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Your gateway to feeling well again! End digestive symptoms, repair the immune system, reduce inflammation and heal arthritis.

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Our team at Blum Center has created an accessible way for you to see us, so that we can support your needs during this time.

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A Doctor’s 4-Step Program to Treat Autoimmune Disease

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Can Vaccine Repurposing Help During Covid-19?

With the imminent arrival of fall there are many unanswered questions about how we will be functioning in the world with COVID-19. Will schools be open? Will we have to go on lockdown again? What happens when the cold and flu season hits and we are also dealing with a variety of other common seasonal viruses? 

As I have been advising patients through this entire process, my approach has evolved: information we knew early on has drastically changed; whereas once the use of mask wearing was in question, there is now no doubt that it is essential in significantly decreasing infection from COVID-19. This has led to a lot of confusion as people try to make sense of the latest data and is complicated by some offering up doubts and conspiracy theories. This makes for a good book, but one story I would rather us not be living in.

What is quite clear to me is that we will not have a vaccine in time for the fall flu season. 

So what more can we possibly do?  

I think a reasonable possibility at this time might be the exploration of repurposing existing older vaccines. Last year, my area in Rockland county New York had a major outbreak of measles. A disease that we had not witnessed in many decades began to re-surface. 

Prior to this many susceptible populations, like newborns and infants, were protected by what is known as herd immunity. Herd immunity works only if a significant portion of the population has immunity against the disease. 

As a result, my son’s school was shut down for a period of weeks until the unvaccinated were vaccinated, and the number of cases began to significantly decline; an interesting precursor to times ahead. But now we know on a magnified scale of that event and dealing with a virus we have just started to understand.

The question now becomes: can we support our immune response in an unprecedented time like this?

I recall reading some research as early as May of this year where expert virologists had suggested that giving the Polio vaccine, one that most of us have received, may stimulate the body’s innate immune system in such a way that it could provide protection from a more severe manifestation of COVID-19*.  

Mind you, this is the live oral polio vaccine which is no longer offered in the United States but still available in other countries. We now have an injectable inactivated form of the vaccine. There is a push to do more research in this area and hopefully be able to bring this therapy available to the U.S. again. Dr. Robert Gallo, the director of the Institute of Human Virology at the University of Maryland School of Medicine and co-founder of the Global Virus Network, a coalition of virologists from more than 30 countries, is leading the push for this cheap and easily accessible preventative strategy. 

How does that information help Americans since we can’t access that easily?  Recently, another report hypothesized, with supportive rationale, similar effects from the Measles Mumps Rubella (MMR) vaccine –the same one you need to get immunity against measles. The report discussed the potential protection in dampening the severe effects associated with COVID-19 infection. And, many of us have had waning immunity to vaccines we got a lifetime ago.  

Referencing the measles outbreak last year, many people in the New York area began to look at their measles titers to see if they had immunity.  Interestingly, many found that they no longer had adequate protection against measles and sought to revaccinate again. So, a thought occurred to me: maybe this is a great time to do testing for MMR titers. If there is an indication that there is a blunted immune response, then revaccinate. It’s possible that by doing so, you may offer some level of protection against COVID-19. If you are living outside of the U.S. where the oral polio vaccine is offered, that may be yet another option you have.

As a natural “prepper” (I like planning in general and preparedness for unexpected life events like hurricanes and superstorms have led me to think more catastrophic possibilities these days), I urge you to get your MMR titers tested, and consider this possibility of re-vaccination as another layer of protection as we all prep for the coming months.

 

 

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY where she creates highly personalized treatment plans for each of her patients. Dr. Yee has a special interest in integrative cancer care, immune disorders, and lyme disease. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

 

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How Your Gut Affects Your Immune System

Did you know that your biggest exposure to the outside world every day 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 to the body (called antigens because they stimulate the immune system), which believe it or not includes food and the toxins and microbes that ride along with the food that you ingest while eating.

Your gut, which starts in your mouth, travels through your stomach, small intestine, colon or large intestine, and ends in your rectum, is supposed to be a closed tube – with the intestinal lining creating a barrier that separates the inside of your body and immune system from these outside exposures.  When you digest your food, the intestinal lining can then selectively choose what can enter your body by opening and closing special gates called tight junctions.

In functional medicine, an intestinal barrier with damaged tight junctions that isn’t keeping antigens out of the body is known as a leaky gut.  Studies have increasingly found that a leaky gut can damage the functioning of your immune system and is also associated with arthritis, autoimmune disease, allergies, and food sensitivities.

Causes of leaky gut vary, but the most important is dysbiosis, which is an imbalance in the bacteria in the gut, also called the gut microbiome.  Dysbiosis can be an overgrowth of harmful bacteria, yeast or parasites, or not enough good bacteria, and is commonly caused by a poor diet, a course of antibiotics, frequent use of antacids, stress, and many other things like medication and toxins. These gut bacteria are important because they interact with your immune system to keep it healthy, and they turn the food we eat into healthy compounds called short chain fatty acids which heal the tight junctions between your cells and also support immune health. 

The good news is that you can rebuild your microbiome and repair your gut, and this is the best thing you can do to maintain and improve the health of your immune system. Here is how to do this:

  1. CHANGE YOUR FOOD:  has the most influence on the diversity of the microbiome, and that’s why you should always start with changing your diet by increasing fruits and veggies, especially those rich in polyphenols, bioflavonoids, and fiber because these tend to increase the good bacteria that make short-chain fatty acids and heal the gut. Also, you need to remove foods from your diet that feed the bad bacteria like sugar, processed flour products, alcohol, and too many animal products (more than 30% of your daily diet).  You also need to test yourself for food sensitivities and remove sensitive foods such as gluten, dairy, soy, corn, eggs and the nightshade vegetables. Our elimination diet explainer shows how to do this. 
  2. TREAT YOUR DYSBIOSIS:  At Blum Center for Health we start with cleansing herbs like berberine, grape seed extract, black walnut, and oregano that can clear out bad bacteria and yeast from the gut ecosystem. In fact, we created our own custom herbal antibiotic mix called Gut Cleanse, and we use this in our do-it-yourself 10 or 30-Day Gut Cleanse Program.  Once you have eliminated the bad bacteria and yeast, probiotics and the right food can help you rebuild the good stuff, repair the gut lining, reduce inflammation, and eliminate food sensitivities. 
  3. TAKE A PROBIOTIC:  These are supplements filled with different strains of beneficial bacteria that help positively influence your gut ecosystem and improve the functioning of your immune system.  We recommend probiotics as a foundation for supporting immune health.  

These simple steps will not only improve your gut function, but will also lay down a foundation for immune health that will continue to improve in the future.

 

Susan Blum, MD, MPH an Assistant Clinical Professor in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, has been treating, healing and preventing chronic diseases for nearly two decades. A Preventive Medicine and Chronic Disease Specialist, Dr. Blum is the Founder and Director of Blum Center for Health in Rye Brook, New York, where she leads a multi-specialty team of physicians, nurse practitioners, nutritionists and health coaches, all providing cutting edge Functional and Integrative Medicine services.

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HOW TO HANDLE CANCER DURING THE PANDEMIC

Do you have a health condition, like cancer, that you’d normally seek medical care for but you haven’t during the coronavirus pandemic?  Is this because you think you’re safer at home and going out would risk infection, or your usual physician is not available to see patients?  You aren’t alone.  

One of the most disconcerting things to me as a physician during this pandemic is that the other medical conditions people have been suffering with have mysteriously disappeared.  It makes sense that emergency rooms have noted a dip in occurrences like car fatalities and injuries since many of us are not out and about driving. However, what about heart attacks and strokes?  These are time-sensitive events that if treated early, make a significant difference in someone’s survival.  Many people are afraid to call an ambulance or go to the ER with concerning symptoms like chest pain or sudden weakness in parts of the body because they fear they will get infected with Sars-CoV2.  And unfortunately this is leaving many people to die at home or they are left with permanent disabilities because they received medical attention too late.  These are not conditions where the wait-and-see approach works.

SCREENINGS FOR CANCER DURING THE PANDEMIC

Have you been due for your regular screening colonoscopy or mammogram and have delayed calling to make that appointment because it isn’t an emergency or you decided it can wait until we have some clarity about returning to normal life? Again, you are not alone.

In a typical year, roughly 150,000 cases of cancer are detected monthly in the US population.  As a physician specializing in Integrative Oncology, I am very concerned that people with signs of cancer – a new mass or lump – are not being assessed quickly enough and that these new cases are being missed in the earliest stages when treatment is most effective.  Many people have been choosing to wait until it is “safe” to make the phone call for an appointment.  Every doctor and health system is doing their best to create a safe environment for patients, and while we don’t have all the answers, it is now time to reach out to your provider through telemedicine and share your concerns so that you can create a plan of action together.

CANCER AND COVID

As someone with cancer during the coronavirus pandemic,  are you concerned about what you can do beyond secluding yourself at home? 

During the past 3 months, I have been hearing from many of my cancer patients with concerns about what else they can do. Whether they have a past history of cancer, or are actively in treatment, these patients are looking to have an action plan in place that will help when they are going to reintegrate into the world.  

During this exceptional time, it has also been more difficult for my cancer patients to find some semblance of security in their treatment or monitoring.  Many have felt that their diagnosis has taken a backseat to the pandemic at large.  One of my patients called for a telemedicine followup with her oncologist to find that he was recruited by his hospital to work in the ER managing COVID-19 patients.  Another patient was told to forgo treatment for one month due to a high risk of exposure; her tumor markers became elevated the following month.  Others have found that when they questioned their current regimen, they were told to stay the course until things resumed to a more normal format.  And just like everyone else, those with cancer are very reluctant to go to an ER (whether for a cancer related issue or anything else like heart attack or stroke symptoms), because they are known to be a high-risk category because of a weakened immune system. 

INTEGRATIVE ONCOLOGY

I have been practicing integrative oncology for well over 15 years, helping people to navigate through conventional treatments by offering ways to naturally mitigate symptoms from chemotherapy, radiation and surgery as well as exploring other areas of evidence based treatments that lie outside of the box of their oncologist.  Often, people seek me out to support their treatment nutritionally or to “boost immunity” during treatment, and this is a good place to start.  But then most people discover there is a plethora of other adjunctive possibilities outside of what their oncology team has offered.  Cancer is a diagnosis that I hope that one would consider all angles and possibilities and various opinions to help construct the most solid plan to move forward and try to conquer the disease.

One of the areas that I focus on is supporting immunity and treating immune issues with these patients.  It is interesting to me that many of the natural herbal and nutraceutical treatments that I have used in cancer for various reasons, have activity in some format against Sars-CoV2. For example, I’ve  utilized Chinese Skullcap (also known as scutellaria baicalensis) in both breast and ovarian cancers (as well as other cancers such as colorectal and prostate cancer) because of its anti-proliferative activity against tumor cells but interestingly it has a place in combating Sars-CoV2 by enhancing not only immune function but also possessing anti-inflammatory activity for a variety of cytokines and can potentially block the virus from attaching to ACE-2 receptors that are unique to this virus.  A good review can be found HERE.

The field of integrative oncology is immense and I have always gravitated to working with cancer patients for a number of reasons.  It presents an incredibly difficult time that often necessitates a change in mindset, which allows me to show people that this challenge is an opportunity not only to make positive and sometimes radical change in one’s life. It’s also a time to take control and not always assume that there is nothing out there beyond what the oncologist or surgeon is offering.  And with over 100 peer reviewed publications that come out daily, the field is constantly evolving and my work is never “protocol.”  These are just a few reasons why I find working with cancer patients extremely rewarding. The current pandemic adds yet another layer to work through with patients and I accept the challenges ahead.

 

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY where she creates highly personalized treatment plans for each of her patients. Dr. Yee has a special interest in integrative cancer care, immune disorders, and lyme disease. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

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An Update on Supplement Usage During the Coronavirus Pandemic

An Update on Supplement Usage During the Coronavirus Pandemic

As of 5.8.20

By the team at Blum Center for Health:  Susan S. Blum, MD, MPH; Pamela Yee, MD; Elizabeth Greig MSN, FNP 

As the days turn into weeks, we are learning more and more about how this virus behaves, and what we might do to support our immune system to better protect ourselves.  From a Functional/Integrative medicine perspective, thus far we have been focusing on nutrients and herbs that have been well studied, in general, for their ability to support, modify or boost the immune system.  I have been talking and writing extensively on helping people to choose the right supplements.

Today, I have updated this blog to reflect new information that I want to share with you.  

Summary of what we’ve already discussed so far:

ACE receptors:  We have learned that this virus uses the ACE receptor on cells to gain entry.  This led to alarm bells in the Integrative Medicine community because we have read that one of the many actions of Vitamins D could be to increase the number of ACE receptors on the cells.  HOWEVER, now, after reading the most recent studies on this topic, it appears that what’s more important is the level of Angiotensin Converting Enzyme 2 (ACE 2) in the blood, and NOT the amount of receptors.  And since Vitamin D might help reduce the levels of ACE 2 (a good thing), it appears that the concern about ACE receptors is a thing of the past and we can safely take Vitamin D.

Cytokine storm:  When the virus gets going in your body, it can sometimes create something called a cytokine storm, which is when your immune system reacts vigorously and releases an enormous amount of chemicals (cytokines) and free radicals to destroy the virus. Specifically, it is caused by activation of NFKB and an overacting NLRP3 Inflammasone, the system that makes these cytokines.  

There is concern that in some people, among other things, the cytokine storm contributes to the lung damage that we hear about.  We have been reading about the possibility that some immune boosting vitamins might make the cytokine storm worse by increasing the NLRP3 inflammasone system.  Many of you have been contacting us, asking for guidance on this.

Here is new information, as of May 8, 2020.  

We are changing our recommendations based on the release of a comprehensive review by the Institute for Functional Medicine, of the following supplements.

We must state that there are no studies that prove that any of the below supplements contribute to a cytokine storm, and there is now a widespread understanding that these supplements are all safe to take, and will not have a negative effect on cytokine storm, if it happens.  

**Please note that these recommendations are NOT medical advice.  Most are not safe for pregnant women, and if you are taking medication or have any serious health condition, please check with your doctor.

IMMUNE BOOSTING SUPPLEMENTS

Vitamin D:  5000 IU daily in absence of serum levels from a blood test.  

Vitamin A:  up to 10,000 – 25,000 IU/day  

Vitamin C:  1-3 grams daily

Elderberry:  500 mg daily (of USP standard of 17% anthocyanosides)

Beta Glucans:  250 – 500 mg daily

Mushrooms:  Shiitake, Lion’s mane, Maitake, Reishi.  Dose depends on preparation

N-Acetylcysteine (NAC):  600 – 900 mg twice/day

ANTIVIRAL SUPPLEMENTS

Zinc:  30 – 60 mg daily in divided doses

Licorice root:  200-400 mg/day in divided doses, standardized to glycyrrhizin.  Short term use <4 weeks.

Also Vitamin C

REDUCE CYTOKINE STORM (NLRP3 Inflammasone)

Resveratrol:  100 – 150 mg daily

Melatonin:  5-20 mg daily

PEA:  Palmitoylethanolamide:  300 mg twice/day for prevention.  600 mg 3 x daily for 2 weeks to treat infection.

ANTIVIRAL PLUS REDUCE CYTOKINE STORM

Curcumin:  500 – 100 mg twice/day.  Choose absorption enhanced.  

EGCG:  4 cups daily or 225 mg daily

Chinese Skullcap:  750-1500 mg/day.   Standardized to flavonoids baicalin or baicalein.

Quercitin:  1 gram twice/day.  Phytosome:  500 mg twice/day

PUTTING THIS TOGETHER

  • Supplements:

    • We suggest choosing supplements from each category so that you have the broadest support possible.  
    • You don’t need to take ALL of the recommended vitamins and herbs.  
    • As a core program, make sure to take Vitamin D, C, and Zinc.
    • Next, the most common that we recommend are Vitamin A, Curcumin and Mushrooms (or Beta Glucan).
    • After that you can choose additional supplements from the list above as desired or needed.
    • You can find our COVID Immune recommendations for purchase on Fullscript.  Click here to sign up and order from that dispensary.
  • Remember, if you develop a fever, consider not taking any fever suppressing medication because fever helps kill the virus.  However, it is dangerous to let your fever go over 103, and so if you need it, consider taking Tylenol (Acetominophen) instead of ibuprofen (Advil).  It appears that ibuprofen may make things worse.  This is another area that is rapidly evolving, and if you can’t find Tylenol in the stores, you should speak to your doctor about other options.
  • Here are the things you should STILL DO for risk reduction:

    • Good gut health: which means lots of beneficial bacteria. Take a probiotic every day with at least 20 billion cfu of mixed strains lactobacillus and bifidus species. 
    • Balanced stress hormones: Get a good night’s sleep and don’t overwork yourself during flu season. Stress harms your ability to fight viruses.  Practice some form of mediation daily.  Melissa, Blum Center’s Health Coachwrote a great blog with tips for managing stress during this time. 
    • Eat foods that are good for your immune system: Avoid processed foods and focus on fruits and veggies that are rich in antioxidants and vitamins. Support the removal of toxins by eating lots of cruciferous veggies, which boost the detox system in your liver.

Sending prayers and good wishes for you and all of us to stay safe and well during this challenging time.  I will be having a weekly LIVE webinar every Friday at 11 am EST to answer questions.  Sign up here

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COVID-19 Nutrition 101: Let Food Be Your Medicine! 

A walk through the grocery aisles early this morning was a little shocking: The produce section was overflowing and the packaged processed food aisles were … empty.

The Number One thing you can do to support your immune system is: Eat Real Food

Your immune system is fueled by the food you eat. After all, over 75% of your immune system lives in your digestive tract. This means that every bite of food you eat influences your gut microbiome, which in turn determines your body’s ability to mount the appropriate immune response to invaders like COVID-19. 

Stroll on by the cookies, the sweets, the empty-calorie crackers, the high sodium frozen dinners and opt for packaged foods with minimal ingredients. Take a peek at the ingredient list and use this litmus test, “Am I willing to eat each ingredient with a spoon?

Here are 6 no-nonsense things you can do right now to help boost your immune system and keep your body healthy.

Choose whole, nutrient-dense foods. 

Eat the rainbow! Focus on fruits and vegetables of all colors — They  are filled with antioxidants that support your immune system, and fiber that feeds your healthy gut bacteria. Choosing foods that mirror the colors of a rainbow ensures that you eat a large variety of vitamins, minerals, antioxidants, and phytochemicals that have enormous protective and healing powers.  

These rainbow foods are particularly good right now: 

Green produce helps boost the immune system and detoxify the body.

All healthy diets require green-colored produce and that is particularly true now. In fact, research suggests that green vegetables are the source of a chemical signal that is important to a fully functioning immune system. They do this by ensuring that immune cells in the gut and the skin known as intra-epithelial lymphocytes (IELs) function properly. (1)  Include green vegetables, such as arugula, asparagus, broccoli, Brussels sprouts, collard greens, green beans, kale, peas, romaine lettuce, spinach, swiss chard, and zucchini. Enjoy fruit, such as avocado, green grapes, and kiwi. 

Orange and yellow-colored produce help improve immune function.

Chock full of beta-carotene, a powerful antioxidant, vitamin A and vitamin C, these include vegetables, such as carrots, sweet potatoes, all varieties of winter squash, yellow summer squash, orange and yellow peppers and golden beets. It also includes fruits, such as oranges, grapefruit, lemons, mangoes, papayas, pineapple and peaches. 

Pro Tip: A great way to ensure you’re getting enough vegetables is to make your plate at lunch and dinner is at least half vegetables. 

Here are a few resources for getting organic, healthy foods delivered:

Check out Misfits Market — they will send you a box of seasonal produce at up to 40% less than what you would pay at the grocery store. (Use the code COOKWME-DY5XFK for $25 off.)

You might have access to a local CSA that will deliver to your door. Do a google search for your area or you can start with https://www.localharvest.org/csa/

Check out Butcher Box — they deliver 100% grass-fed beef, free range organic chicken and heritage breed pork directly to your door. 

Ditch sugar and processed foods.

The stress and anxiety of COVID-19, combined with “Sheltering at Home” creates the perfect recipe for craving sugary and processed foods — they temporarily make us feel energized but a big crash comes shortly afterward. Beyond that sugar and processed foods SUPPRESS your immune system. To help you kick the sugar habit, enroll in our 7-Day Sugar Detox Here

Eat high quality protein foods.

Protein is critical for immune function. What’s an adequate amount? Roughly half your bodyweight in grams a day. These include plant-based proteins, such as legumes and nuts and seeds, as well as organic, clean, humanely-sourced animal protein. 

Plant-Based Protein Superstars:

  •     1 cup cooked lentils = 18 grams
  •     3 tbsp. hemp seeds = 10 grams
  •     I cup cooked quinoa = 6 grams
  •     3 ounces extra firm tofu = 9 grams
  •     1 cup chopped broccoli = 8 grams
  •     ¼ cup raw almonds = 8 grams
  •     ¼ cup raw sunflower seeds = 7 grams
  •     2 tbsp. chia seeds = 6 grams
  •     2 cups chopped kale = 4.5 grams

Wild-caught salmon has 13 grams, chicken has 18 grams, and ground beef, 11 grams — all per 2 ounces.

Eat cultured and fermented foods to feed your microbiome and support immune health.

Include sauerkraut, kimchi, natto, chickpea miso, yogurt made from coconut or almonds. These foods give your body a dose of healthful probiotics — live micro-organisms crucial to a healthy intestinal microbiome (the microbial community in the gut) — which plays a role in supporting the immune system and warding off damaging inflammation inside the body. 

Make friends with mushrooms.

Mushrooms are medicinal!  They have immune-boosting polysaccharides that have anti-viral, antibiotic properties. Shiitake, maitake and oyster mushrooms are easy to prepare — a simple roast, sauté or simmer will do. In fact, you can throw them in everything — soups, omelettes, stir fries, stews, vegetable dishes. 

Add garlic, onions, cloves, cinnamon, ginger, turmeric, rosemary, oregano and more when cooking. 

These herbs and spices not only add flavor to your food, they are anti-inflammatory powerhouses. Add them to soups, stews, vegetables, oatmeal, or just about anything! Did you know that garlic and onions offer wide spectrum antimicrobial propertiess.

Drink plenty of fluids.

Your body depends on it, as does your immune system. Water and herbal teas,of course, but soups and broths also count! Stay away from fruit and vegetables juices — they are full of sugar (yes, even the so-called healthy ones.) 

Wondering what else you can do?

Join Dr. Blum’s FREE Friday Open Office Hours Q & A, to have all your lingering questions answered: Register Now

Schedule a 45-Minute Immune Support Consult with one of our healthcare practitioners.  Schedule an informational call here

Read my recent blog post: 10 Ways to Reduce the Coronavirus Stress Response

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. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

Resources:

  1. Ying Li, Silvia Innocentin, David R. Withers, Natalie A. Roberts, Alec R. Gallagher, Elena F. Grigorieva, Christoph Wilhelm, Marc Veldhoen. Exogenous Stimuli Maintain Intraepithelial Lymphocytes via Aryl Hydrocarbon Receptor Activation. Cell, 13 October 2011 DOI: 10.1016/j.cell.2011.09.025
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Pregnancy and Pandemic

Please note: This article should NOT be considered medical advice. Information about COVID-19 is constantly evolving and subject to change. Following proper procedures for handwashing, social distancing, masking and surface cleaning remain the best interventions available. Personal recommendations for pregnancy planning should be discussed with your health care provider

Pregnancy is a time of hope and excitement as well as increased concern for what the future will bring for your growing family.   Pregnancy during a pandemic can add to the fear that any parent-to-be may feel. The areas of concern are three-fold: What effects COVID-19 (SARS-CoV2) may have prenatally, how it will inform labor and delivery, and what effects it might have in the first years of life and beyond.  Expectant mom’s need guidance to help them navigate the changing landscape of pregnancy during pandemic. Arming yourself with knowledge and a plan of action can help you navigate this confusing time. What should you know and what can you do now to protect your baby?

We do not have a lot of information about pregnancy and birth outcomes related to COVID-19 as of yet.  Studies are based on small population size, and only exist from women in their third trimester. While we do not know what, if any effects, in utero or early exposure to COVID-19 may have on baby’s early and long-term development, new information is continually emerging, and we can use the currently available data to guide our choices. 

Prenatally, protection and prevention are absolutely the first line of defense. Follow standard recommendations for social distancing, frequent hand washing, thorough surface cleaning, and face covering. Discuss with your provider their policies regarding in person vs. telehealth prenatal visits. Basic health measures such as high-quality nutrition, physical activity, restful sleep and stress reduction become even more important, even while quarantine conditions add an additional layer of challenge to achieving these goals.  Consider pregnancy safe immune support such as vitamin C and D, zinc and echinacea as appropriate, but be careful with any supplements-herbs such as licorice and andrographis being touted as protection against SARS-CoV2, they are unsafe during pregnancy. Other compounds such as quercetin and melatonin, which may have anti-COVOD-19 activity, are lacking in safety data regarding pregnancy.

Once baby is ready to enter the world, the goal is to minimize risk to mom and newborn.  There is a higher risk of preterm delivery and low birth weight in babies born to infected mothers but thankfully, vertical transmission (from mom to baby in utero) of COVID-19 appears unlikely. In only rare cases has a baby been born with positive antibodies (a sign of prior exposure) to the disease. Horizontal transmission (from mom to baby after delivery) has occurred, likely due to exposure to respiratory droplets after birth, but in most cases, the infants have recovered well, and appear less seriously affected than adults. Because of the fear of both vertical and horizontal transmission, as well as respiratory concerns for mom, C-section deliveries and separation of mom any baby after birth were regularly initiated in early cases, but with more information these guidelines have changed.  For COVID-19 infected mothers, the World Health Organization (WHO) currently does not recommend routine C-section, unless deemed necessary for other reasons. The CDC does not support routinely isolating a newborn from its mother and WHO maintains the importance of room-sharing, skin to skin contact and breastfeeding to provide the baby with optimal immune support. There is no evidence that the virus can be transmitted via breast milk, however, COVID-19 positive mothers must use precautions such as wearing a mask while nursing, washing hands before and after touching the baby, and disinfecting all surfaces. In addition, if a mom is expressing her breast milk for any reason, including being too ill to nurse, all equipment must be carefully and thoroughly cleaned.

For the first year and beyond

Preterm delivery, C-section birth, antibiotic use, as well as maternal fever, infection and use of acetaminophen during pregnancy have been associated with an increased risk for autism spectrum disorders, ADHD, developmental delay and depression in children.  We suspect this is linked to disruption of the infant microbiome and alteration of innate immune function. Research is clear that healthy balanced gut flora exerts powerful effects on not only digestion, but immune and neurologic function as well. Alterations in these pathways are correlated with a variety of developmental and mental health challenges in children and adults. 

HOWEVER, remember that having a baby should be a time of joy and hope.  We cannot and should not live in fear of negative outcomes. What we can do is be aware, and proactive in supporting normal immune and gut health in our newborns, and be especially mindful of those who have been exposed to SARS-CoV2.  Being proactive includes breastfeeding for 6 months or longer whenever possible. Breast milk provides important immune modulating compounds as well as molecules called Human Milk Oligosaccharides (HMOs) that are used specifically by the gut flora to grow and thrive.   If appropriate, Vitamin C and D, probiotics, omega 3 fatty acids, and zinc can be used to enhance immune function.  While these nutrients are safe for both breastfeeding moms and babies, appropriate dosing is essential. Parents should watch carefully for signs of digestive and immune dysfunction such as colic, reflux, poor sleep, eczema and ear infections.   If you suspect your child is not achieving appropriate developmental milestones, then modify the familiar saying and “if you don’t see something, say something”. Work closely with a provider experienced in functional care who will take your physical and developmental concerns seriously, and intervene early.

This information is not designed to scare but to educate.  By knowing the facts, working closely with your healthcare provider to decide what is best in your individual situation, and making decisions with both short and long-term effects in mind, you can lay the foundation for a happy thriving child. 

 

Vicki Kobliner MS RDN, is a Registered Dietitian/Nutritionist. Vicki has a passion for helping parents-to-be navigate preconception, pregnancy and baby’s first year of life in the face of increasing chronic childhood illness.  She employs a functional nutrition approach to optimal health and healing. Vicki also works with infants through adults with chronic illnesses, digestive disorders, food allergies, ADHD and autism and provides fertility and mental health focused nutrition counseling.   Click here to book an appointment with Vicki.

Looking for more information on being pregnant during a pandemic?  Join Vicki for a live webinar on May 14th at 12 pm where she will explain what information we know so far, and how best to use that information for prevention and protection. Click here to register.
Submit questions forVicki in the comments section – she will address them during this live call! Sign up here.

 

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Coconut Quinoa & Broccoli Bowl with Ginger-Lemon Dressing

Here’s a wonderful recipe that will not only take the chill out of spring, but it also is good for your gut  … which makes it good for your immune system.

Check out all these gut-loving, immune-boosting ingredients: 

  • Broccoli and snow peas — green vegetables are the source of a chemical signal that is important to a fully functioning immune system. They do this by ensuring that immune cells in the gut and the skin known as intra-epithelial lymphocytes (IELs) function properly.
  • Coconut milk and flakes — Coconut contains lauric acid that is known for its antiseptic properties. It assists the body in fighting infections caused by bacteria, viruses, and fungi.
  • Quinoa is a complete protein and is critical for immune function.
  • Sesame seeds contain iron, zinc, vitamin B6, vitamin E, selenium and many more which support the functioning of the immune system.
  • Ginger has powerful anti-bacterial, anti-viral and anti-inflammatory compounds that keep rhinoviruses from binding to cells in the mucus membranes.

Enjoy this easy-to-make crowd-pleaser!

Ingredients:

For the quinoa and broccoli bowl:

  • 3/4 cup quinoa
  • 1 1/2 cups full-fat coconut milk
  • 1 pinch sea salt
  • 1/2 head broccoli florets
  • 1/2 cup snow peas, thinly sliced
  • 1 spring onion, thinly sliced
  • 1/4 cup large coconut flakes, toasted
  • 1 tablespoon black sesame seeds

For the dressing:

  • Zest of 1 lemon
  • one 2-inch knob fresh ginger, peeled and sliced
  • 1 teaspoon honey
  • 1 lime, juiced
  • 1/4 cup olive oil

 

Directions:

  1. Rinse the quinoa under cold water for about 30 seconds. In a medium pot, add the rinsed quinoa, coconut milk, and sea salt. Bring to a boil, then cover and simmer for 15 minutes, until quinoa has absorbed most of the liquid. Remove from heat, let sit with lid on for 5 minutes, and then fluff with fork.
  2. Lightly steam the broccoli until just tender and bright green, no more than 5 minutes once the water boils. Then, rinse broccoli under cold water to stop its cooking, and to retain its color and texture.
  3. Place the coconut quinoa in 4 bowls. Add the warm broccoli, and then top it with snow peas, spring onion, toasted coconut flakes, and sesame seeds.
  4. To make the dressing, place lemon zest, fresh ginger, honey, lime juice, and oil in a small blender and combine until smooth. A If needed, add a teaspoon or two of water to reach the right consistency.
  5. Drizzle the dressing over your  bowl.

 

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. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

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Lyme Disease in the Age of COVID-19

As much of the world has been focusing on the COVID pandemic, many of us are sitting at home for many more hours than we are used to.  We’ve been given this unique opportunity to go outside and visit nature regularly. It’s a good way to combat cabin fever, remain physically active and care for our emotional needs during these times of worry and uncertainty.  

Every day I witness the streets around my home being filled with neighbors I rarely see, families on walks together, kids on skateboards and scooters.  It’s a busy scene for a usually quiet town, and as I try and look for the positive things during these times, this is a beautiful one to witness: that we are all walking more, being with our families and breathing in fresh air.  

Given all the fear and uncertainty around the coronavirus pandemic, as an Integrative Physician with a focus on Lyme Disease in my medical practice, I felt compelled to share critical information so that you don’t get Lyme.  This information is useful, even if you’ve had Lyme before, or have it now, you don’t want to get it again! (And if you are struggling with chronic Lyme, I have some ideas for you, too)

Deer ticks are transmitters of various diseases in our area including Lyme, Babesia, Bartonella, Anaplasmosis, Relapsing Fever and Powassan virus.  This is not just a cause for concern in the spring and summer as conventional thinking goes. Their activity is dependent on the weather. With climate change afoot I see cases all year round.  Most people think ticks are killed off by freezing temperature but in fact, they just go through a stasis period. When the right conditions come about, they reanimate and come to life again.  

Here are some simple things to keep in mind as we approach high season for tick-borne illnesses:

  1. Temperatures: Deer ticks can be active in temperatures above 32-35 degrees when the ground is thawed and not covered in snow.  This is now. Don’t let your guard down just because you still need a down coat.
  2. Location: It’s common knowledge that ticks are found in the woods or specifically in shrubs, leaf litter, rock walls.  However I’ve had many patients get lyme disease from just being on sunny lawn. We are ground zero for Lyme disease, expect the rules to bend and that it’s easier to transmit traditionally thought.
  3. Family Pets: I’ve had patients who have been outside only on concrete and had Lyme disease.  We forget that our animals can bring ticks into the home. They should be checked regularly.  I believe that pets that get treated with medications like Frontline may tend to protect the animal but they make it more likely for a tick not to attach to them but to someone at home. 

What You Can Do To Protect Yourself Against Ticks 

  1. Tick Checks: If you are out in nature make sure you make it a routine to check yourself over.  Oftentimes we are good at checking our children but we forgo ourselves in the interests of time.  I’ve been guilty of that, too.
  2. Deer Fencing: This is incredibly helpful if you are able to have one on your property but it’s not foolproof as smaller animals can bring in ticks. The transmission rates can be reduced by 83-97%.
  3. Clothing: I avoid the use of more toxic insect repellants like permethrin BUT I do like the manufacturers that have bound the permethrin into the clothing fiber.  I do not believe this is absorbed into the body and it can last up to 70 washings and still remain effective. Socks are some of the easiest ways to bring protection into your daily life but other garments such as a hat (since ticks are hard to find on the scalp) are great ideas as well.  Of course you can dress yourself head to toe in clothing and tuck your pants into your socks but who wants to do this when it’s hot. I need my tank top and some vitamin D! 

You’ve Been Bitten by a Tick – What Should You Do? 

While knowledge and prevention can go a long way, ticks are tiny and omnipresent.  Here’s what to do if you find you’ve been bitten by a tick.  

  1. Having the right tools at home or travel when you need them is imperative.  There are many companies that make a tiny portable collection kit complete with tweezers, magnifying glass, picture identification guides and a specimen container. 
    If you are concerned about transmission you should keep the tick and bring it to your doctor for testing.  Most doctors, however, test only for Borrelia Burgdorferi (Lyme) but they don’t look for the other tick-borne infections.  I advise patients to use a company in Pennsylvania called Tick Checks where you send it in directly and have your tick checked for a multitude of pathogens with results in less than 48 hours.
  2. While there are no clinical studies that support the use of topical essential oils after a tick bite, I would still recommend the topical application of clove, cinnamon bark or oregano oil based on in-vitro studies of their activity against Borrelia infections.  It certainly can’t hurt.
  3. Once you get bitten there is no great test to detect early Lyme disease.  Traditional methods become accurate 4-6 weeks after the bite. There are controversial tests that can be done but it’s a gray area where you have to make decisions on treatment based on the clinical scenario. 
  4. After a delay of 3-30 days, be on the lookout for Erythema migrans (EM) rash (Bullseye rash) which can begin at the site of a tick bite, although many people do not have a rash at all. Over the next 4-6 weeks look for symptoms of fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash. See your doctor should you experience any of these symptoms. 

You Have Chronic Lyme – Concerns about COVID

Dr Yee has been treating chronic Lyme for two decades using an Integrative approach that is especially critical during the COVID pandemic as people with Lyme often have a compromised immune system.  Each person with Lyme needs a personalized approach that includes:

  1. Supporting the immune system 
  2. Assessing the best antibiotic regimen
  3. Integrating or replacing antibiotics with herbal protocols
  4. Protecting the gut during antibiotic treatment
  5. Other options for testing and treatment that your conventional lyme doc might not  know about.
  6. Checking aggressively for other tick infections that might have been missed.

If you have Lyme Disease and would like to see Dr Yee, she is now accepting new patients via Telemedicine.  CLICK HERE to set up a call and learn more about how Dr. Yee can help.  

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY where she creates highly personalized treatment plans for each of her patients. Dr. Yee has a special interest in integrative cancer care, immune disorders, and lyme disease. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

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Surviving and Thriving on a “Quarantine Diet”

Our lives have all been powerfully disrupted in the past few weeks. All signs indicate that they will remain so for at least the near future, and the adaptations can be exhausting!  Access to food and household needs, both in person and online, can be a lesson in frustration. For those of us who rely on a healthy, whole foods diet for optimal health, or may have dietary restrictions such as gluten or dairy, the search can be both harder and longer. As a Functional Registered Dietitian/Nutritionist, I can really relate.  If we choose not to stock up on pasta, rice and dry cereal, what are the options?

Here’s what I recommend: 

YOUR FREEZER IS YOUR FRIEND

  •   Stock your freezer as full as you can with unprocessed foods, including animal protein, vegetables and fruits- minimize processed boxed items which take up extra room. 
  •   Prep the items before you freeze them- for example, cook multiple chickens and cut the meat off the bone, and cut up fresh veggies, removing any parts you will not use before freezing to maximize space. 
  •   Freeze eggs! Drop individual eggs in sections of an ice cube tray. Once frozen you can store in a safe freezer bag such as https://www.green-n-pack.com/. If separating whites and yolks, add some salt to the yolk before freezing

PACK THE PANTRY

We want to maximize the nutrient density of the items we are storing. Although I haven’t officially calculated the protein or zinc per square inch ratio, these suggestions should keep your cabinets rich in foods that keep you healthy and satisfied. 

  •   While others are clearing the grocery aisles of white flour, don’t forget that nuts and seeds, their butters and ground meal are powerhouses of nutrition in small packages. Go heavy on these items. 
  •   Canned or dehydrated vegetables can last a long time. In addition to the usual carrots and peas, add some seaweed, jackfruit (it has a meat-like texture), artichoke hearts, hearts of palm, and pumpkin puree. Forager is one of many companies that make a variety of veggie chips. Boxed or homemade vegetable soups like tomato, carrot or squash can round out the assortment. 
  •   Dried fruits are another space-saving option to pack in the nutrients. Buy organic versions without added sugar. You can make your own trial mix or purchase a ready to eat option as well. 
  •   If canned tuna is in low supply, select canned salmon. It is better to rotate tuna and salmon anyway. Choose wild or pole caught options when buying fish. 
  •   Don’t forget legumes! Beans are rich in protein, fiber, and a variety of important nutrients. The dried versions are more cost and space friendly than cans, but either will work. Lentil chips, Brami snacking beans and Biena roasted chickpeas add textural variety to your choices. 
  •   Think like a cowboy and stock up on jerkies and meat sticks (like CHOMPS and PRIMAL ) which have a long shelf life. 
  •   Energy bars like EPIC, RX  and Lara are made with only real foods, and only a few of them. 
  •   Forget wheat pasta- bean pasta is readily available online and in many stores- try fiber and protein rich Explore Asian Mung Bean pasta, Banza chickpea pasta or Tolerant varieties which are organic and free of all major allergens. 
  •   Who needs rice when you can grab up some quinoa and buckwheat? Richer in protein and fiber, gluten free and not sold out! 
  •   Keep spirulina and nutritional yeast nearby.  Just a spoonful of spirulina  adds protein, iron and potassium, while nutritional yeast contains B vitamins and has a great cheesy taste. 
  •   Make sure you have herbs and spices on hand. Stressful times tax our immune systems and we can use these ingredients to add more than flavor.  Cinnamon, turmeric, thyme, oregano and rosemary contain compounds that boost our immunity, reduce inflammation and help kill germs. 
  •   My go-to ready-to-drink shake is from Orgain. Organic, tasty and comes in a dairy and vegan option.

SCHEDULE DELIVERY

Many grocery chains are scheduling deliveries two weeks out, and stock varies widely.

  •   Neighborhood shops may be able to meet your needs more quickly, and allow you to help the local economy. Call your local merchant and see what they offer.
  •   Sign up for a subscription service and you will know you have a steady supply of nourishing options coming straight to your door. Some of my favorites include:

o   Misfits Market supplies healthy, high quality produce at lower cost. It also reduces food waste!  (Use code COOKME-BB6IJG)

o   Walden Local Foods ships in the Northeast and supplies a wide variety grass-fed or cage free proteins (use the link to get some free eggs and bacon)

o   Butcher Box  delivers a variety of grass-fed, organic free range proteins directly to your door. 

o   Imperfect Foods https://www.imperfectfoods.com/ offers conventional and organic plans, which can be customized to your liking

In troubled times, nutrition becomes even more essential to support our immune system, modulate stress and keep us physically and emotionally resilient. Quarantine does not have to mean compromising on our well-being.

 

 

Vicki Kobliner is a Registered Dietitian/Nutritionist with over 20 years of expertise applying a Functional Nutrition approach to the care of children and adults. She utilized her wealth of experience with both traditional and integrative modalities, incorporating the power of food, herbs and targeted nutrition support for both prevention of and healing from both acute and chronic illnesses.    Vicki sees pediatric patients and their families at Blum Center for Health, and has extensive experience in addressing a wide variety of childhood illnesses.

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10 Ways to Reduce Your Coronavirus Stress Response

Out of nowhere we’ve been blindsided. Two months ago we never could have imagined the Coronavirus pandemic that is literally bringing the world to a halt. 

We want you to be safe. We want your loved ones to be safe.  And when you stay safe, you help the greater community stay safe, too.

And besides everything you can do physically to ensure safety — washing your hands repeatedly and staying at home as much as humanly possible (yes, isolating) — you must also give your stress response a break. Seriously. Your immune system depends on it.

One of the common threads of Dr. Susan Blum’s books, The Immune System Recovery Plan and Healing Arthritis, and in all our clinical work at Blum Center for Health is this: Stress damages the immune system.

In order to keep your immune system strong, you must employ strategies to minimize the effects of stress.

10 Ways to Reduce Your Coronavirus Stress Response

Create News Blackout Periods — Constantly scrolling, listening to the radio or watching television puts your body on unrelenting periods of high alert. Put in place a news plan. When will you consume your news? I recommend once in the morning and once in the evening for no more than 60 minutes. During the rest of the day, shut off the notifications on your phone, turn off the television and stream podcasts and music that makes you feel good. 

Use Social Media Wisely — Your feed is inundated with COVID19 related news — some of it accurate, some of it false, much of it alarmist, and you likely have friends and family that are in pure panic mode. Perhaps you need to mute a few people, but more than likely you need to step away. Just as I’ve suggested News Blackout Periods, do the same with social media. No, you don’t need it to stay connected to people.  You know who your friends and family are — reach out to them the old fashioned way — call them!

Reframe Your Worries — Here’s an example: My mom is 87 and lives with me. I’m doing everything I can to minimize her exposure. And, my father-in-law is in assisted living — while the building has been closed to visitors for a week, we received notification that someone who visited a resident has since tested positive. I’m a worrier. But, every time I start to feel myself getting worked up, imagining worst case scenarios, feeling that too-familiar constriction in my chest, tingling arms,  combined with swallow breathing, or most likely, holding my breath, I ask myself: “Does my worry change anything in this moment? Is there anything that I can change that would alleviate the worry?” If the answer is yes, I do it. If the answer is no, then I shift my thinking to: “What are my blessings in this moment?” My mom is fine, I’m doing everything I can to keep her safe. My father-in-law is okay. There are no reported cases at his home, and they’ve been closed to visitors for a week. I’m grateful for the sunny day. I’m grateful for the food in my fridge. I’m grateful for an internet connection so that I can stay in touch with my family and friends.

Get Out in Nature — Take a walk. Research shows that walking in nature has a calming effect on your immune system. Take one long walk, or you can take several mini walks throughout the day. 

Breathe — If you’re already meditating, awesome! Now is a great time to deepen your practice. If you’ve been “too busy” to start meditating, well … opportunity knocks! This is the perfect time to get started.  Use an app like Headspace or Calm, and start with 10 minutes a day. There is clear evidence that a mindfulness practice reduces stress, promotes healthier bodies, including taking care of your immune system, and over time, teaches you how to respond to stressors rather than react to them. That comes in pretty darn handy in times like this!

Choose Movies and TV Shows Wisely — Watching disaster movies, action movies and Debbie Downer dramas and documentaries are probably not the way to go right now. Your brain and your body absorb all the negativity, elevating your stress response — not only in the moment, but it fuels your worries and plays a role in disrupted sleep. Choose uplifting, fun, funny shows to watch. I bet you have a list!

Use the Time to Nest — When was the last time you were told to stay home? I mean, were you ever told to stay home? Yes, it’s a very worrying time, but you can also look at the bright side. What projects do you have that have been on the back burner for when you have  more time? Clean out closets, organize your home office, spring clean, get out the clothes that need mending, make your space feel homey and light. You might even try some aromatherapy — use your diffuser, if you have one, or light candles (preferably soy-based, rather than paraffin).

Have Fun with Homesteading — What do I mean? Bake from scratch, include your kids in cooking meals, try some new kitchen skills, like sprouting beans or preserving lemons. Or maybe there’s an InstaPot recipe you’ve been wanting to try. Now’s the time!

Connect with Friends and Family via Video (or Telephone) — Just because you’re home doesn’t mean you have to be isolated from your friends and family. In fact, with nearly everybody at home, it couldn’t be easier to connect with those you love. Use video to make lunch dates or connect in the evening rather than watching television. Do you have older people in your life that aren’t comfortable with technology? A good ole phone call will make their day (and likely yours too.)

Eat Real Food — During times of stress many people lean on packaged foods, and sugary, empty calorie foods — these deplete your immune system! Focus on antioxidant-rich vegetables and fruits — at least half your plate at every meal — healthy fats, like avocado, wild caught salmon, nuts and seeds; and whole grains, like gluten-free oats, wild rice and quinoa. Legumes are a great source of plant-based protein.

What are some of the ways you reduce stress during trying times? Share them. We’d love to hear.

Wondering what else you can do?

Read Dr. Blum’s blog post: Tips for Boosting Your Immunity 

Check out Dr. Yee’s Fire Cider Brew to help boost your immune system. 

 

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. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.