroesophageal reflux, or GERD.

About 60% of American adults will have some symptoms of reflux or heartburn in a year’s time, and more and more children are developing them, too. Silent reflux is another very common diagnosis, even when you don’t have classic “acid indigestion” symptoms.

Why is it so common? Many of us have gut bacteria imbalances lower down in the gastrointestinal (GI) tract from too much stress, too many antibiotics, or food intolerances that have upstream effects creating reflux, gas, bloating, or abnormal stools.  Or perhaps your anatomy gets in the way of normal downward muscular action of the esophagus so that your food doesn’t drop down into the stomach normally.  Many medications can also predispose to reflux, as can sleep apnea.

When we take an acid blocker such as “the purple pill” or Prilosec, we get relief from that terrible burning sensation, but it only makes matters worse in the long run.  

We are learning more and more about the long-term side effects of these medications, which includes diarrhea, pneumonia, muscle spasms, osteoporosis, and more concerning cancer and dementia. Once started on these medications, people often continue them for years because they don’t know how to solve their underlying imbalance to eliminate the reflux and the need for medication.

Here are 5 Tips for Avoiding Reflux:

  1. Don’t eat a meal within two hours of going to bed, so that the stomach is empty when you lie down. 
  2. Dairy products cause reflux, or can make it much worse. 
  3. A tablespoon of apple cider vinegar in a little water at the end of your meal may nip reflux in the bud if too little stomach acid is the cause of your reflux. 
  4. If apple cider vinegar makes your reflux worse, try a ½ tsp of baking soda in a little water instead; if this brings relief, then you may have a problem with too much acid.
  5. Simple modifications such as elevating the head of your bed and lying on your left side can help.

Live in our neighborhood? Come join our community talk, “Get to the Root of your Reflux” and find out more about common causes GERD, how to figure out what might be your specific trigger(s), and how you can solve the problem by getting to the root cause. Dr. Gereau and Elizabeth Greig will be talking about symptoms in both children and adults and there will be time for answers to your questions.  Sign up here.  

Meet Dr. Gereau: Sezelle Gereau, MD, is an integrative ENT/Allergist with more than 20 years of experience. She uses an integrative and functional medicine approach to conditions such as sleep apnea, headaches, allergies and chronic sinusitis. Learn more about Dr. Gereau’s practice.

Meet Elizabeth Greig, FNP: In her dual role as our Functional Medicine Nurse Practitioner and a teacher in our Mind.Body.Spirit programs at Blum Center for Health, Elizabeth Greig, MSN, FNP, helps treat and heal patients with complex chronic health conditions. Whether she’s treating a medical condition or leading a class in meditation, Elizabeth helps people understand that when it comes to healing, it’s more about nourishing life, than it is about battling illness. Learn more about Elizabeth’s practice.

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10 Ways Women Can Reduce Holiday Stress

Fact: Holiday stress is disproportionately felt by women.

Why? Because women do the holiday “heavy lifting.” According to research by the American Psychological Association (APA), women shoulder the majority of the family burden for shopping and holiday celebrations (think cooking and cleaning), and they feel particular stress from the time crunch of getting it all done.

Many women during the holidays put stress management practices, such as daily meditation, yoga or walks, on hold while cramming too much into too little and turning to comfort foods as a way to cope. This leads to arthritis flares, increased symptoms of autoimmune disorders, such as fatigue and chronic pain, increased anxiety and depression and for some, weight gain.

Here’s how holiday stress impacts women, according to the APA study:

  • 44% of women report that their stress increases during the holidays
  • 69% of women feel stress from a lack of money
  • 51% of women feel pressure to give or get gifts
  • 69% of women feel stress from a lack of time
  • 41% of men strongly agree that they feel like they can relax during the holidays while only 27% of women feel this way
  • 41% of women eat for comfort during the holidays
  • Women are twice as likely to report that they cook, shop for food, and clean.

Many women also struggle with the stress created by the double shift of work and family of responsibilities. The worries of weight gain, the stress of so many social commitments (another holiday party?), family, friends, and the ever-shrinking bank account can all build up to feel like one giant pressure cooker. After all, food is always around, and with all the running around to get stuff done women will drop their fitness routines in order to just sit for a while.

“Women in particular need to be mindful that their responsibilities may have more stressful consequences than they realize, and that they are reacting to the stress in unhealthful ways, like eating and not permitting themselves to relax,” according to the APA.

Ladies, it’s time to bring down the holiday stress level several notches!

10 Ways To Beat Holiday Stress & Create a Healthier, Happier Holiday:

  • Take a daily walk with no phone, no agenda. Unplug from the world. Twenty minutes every morning makes a huge difference in how you face the day.
  • 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!
  • 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.
  • Say “No.” We go overboard to please others. Accept the commitments you want. Period.
  • Ask for help and delegate. Accustomed to doing it all? Most of the people in your life are accustomed to you doing it all too, and most likely, they don’t realize you need help. They aren’t mind readers. Ask for help, and be ready to assign a task.
  • 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!
  • Simplify — ask yourself, “How can I make this easier?”
  • Downsize meals — consider less dishes, or host a community meal where everyone brings their favorite dish. This creates inclusion and connectedness.
  • Reduce gifting — Set boundaries and limits early, and stick to them. Decide for whom you are buying presents, and decide on a quantity. When we give with overabundance to the people in our lives we desensitize them to the meaning of the gifts.
  • Simplify plans with close friends Save the holiday get-together for after New Year’s. For now, get together for coffee as a respite from the holiday flurry.

In essence, what all of this means is slow down, enjoy the sights and sounds of the holidays, and most of all fill your holiday with joy, love, gratitude and merriment. There’s much to celebrate — including a less-stressed you!

Resource: Greenberg, Quinlin & Rosner, 2006. Holiday Stress Report. American Psychological Association.

Looking for a Detox Recovery Plan after the New Year? If you live in our neighborhood, join me in a dynamic group detox that will not only detox your body, but will also renew your spirit and help dissolve any negative thinking. Join us. I can’t wait to meet you! Learn More and Sign Up

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters.

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Hypothyroidism: A Silent Epidemic

Guest post written by Jill Grunewald

If you’re even loosely tuned into online health communities, it probably seems as though “thyroid” is all the rage. Everyone appears to be talking about it. But that doesn’t mean that addressing—or assessing—thyroid health is a fad or “the next big thing.”

In fact, although the thyroid is a tiny gland, it is a big thing.

Why? Because every cell has thyroid hormone receptors. This is why the symptoms of hypothyroidism can run the gamut from mild fatigue to pronounced depression, for example. Additionally, more and more women—and to a lesser but no less concerning degree, men—are being diagnosed with hypothyroidism or low thyroid function. The problem is even starting to affect young girls, for reasons discussed below.

Hypothyroidism as a condition isn’t new. Lab testing for thyroid function has been around since the 1950s. You may have had a grandma or great aunt who had a “glandular problem,” which often meant they were hypothyroid.

What is the Thyroid?

This little butterfly-shaped gland in our neck is the maestro of our endocrine (hormonal) system. I like to refer to it as the spoon that stirs our hormonal soup.

Thyroid hormones—primarily T3 and T4—play a significant role in energy and metabolism. This is why the thyroid is often called “the master gland of metabolism.” These hormones also influence the brain, gallbladder and liver function, body temperature regulation, the gastrointestinal tract, our reproductive and cardiovascular systems, red blood cell metabolism, steroid hormone production, and bone metabolism.

The thyroid takes a mineral and an amino acid, iodine and tyrosine respectively, and converts this combination into T3 and T4. T3 is the most biologically active thyroid hormone—it’s what helps keep us lean, sharp, and warm.

Familiar symptoms of hypothyroidism include:

  • Fatigue
  • Brain fog
  • Constipation
  • Depression
  • Weight gain/weight loss resistance
  • Hair loss, including outer third of eyebrows
  • Dry skin
  • “Thyroid hair” (dry, brittle hair)
  • Weak reflexes
  • Feeling cold when others are comfortable

Symptoms often not recognized as being associated with hypothyroidism include:

  • High cholesterol
  • Edema/fluid retention (often present around the eyes/face)
  • Recurring infections
  • Going prematurely grey
  • Low libido
  • Anxiety
  • Headaches
  • Infertility
  • Miscarrying
  • PMS
  • Pronounced morning fatigue
  • Being stiff and achy upon waking
  • Digestive issues
  • Irregular menstrual cycles
  • Parched mouth
  • Gravely voice

One of the reasons that hypothyroidism is a silent epidemic is that too many of the above symptoms are viewed in isolation—too often, an underactive thyroid isn’t suspect. If you’re depressed, you may get a prescription for an antidepressant. If you’re constipated, a laxative. If you’re gaining weight or weight loss resistant, a recommendation to eat less and exercise more. If you’re struggling to get pregnant, a suggestion to try IVF.

To complicate matters, even when thyroid function is tested, it’s often not evaluated thoroughly—doctors often run a simple TSH (thyroid stimulating hormone) test, which only tells a small part of the story. TSH should always be taken in the context of other thyroid hormones, especially considering that TSH can be within normal limits in the face of hypothyroidism. These additional labs include Free T3, Free T4, Reverse T3, and thyroid antibodies that could show the presence of Hashimoto’s (autoimmune hypothyroidism): thyroperoxidase antibody (TPOAb) and thyroglobulin antibody (TgAb).

Hypothyroidism: Root Cause?

Hashimoto’s is the most common form of thyroid dysfunction—it’s estimated that over 90% of people with low thyroid function have the autoimmune form of the condition. In fact, Hashimoto’s is the most universal autoimmune disease and it’s estimated that 30 million women alone have it, whether they know it or not.

Historically, iodine deficiency has been considered the culprit, but this too tells a small part of the story. Today, iodine-deficient low thyroid function, without the autoimmune component, is unusual, but that’s not to say that those with Hashimoto’s can’t be low in this important mineral.

Other, “modern” causes of hypothyroidism/Hashimoto’s include:

  • Exposure to environmental toxins (including heavy metals and pesticides) *
  • Unrelenting stress, which can result in adrenal dysfunction/HPA axis dysregulation
  • Systemic/cellular inflammation
  • Intestinal permeability
  • An infection
  • Nutrient deficiencies

* Environmental toxins in the form of chemicals added to skin care and cosmetics products is why we’re seeing Hashimoto’s—and other forms of autoimmunity—much more frequently in the female population, including younger and younger women. As Dr. Susan Blum states, “. . . every chemical you are exposed to adds to your toxic load. Having a high toxic load makes it harder for your liver to handle pesticides and environmental estrogens, toxins that we know will affect your immune system.”

Spotlight: Nutrition for the Thyroid

Perhaps you’ve already been diagnosed with hypothyroidism or Hashimoto’s. You may be on thyroid hormone replacement—or maybe not. Regardless, the thyroid is extremely nutrient dependent and being mindful of your diet is critical for managing Hashimoto’s and giving your thyroid the nutritional love it so depends on.

Eating minimally processed foods with naturally occurring vitamins, minerals, amino acids, and phytonutrients is one of the best ways to support the thyroid—and immune system.

Genetically modified foods (GMOs), artificial sweeteners and additives, toxic oils, and antibiotic- and hormone-laden foods—all part of the standard American diet (SAD, and yes, it really is sad), trigger oxidative stress, which in turn affects how our cells communicate. Knowing that every cell has receptors for thyroid hormone, it’s not difficult to recognize how a diet deficient in key nutrients can disrupt this cellular communication.

So, what are these key nutrients?

I spent many weeks digging deeply into thyroid- and immune-supportive nutrition and then identifying foods rich in those nutrients. This meticulous research and subsequent ranking system became the foundation, the “nutritional springboard” for my best selling cookbook, The Essential Thyroid Cookbook.

This first-of-its-kind cookbook will leave no trace of doubt that our recipes are uniquely beneficial to your thyroid and immune system. They’ll support you for a lifetime of peak thyroid function no matter where you are on your wellness journey.

And finally, as for the multi-faceted nature of hypothyroidism symptoms, often, they no longer need to be seen as silos warranting individual treatment. Support the thyroid and immune system, and likely, you’ll see far-reaching improvement with these previously maddening symptoms.

Jill Grunewald, HNC, is an integrative nutrition and hormone coach and best selling author of The Essential Thyroid Cookbook.

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Curcumin – the Anti-Inflammation Wonder Herb

Turmeric (Curcuma longa) is a culinary herb that is an amazing medicinal multi-tasker! It has a bright yellow/orange hue that gives curry its vibrant color. A member of the ginger family, turmeric contains many compounds including several in the curcumin family. Curcumins are known to have anti-inflammatory, anti-oxidant, anti-cancer properties.

Despite that curcumin has been used medicinally in Ayurvedic medicine in India for centuries, it is only more recently that interest has caught on in the U.S. Luckily for all of us, the enormous potential of curcumin has resulted in a growing body of research to help us understand how it works and which scenarios it works best in. Currently there are ongoing studies looking at arthritis, inflammatory bowel disease treatment, colon cancer prevention, Alzheimer’s disease, depression, to name just a few.

Cooking with turmeric is an easy and healthy way to benefit from curcumins. It adds a delicious color and flavor to dishes. Turmeric tea is another excellent way to enjoy this powerful herb.  It does seem, however, that the doses needed to get full medicinal effect are much higher than one could ever get in a helping of your favorite curry. Although I always encourage people to get their nutrition from food before supplements, this is one case where taking a curcumin supplement does much more for you than simply cooking with it.

How to use Curcumin Medicinally

Arthritis

In the case of arthritis, curcumin works by neutralizing free radicals as well as by inhibiting pain and inflammation. In fact, it suppresses multiple inflammatory chemical messengers that the body makes.  It does this by inhibiting several enzymes along the inflammation cascade, the very same enzymes that ibuprofen and naproxen block.

And research supports this. A well designed study of 367 arthritis patients found it to be as effective as the traditional anti-inflammatory drug, ibuprofen with fewer side effects1.  Additionally, curcumin has been found to decrease substance P in nerve cells which is an additional way that in can improve pain in all kinds of arthritis.A typical dose would be 500mg taken 1-3 times a day.  

PMS

As a gynecologist I am always looking for ways to help women manage their period problems. For the same reason that curcumin helps arthritis, it is logical that it would be helpful for pain associated with menstrual cramps. One prospective randomized trial of 70 women with PMS showed that 100mg taken twice a day for 10 days starting one week before menses reduced PMS scores by 59% compared to just 14% in placebo group. Effects were seen for all three symptom categories: physical, behavioral, and emotional2. What’s nice about this study is that the authors used a relatively low dose compared to other applications. Lower doses mean fewer potential side effects.

Ulcerative Colitis

Curcumin’s powerful anti-inflammatory effects and limited absorption from the GI tract make it an excellent agent to treat inflammation in the gut. There are ongoing studies looking at curcumin as a treatment for inflammatory bowel disease. One such study of 89 people with ulcerative colitis found that when in remission, those who took 1,000mg curcumin twice a day for six months, along with their regular medicine, had lower relapse rates than those who took placebo.3

Cancer

From a cancer perspective, curcumin has the ability to alter gene transcription and actually stop cell growth, known as apoptosis. Its anti-cancer properties are also thought to come from anti-inflammatory and antioxidant effects. It has been studied and used for prevention or treatment of colorectal cancer, pancreatic cancer, breast cancer, multiple myeloma, lung cancer.  Interestingly, there are also studies to suggest that whole turmeric has anti-cancer properties beyond curcumin extracts alone.4

Things to Know:

Because curcumin is not well absorbed by itself you will need to use a preparation that has been specially formulated so that your body can digest it. Many supplement preparations have black pepper, also known as bioperine, added to it which improves intestinal absorption by about 1000%. There is some concern that pepper is irritating to the GI lining which might be problematic. Alternatively, some brands have specially formulated the herb in a delivery system that optimizes absorption.

Dr. Blum’s non-GMO Super Curcumin, available in our online store, is formulated with super-absorbable sunflower lecithin so that you will reap the benefits of every milligram. See it Now

Who Should Not Take Curcumin

Curcumin is usually well tolerated but can lead to GI upset if taken in high doses and could cause an allergic reaction. People with gallbladder obstruction should avoid curcumin because it can cause the gallbladder to contract. This can be helpful for some kinds of digestion, but could make things worse if you have a gallstone blockage. Additionally, patients with gastric ulcers should avoid curcumin. Patients on blood thinners should be careful with curcumin. Always tell your healthcare provider if you are taking any herbs.  I don’t recommend curcumin supplements in pregnancy due to lack of safety data.

Do You Suffer With Arthritis?

Are you ready to live a pain-free life? Whether you suffer with an autoimmune condition like Hashimoto’s or arthritis, Dr. Blum can help you!

In her new book, Healing Arthritis, Dr. Blum presents the exact 3-Step Protocol that we use with patients at Blum Center for Health. You will learn the best food plan for arthritis, the precise supplements and dosage we recommend for an arthritis-free life, how to build resiliency so that life’s stressors won’t affect your health, and what your gut has to do with your arthritis symptoms. In essence, Dr. Blum gives you all the tools you need to fix your gut and heal your arthritis. Get The Book Now

Resources:

  1.  Kuptniratsaikul V et al Clin Interv Aging. 2014 Mar 20;9:451-8. Efficacy and safety of curcum domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study.
  2.  Khayat S et al Complement Ther Med. 2015 Jun;23(3):318-24  Curcumin attenuates severity of premenstrual syndrome symptoms: A randomized, double-blind, placebo-controlled trial
  3. Hanai H, et al  Clin Gastroenterol Hepatol. 2006 Dec;4(12):1502-6   Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial
  4.  Devassy JG, et al  Nutrition Reviews, Volume 73, Issue 3, 1 March 2015, Pages 155–165.  Curcumin and cancer: barriers to obtaining a health claim

 

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5 Easy Ways To Survive the Thanksgiving Food Fest

Gobble, gobble, indeed! According to research from the Calorie Control Council, the average American may consume more than 4,500 calories on Thanksgiving Day. Whoa! That’s more than double the average person eats on a regular day. That’s pretty shocking.

This is particularly problematic for people with autoimmune disease, such as rheumatoid arthritis or Hashimoto’s, or those who contend with joint pain, reflux or food sensitivities. Underlying conditions almost always flare! Sometimes immediately, sometimes up to two days later.

Why, oh why, do we do that to ourselves?

Of course, you hear the stories of family drama, but it seems to run much deeper than that. It’s as if Thanksgiving has become an overeating contact sport. We start preparing in advance and even start bemoaning the after-effects of too much food well before the actual event. We act as if eating until bursting point is expected and completely out of our control. And just like a football game, Thanksgiving comes replete with the after-game commentary and play-by-play.

We also tend to do what we’ve always done. Overeating on Thanksgiving, in essence, has become a habit!

The great news is: You can change that script. It is entirely possible to indulge in all of Thanksgiving’s deliciousness AND feel satiated, content and even full, WITHOUT having to resort to elastic-waisted pants for a few days.

5 Easy Ways To Survive the Thanksgiving Food Fest

Eat Throughout The Day — Often we approach Thanksgiving thinking that we will forgo food during the day in order to partake more heartily during the main event. Big mistake! In fact, when we skip meals we generally eat more. Choose small, filling meals. For breakfast, have a bowl of gluten-free oatmeal with berries and nuts. For lunch, have coconut milk kefir with nuts and fruit, or avocado toast — think slow-digesting carb with a healthy fat and protein. It will stabilize your blood sugar, keep you satiated, and set you up for a healthy Thanksgiving meal.

Skip the Snacks — One of the wonderful things about Thanksgiving is the home-cooked meal. Mindlessly eating chips, store-bought white breads, and other processed foods, not only is unhealthy and stimulates your appetite, but it’s also not tasty. Stick with real food — fruits and crudite are great choices for healthy snacking.

Forgo The Impulse to Mirror Other People’s Eating — How often do you reach for food when you see someone else eating? Right. Me too. It takes awareness. Every time you start to reach for something at the hors d’oeuvre table, ask yourself, “Why am I reaching for this?” If it’s because someone else is eating, pick up a glass of sparkling water instead.

Eat Your Veggies! — Rather than filling your plate with everything on the table, start with a plateful of salad and vegetables. Most Thanksgiving meals have salad, green beans, Brussels sprouts, and other delicious but overlooked vegetables. Start with them instead of making them an afterthought. Once you’ve enjoyed your veggies, then take a little bit of everything else. In fact, switch your plates. Use the dinner plate for the salad and vegetables, and the salad plate for turkey, sweet potatoes, mashed potatoes and stuffing.

Slow Down! — Put down your utensils between bites, sip water between bites, and focus on connecting with those around you rather focusing on the food in front of you. Take the time to appreciate your food, smell it, look at it, and savor it.

Oh, and give yourself permission to leave food on your plate!

Happy Thanksgiving!

 

Do you have a hard time staying on track during the holidays? Or, does holiday stress overwhelm you? Consider working with a Health Coach (hey, I’m one!) who will help you create a stress-free holiday survival plan and stick with it. Learn more about CoachMe.

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters.

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3 Steps to A Healthy Blood Sugar Level

Here’s a common scenario: You see your primary-care doctor for your annual physical, and you are told your sugar is a little high, and you may even have “pre-diabetes”….and you think, wait, what?  And the news keeps on coming. Your insulin may be “a little” high as well, or your cholesterol markers show a less than perfect balance.  If the numbers are mild, you’re usually told to “eat better, lose weight, exercise”, and if the numbers are really bad, you’re told to start medication.

Without a clear understanding of what these markers mean and how these early imbalances in your sugar system can eventually become full-blown pre-diabetes and then diabetes, you might have little motivation to do the work to change them.  And while yes, lifestyle change can feel like work sometimes, you might be surprised to find that some simple changes will do the trick. Perhaps you are a little overweight, are a little stressed out, and/or you aren’t exercising much.  Addressing these things with some simple suggestions, can really make a big difference, and that’s why it’s important to take these early abnormal numbers seriously, because now is the best time to reverse the direction that you are heading in.  

My goal for our discussion today is to first make it clear that if you ignore these first subtle changes, you will likely find yourself with a bona-fide disease down the road.  But even now, the high sugar in your blood is inflammatory and damages your blood vessels and organs. This is a huge issue!  There are 84 million people currently diagnosed with pre-diabetes (and rising!) and you don’t want to end up with type 2 diabetes, which is a major contributor to heart and vascular disease —  the leading cause of death in the developed world.   

That’s why, now is the time to do something about it.

And the good news? High blood sugar, pre-diabetes and yes, even if you already have diabetes, these are all reversible!

4 Steps to Reverse Pre-diabetes

Step 1: Recognize the implications this has on your health.

The first step is to listen to your body and understand what it’s trying to tell you.

Here is what you need to know to tune into your blood sugar system:

  • Know your risk: At Blum Center for Health we generally screen everyone for early blood sugar abnormalities and diabetes using a simple blood test. I screen for insulin resistance and pre-diabetes in patients who are older (over 45), overweight, physically inactive, have family members with diabetes, gave birth to a baby over 9 pounds (or had gestational diabetes), have PCOS, and/or have other risk factors for heart disease – like high cholesterol or high blood pressure.  

 

  • Check these labs:  The list of labs includes fasting glucose, fasting insulin, and hemoglobin A1C (a measure of the average sugar in the blood over a period of time). We do advanced cholesterol testing, because higher triglycerides and lower “good” cholesterol gives clues to insulin resistance.  Sometimes we do glucose tolerance testing, where we look at the amount of sugar and insulin in the blood after drinking a sugary drink. This tells us how hard the pancreas is working to produce enough insulin to decrease sugar in the blood.

Step 2: Make impactful changes to your health.  

Here is the good news.  Catching diabetes before it manifests and treating insulin resistance is relatively straightforward, although you do have to commit to some permanent changes, which for some people can be difficult. The lifestyle changes that improve the entire spectrum of metabolic and blood sugar issues are tried and true. In fact, lifestyle changes have been shown to improve numbers in these early stages of diabetes more than medication.

Focus on these 3 lifestyle behaviors to improve your personal glucose system:

  • Diet –  Eating a higher protein, higher fat and lower simple carbohydrate diet is key.  There are many nuances to this, and we suggest working with a nutritionist or health coach to help you figure this out, because it is the quality of the protein, fat and carbohydrates that counts as much as the amounts.  Also, losing weight helps – even a 5% drop in weight (about 8 pounds for a 150 pound person) will improve insulin resistance. I refer nearly all my pre-diabetic patients to our Functional Medicine nutritionist or our Health Coach to create a personalized food plan that dovetails your individualized treatment plan. Learn More If you live far away, you can also work with our Health Coach online!  Sign up HERE.
  • Exercise – Physical activity allows muscles to use up the sugar from the blood which lowers blood glucose and improves insulin sensitivity. Just 30 minutes of exercise, 5 days a week will help. Brisk walking after meals recruits muscles to move glucose from the blood.
  • Sleep – Getting plenty of restful sleep is good for us in so many ways, metabolizing sugar being one of them. Disturbed sleep and sleep apnea is correlated with the spectrum of sugar dysregulation.

Step 3:  Get the support you need!

Once you begin to make changes to your daily habits, you might need support to keep you focused and in the game!  What can this look like?

  • For some people, support is letting everyone around you know what your health concerns are, and why you’ve decided to work on new food and exercise goals. Having your family, coworkers and friends on board can make it less likely for you to slip up.
  • Enlisting others to do it with you is another option that can be very satisfying for all involved.
  • For others, being mindful and collecting data about your food, activity, and sleep is what is key. Fitbits and other tracking devices, food diaries, and keeping careful logs of sugars can be very helpful for you and your doctor.  
  • Make sure you have a supportive medical team, including a doctor who is invested and spends time with you to encourage and follow your progress.  
  • One of the most powerful ways you can create positive change is by working with a Health Coach who will help you overcome obstacles and keep you focused on the prize. Learn More

Step 4: Monitor markers and observe progress.  

Keep track of your markers and notice when things change. I guarantee that if you make the changes above, to diet, movement, and rest – the numbers will move in the right direction.  If not, something else is brewing and needs our attention.

  • Tracking progress:  As I discussed above, there are many ways to track insulin sensitivity, prediabetes, and type 2 diabetes. Glucose and hemoglobin A1C are not the only biomarkers playing into this metabolic orchestra. Ask your physician to do more in-depth diabetic screening, advanced lipid testing and hormone testing. If you see a functional medicine doctor, adrenal testing can be telling, as can stool testing for a look into the gut microbiome. Further investigation into inflammatory markers, toxins, and nutrient status can also help guide overall health.

Live in the NYC metro area and want to learn more?

Join me for a community talk An In-Depth Discussion on Diabetes on Wednesday, November 15th at 7pm. Register Now! I will review how we treat these conditions from a functional medicine perspective – dietary guidelines, supplements, and medications that work.

Are you interested in meeting with me or one of my colleagues? We would be happy to help. People travel from all over the world to work with us. Come join our family!

If traveling to us is not possible, you can work with our Director of Nutrition or Health Coach by phone or Skype. Call 914-652-7800 for more information.

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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Try This Hearty Breakfast Cereal for Cool Mornings

As the weather turns cooler you may be wondering how to incorporate a heartier breakfast that’s good for your gut and good for your joints.

Start the day well with a warm and healthy breakfast cereal. A bowl of hot quinoa cereal on a cool morning is one of life’s simple pleasures and incredibly versatile.

You can use different combinations of spices, toppings, and fruits to customize your breakfast.

Think seasonal: Experiment and try adding autumn fruits, such apples, pears and blackberries. Stir in some of your favorite nuts and seeds, including chia or flax seeds — it’s a great to add fiber and protein! And, consider playing with some warming spices, such as ginger or cardamom. You can’t go wrong!

Use our basic recipe as your starting point:

Hot Quinoa Cereal with Fruit & Nuts

3 servings

  • ½ cup quinoa
  • 1 cup water
  • 1 cup non-dairy milk, like almond, coconut or rice milk
  • ½ tsp sea salt
  • ¾ Tbsp maple syrup
  • ¼ tsp ground cinnamon
  • 1 tsp  vanilla extract
  • ¼ cup slivered almond or toasted walnuts
  • Optional: fresh berries, ghee

Directions:

  1. Rinse the quinoa with cold water in a fine mesh strainer and drain.
  2. Put the water, milk and salt in a pot and bring to a boil.  
  3. Stir in the quinoa, turn down the heat to medium low, cover the pot, and simmer gently for 15 minutes, stirring occasionally and adding more milk if needed. The cereal is done when the quinoa is soft and has the consistency of oatmeal.
  4. Remove from the heat and stir in the maple syrup, cinnamon and vanilla.
  5. Transfer to bowls and serve warm or cold with toasted nuts and fresh berries and stir in a teaspoon of ghee if desired.

 

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters.

 

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What Your Doctor Won’t Tell You about Arthritis

The “itis” in “arthritis” means inflammation. Inflammation is the most basic problem in all arthritis, whether it is what we traditionally call “inflammatory arthritis,” like autoimmune rheumatoid arthritis, or the arthritis most associated with wear and tear on joints over time, osteoarthritis.

The traditional medical approach to these two kinds of joint inflammation is to use different medications, depending on the type or arthritis, to block the inflammation process. Although these can be successful in decreasing symptoms and can in some cases prevent further joint destruction, the medications don’t get at the root cause of why you developed the inflammation in the first place.  

Functional medicine takes a deeper look at the causes of inflammation and gives you options for reversing the process where it starts: in the gut, in the mouth, from your food, and from the stress response. Traditionally, doctors almost never evaluate these areas when addressing joint pain, but fortunately, functional medicine has the tools to do just that.

This is exactly why Dr. Blum, our Medical Director of Blum Center for Health, the medical center where I am a Functional Nurse Practitioner, wrote her new book, Healing Arthritis. After being diagnosed with arthritis, she cured herself and then spent the better part of two years studying arthritis and writing this book. How do I know it works? Because we successfully treat our patients with the very same protocol every day! Learn More about Healing Arthritis

What Your Gut and Mouth Have to Do with Arthritis

The mouth and the gut are two of the biggest reservoirs of beneficial bacteria in the body. These bacteria are vital to our health and we can’t live without them. Normally, the bacteria in the gut do many good things for us, like nourishing our gut lining to keep it healthy—but keep in mind that the health of these bacteria depends on things like eating plenty of fiber, avoiding sugar, having very little exposure to antibiotics, and having strong digestive power.

Gut bacteria can become a major source of inflammation, if the bacteria are not in balance, leading over time to a condition called leaky gut, or increased intestinal permeability.  Leaky gut allows the bacteria, food particles and inflammation to seep out of the gut and spread throughout the body, especially to the joints, causing pain and inflammation. Research has borne out this connection: many people with arthritis will experience significant reduction or reversal of their joint pain and inflammation by rebalancing their gut flora with a program of food, antibacterial herbs, probiotics, and glutamine.   

In a similar way, the abundant bacteria in the mouth can create inflammation in the body in people with gingivitis or periodontal disease. The inflamed gums allow the inflammation generated by the bacteria to enter the body and cause system-wide inflammation. One of the most important things you can do to prevent this trigger for joint pain, in addition to eating a diet low in sugar and high in vegetables, is to floss every day and have your teeth cleaned regularly. Studies have shown—and it is our experience at Blum Center—that for a certain percentage of people with inflammatory arthritis, reversing their periodontal disease also reversed or reduced their joint disease.

The Food You Eat & Arthritis

At Blum Center, we have any number of patients with both osteoarthritis and inflammatory arthritis who have done an elimination diet and found out that by eliminating foods such as gluten and dairy, their joint pain got much better.  When they reintroduce these foods, they get a flare of pain. Most of the time, their rheumatologist will tell them that eliminating foods will not help arthritis, but we see the benefits every day and medical research supports the association as well.

And, Yes, Stress is a Major Arthritis Trigger

And then there’s stress!  We so often leave it for last, I think because we find it so challenging to figure out what to do about it. When stress comes into the body, it can make a significant impact on our biochemistry by changing hormone balance, energy production, and digestive power. Many of these biochemical changes lead to some form of inflammation and patients’ experiences, as well as our own, show us that a flare of symptoms often follows a stressful time. Doing practices like meditation, listening to beautiful music, restorative yoga, a walk in nature can shift this inflammatory biochemistry even when you may not be able to eliminate the life events that are triggering a stress response.  Ten minutes of focused breathing or meditation can make a world of difference as well as a difference in our world!

In her new book, Healing Arthritis, Dr. Blum presents the exact 3-Step Protocol that we use with patients at Blum Center for Health. You will learn the best food plan for arthritis, the precise supplements and dosage we recommend for an arthritis-free life, how to build resiliency so that life’s stressors won’t affect your health, and what your gut has to do with your arthritis symptoms. In essence, Dr. Blum gives you all the tools you need to fix your gut and heal your arthritis. Get The Book Now

Meet Elizabeth: In her dual role as our Functional Medicine Nurse Practitioner and a teacher in our Mind.Body.Spirit programs at Blum Center for Health, Elizabeth Greig, MSN, FNP, helps treat and heal patients with complex chronic health conditions. Whether she’s treating a medical condition or leading a class in meditation, Elizabeth helps people understand that when it comes to healing, it’s more about nourishing life, than it is about battling illness. Learn more about Elizabeth’s practice.

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3 Things You Can Do Today to Stop Arthritis Pain

Yoga can help heal arthritis

As you may know we’ve been talking about arthritis a lot recently. You see our Medical Director, Dr. Susan Blum, just wrote a new book, Healing Arthritis, and it releases on October 24th. This is very exciting for us and it’s created a lot of interest in arthritis-related information from our patients.

In my medical practice at Blum Center for Health, arthritic patients most commonly ask me, “What can I do about my pain?”

3 Things You Can Today Do to Stop Arthritis Pain

The first thing you must do is make pain-free food choices.

In fact, the single most important influence on reducing your pain is the food you eat!

Here’s what you need to do:

Increase the number of healthy foods you are eating.

  • Your grocery list should include antioxidant rich dark leafy greens like spinach, kale, swiss chard; and deep colorful berries like blackberries and blueberries.  
  • Make a habit of eating clean fish once or twice weekly, it’s full of inflammation-lowering omega 3 fatty acids. Buy high-quality, grass-fed, non-GMO animal products and eat them sparingly, perhaps once each week.
  • Eat loads of healthy, high-quality oils and fats like olive oil, avocado, nuts and seeds.
  • Buy or make bone broth, rich in collagen, and take a good quality  B vitamin.
  • And don’t forget to fit lots of fiber onto your plate in the form of whole grains, legumes, beans, and veggies — to feed the good bacteria of the gut. (Avoid gluten if you know you are sensitive to it, or if you have autoimmune disease).
  • Spice your foods with turmeric, the bright yellow indian spice that’s not only delicious but also combats inflammation.  

Avoid inflammatory foods — this includes highly processed foods made with white flour and white sugar, and practically everything that comes in a box.  Avoid processed flour products like baked goods and cookies, and sweetened dairy products like ice cream. Shop the perimeter of the store – buy real, whole foods in their natural state.

Remove common food allergens by doing the allergy elimination diet – what Dr. Blum calls the Leaky Gut Diet – no gluten, soy, corn, dairy, eggs, or nightshade vegetables.  After 3 weeks, reintroduce each food one at a time to see if any trigger symptoms. The elimination diet not only cuts out common irritating foods but also helps you avoid processed food and many added inflammatory fillers that often come with them. It’s a great starting point.

 

Utilize anti-arthritis supplements to decrease pain.

There are several supplements that have been scientifically proven to decrease inflammation and pain. These are some of the supplements I commonly use with my arthritic patients.

  • Omega 3 (EPA and DHA) & Omega 6 (GLA) Fatty acids – these powerful anti-inflammatory fats have been found to reduce pain and improve physical function in Rheumatoid Arthritis.
  • Curcumin – this plant-derived antioxidant and natural anti-inflammatory  has been found to reduce pain and stiffness in Osteoarthritis.
  • Vitamin C – the link between oxidative stress and joint damage is clear. Vitamin C (and other antioxidants) have been shown to reduce pain (and oxidative stress) in inflammatory joint disease.
  • Probiotics – when we think about joint health, our attention naturally turns to the gut and the health of the microbiome (the bacteria that live in the digestive tract).  Improving the balance of the terrain in your gut with a good probiotic can help with the arthritic pain and inflammation throughout the body.

Powerfully deal with stress: Less stress = less pain.

When it comes to arthritis, the impact of stress is largely overlooked. However, stress and trauma have serious consequences on your gut, your immune system, and your arthritis pain.  Improving your resilience in the face of stressors will keep your arthritis from flaring.  

How to destress:

  • Simplify your schedule. If you are suffering from arthritic pain this is a cry for help from your biological system. Give yourself time and space to renew and rebuild the resilience that you are lacking. Open space in your week to just be.
  • Find time for sleep. Make sure you are getting over 8 hours of sleep a night. Work backwards from your wake-up time and get into bed 1 hour prior to that. Make a routine at bedtime that is relaxing and supportive – take a bath, sip some tea, read a pleasant book. Avoid screens 2 hours prior to bed and help the whole family get on board. Doing things with support makes them much easier!  
  • Make room for movement. You don’t need to add a strenuous exercise routine right away unless you find that that helps your pain, but work towards getting there. To start, just make a plan to have a short walk outside, or put down your yoga mat and gently stretch and move your body beyond the confines of the standing and sitting of your normal day. If you’re feeling more ambitious, try a yoga or tai chi class for meditative movement.
  • Book a massage – or other bodywork – for pain relief and stress reduction.  Acupuncture, craniosacral, myofascial release are all good options to check out.
  • Explore mindfulness meditation.  This can be a simple as listening to a guided meditation on an app or with our Blum Center recordings.  It can be more regimented like finding an MBSR or TM class in your area and starting a daily practice.  It can also be as simple as breathing in and out throughout your day with intention.  
  • Consider therapy.  The stress and trauma from past experience sometimes holds us back from being able to let go of tension in the body.  We know that past traumatic experience leads to worse pain and function in autoimmune disease – and we’ve found that addressing it can lead to improved symptoms.  

The great thing is you can do this yourself!

In her new book, Healing Arthritis, Dr. Blum presents the exact 3-Step Protocol that we use with patients at Blum Center for Health. You will learn the best food plan for arthritis, the precise supplements and dosage we recommend for an arthritis-free life, how to build resiliency so that life’s stressors won’t affect your health, and what your gut has to do with your arthritis symptoms. In essence, Dr. Blum gives you all the tools you need to fix your gut and heal your arthritis. Get The Book Now

To recap, the 3 actions you can start today to decrease your arthritis pain is 1) eat an anti-arthritis diet 2) take the appropriate supplements and 3) build resiliency against stress. Do these things and you will feel better with less pain and much more energy.

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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Surviving Menopause: Hormones, Herbs, and More

Woman practicing yoga for self-care

A common question from patients is: “Should I take herbs or hormones for menopausal symptoms, and if so, which ones?”

This is a huge topic and the truth is there is no “right answer.”

Treating menopausal symptoms needs to be based on each woman’s unique situation accounting for her personal history, family history, current health goals. Without question, estrogen replacement is the most effective treatment for hot flashes and other menopausal symptoms.

While hormone replacement isn’t for everyone, there IS a lot of buzz right now around bioidentical hormones. For you to make an educated decision, it’s important to understand the difference between bioidentical (often compounded) and non-bioidentical hormones (conventional), and when you might consider using them.  In my upcoming talk at Blum Center, and further down in this blog, we will review all of this information.

But, not everyone wants to take extra hormones or can’t take hormones for health reasons.  Well, hope is not lost!  I will review several herbal remedies and lifestyle changes that women can use successfully.  This is a meaty topic, so let’s dive in!

“Hot Flashes?  No Hormones?  No problem!”

Many women come to me seeking strategies to address things like hot flashes, vaginal dryness, sleep disruption, and mood changes without hormones. In this case we have SO much to offer. Conventional medicine offers several antidepressants that have been found to work for hot flashes: paroxetine and venlafaxine are some examples. Gabapentin is another option.  Unfortunately, these drugs do tend to have other unwanted side effects such as sleepiness, headache, nausea, dizziness, and more. Rest assured, this is NOT our approach at Blum Center!  You don’t have to take an antidepressant to get you through menopause!

Here are just a few of the options that we can offer you:

St. John’s Wort has been shown in multiple studies to improve women’s sense of wellbeing, decrease hot flashes, improve sexual wellbeing, and reduce overall menopause rating scores (Grube, 1999 and Abdali , 2010).  Studies show that improvement was seen after 2-3 months and dose is typically around 300 mg taken three times a day.  St. John’s wort is metabolized in the liver and can interfere with the metabolism of many other drugs, so always tell your doctor if you are taking it.

Panax Ginseng has been shown to improve menopausal symptoms of depression and well being, increase energy, decrease insomnia (Wiklund, 1999 and Tode, 1999).  The dose is typically a standardized extract of 200mg a day.

Sage has been shown to decrease sweating by up to 64% in women who have hot flashes (Bommer, 2011).  If you are using dried leaf in capsule or tea take 1000mg twice a day.

Soy, Red Clover, Kudzu all contain various isoflavones such as daidzein, genistein, and puerarin. These compounds act as weak estrogen receptor modulators. Data on isoflavones for hot flash relief is mixed. Some studies show a benefit, others do not.  The tricky thing about some of these compounds, like daidzein, is that it turns out your gut bacteria have to convert it into equol to have the biggest impact. But it is estimated that only 30-50% of humans are “equol producers.” This may account for why soy seems to help some women more than others when it comes to hot flashes.My suggestion is to try it for about a month and if you see no improvement then stop. For soy, I would rather see patients eat whole, organic soy foods such as edamame, tofu, soy milk instead of taking a pill. Food is always better than supplements and foods with whole soy proteins (not soy protein isolate) are better for you. As always, any food or herb that has estrogenic qualities, you must use with caution in the setting of an estrogen-related cancer. Additionally, soy in large quantities (three times a day) can impact your thyroid function, so ask your doctor if you need to limit it. Also, these could interact with platelet/anticoagulant medicines.

Black Cohosh has shown mixed results in studies for menopausal symptoms. Many studies look at Black Cohosh along with a few other herbs. This is common practice in botanical medicine, taking advantage of the synergistic effects that herbs can have when taken together. It does make it more difficult to know if individual ingredients are beneficial. Black Cohosh is generally well tolerated and I mention it because it shows up in a lot of supplements that are geared for women’s health, menopause in particular. It is unclear if Black Cohosh directly interacts with estrogen receptors in humans, but to be on the safe side, I would avoid this one if you are an estrogen receptor positive cancer.

Clinical Hypnosis can decrease hot flashes by 55% compared to 13% in one well designed randomized study of 187 women (Elkins GR, 2013).  Hypnosis also helped with improvement in hot flash interference, sleep quality, and treatment satisfaction.

Acupuncture has been shown in multiple studies to improve sleep disruption (Chiu, 2015).  Researchers did a summary review of 31 studies involving over 2400 patients and found there was significant improvement in sleep as well as changes in blood hormone levels of estradiol and follicle stimulating hormone. And the larger the hormonal changes, the bigger the improvement on sleep. Data on acupuncture for hot flashes, however, is mixed. It appears that when acupuncture is compared to no acupuncture, there is a significant improvement seen. But when researchers compare real acupuncture with sham acupuncture, they don’t see a difference. This indicates that at least for hot flashes, acupuncture probably has a strong placebo effect. In my opinion, when the placebo effect works in our favor, it is a wonderful thing and I think we should take advantage of it!

Yoga has also been shown to be beneficial for hot flashes and emotional symptoms like stress in multiple studies (Joshi, 2011 and Chattha, 2008). Yoga has so many health benefits that I recommend it to almost all of my patients. In this fast-paced world, the practice of yoga slows down our sympathetic nervous system which is integrally involved with hot flashes. One caveat: I don’t recommend hot yoga as that will most assuredly make hot flashes worse!

“I’m Fine with Hormones – Bring Back the Estrogen!”

There has been a lot of research in the past few decades looking at hormone replacement for menopausal symptoms and the field is constantly growing. As with most medicines, there are risks and benefits to consider when deciding if you want to take hormones and it is important to have that discussion with your healthcare provider, or come and see me to discuss, because your personal and family history influences this decision enormously. In general, we do believe that hormone replacement therapy, especially bioidentical therapy, in low dose for the first few years of menopause is safe for most women.

My approach?  I always use bioidentical hormones and aim for the lowest effective dose, and prefer topical or local estrogen to limit unwanted effects.

“Bioidentical, Synthetic, I’m Confused…”

Bioidentical hormones are compounds that exactly mimic the hormones that we have circulating in our bodies. Those bioidentical hormones may be synthetic, in the sense that they were made in a lab, and that is not necessarily bad. Two of the most common hormones prescribed in this country are not bioidentical: conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA). These compounds act similarly to our own estrogen and progesterone, but nevertheless, have actions in our bodies that are distinct.

Historically, we assumed that CEE and MPA would be equivalent to bioidentical hormones, but as researchers have begun to compare the two in head-to-head studies, we now know there are differences especially in the progestogens (Stanczyk, 2013). Consensus is now building that bioidentical progesterone is probably safer than MPA. Although CEE and MPA are the most commonly prescribed hormone replacement regimens in this country, there are plenty of FDA approved bioidentical options for us to choose from including estradiol pill, patch, or gel form as well as micronized progesterone in pill form.

“So What is Compounding?”

Compounding medicine is the practice of taking one or more individual ingredients and mixing them together in the lab and creating a new compound that isn’t otherwise sold as a brand name product. The new medicine can be specially formulated for an individual patient to avoid allergenic ingredients, create new doses, convert a pill to a cream, combine medicines into one, etc.

Having access to high quality compounding pharmacies is extremely valuable in expanding the range of pharmaceutical offerings to the public.  For example, one FDA approved bioidentical progesterone product on the market in the US. contains peanut oil which some women are allergic to. This is a prime example of when compounding progesterone is a life saver!

There are pros and cons to using FDA approved drugs vs compounding drugs. The advantage of using an FDA approved medicine is that the approval process is stringent in terms of demonstrating safety, appropriate dosing, and efficacy. Additionally, the FDA drugs and facilities are highly regulated. Also, since the majority of research has been done using FDA approved drugs, physicians feel more comfortable prescribing them as they have been thoroughly vetted in clinical trials.  [A side note: the drug companies are the ones that fund the bulk of research since they can afford to do so. It costs millions of dollars to carry out a large clinical trial and very few entities can fund those studies.] The disadvantage is that sometimes we might want to give a drug in a different form than is available. In terms of compounding, the advantage is the ability to tailor a medicine specific to the needs of an individual patient.  The downside is that there is not as much safety and efficacy data on individual formulas, nor as much regulation on the actual compounding pharmacies themselves.

My approach to menopause is to get to know my patient, figure out what her goals are for the menopause transition, determine her risk profile, and come up with the best treatment plan together.

Meet Dr. Fitz:  Bronwyn Fitz, M.D. is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.