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{Recipe} Bok Choy Sautee

In the Spring, the land once again becomes fertile and the earth is wanting to feed us with fresh, crisp, and alive food to give us a boost of energy from the long, dark, and cold winter days. An abundance of lighter vibrant vegetables should now be included in your diet each day along with a variety of sulfur-rich sources such as cruciferous vegetables, which are great for detoxing during the spring months.  The best picks for the spring include cabbage, broccoli, asparagus, collard greens, garlic, onions, and Swiss chard. My favorite is Bok Choy.  Here’s an easy to re-create recipe with nutrients and flavor abound!

Bok Choy Sauté

Ingredients:

4 cups fresh bok choy, roughly chopped

2 cloves of garlic, minced

1-2 tbsp sesame oil

1 ½ tbsp coconut aminos

salt and pepper to taste

Directions:

In a large skillet, heat oil. Add garlic and Bok Choy stems, sauté until tender. Add Bok Choy greens and coconut aminos and continue to cook on low until wilted but not mushy. Season with salt and pepper.

 

Keri Lynn MacElhinney, RD, CDN, CLT, IFNCP is a Functional Medicine Nutritionist at Blum Center for Health.  She has over 20 years of professional experience as a Registered Dietitian and holds a nutrition license in New York and the State of Connecticut. In her early years, her field experience covered a wide array of areas including acute care hospitals, community health centers, substance abuse.  Make an appointment with Keri Lynn at 914-652-7800.

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Dr. Jay Lombard: Wire Your Brain for Optimal Health

We sat down with Blum Center for Health’s Internationally-acclaimed Neurologist, Dr. Jay Lombard, to discuss how we can improve our brain health.

Question: What is most overlooked when it comes to brain health?

Dr. Lombard: Connectivity! How the biological, emotional and sociological functions of the brain are connected is fundamental to the health of both the body and the brain. We need to help all the circuitry work better!

Let’s take Post Traumatic Stress Disorder as an example. From a biological perspective – PTSD is a psychiatric disorder of disconnected pathways in the brain that are not functioning harmoniously. This leads to imbalances and behavioral problems.

Research in PTSD shows a disconnection between the rational prefrontal cortex and the limbic system, which is more emotionally oriented. Patients suffering from PTSD don’t have the ability to override involuntary emotions, such as fear and anxiety, leading to an over-exaggeration of symptoms, and an inability to reduce them through rational and coherent interventions and processes.

We are learning more and more about how all kinds of stress, not just PTSD, interrupts our circuitry.

Question:  How can we improve this Connectivity?

Dr. Lombard:  The good news is that technologies are now being developed that can help reconnect the circuits and balance those two parts of the brain so they work in coordination, not opposition. For example, we can personalize specific supplements that enhance and stabilize brain biochemistry.  One of my favorite non-pharmaceutical options is magnesium taurinate.

Question: Can you tell us more about the impact stress has on the brain and what can be done about this?  

Dr. Lombard: Stress can be a neurotoxin. Biological components of stress, like the hormone cortisol, is a very simple measure of one’s stress response. If cortisol is too high in the evening it can lead to sleep problems, changes in appetite, mood changes and even conditions such as metabolic syndrome and heart disease.  

Elevated cortisol as a result of stress is a measurable biomarker that can be used in clinical practice.  This is helpful because there are approaches we can use to bring balance such as the ability to self-regulate cortisol through exercise, or by reducing certain foods that produce fight or flight responses, such as sugar and salt.  

Question: What foods can I eat to promote brain health?

Dr. Lombard: There is no one diet that fits every situation and sometimes I prescribe specific plans like a ketogenic diet for neurodegenerative diseases.  However, for the average person, I generally recommend eating a diet is as close to the Mediterranean diet as possible. This is a well-balanced food plan filled with healthy fats, antioxidants, and polyphenols from fruits and veggies. Also, sesame oil for cooking is my particular favorite at medium heat, and so delicious. In other words, make your meal as colorful as possible!

Question: How can a consultation with you help me?

Dr. Lombard: My focus in clinical practice has been to help patients find answers to complex medical issues. The typical patient who has been referred to me in the past have been ” diagnostic dilemmas” where there is an overlay between neurological and behavioral problems.

My approach is not ” functional or Integrative”- it’s based upon systems biology.  

Systems biology means having a deeper appreciation for the connection between sub systems such as between the brain and immune system. The good news is that by recognizing these connections clinically we can develop a more patient-centric approach regardless of what a specific diagnosis a patient may or may not have.

The areas of clinical research that I am most familiar with are patients with neurodegenerative disorders. These include ALS, Parkinson’s, MS and early dementia.

Question: What’s your Motto to live by:

Dr. Lombard: Live Your Purpose!

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The Autoimmune and Leaky Gut Connection

Leaky Gut and Food Sensitivities

Have you heard of the term “leaky gut” but are unsure what it is or if you may have it?

Consider this common scenario we see at Blum Center for Health.

Jane (not her real name) is a 48-year-old woman with three autoimmune conditions: Hashimoto’s thyroiditis, psoriasis, and alopecia areata, a form of patchy hair loss on the scalp. The Hashimoto’s was diagnosed after her first pregnancy at 34 when she just couldn’t get her energy back postpartum.  She eventually started on low dose thyroid replacement medication but every few years has had to increase her dose. The psoriasis began a few years after that on her elbows and she controls it with a steroid cream. And then last year she noticed a big clump of hair in the drain and looked more closely at her scalp only to find a bare spot the size of a quarter.  When her doctor told her it’s her third autoimmune condition, she knew she needed to look more deeply for answers to why her immune system is becoming more dysfunctional.

When Jane came to see us at Blum Center, she also reported that she’d had irritable bowel syndrome, or IBS, for many years.  For her, that means sometimes diarrhea, sometimes constipation, occasional crampy abdominal pain, and embarrassing gas almost every day.  She had begun to feel that that was just “normal,” since she’d lived with it since her 20s.

Along with increasing autoimmunity, Jane’s gut symptoms are some of the hallmarks for increased intestinal permeability, or leaky gut.  When the lining of the intestines becomes inflamed even at a microscopic level by food, gut bacteria imbalances, toxicants, or stress, the intestinal lining cells start to lose their protective integrity.  Instead of just letting micronutrients into the body through small “gates” that can open and close between the cells, the gates get stuck in the open position and larger and larger molecules, and even your gut bacteria, can come into the body.  These large molecules and microbes weren’t meant to have access to the body, so the immune system sounds the alarm. In trying to manage the flood of disinformation, the immune system often begins to overreact leading to trouble telling what is “not me” and what is “me,” starting the autoimmune process.

The good news: we can usually fix leaky gut and along with it, improve autoimmune symptoms and markers.  When we can decrease the burden on the immune system, it often begins to heal. Start by reviewing your treatment options using these tips on how to heal a leaky gut. The first step is usually to treat dysbiosis, an imbalance in the gut microbiome.

If you suspect you have Leaky Gut, or if you suffer from digestive problems, such as cramping, bloating, burping, flatulence, diarrhea or constipation our 30-Day HealMyGut Program will help bring balance to your to gut microbiome, repair your digestive tract lining and relieve these painful and uncomfortable symptoms. HealMyGut features our exclusive antimicrobial packets in addition to 3 other gut-healing supplements, a detailed guidebook with recipes from our test kitchen — everything you need to heal your gut and feel well again. → Check out HealMyGut

 

Live in Our Neighborhood?  Come to Elizabeth Greig’s FREE talk, Causes and Treatments for a Leaky Gut, on Wednesday 4/11 at 7pm. You will learn more about what causes leaky gut, how we diagnose it, and what to do about it! And, bring your questions for the Q&A toward the end → Register Now

About Elizabeth Grieg, 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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Dr. Susan Blum Sits Down with Dr. Frank Lipman and Talks “How to Be Well”

A pioneer in functional and integrative medicine, Dr. Frank Lipman is the founder and director of Eleven Eleven Wellness Center and a New York Times best-selling author. In his four decades of clinical experience, Dr. Lipman has helped thousands of patients heal and change their lives with his unique blend of ‘good medicine,’ which combines the best of modern medicine with the best of alternative and complementary medicines, and integrates essential elements from Chinese and functional medicine as well as nutrition, acupuncture, meditation, yoga and more.

In his newest book, How To Be Well: The Six Keys to a Happy and Healthy Life, Dr. Lipman gives readers the ultimate cut-to-the-chase, at-your-own pace, total wellness toolkit with which to build a lifetime of vitality, resilience  and good health.

Recently, Dr. Blum sat down with Dr. Lipman to talk about the new book. Here’s what he had to say:

You talk about a Good Medicine Mandala in the book, Explain?

For the book, I created my “new map for a new era of medicine” around a unique organizing structure: The Good Medicine Mandala. A mandala is a symbol used in many wisdom traditions of the world. Almost always a circle, it represents wholeness, potential, and the infinite. It represents the unknowable and the eternal and suggests a cosmos or even a universe; it depicts continuity—one ending is another beginning—and captures the wheel-like turning of time, seasons, and of course, our own human life.

As such, it is used as a tool for establishing sacred practice, especially in Eastern traditions. They deploy it in practices of meditation as a focal point of contemplation to help you gain awareness of the totality of your Self—from the rudest physical aspect of your human body to the immeasurable and expansive nature of your spirit. At its most fundamental level, the mandala is a symbol that restores order.

The Good Medicine Mandala is a circular system in which you, not a doctor or any other authority figure, stands at the center. It is an antidote to old-school linear thinking (which often, just boxes you in). Six rings surround you, representing the six spheres of life that, as an integrative physician trained in modalities of East and West, I know to be the pillars of long-lasting health. When you restore and/or optimize all these spheres, you lead the pack in terms of your standard of health and enjoyment of life.

Each of the six rings contains the blueprints for an abundance of small actions you can take, beginning right now, to improve and strengthen your resilience and functioning. In an echo of a traditional mandala, the Six Rings of Good Medicine ripple outward from the most material aspect of health—the food we eat—to the most subtle one—our sense of connection to the world at large. The Six Rings are:

How to Eat Well – mastering the very building blocks of life: food

How to Sleep Well – re-prioritizing and restoring one of your most fundamental needs

How to Move Well – supporting the body to move in all the ways that nature intended

How to Protect Well – mitigating and preventing the invisible assaults of everyday toxins

How to Unwind Well – consciously switching off to allow for complete mental and physiological reprieve

How to Connect Well – awakening and enhancing a sense of belonging and meaning

Within each ring, you will find the instructions for the essential habits, routines, and tactics that boost resilience and improve functioning. These are universal by design. The way you use them however, is personalized. You can navigate through these rings in several ways, depending on your personality and your individual preference for changes—deep and focused, or gradual and gentle.

What do you want readers to take-away from How To Be Well?

My goal is to show people the extraordinary power of ordinary actions, both small and large, done on a daily basis. Even just one new habit can have a surprisingly wide reach when it comes to the interconnected system that is our human body. Once established, each new habit creates a ripple effect, making the next new habit easier to embrace and ingrain. I want readers to have the tools they need to develop the habits that will, over time, ensure life-long vitality – looking good, feeling good, dodging dysfunction – and enjoying life!

To pre-order your copy and receive some free gifts, visit HowToBeWell.com/preorder and begin your How to Be Well journey!

 

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Flu Season Isn’t Over Yet: Keep Your Immune System Strong Through the Spring!

At this time of the year many patients ask me how can they enhance their immune system.  The truth is that our immune systems are designed to work just fine if we eat a healthy diet, exercise regularly and get enough rest.  However, if you find yourself getting sick with an upper respiratory infection (URI) there are some herbs and supplements that can shorten the duration of symptoms.  They work best if taken at the very first sign of a URI, and stopping them when those symptoms clear.

7 Supplements for Immune Health

Elderberry : Elderberry has both antiviral and antibacterial effects. Research suggests its efficacy — even against the H1N1 virus. Four tablespoons of the elderberry fruit syrup Sambucol daily for three days, has been shown to reduce symptoms of fever and muscle ache by about 50 percent. For kids, reduce the dosage to one tablespoon twice a day.

Medicinal Mushrooms: Mushrooms have been shown to work against bacteria, viruses and some forms of detrimental mold. They contain polysaccharides, a component of cells that can prevent bacterial growth in the laboratory setting. I have my patients keep on hand a product known as Mycommunity, which is a blend of 17 fungi types.

Zinc: You want to make sure you’re taking a good multivitamin with zinc – 15 milligrams is generally thought to be a good amount for maintenance, but you can go up to 30 daily.  Zinc glycinate and zinc gluconate are usually well tolerated, and start with 10 milligrams as these are least likely to give you stomach upset. Otherwise, take as directed on the package.

Andrographis:  Andrographis — sold under the name Kold Kare — is an herb widely used in Ayurveda, the traditional form of medicine in India. When started within 72 hours of the onset of symptoms, it can improve symptoms of the common cold.

American Ginseng: There are various forms of ginseng and some may be beneficial if used early in the onset of cold symptoms. Some evidence suggests that taking 200 milligrams twice daily of the American ginseng extract CVT-E002 (brand Cold-fX) during influenza season may decrease the risk of developing URIs, and seems to reduce both the severity and the duration of symptoms. Another combination ginseng product called Kan Jang, which contains Siberian ginseng and Andrographis, may also prove effective.

South African Geranium: A number of studies have shown that extracts of the South African geranium can be helpful in reducing symptoms of bronchitis, sore throat, sinusitis and the common cold. Both children and adults tolerate it well. These products are usually readily available in your local health food store, marketed under the brand name Umcka.

N-Acetylcysteine (NAC): One of my favorites for preventing cold and flu.  NAC is widely used in the medical community for a number of conditions, and has terrific clinical data that shows it to be helpful for patients with chronic respiratory illnesses.  It also helps to keep the immune system in its best condition for warding off illness. It can be helpful with coughs, cold, runny noses – it also converts to Glutathione, the body’s most powerful antioxidant.  I usually recommend 900 milligram tablets – start with one twice daily and increase to two twice daily as needed. Pharmanac, a Canadian brand that comes in an effervescent form is easy to take as a fizzy drink – even for children!

My thoughts on immune enhancement:

If you wanted to take something throughout season that will help to keep you healthy, I’d recommend Vitamin D.  It is essential for immune health, and our levels often drop during the winter months because we get less sun exposure. A large study performed in elderly adults at Yale University suggests that even patients with low-normal levels of Vitamin D are more prone to URI’s than patients with higher levels. Many of us are deficient in Vitamin D, so try at least 2000 iu of vitamin D3 – and include a good quality fish oil, as it will give you an additional D boost but will also serve as  a great antioxidant. One that has at least 1,400mg EFA/925 DHA is a good dose to be used twice daily in patients with underlying asthma and allergies as well.

As in with any supplement, be cautious in taking with medicines, or other herbs or supplements.  Ginseng can interact with medicines for diabetes. Fish oils can cause blood thinning. And if you have allergies or are on medications, please check with your doctor first before adding any new her or supplement.  All of these products must be avoided if you are on medications or other herbal supplements that thin the blood.

I’m here on Thursdays if you need more advice or have chronic sinus or ENT issues – happy to see you for a consultation!

Live in our neighborhood and need help with chronic sinus or ENT issues?  Make an appointment with Dr. Gereau. She will address your concerns and develop an integrative plan that focuses on holistic, high-impact treatments. To make an appointment, call 914-652-7800.

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.  

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Here’s the One Easy Solution to Your Food Allergies

For many people with food allergies, completely avoiding problem foods isn’t easy or even practical. Accidental exposures happen and, as we’ve seen recently in the press, can lead to dangerous and sometimes lethal consequences.  

Sublingual immunotherapy (allergy drops) for foods, otherwise known as SLIT, can help both adults and children safely build tolerance in case an accidental exposure to allergens occurs. For some, it can help them enjoy many foods that once caused reactions.  

While it is common knowledge that shots can be helpful for patients with  environmental allergies, SLIT is not as widely recognized in the United States. Just as shots work by injecting tiny amounts of the tree, dust, or pollen that you are allergic to, SLIT works by giving that same substance as a drop placed under the tongue. The amount is enough to prime the immune system to stop reacting to the substance, yet is below the level that triggers an allergic reaction.  

Allergy drops are safe and effective as treatment for both environmental and food allergies.  They have been used in the US and Europe for over 50 years.

6 Common Questions About Allergy Drops:

How does sublingual immunotherapy for food allergies work?

All forms of immunotherapy work in the same way – by giving you small amounts of allergen so that your body learns to tolerate them without having reactions.

What food allergies can be treated with sublingual immunotherapy?

The most common food allergies that are treated with sublingual immunotherapy are the usual culprits –  egg, milk, corn, yeast, wheat, soy, peanut and shellfish, but more than 100 different foods can be treated if needed.   Your doctor formulates a special prescription of drops for you – you then take these 3 times daily to impart what is known as “tolerance”.  This gives your body the ability to be exposed to the food without reacting.

How are food allergies diagnosed and what tests are performed?

Diagnosing food allergies starts by observing symptoms when troublesome foods are included in a person’s diet.  Runny nose, mouth itching, or skin rashes can occur with food or environmental allergies.   Other symptoms, though, such as upset stomach, fatigue and loose stools are more specific to foods.   There are a number of ways to test for these allergies, and determine the level to which your body is reacting to the allergen. Special blood tests reveal the level to which your body is reacting – and the drops are formulated specifically for your unique level of reactivity to those specific allergens.

What about my seasonal allergies?

It’s always important to treat environmental allergies either first, or relatedly. Environmental allergies are much more common than food allergies, and the symptoms are often confused. Also, once environmental allergies are more under control, the body could become less reactive to foods, and thus you can treat fewer allergens, or perhaps not treat the foods at all.  If you begin immunotherapy for environmental allergies and aren’t seeing results after three to six months, you may consider asking about food allergy testing and treatment.

How long does it take to see results?

Studies show that improvements in immune tolerance begin within days, while more permanent changes require more than a year of treatment. The length of treatment depends on the severity of your allergies and how compliant you are in taking the prescribed treatment. For mild to moderate allergies, a common treatment length is three to five years; more severe food allergy cases can take longer.

What is the end goal for the patient treated with sublingual immunotherapy for food allergy?

The goal of sublingual immunotherapy treatment for food allergy will vary by individual. If you have mild to moderate allergies, it may be possible to reintroduce allergic foods into your diet. If you have severe and life-threatening allergies, the goal is to reduce the likelihood of an allergic reaction to an accidental exposure.

Live in our neighborhood?  Join Dr. Gereau for a free community talk, A Novel Approach to Treating Food Allergies.  Come fInd out more about allergy drops and if they are right for you and your family.  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.  Make an appointment with Dr. Gereau.

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Testing and Treatment for Traumatic Brain Injury (TBI) (Part 1)

In the United States, there are more than 3.5 million emergency department visits for TBI, which may be categorized as mild, moderate or severe. There are also many more individuals who may never seek medical attention. The majority of TBI cases are classified as mild TBI (mTBI). Approximately half of patients with TBI in the United States experience some form of short-term disability. However, brain injury after significant trauma has been associated with an increased risk of Alzheimer disease and seizures and repetitive TBIs is a risk factor for chronic traumatic encephalopathy(CTE) and Parkinson’s disease.

Very often, TBI after a concussive injury is not managed beyond an ER visit where a CT scan may or may not be performed. Acute hospitalization or Neurological follow up are usually only recommended if there is loss of consciousness or evidence of serious injury. Brain imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) are often used but unfortunately can be interpreted as being “negative” or normal despite the fact that brain injury is present.

The good news is that there are now better options, including using biomarkers, newer brain imaging modalities and laboratory diagnostics, that can help make a diagnosis of TBI.  And these advances also make it possible to help identify the degree of brain injury after TBI and direct better treatment. Here we will focus on biomarkers and laboratory testing, and in my next blog we will focus on brain imaging.

Hormone Imbalances in TBI

Depending on the degree of brain injury, approximately 10-20% of patients with TBI can develop hormonal imbalances, including pituitary insufficiency. The pituitary gland is the factory for hormone production involving growth, reproduction, thyroid, etc.

  • Growth hormone deficiency (GHD) is one of the most frequent pituitary disturbances after TBI, followed by gonadotropin (sex hormones such as the precursors for testosterone), cortisol and thyroid-stimulating hormone insufficiency. Common symptoms after TBI, such as memory and concentration difficulties, anxiety, depression, social isolation, weight gain, bone loss, and exercise intolerance can be symptoms directly related to TBI or hormone imbalances.
  • We can measure subnormal Growth Hormone levels by measuring the levels of insulin-like growth factor-1 (IGF-1) which is used as a surrogate biomarker for Growth hormone. But results of IGF1 are often normal, and therefore reliance on IGF-1 as an assessment of GH function after TBI may be misleading.

Specific Hormone Assays to Evaluate TBI

Here are the tests you should ask your doctor to do, for a better evaluation of the severity of your TBI or head injury.  

  • After an overnight fast, serum levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), follicle stimulating hormone (FSH), luteinizing hormone (LH), total and free testosterone (males only), estradiol, cortisol (a.m.) and IGF-1 are measured at  baseline.  
  • Serum and urine sodium and osmolality and urine specific gravity are also collected to assess posterior pituitary function.
  • For Growth hormone (GH) deficiency, Glucagon, 1mg is administered intramuscularly, and blood (serum) is drawn at baseline, 90, 120, 150, and 180min to measure GH.

Integrative Treatment (non-pharmaceutical)

Here are some suggestions for repairing the hormone imbalance caused by TBI:

 

  • Vitamin D3/week has been shown to significantly raise IGF1 levels.
  • Angelica sinesis is a natural herbal treatment that contains polysaccharides such as  arabinose, rhamnose, and mannose which act to  stimulate IGF1/IGF1R gene expression.
  • Andrographolide is another herbal treatment has been shown to decrease levels of NSE, S-100β, and IL-6, inflammatory factors that are frequently elevated in TBI patients. . Andrographolides may help to  turns off the over-reactive inflammatory response related to alterations in blood brain barrier permeability, a frequent occurrence in TBI patients that may account for inflammation.
  • Resolvins are bioactive novel endogenous products which are metabolites of the polyunsaturated ω-3 fatty acids. They have potent anti-inflammatory and pro-resolution effects in the brain. I will discuss these in more detail in my upcoming blog on the use of biomarkers in TBI related to inflammation and neurodegeneration.
  • Nucelotides such as Inosine and Cytidine have been shown to activate repair mechanisms after brain injury and potentially promote remyelination.

Medical Options to Treat Hormone Imbalance from TBI

  • Growth hormone replacement if clinically indicated (GH of <3ng/mL is considered as being deficient and in need of GH treatment). GH replacement therapy 0.3 mg/day to 1 mg/day, showed significant improvement in cognitive functions. Ideally, these treatments are best given under the supervision of an Endocrinologist.
  • Cortisol replacement, such as low doses of hydrocortisone can be used if clinically warranted and if there are no contraindications.
  • In human studies, intranasal insulin has been shown to enhance memory. Clinical studies using 10 IU of insulin twice a day nasal drug delivery device designed to deliver drugs to the olfactory region are currently ongoing.
  • Cerebrolysin, a neuropeptide preparation of porcine origin, consists of neuropeptides and free amino acids and has been shown to enhance nerve growth and capable of stimulating the restorative capacity of the brain after injury. It is approved in Europe for recovery after brain injury but can only be administered in IV fashion.

In my next blog, I will review advances in brain imaging for TBI patients including SPECT, MRI, DTI and PET studies, as well as novel blood tests that assess tau protein, enolase and S100B. These can be utilized to help develop a unique treatment program for patients with TBI.

Meet Dr. Lombard: Dr. Jay Lombard is an Integrative Neurologist and co-founder of Genomind. He maintains a private practice at the Blum Center in Rye Brook, NY where he is known as the brain detective because of his ongoing research in patients with complex neuropsychiatric disorders.

Make an appointment:  If you live in our area, Dr. Lombard is available for in-person appointments at Blum Center for Health.  If you don’t live nearby and would like to work with Dr. Lombard, he is available for remote consultations via video or phone.  Please use this link to make an appointment.

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What is Leaky Gut — And What Can You Do About It?

Stomach pain from IBS

Did you know that your biggest exposure to the outside world everyday is through your mouth? That’s why 70% of your immune system lives in your gut, lying in wait to protect you from anything that seems foreign (or “antigenic”) to the body. “Antigens” include bugs, like bacteria, parasites, or viruses. And believe it or not, they are  also in the food you eat – and the toxins and microbes that ride along with the food..

Your gut, which is essentially a tube starting at your esophagus and ending at your rectum,  has barrier walls separating the inside of your body and immune system from the outside world.  When you break down and digest your food into tiny particles, the intestinal lining serves to very selectively choose what can enter your body through a variety of mechanisms, including opening and closing gates called tight junctions.

Leaky Gut Syndrome

An intestinal barrier with damaged tight junctions, that isn’t succeeding in keeping those antigens out, leads to a condition known as Leaky Gut or Increased Intestinal Permeability.  The lining of the tube is damaged, and because of that, more and larger food molecules and gut bacteria are able to pass through to the other side (your bloodstream).  This leads to immune system activation as the body is overloaded with antigens, and this in turn can lead to inflammation and a variety of system-wide conditions.

Common Causes of Leaky Gut

Causes of leaky gut vary, but the most important might be dysbiosis, which is an imbalance of bacteria in the gut, also known as the gut microbiome. Dysbiosis shows up in a number of ways, for a number of reasons. It can be an overgrowth of harmful bacteria, yeast, or parasites, or simply a dearth of good bacteria, or any sort of bacteria growing in the wrong place in the gut.

Dysbiosis is caused by poor dietary choices, frequent antibiotic use, use of common over-the-counter medications (like antacids or painkillers), and can even be caused by stress, and chronic constipation.  A healthy microbiome helps you by interacting with the immune system in beneficial ways, and also by turning the food you eat into compounds that heal the tight junctions between your cells, protecting the integrity of the gut lining. Balanced gut microbiota leads to a strong barrier!

Leaky gut and the Connection to Chronic Disease

Studies have increasingly found that a leaky gut is associated with arthritis, autoimmune disease (like Hashimoto’s Thyroiditis or Rheumatoid Arthritis), allergies, and food sensitivities.  But why is it that leaky gut is associated with inflammatory diseases like arthritis? When the contents of your digestive tract, which includes gut bacteria and larger molecules of food and toxins, “leak” into your body, your immune system is activated, creating inflammatory chemicals that travel throughout your body and cause system-wide inflammation, especially in the joints. And this happens nonstop until your gut microbiome and the lining are repaired.

Leaky Gut and Nutritional Deficiencies

Leaky gut can also contribute to malabsorption of vitamins and minerals.  Ongoing inflammation can cause damage to the carrier proteins in the lining of the gut that are supposed to work to bring the good stuff into the body. The most common are iron, B12, magnesium and zinc deficiencies. These lead to all sorts of symptoms like fatigue, hair loss, rashes and muscle pains.

How to Heal Leaky Gut

The good news is that you can rebuild your microbiome and repair your gut, it just takes a little effort and sometimes some detective work. Here are five areas that deserve your attention:

  •      Food Choices: Food has the most influence on the diversity of the microbiome – and that is why we always recommend starting by changing your diet. Increasing your intake of foods high in fiber, mostly fruits and vegetables, is the simplest change we can make. These tend to increase that good bacteria that plays such a role in keeping the gut lining healthy and working. Removing foods that feed the bad bacteria is also important – so quitting – or at least decreasing the amounts of sugar, processed foods, alcohol, and bad fats will support rebalancing the microbiome.
  •      Food Sensitivities: Recognizing the foods you are sensitive to and removing those from your diet is an important way to help heal the gut lining. If the gut is constantly barraged by a particular food that is stressing the immune system, local inflammation at the gut barrier will create imbalance and lead to leaky-ness. A simple elimination diet is often the best way to determine food sensitivities. Food allergy testing can also guide us in helping you to figure out what to eat and what not to eat.
  •      Stressors: We all know that stress affects our gut. Think about it, when you don’t feel relaxed, you just don’t digest as well. Many people manifest emotional distress in their digestive tract, suffering from an uneasy stomach, loose stools or sometimes chronic constipation, bloating, cramping and food intolerance. Making sure that stress is dealt with, by looking into your habits and working to improve potential sources of stress – like lack of sleep, lack of exercise, or mood imbalance is essential. Your digestion benefits from 8+ hours of sleep nightly, a good exercise regimen that keeps you moving daily and a meditation or mindfulness practice that helps ground your mind.
  •      Toxins: Decreasing your  total body toxin exposure should be a crucial part of your gut healing strategy.  Eating well-sourced, non-gmo, organic foods as much as possible and avoiding common environmental exposures that further tax the system and damage the intestinal lining, helps decrease permeability and inflammation.
  •      Dysbiosis: Sometimes the imbalanced gut is really off.  So much so that improving diet won’t fix it completely.  In these cases, we usually use testing (stool, breath, urine) to help determine the best method of gut healing – or cleansing – with herbal preparations, medications, and probiotics.

Treatment options for leaky gut:

  •      Glutamine, an amino acid, has been shown to reverse intestinal mucosal damage from various insults.
  •      Marshmallow root and DGL (Deglycyrrhizinated licorice) extract are agents that stimulate protective mucus secretion in the gut.
  •      Probiotics are an essential part of healing the gut lining – a broad spectrum probiotic that contains lactobacillus and Bifidobacteria species is recommended.  Saccharomyces boulardii, a beneficial yeast, is also an important supplement to restore gut health.
  •      Fish Oil – to reduce intestinal (and systemic) inflammation.
  •      Vitamin D – at doses of 2000-5000 IU daily (get blood levels checked intermittently) supports the mucosal immune system in the gut lining.

What to do if you suspect you have Leaky Gut:

If you live in our neighborhood, make an appointment!  In my  practice at Blum Center for Health, I take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnose, and treat your condition.  We take your health seriously and get to the root of the problem rather than simply throwing medication at it.  For more information, please call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

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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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.