Author: Dr. Susan Blum

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Eliminating Food Sensitivities To Treat Arthritis

 

Having just finished a book on arthritis, arthritis is really on my mind! There’s a lot of confusion around arthritis, so let’s start with a definition. To have arthritis you must have evidence of inflammation with redness, pain, swelling, and heat in at least one of your joints. Typically if you have arthritis you can see it.  If you have pain in a joint but no swelling, we call that an arthralgia.

To begin to understand arthritis, the first step is to realize that there are a number of categories.  As I explain in detail in my book, Healing Arthritis, it is important to know what kind of arthritis you have so that you can target your treatment.  This is especially true if you have arthritis from an infection (for example lyme, a virus like parvovirus, or a bacteria like mycoplasma and prevotella), because treating the infection is always the first place to start.  It’s a good idea to ask your doctor to test you for these infections and treat what you find.

Most people with chronic, painful arthritis fall into one of these two categories:

  • Inflammatory Arthritis – which includes rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and arthritis from autoimmune conditions.
  • Osteoarthritis –  also known as degenerative joint disease

Although they seem to be different on the surface, both are inflammatory in nature, and that’s why the foundational approach to both is to seek out and treat all the triggers of inflammation in your body, typically these are food, stress, and gut health. The first two factors (food and stress) have a direct effect on inflammation, and they are also the biggest influences on your gut health, too. There is an enormous amount of evidence and research now proving the gut-arthritis connection, and this research also shows that healing the gut to heal the joints is a valid and successful approach. That’s why we always start our treatment programs with eating an anti-inflammatory diet.  And the first step for this is to identify and remove foods that are triggering arthritis symptoms, often referred to as food sensitivities.  

How does food trigger joint pain?  Those with arthritis tend to have damage to the tight junctions in their intestinal lining, causing holes or gaps that allow foreign looking food particles and pieces of gut bacteria (collectively called antigens) to slip through the lining and enter the body (a condition called leaky gut).

Once these antigens enter the body they start an immediate immune reaction, which ends up in your joints leading to inflammation and pain. This is also a process that can lead to food sensitivities! Often, the food you eat isn’t really the problem, instead, the problem is the leaky gut is allowing food particles to pass through. This is why you will continue to have food triggers and symptom flares if you eat sensitive foods while the gut is still damaged.  The good news? After you heal the gut you can often eat these foods again.

To get started treating your arthritis with food, the first step is to identify your food triggers and remove them from your diet.  Then you can focus on healing your gut.  Sadly the standard American diet is abundant in foods that can damage the gut and also cause food sensitivities like:

  • Gluten
  • Dairy
  • Soy
  • Corn
  • Eggs
  • Sugar
  • Processed foods
  • and especially for arthritis sufferers, the Nightshade Vegetables (tomatoes, potatoes, eggplant, peppers)

Try removing these foods for 3 weeks, and then reintroduce each one separately for a few days, one at a time, to see if you experience any symptoms.  If you do, then remove the food for 3-6 months while you work on healing your gut.  

Removing food sensitivities is the first part of an anti-inflammatory diet.  The second part is to follow a sensible, basic, food plan, and my recommendation is a Mediterranean Diet.  I have dedicated an entire section of my book to reviewing the different diets and explaining exactly what foods you should eat for reducing inflammation and promoting good gut health and why.

For more please review the full Facebook Live video above, or join my Healing Arthritis Challenge.For 12 weeks, I will host live, 1-hour interactive classes with Melissa Rapoport, my Lead Health Coach at Blum Center for Health. We will provide personalized coaching based on my 3-Step Arthritis Protocol from my best-selling book, Healing Arthritis.  

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What is Dysbiosis – and What You Can Do About It

Dysbiosis is like having weeds in your gut garden

You have within you trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract.  This lively bunch of microbes is known as your microflora. Often referred to as “The Garden Within,” your microbial garden can shift out of balance. Think about how a garden can become overgrown with weeds. When that happens, we say a person has dysbiosis.

Three Ways Dysbiosis Can Impact Your Gut

  1. Too much of the bad stuff overgrowing in the gut is the most basic imbalance.  An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast (candida albicans is a particularly common and unwelcome yeast in large amounts), are two examples of overgrowth that cause dysbiosis.  An unwelcome virus or parasite can also cause overgrowth imbalance.

    To treat this type of dysbiosis we sometimes prescribe medications to kill unwanted bacteria, parasites, or yeast, but more often we use gentler, broad-spectrum anti-microbial herbs to weed the garden, improving the balance of good and bad bacteria. We also use probiotics and fiber-rich foods to encourage growth of the good while we get rid of the bad.
  2. Microbial undergrowth can be the culprit. It is rarer than the situation above, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise.  An under-abundance indicates we need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. We do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.
  3. Your microbiome settles in the wrong place. Living microbes are wanted, but we need them to live where they belong, and not take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well.  Herbs and antibiotics are our go-to for treating SIBO.

Could you have dysbiosis?

In our medical practice at Blum Center for Health, we suspect an imbalance in the flora (a dysbiosis) in anyone who complains of stomach troubles. Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have stomach upset after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating, we think of dysbiosis.  If you have bowel problems, like excessive gas, lower belly pains, constipation, or diarrhea – then dysbiosis is our prime suspect too.

Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, also make me suspect dysbiosis.  We are becoming more and more aware the impact our microbiome has on our whole being – our whole health – and our disease processes.

When I see someone whose health concerns are not primarily digestive in nature – even those who report having a perfect digestive system – I usually investigate their microbiome, and will almost always prescribe a probiotic. Why? Because sometimes dysbiosis is silent gut-wise, while still causing trouble in other areas of your body.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  

How do you know if you have dysbiosis?

How does your internal garden grow?  The tests we most often request are simple:  Stool, breath, and urine testing – all of which give us a picture of what your personal microbiome looks like.  We learn from the test results how many beneficial bacteria are growing, and how many malicious bacteria have taken up residence in your gut. We use that information to create your personalized treatment plan.

With some patients we assume dysbiosis without testing – and just get you started on the good stuff  – probiotics and healthy, fiber-rich foods.

Not sure if you have dysbiosis? Take our Assessment and find out!

How did you get this dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as does any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

What to do if you suspect you have dysbiosis:

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

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

 

Check out my FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

 

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FODMAPs Chart for treating SIBO and IBS

FODMAPs Chart for IBS and SIBO

As I discussed recently on Facebook Live, Small Intestinal Bacteria Overgrowth (SIBO) is an all too common gut ailment that can lead to many uncomfortable symptoms like chronic diarrhea or constipation, bloating, lots of gas, and abdominal cramping. SIBO is caused by an overgrowth of gut bacteria in the small intestine, crowding this area in high numbers where they don’t belong (only 10% should be in the small intestine, and 90% in the large intestine) and is particularly common in those with Irritable Bowel Syndrome (IBS).

Because all your nutrients are absorbed in this part of your gut, SIBO can cause malabsorption and lead to deficiencies of vitamins, minerals, fats and amino acids. Fortunately, herbal supplements and dietary changes can provide quick relief.  For instance, our Gut Cleanse Packets are designed to clear out the overgrowth of bad bacteria and yeast, but dietary changes can help, too, and may be necessary especially if you have lots of symptoms.

One category of food should stand out for those with SIBO and IBS – Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols (FODMAPs). FODMAPs are foods that are fermented by the bacteria in your bowels. When you have SIBO, there are lots of bacteria that are exposed to these foods very soon after you eat, and the fermentation creates excessive amounts of painful gas. Thus, foods high in FODMAPs are more painful to digest and foods low in FODMAPs are easier to digest for those with this condition.  

But, temporarily eating a restricted FODMAP diet won’t just reduce your digestive symptoms, it also reduces the gut bacteria’s access to food and thus assists in rebalancing your gut microbiome for optimal health. If you have IBS and aren’t sure if you have SIBO, you can often diagnose yourself by following the low FODMAP diet.  If you feel much better, then you likely have SIBO.  So what is the low FODMAP food plan? The food lists won’t necessarily be intuitive. Bananas and blueberries are some of my favorite low-FODMAP foods, while delicious fruits like apples and mangoes can actually cause acute pain!

Rather than trying to guess what foods should be high or low in FODMAPs, use this handy FODMAP Chart.

Once you’ve taken a moment to review the chart you may be shocked at how many foods could pose a problem for you. A FODMAP diet is a very restrictive diet, that’s why I don’t recommend it as a long-term solution. But, switching to a FODMAP diet could give you quick relief and the control to permanently improve your gut symptoms. Then once you’ve got a handle on your symptoms you can begin to progressively introduce foods back into your diet seeing what works for you.

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What’s the Difference Between a Detox and a Cleanse?

The terms cleanse and detox are often used interchangeably, and while they both remove toxins from your body, a detox and a cleanse are two different things! At the root of the word “cleanse” is clean, and you should think of a cleanse as a way of cleaning your body. Often a cleanse uses supplements or pills to eliminate substances directly and cleanses normally focus on the digestive tract. On the other hand, detox programs strive to support your body’s natural toxin-eliminating processes. Since the body’s main detoxing centers are the liver and the kidneys, good detox programs focus on supporting your liver and kidneys by giving them the nutrients and supplements they need to function optimally.

So what are toxins anyway? Heavy metals including mercury are top of mind, but the lists also include persistent organic pollutants, plastics, and pesticides. Basically, toxins are harmful particles that can stay in your body, irritating cells, causing inflammation, and interfering with your body’s normal functions.

Signs of toxicity or a high toxic load (and thus the need for a detox or cleanse) include:

  • fatigue,
  • headaches,
  •  joint pain,
  • depression,
  • anxiety,
  • and constipation.

But there’s much more to detoxes and cleanses, in fact, season is important. Watch the short video above to see why spring is a great time for a cleanse, to find out why a toxin load is important, and what lowering your toxin load can do for you. Or view the whole video on my Facebook.

For more information, we offer a Detox Treatment kit with our Detox Guidebook, Fiber Blend, Liver Support with Antioxidants, Daily Detox Support, and Magnesium Tablets and you can take our Medical Symptom Questionnaire for toxins.

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Gut-Friendly Coconut Carrot Soup

Carrot Ginger Soup

COCONUT CARROT SOUP
Serves 10

2 tbsp coconut oil or extra virgin olive oil
1 large yellow onion, chopped
3 lbs carrots, peeled and cut into ½ inch pieces
2 tsp grated fresh ginger
½ tsp curry powder
½ tsp ground cumin
¼ tsp ground coriander
⅛ tsp ground cinnamon
Small pinch red pepper flakes (omit for arthritis)
1 tsp kosher salt
6 cups vegetable or chicken broth
1 can coconut milk
⅛ tsp honey (optional)

DIRECTIONS

1. Warm the oil in a pot on medium high heat.

2. Add the onions and a pinch of salt and sauteé until golden, about 15 minutes.

3. Add the carrots, ginger, curry, cumin, coriander, cinnamon and pepper flakes and stir to combine.

4. De-glaze the pan with 1 cup of stock and let reduce by half. Add the remaining stock, salt and coconut milk and cook uncovered for 15 to 20 minutes until the carrots are tender.

5. Using a hand blender, puree the soup.

6. If necessary, add water to make the soup consistency that you like. It should be thick and lightly sweet. Add the maple syrup if you would like it sweeter. Check seasoning and add salt and pepper if desired.

7. Serve hot.

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Blueberry and Spinach Smoothie

Blueberry Spinach Smoothie

When most people think of smoothies, they think of all-fruit drinks. But smoothies are a great way to pack in the vegetables and the antioxidants, vitamins, and minerals your liver needs to eliminate harmful substances.

Serves 1-2

Ingredients
1 cup almond, coconut, or rice milk
¾ cup frozen blueberries
1 banana
1 T. ground flax seeds (optional)
1 scoop protein powder
1-2 handfuls of spinach or kale

Directions
Blend all ingredients until desired consistency is reached, adding water to thin if necessary.

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3 Simple Steps To Great Gut Health

By Susan Blum, MD

If you have gas or bloating after you eat, or if you experience constipation and/or loose stools, or any type of intestinal discomfort, you have a problem with how your gut is functioning. While this is commonly labeled irritable bowel syndrome, or IBS, the diagnosis doesn’t tell you why you’re having this problem.

Usually, the issue is something called dysbiosis, which means your gut flora isn’t healthy. You might have an overgrowth of harmful bacteria, yeast or parasites, or you might not have enough of the good stuff: those probiotics you find in yogurt and cultured foods.

But who cares about a little gas or bloating?

You should! Your gut flora needs to be fixed, because the symptoms you’re having could just be the tip of the iceberg. A whopping 70% of your immune system is located in your gut and if the flora are out of balance, you have an increased risk of something called Leaky Gut Syndrome, and this can lead to autoimmune disease.

Here are my tips to heal your gut, which will treat your symptoms and keep your immune system happy, too.

  1. For your digestive symptoms, find out whether or not you’ve got food sensitivities, which could be causing the problem. Check yourself for gluten and dairy by removing them both from your diet at the same time for three weeks, and then reintroduce each one at a time, four days apart and monitor how you feel.
  2. For your flora, eat cultured food every day, like coconut or almond milk yogurt and kefir, sauerkraut or kimchee, and consider taking a probiotic supplement.
  3. If the above doesn’t do the trick, consider a gut-cleansing program using herbs like berberine or oregano to remove the harmful microbes. Our new HealMyGut program will help you do just that!
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Turn Off the Effects of Stress on Your Immune System

Stress is really about the degree of change you experience and how much it throws you out of balance.  Studies show that when stress pulls you too far off center, it affects your immune system in a negative way.  The body has a built in stress response for emergencies, which is often called “fight-or-flight.” In general, this is a good thing because it supports you when you need an adrenaline rush and cortisol boost from your adrenal glands to help you run, fight, or face an intense stressor, be it emotional or physical.

But when you think too much, you can get stuck in your thoughts, worrying about the future and replaying the past. At the same time, your adrenal stress hormones get stuck in the “on” position, producing those stress chemicals that have a negative impact on your immune system. It is this chronic stress that is the problem and the type of stress that makes you sick.

When you practice mind-body skills such as meditation, walking in nature, turning off the nightly news, knitting, or singing, to name just a few, you will learn to “turn the switch off” and your system will find balance again. Then you can easily move in and out of stress mode, benefiting from the adrenal boost when you need it and letting your system relax when you don’t.  But remember, learning to relax takes practice!

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Summer Sun and Vitamin D

Everyday, I am asked by someone, whether or not they need to take Vitamin D in the summer. Now that we are in the midst of lots of sunshine and summer is here, I thought this would be a good topic for our August newsletter. Vitamin D is much more than a vitamin. In fact, every cell in your body has a receptor on it for D, which makes it more like a hormone, than a vitamin. It supports your immune health, and is critical for people with autoimmune diseases. It is also necessary for your body to absorb calcium, and women with low vitamin D levels are at a higher risk of osteoporosis. And let’s not forget about mood … many of you might notice you feel bluer in the winter when there is less sunshine.

Yes, Vitamin D is made by sunshine. However, in the northern latitudes where we live (New York), the sun is only strong enough to stimulate Vitamin D production in your skin 3-4 months/year, May-August. During these months, your skin will make enough Vitamin D to support good blood levels, IF you are outside for at least 20 minutes/day, without sunscreen, between 10am – 2pm, in shorts and a tank top. Meaning your arms and legs need to be fully exposed without sunscreen during peak hours of maximum sun. Do most people get this? No. So if you walk or exercise outside, spend time in the garden or other outdoor activities regularly, and don’t use sunscreen every minute, you are probably okay taking the summer months off. But honestly, most of the people I see in my medical practice don’t have an appreciable bump in their Vitamin D levels in the summer. They simply don’t get as much exposure as they think so they need to stay on their normal regimen. And that could be you.

While I am certainly not advocating NO sunscreen, I do think it would be okay, to spend 20 minutes a day without it, if you are trying to get your D. But then be sure to slather up with a broad spectrum SPF!

Here are my suggestions:

  1. If your Vitamin D levels were in a good range before the summer (above 40) and you are outside most days during peak hours, you can probably take the summer off.
  2. If your Vitamin D levels were low before the summer, or if you aren’t outside much without sunscreen during the middle of the day, you should continue your supplement.
  3. In my experience, 2000 iu/day of Vitamin D3 (cholecalciferol) is the minimum amount to maintain your levels. If you are trying to raise them, double the dose to 4000 for 3 months or until you are tested again.
  4. Always adjust your dose by following blood levels. Your primary care doctor can do this for you.
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Mercury and Your Health

Sardines

By Susan Blum, MD 

Are you concerned about your exposure to mercury from the food you are eating?  If you eat fish at all, then you should be. This can be confusing, but is very important because mercury can cause autoimmune disease and other health-related problems.  That is why I decided to dedicate our April newsletter to this topic…to shed some light on this issue and to help you decide what to eat, and what to do to protect yourself from this environmental toxin.

Where do you find mercury and what is it?

Mercury is part of a group of compounds called heavy metals. There are ‘good’ heavy metals like iron, cobalt, copper, manganese, molybdenum, and zinc.  They are good because humans require these metals to function properly.  However, keep in mind that these too can be toxic at excessive levels.

On the other hand, heavy metals such as mercury, lead, and plutonium are ‘bad’ toxic metals and if they accumulate in the body over time, can cause serious illness.   For our purpose today, I will focus on mercury because there is plenty of data that explains what it does in the body and how we are exposed.

Where does Mercury come from?

There are 2 main sources of mercury that we are exposed to.  First, mercury is released into the air from coal burning power plants and from volcanoes.  After it settles in the oceans and soil, we end up eating it from the fish or plants or animals that grow and live in these places. The big fish eat the little fish, and the mercury bio accumulates, which means it gets more concentrated in the bigger fish.

The other main source of mercury is the vapor released from silver fillings.  While this is somewhat controversial, there is enough evidence suggesting this is a real issue, and why I recommend replacing your fillings if possible.

There are also other places you can be exposed to mercury, like in the preservative of some vaccines, and old thermometers.  But fish and silver fillings are the biggest problem.

How does mercury accumulate in your body and make you sick?

Your body was created with multiple detox systems in place to clear out the mercury you are exposed to.  One of these, called the glutathione system, is very active in your liver and also in all the cells in your body.  If you are exposed to more mercury than this system can handle, the mercury can build up in your body and cause damage to your nerves, thyroid, immune system (autoimmune disease, for example), and all the cells in your body by causing something we call oxidative stress.  This simply means that you run out of the important antioxidants that your body needs to protect itself, resulting in free radicals created by the mercury that can then damage the tissues.

To protect your cells and tissues, it is critical that you keep your liver detox system in tip-top shape by eating lots of antioxidant-rich fruits and vegetables with plenty of color.  In addition, you can take specific antioxidant supplements to boost your glutathione.  Our favorite and most convenient way to do this is by taking our BlumBox Immune & Antioxidant Support Packets, created for just this purpose.   

The next step is to support your liver and its ability to clear this metal out of your system. The best strategy is to do a liver detox program once or twice/year, and to make sure you are eating foods with selenium, sulfur (onions), cruciferous veggies, and lots of antioxidants.