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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.

 

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{Recipe} Dr. Yee’s Fire Cider Brew

First, hand sanitizer became liquid gold. Then toilet paper, another commodity whose worth has skyrocketed all in an effort for people to feel safe and well-stocked.  Now, herbal and nutraceutical solutions for improved immunity have also flown off the shelves of health food stores. Finding them online has proven to be just as difficult.  Everything is BACKORDERED.  

In every single conversation I’ve had with patients these past few weeks, everyone wants to know what they can do to improve how well their immune system can prevent infection.   Recently, Dr Susan Blum had given her tips to boost immunity, and it’s a great start. If you are having a hard time procuring any of these products, read on for what I do personally to boost my immune system. 

For years, I have been taking a simple regimen of medicinal mushrooms at high doses. This year, long before coronavirus became the prevailing thought in each and everyone minds, I added a tablespoon of fire brewed apple cider vinegar to my regimen each evening and I have to say it has been extremely effective.  Granted, this is a “N-of-1” anecdotal report, but I feel quite strongly about it.  

Apple cider vinegar has been used as one of most common home remedies for a wide variety of health conditions from reflux to yeast infections to sunburns.  There is some pre-clinical data showing its efficacy as an anti-viral, anti-fungal and anti-bacterial agent but there is no hard clinical proof here. Typically I don’t recommend things without some level of evidence but here we are – empty shelves and backordered items.  It’s been working for me and its dirt cheap! 

You can find locally crafted concoctions of Fire Cider in health food stores and farmers markets but I like to make it at home.  Try this recipe while you are home social distancing and in a few short weeks you’ll have your own Fire Cider brew to boost your immunity as we get back to normalcy.  Wishing you good health! 

Recipe: Fire Cider Brew

(adapted from Rosemary Gladstar’s recipe)

Ingredients:

  • ½ cup grated fresh horseradish root
  • ½ cup or more fresh chopped onions
  • ¼ cup or more chopped garlic
  • ¼ cup or more grated ginger
  • 1 Tbs Turmeric 
  • 2-3 Tbs Honey
  • Chopped fresh or dried cayenne pepper ‘to taste’. Can be whole or powdered. 

Directions: 

  1. Place herbs in a half-gallon canning jar and cover with enough raw unpasteurized apple cider vinegar to cover the herbs by at least three to four inches. Cover tightly with a tight fitting lid.
  2. Place jar in a warm place and let it sit for three to four weeks. Best to shake every day.  
  3. After three to four weeks, strain out the herbs, and reserve the liquid.
  4. Add honey ‘to taste’. Warm the honey first so it mixes in well. 
  5. Rebottle and enjoy! Fire Cider will keep for several months unrefrigerated if stored in a cool pantry. 
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Tips for Boosting Your Immunity

My anti-viral approach is to help you build a strong immune foundation so that you boost your immunity and don’t get sick from any virus. A strong immune system is the basis for staying healthy in general and should be a year-round strategy…not just during flu season or when there is a threat of a novel previously unknown virus. This is, by far, the best prevention and protection!

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. If you are taking antacids or proton pump inhibitors -stop- because this alters your gut flora in a negative way.

Balanced stress hormones: Get a good night’s sleep to boost your immunity and don’t overwork yourself during flu season. Stress harms your ability to fight viruses.

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.

Take your vitamins! Here are some important ones you will need:

a. Vitamin D 2000 iu/day minimum. The dose is based on your blood levels, so if you havelow vitamin D you will need more.

b. Vitamin A retinyl palmitate 5000 iu/day. If you are pregnant or nursing, do not take morethan 5000 iu/day of this kind of Vitamin A (retinyl palmitate).

c. Zinc 30 mg/day.

d. Vitamin C 3-4000 mg/day as an immune booster. 1-2000 mg/day is good for general prevention.

Additional supplements to consider to boost your immunity:

a. 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 ( and so it is very useful for support treating respiratory viral illnesses). It also converts to Glutathione, the body’s most powerful antioxidant.  I usually recommend 900 milligram capsules or tablets – start with one twice daily and increase to two twice daily if needed. Pharmanac, a Canadian brand that comes in an effervescent form is easy to take as a fizzy drink – even for children!

b. Whey Protein Powder is high in immunoglobulins that boost your immune system. For a non-dairy alternative, try SBI Protect powder from Orthomolecular, packed with immunoglobulins

c. Herbs like Elderberry, Echinacea, Astragalus, and Beta Glucan (mushroom extracts). We love Immunoberry Liquid from Designs for Health, which is a potent and convenient blend of these. 1 dropper each day in your shake, or in a little water, is all you need for ongoing protection. We also love Immune Builder from Mushroom Science: 2 daily for prevention. Both of these supplement doses can be doubled or tripled if you are concerned that you had exposure or feel you have early symptoms of a viral illness.

Lastly, make sure to wash your hands multiple times a day — especially before you eat, and after exposure to public transportation like riding the subway.

 

The items listed are available for purchase from our office, or from our online store:

https://us.fullscript.com/welcome/blumcenter

 

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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I Had My Brain Mapped: Here’s What Happened

For years I’ve struggled with migraines. Diagnosed at 4-years old, I can’t really remember ever being completely headache-free. You might be thinking, “Of course you feel fatigued. Who wouldn’t?”

But, it’s a little more complicated than that. I also had a few concussions as a martial artist, and in sports, like flag football. Perhaps most notably, I had a traumatic brain injury in my 20s when I was hit by a car on my bicycle — yes, a life-changing event. I’ve also had viral meningitis and Lyme disease twice — two more migraine triggers.

In the last year, I started wondering, “Is all of this affecting the way my brain works? Is it just one thing, or is it some combination of these potential brain-affecting ailments? How can I tease all of this apart?”

In comes Field, a wellness team currently located at Blum Center for Health in Rye Brook, NY, that offers brain optimization, or in their own words, “Much like computer software, you can think of brainwaves as code that we can train, tweak and reprogram.” 

They claim that by mapping the brain, actually seeing how the brain responds to stimuli (or lack of stimuli), they can help people rewire the brain to respond or fire differently. The treatment particularly helps people with ADD/ADHD, depression, concussions, stress/anxiety, PTSD/trauma, even insomnia.

Could this be the answer to my headaches? It certainly peaked my interest. 

I decided to give it a try.

Prior to my initial assessment appointment I filled out a questionnaire — basically, a brain health history. I elaborated on my reasons for the appointment, and although I was a bit nervous to have electrodes — electrocephalography (EEG) — attached to my head (this is my brain after all!), I felt reassured that they knew what they were doing.

On the day of my appointment I sat in a beautiful slightly reclined chair — I figured it was a way to get me to relax a bit. Co-founder Devon White sat behind a bank of computer screens, and Kitty Boyle, the technician, placed a space-age cap on my head and attached the electrodes to capture my brain’s activity. They explained everything that would happen. So far, so good.

Kitty instructed me to close my eyes and relax. I could hear the white noise of the computer working, a few whispers between Devon and Kitty and then, “Melissa, try not to blink.” Did you know that you can blink with your eyes closed? Evidently I blink a lot!

This first assessment probably only lasted a couple of minutes, but it seemed longer. Trying not to blink took a lot of concentration.

The second assessment was the same as the first — only this time, eyes open. And again, no blinking. 

The third assessment was math-related — counting down from 1,000 by 7s to see how my brain was firing when given a task.

And lastly, Devon and Kitty did a Traumatic Brain Injury Assessment to determine the impact of the injury.

Once all the data was in, all my brain images flashed up on the wall in front of me. Sitting in the comfy chair, it kind of felt like a movie screening — only it was all about me. I was so eager, and even though the assessment was in real time, the anticipation was palpable. What’s going on in there?

Devon and Kitty walked me through all the data. We looked at all the brain waves — gamma, delta, theta, alpha and beta. They took the time to explain what these meant in relation to my assessment. We looked at the Mental Math EEG and the Traumatic Brain Injury Discriminant Analysis.

Here’s what I learned:

  • I have a beautiful, fast-firing, high functioning brain. Phew!
  • One thing that popped out is that I have lots of activity at F7 — the front left of my brain — in fact, it never seems to turn off unless I’m keeping it busy with an activity. It makes me hyper alert — and it can make me exhausted if I can’t turn it off. This is so true! Now that it has been brought into my awareness, I’m noticing it all the time. During meditation, when I’m trying to fall asleep, when I just rest with my eyes closed. My brain NEVER gets quiet!
  • There is a pronounced lack of activity in the T4 region — the right temple. This could be the area of my Traumatic Brain Injury.
  • Lastly, there was a TBI, but the great news is: it’s effect is minimal. Hooray!

Devon and Kitty recommended neurofeedback, a type of biofeedback that focuses on the brain and its firing patterns. It utilizes real-time displays (EEG) of brain activity — in order to teach self-regulation of brain function. 

Here is what they recommended:

  • We would increase alpha waves while my eyes are closed in order to help facilitate daydreaming and quiet down my brain that never stops firing.
  • Give theta to T4 in order to take down headaches.
  • Use neurofeedback to find plasticity in the part of my brain that isn’t firing and discover if this is indeed residue from my TBI.

So, I’m going to give it a try! I’m hopeful and optimistic. And, I’ll keep you posted on my progress.

Interested in learning more about brain-mapping? Contact my friend Devon, at Field. 

 

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.