Category: Wellness & Health

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Your True Risk for Cardiovascular Disease: The Blood Tests You Need

functional medicine heart labs

Heart health is everyone’s business. Consider these staggering statistics: 

  • 44% of American women currently have heart disease, which is almost an incomprehensible percentage of us.1
  • 22% of deaths of women in America are due to heart disease.2
  • Heart disease kills 40% more Americans each year than all cancers combined. 
  • The generations being born right now, are more likely to die younger than our current generation, and unfortunately CV disease is on the rise since 2017 in the US

WHAT IS HEART DISEASE?

When we talk about heart disease, we are referring to people with coronary artery disease (blocked arteries in the heart usually from cholesterol), those with heart failure (the heart stops pumping properly), and those with arrhythmias like atrial fibrillation (abnormal electrical activity). It’s a huge concern that the fastest growing population affected by heart disease is 25-44 year olds. This highlights the importance of early intervention, so that we can help reduce the length of time that the body is exposed to all the things that cause heart disease, like “bad” inflammatory cholesterol (for example a lipid particle called ApoB), and environmental toxins.  

This is the classic definition of prevention:  Before the disease manifests, you can make changes that prevent you from getting that disease. For example, lifestyle changes (exercise, diet, targeted supplements and lowering toxin load) have the power to lower your risk of heart disease.  And the prevention power gets even stronger when you add our favorite blood tests for early detection and screening.  We can see if you are heading down the wrong path, and need to make a course correction! 

HOW WE WORK TOGETHER 

Most doctors who think about heart health will focus on optimizing hypertension, cholesterol, and diabetes with prescription medications, risk factors that when managed well can have life-saving benefits for many people. We work closely with local cardiologists and internists, and join your team to add additional Functional Medicine support for getting to the root cause of your heart disease.  We focus on Lifestyle Medicine, and also offer advanced testing, assessments and treatments for oxidative stress, inflammation and disorders in your blood sugar and stress systems. 

By using advanced testing alongside one’s medical conditions, family history and lifestyle, we can get an accurate understanding of your risk for heart disease. Some of the advanced tests we offer here at Blum Center are below. Ultimately these specific blood tests help us create a personalized and comprehensive treatment plan for you. 

Specific cardiovascular risk factors we like to assess include:  

  • LDL particle size: While traditional lipid panels will tell you your total LDL, HDL, and triglyceride cholesterol quantities, a more advanced and detailed risk assessment will give us a size profile and particle characteristics of someone’s LDL.  We can see if your LDL is light and fluffy, or small and damaging to the arteries, and this gives us information about how dangerous your individual LDL cholesterol number is. 
  • Lp(a) quantity:  this is a risky and largely inherited subclass of LDL that is particularly atherogenic (plaque inducing).
  • ApoB level: the most common carrier protein for LDL, this may be an even more relevant predictor of heart disease than LDL quantity. 3
  • Lanthosterol and desmosterol vs beta-sitosterol and campesterol– these numbers are markers of the level of cholesterol absorption from the GI tract vs cholesterol production from the liver, and guide both lifestyle and medication and supplement treatment plans  
  • LP-PLA2 activity, myeloperoxidase level, hs-CRP,  and fibrinogen levels- these tell us about inflammation in the arteries and help us see if there is an increased risk for blockages forming or breaking. With this you can better understand how at risk you are for making plaque and therefore heart disease, and helps determine how aggressive we need to be. We also monitor these to determine whether a particular intervention is helping you. 
  • fasting insulin, adiponectin, glycated serum proteins, Hgb A1c- these types of measurements can give a good sense of your metabolic health, a very important risk factor.
  • F2 isoprostane, oxidized LDL- these are measured in the serum, and are markers of oxidative stress, a precursor to inflammation, and both are markers of atherosclerosis and significant risk factors for heart disease,4,5 
  • Oral microbiome- Because of the strong association between high-risk oral pathogenic bacteria and heart disease, we can perform oral DNA testing to assess for pathogenic vs beneficial oral flora. If indicated, we can refer you to dentists who provide specialized periodontal treatments to encourage a healthier oral biome. 6   
  • Genetics- We can provide genetic testing specific for cardiovascular disease, which indicates whether you are at risk for blood clots, statin-induced myopathy, or the ApoE gene, which is a risk factor for both cardiovascular disease and Alzheimer Disease. Genes like KIF6 predict statin response and heart attack risk, while others like 4q25 predispose to atrial fibrillation. Genetics can provide much information about modulating one’s individual risk. 7
  • Omega 3 index: By looking at the fatty acids in your blood, we can advise you how to rebalance your fatty acid profile towards a lower risk one. 8
  • Radiology tests: A coronary artery calcium score, which is a visual test performed by CT (computed tomography), can assess whether you have calcified plaque in your coronary arteries currently. A Cleery scan is coronary computed tomography angiography that visualizes soft plaque and blockages and can avoid the need for invasive imaging. The Cleerly ischemia scoring system was shown to outperform true angiography in one study in determining risk for heart disease. It is an encouraging option, particularly for those seeking to avoid invasive testing. 9 

Once we figure out what your risks are, now we get to do the fun part of using the best science has to offer to lower risk in a preventative way. Our plans at Blum Center always focus on lifestyle, and you will certainly leave with a prescription for stress, sleep, exercise, nutrition, but at the same time we are going to look for the root causes for your oxidative stress and inflammation. We address metabolic health, and look for environmental toxins and contaminant metals, which have been shown to impact coronary plaque.10  Our ability to address oxidative stress and inflammation and address root causes makes us an optimal partner to help you reduce your risk of heart disease.  You can change your health trajectory!  While we have many strategies, knowing your personal data and risks is often the way to start. 

Schedule an appointment with Dr Jane Andrews for a complete heart health assessment.  914.652.7800 or click here. 

 

Dr. Jane Andrews is a Functional Medicine doctor with a background in internal medicine physician doing both inpatient and outpatient clinical medicine for 12 years prior to joining Blum Center. Dr. Andrews received her MD from the Johns Hopkins School of Medicine, her MPH at Johns Hopkins School of Public Health with a concentration in biostatistics and epidemiology, and is a graduate of the NIH-funded Predoctoral Clinical Research Training Program. She completed residency at Tulane University and was faculty at Tulane, followed by Yale School of Medicine, and finally at UT Health where she was an Associate Professor. 

 

  1. https://www.cdc.gov/heartdisease/women.htm
  2. https://www.cdc.gov/women/lcod/2017/all-races-origins/index.htm
  3. Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, et al.  Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol 2019;4:1287–95.
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686621/
  5. https://pubmed.ncbi.nlm.nih.gov/18625445/#:~:text=Oxidized%20LDL%20(oxLDL)%20represents%20a,formation%20of%20macrophage%20foam%20cells
  6. https://pubmed.ncbi.nlm.nih.gov/17645769/
  7. https://pubmed.ncbi.nlm.nih.gov/27277824/#:~:text=ApoE2%20and%20apoE4%20increase%20the,to%20downregulation%20of%20LDL%20receptors)
  8. https://pubmed.ncbi.nlm.nih.gov/25720716/
  9. AI Evaluation of Stenosis on Coronary CT Angiography, Comparison with Quantitative Coronary Angiography and Fractional Flow Reserve. Journal of the American College of Cardiology. Published February 2022.
  10. https://www.dropbox.com/scl/fi/myzk4vzmgk941zbp77rp8/lamas-et-al-2023-contaminant-metals-as-cardiovascular-risk-factors-a-scientific-statement-from-the-american-heart.pdf?rlkey=ju0veckl8b4yazha9vyz0iw42&dl=0
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How Ketamine is Helping Patients with Chronic Stress and Trauma

Ketamine Infusions at Blum Center for Health

In functional medicine, we see trauma as more than just emotional distress; it has a tangible impact on both your physical and mental health. Picture your body as a well-coordinated orchestra, each section representing a different system. Trauma throws off this balance, affecting everything from hormones to digestion. 

The stress response triggered by trauma can lead to inflammation, impacting your immune system and overall well-being. Our goal as practitioners is to address these interconnected factors, restore balance and support healing. 

The Biology of Trauma

In recent years, there has been a growing interest in understanding the biological mechanisms underlying trauma and exploring innovative treatments. Dr. Stephen Porges introduced the Polyvagal Theory, a groundbreaking framework for understanding the autonomic nervous system’s role in responding to stress and trauma. According to this theory, the autonomic nervous system consists of three branches: the ventral vagal, sympathetic, and dorsal vagal systems.

  • Ventral Vagal System: Associated with social engagement and relaxation, this branch promotes feelings of safety and connection.
  • Sympathetic Nervous System: Known for its “fight or flight” response, the sympathetic system activates during stressful situations, preparing the body for action.
  • Dorsal Vagal System: Linked to immobilization and shutdown, this branch activates when an individual perceives a life-threatening situation, leading to a state of dissociation or freeze.

Understanding the interplay between these systems provides insight into how trauma can impact an individual’s physiological responses and overall well-being.

Trauma’s Impact on the Nervous System: 

When an individual experiences trauma, the autonomic nervous system may become dysregulated. Chronic exposure to stressful or traumatic events can lead to a heightened sympathetic response and an impaired ventral vagal system, hindering the ability to regulate emotions and navigate social interactions effectively. 

Additionally, trauma may result in an overactive dorsal vagal system, contributing to symptoms such as dissociation, anxiety, and depression. 

Understanding these neurobiological changes is crucial for developing effective interventions. Here’s several examples of patients* who’ve who’ve come to me for treatment:

  • The middle-aged patient with depression, who finally connects his dissociation and inability to focus, constipation, and recurrent sinus infections to the stress of his childhood-being raised by an alcoholic mother.
  • The 21 year old college student  who has diarrhea, difficulty tolerating foods, eczema and painful periods- who also lives in a state of fight or flight that she experiences as ADHD and anxiety.
  • The perimenopausal small business owner who is starting to have night sweats, weight gain, change in her bowels.
  • The sleep deprived mom of 3- shuffling kids from activity to activity, managing a household, cooking, who has difficulty finding time to exercise, meal prep, and meditate and who experiences chronic HIVES and cannot clear toxins like mold from her system.
  • The retired patient who has long haul covid after years of reflux symptoms, a short fuse and anger management issues, recurrent sinus infections, and a history of insomnia.  

Ketamine and Trauma Treatment

Ketamine, traditionally known as an anesthetic, has garnered attention for its potential therapeutic effects on trauma-related conditions. 

Recent research suggests that ketamine may influence the N-methyl-D-aspartate (NMDA) receptor,  a receptor in the brain leading to neuroplasticity and the formation of new neural connections.  

What this means is that the brain is literally rewiring itself, allowing faulty connections (synapses) to reconnect stronger and with more integrity. And what we experience physically is less anxiety and depression and the somatic manifestations of those states of being. 

Moreover, ketamine’s impact on glutamate transmission may play a role in dampening hyperactive neural circuits associated with trauma. 

Studies exploring the use of ketamine-assisted psychotherapy indicate promising results in alleviating symptoms of post-traumatic stress disorder (PTSD) and depression.  

I’m brought to my 20-something  patient who came to me, unable to work, in chronic pain, almost bed bound and with suicidal ideations.  After only 2-3 months of treatment, he is starting graduate school, his pain well integrated and understood, and walking with a new found confidence in himself.   Both having rewired the neural-circuits and integrated his experiences during his sessions into his daily life and conscious awareness.  

Ketamine, with its potential to modulate neural circuits and promote neuroplasticity, emerges as a novel avenue for trauma treatment. As research in this field continues, integrating biological insights with innovative therapeutic approaches holds promise for advancing chronic stress and trauma care and improving the lives of individuals affected by trauma.

As a practitioner, having a cutting edge tool like ketamine has been one of the most profound ways I have helped patients heal their physical body. If you’d like more information about Ketamine treatments at Blum Center for Health contact our team at 914.652.7800 or on our website www.blumcenterforhealth.com 

*distinguishing characteristics have been removed to protect patient identity.

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5 Ways to Make Your Health Goals A Reality

Functional Medicine Health Coach

Let’s jump to the chase: New Year’s Resolutions don’t work.

Thanksgiving hits and all through December we say to ourselves, “Come January 1st all this is going to change.” Year in and year out. 

But, does it?

Does everything change?

The answer for over 95% of us? A big, fat NOPE.

The reality is, that every single day is a “clean slate” opportunity. 

We put a tremendous amount of pressure on the first day of the year. 

But think about this: Putting all your eggs in the basket once a year gives you only ONE OPPORTUNITY. 

Thinking about everyday as a clean slate gives you 365 OPPORTUNITIES!

Regardless of whether you’re into New Year’s Resolutions, there are ways you can make your goals achievable any time of year. 

 

5 Ways to Make Your Health Goals a Reality

Focus on one goal at a time: Trying to change multiple aspects of your life at once can be overwhelming. Concentrate on one resolution until you feel confident in your progress before adding another one.

Make realistic and specific goals: Setting vague and unachievable goals sets you up for failure. Instead, be clear about what you want to achieve and ensure it is within your capabilities. For instance, don’t commit to getting washboard abs, start with “I’ll workout for a minimum of 10 minutes, three times a week.”

Break it down: Breaking your goal into smaller, manageable steps makes it easier to achieve. This way, progress can be easily measured, keeping motivation high.

Celebrate milestones: Recognize and celebrate the small victories along the way. These milestones serve as positive reinforcement, helping you maintain motivation and continue striving towards your goal. Take a vacation day, get a massage, do something that makes you happy. (Ummm, not a food reward – that creates another habit to break!)

Find support: Share your goal with friends and family (not frenemies who undermine your goals) or join a support group – both can provide encouragement, advice, and accountability. For the ultimate in support, though, hire a coach! A top-notch coach (ahem, like me) will help you identify the habits and behaviors that hold you back from progress, and help you “rewire” them. 

 

Want to learn more about working with Melissa? Make an appointment with our team to answer all your questions. Yes, I want support now

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Is Mold Making You Sick?

Are you struggling with non-specific vague symptoms that do not fit a known pattern for diagnosis? Have you been to a slew of specialist physicians and are still left without answers? Have you ever lived or worked in a place with water damage? Have you noticed your symptoms change or improve if you’re away from your primary home for an extended period of time?

If this resonates with you it’s time to consider mold as the root cause of your illness. 

Here’s why: Mold is dangerous to your health. Hard stop. 

Add to that, it is often overlooked as a source of illness since most conventional doctors are not trained in identifying it. 

But, don’t worry! It has become my mission to uncover and treat mold illnesses. My private practice is filled with people suffering from mold exposure, many of which were misdiagnosed or told there was nothing wrong and had they considered a psychiatrist.

Here are some of the most frequent questions I hear:

What is Mold, Mold Allergies, and Mycotoxins?

Mold is a type of fungus that loves to grow in moist, damp, and dark environments.

We are constantly exposed to mold in our outdoor and even indoor environments. Some people are more sensitive to such mold spores and develop mold allergies. You may recognize these symptoms to be watery/itchy eyes, sneezing, and or runny nose. Doctors can diagnose mold allergies through blood testing and such allergies are treated with antihistamine medications. Finally, some molds produce mycotoxins, compounds that are invisible and can be inhaled or absorbed through your skin. These are the toxins that may cause mold illness if you are susceptible.

How do you know if you have been exposed to or are currently exposed to mold?

Part of my approach is taking a thorough environmental history during our first visit together. I delve into the history of water damage, musty smells, visible mold in your current and past homes. In general, most people find themselves with mold in their homes if the initial water damage is not remediated properly, if there’s a hidden leak behind a wall, or if there is moisture intrusion in the house that’s not obvious, just to name a few scenarios. 

Why are mold toxins difficult for the body to process?

Your liver helps process mycotoxins through bile and ultimately they are removed in the stool. In some, this process is not successful and leads to recirculation of the mycotoxin. So your immune system may have successfully killed the actual mold; however, the mycotoxins that the mold secreted can persist in your body. 

Many people are exposed to toxic mold; however, not all become sick. Why? About 25% of people are genetically handicapped to deal with these toxins. Even if you’re not one of the 25%, anyone’s detox system can become overwhelmed if exposed to high quantities of toxins over a long time. This helps explain why some members of your household can become severely ill and others are fine while being exposed to the same mold environment. The molds that produce the most dangerous mycotoxins include Stachybotrys, Aspergillus, Penicillium, Fusarium, Alternaria, and Walemia. 

Are you suffering from mold toxicity?

Mold is always a part of my differential diagnosis in anyone who presents with a myriad of symptoms in multiple organ systems. At the Blum Center, our patients complete a Medical Symptom Questionnaire and when their score is more than 80, I often suspect mold. 

Some of the more specific symptoms include electrical sensations in the body, areas of numbness/tingling that leave neurologists perplexed, unusual tics/muscle spasms, seizure-like events, and dizziness. These symptoms are often paired with fatigue, brain fog, intense anxiety/depression, chronic sinus congestion/recurrent infections, and shortness of breath.

How do mold mycotoxins cause such chronic complex presentations?

The following explanation is based on the ground breathing work of Dr. Shoemaker who synthesized how mold toxins impair your body’s biochemistry and thus came up with The Biotoxin Pathway. 

Mold toxins can easily dissolve in water and fat allowing them to penetrate various tissues. 

  1. Mycotoxin enters your body through inhalation or food (this is less common cause of systemic illness), or are made in your body (i.e. think the sinuses or your gut that has been colonized with mold).
  2. Toxin enters your fat cell and triggers a cascade of events inside the cell leading to cytokine production. Cytokines send signals to activate the immune system causing inflammation. If you are one of the genetically fortunate, the immune system binds the toxins and prevents this cascade of events; however, in 25% of the population there is no process to turn off this activation so the inflammation persists. 
  3. Cytokines affect your brain chemistry, endocrine/immune systems, thus explaining why patients present with such a variety of symptoms that transverse multiple organ systems. This can lead to inadequate production of adrenal, sex, and thyroid hormones. Overall this will also affect your pain pathways (think decrease in endorphins), sleep (think less melatonin), and also cause increased intestinal permeability (think leaky gut). 

If mold is suspected, how do we evaluate it?

Although there are some serum blood markers that give us an idea if you are suffering from mold illness, they are non diagnostic. The best test we have at this time is to assess urine mycotoxins. There are several functional medicine labs on the market offering such testing including RealTime Labs and Great Plains Laboratory. 

As part of the evaluation, It is also important to determine where the mold exposure is coming from (i.e. home, work, or your car), particularly if it’s ongoing. To do this, we recommend you partner with an environmental indoor expert who is trained in how to properly assess the home’s health and perform accurate mold testing and then guide you in remediation (if necessary).

You may prefer to try your own home assessment. You can order testing through Mycometrics the ERMI test (Environmental Relative Moldiness index). You collect dust from your home which is tested for mold.

How is mold toxicity treated?

The journey is often complex with many detours. Two people exposed to the same mycotoxin may present with completely different symptomatology. Treatment progress/resolution often depends on your terrain (what else are you battling with, i.e. your gut health, tick borne infections, viruses, other toxins-i.e. heavy metals) and how sensitive you may be to treatment. 

My approach is influenced by Dr. Neil Nathan’s work, an expert in mold treatment. What does that mean? We assess your gut microbiome, look for exposure in your home (and bring in a home expert if needed), support your detox pathways (after all, we have to get the mycotoxins out of your body), use appropriate botanicals and/or pharmaceuticals for treatment and mold decolonization. 

In the meantime, what can you do to help your body with mycotoxins starting today?

  1. Increase foods that support your liver’s detox pathways such as cruciferous vegetables (think broccoli/kale).
  2. Increase antioxidants, think eating colorful fruits and vegetables that are rich in quercetin/polyphenols (i.e. pomegranates, berries, yellow peppers, green tea).
  3. Spice up your food with turmeric and curry powder.
  4. Move more! Sweating is one of your body’s key daily detox methods. Just remember to shower after exercising so the toxins do not get reabsorbed through your skin.

 

If you’re interested in learning more about mold illness, testing, and treatment please come see me at Blum Center! For more information visit www.blumcenterforhealth.com or call 914.652.7800. 

 

 

References:

Biotoxin Pathway:

https://www.survivingmold.com/resources-for-patients/diagnosis/the-biotoxin-pathway

 

“Toxic” by Neil Nathan, MD; published 2018

 

Resources:

https://iseai.org/about/

 

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Do You Really Know What’s in Your IV Bag? Why Quality and Dosage of Your IV Therapy Infusions Matters

As IV Therapy infusions have gained popularity over the last decade, there still lacks a governing entity or an industry standard. This leads to a lot of variation in the product, dosing, and quality you may receive from center to center. There is great responsibility on the practice and the practitioner to ensure the safety of your infusion and, as the patient, these are important questions for you to ask when determining which center to go to.

What’s are the Contents of the IV Therapy Infusions?

Before getting a vitamin infusion, it is important to ask what vitamins you are getting. Most other infusion centers have only three to four vitamins in their mixes. At Blum Center, our Basic Wellness infusion has nine and our Wellness Plus infusion has 15.  Blum Center prides itself on not only having more vitamins in each infusion, but also higher doses. 

Our Medical Director, Susan Blum, M.D. utilizes her extensive knowledge of Integrative and Functional Medicine to curate infusions that particularly serve the needs of people with medical issues, including immune system and autoimmune conditions, chronic Lyme, severe fatigue, gut issues to name a few. Our infusions have higher doses than walk-in drip centers and we ensure that they are given safely.  As you can see, Infusions at Blum Center are not just simple wellness IVs, but rather medical grade infusions that make a real difference in the body’s healing and ability to function optimally. It’s important to keep this in mind, too, when comparing prices at different locations. 

What is the Quality of Ingredients in the Infusions?

It is equally important to confirm that you are getting quality ingredients. We source our vitamin solutions from the highest quality compounding pharmacies that source their ingredients from FDA-approved facilities and are compliant with Current Good Manufacturing Processes. This means every batch is tested and every vial is visually inspected by the compounding pharmacy before it is shipped out and then visually inspected again by our Infusion Director upon arrival. We then take it one step further and do our own calculations for all the ingredients in the IV bag to avoid any potential complications.

We are proud of the extra layer of strict protocols to ensure quality.  For example, all vials on hand are stored at the correct temperature, are not beyond their use date, and are mixed with aseptic technique, so you can feel confident that you are getting the best product that is carefully maintained. 

Can you Tailor IV Therapy Infusions?

At Blum Center we work hard to ensure that your drip is compatible with your unique biochemistry.  For example, did you know that if you have a history of kidney stones you should receive a custom drip limiting the amount of Vitamin C?

Blum Center practitioners are experts in Integrative and Functional Medicine and hand select each patient’s infusion to ensure their health and wellness needs are getting met.  Whether you are new and meeting with our Infusion Director, or a current patient being supervised by your practitioner, your IV will be customized for you. We believe it is important to understand how a vitamin infusion may benefit you. 

While it may seem like a nice touch to be able to pick out an infusion from a menu at a walk-in drip center, this strategy may not be helping you meet your wellness goals. We know that high dose intravenous vitamins or specific combinations of targeted nutrients can truly make a difference for many people struggling with chronic health issues.

Come let us create a program for you!  The quality, service, and individualized care at Blum Center is unmatched.  Call us at 914.652.7800 to book your appointment. 

 

 

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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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Menopause Made Easy

Ok, let’s face it…every woman will transition through menopause, whether they like it or not. For some of us, it happens without any fanfare. One day your period is gone, and you’re done! (Yes, ladies, this does happen for some women). For others, it is a nightmare with hot flashes and sweats during the day and night, often ruining what used to be a good nights’ sleep. Other symptoms may include difficulty with memory, sometimes called ‘mental-pause’, low sex drive and painful intercourse when you do decide to make it happen.

So what is going on? One theory is that estrogen receptors in the brain become starved of estrogen, and this affects temperature regulation and memory. While this makes a lot of sense, there has to be more to it than that because all women have a loss of estrogen during menopause, but only some women suffer symptoms. To understand this, let’s look at the other influences on your hormones that could be the culprits.

First, you must look at your entire endocrine orchestra and make sure all of your hormones are working optimally. These include your thyroid hormones, your adrenal hormone cortisol, and also your blood sugar hormone insulin. If any of these are out of balance, your sex hormones will be too, and you are more prone to having menopause symptoms.

Second, you must look at your detox system and make sure your liver is doing a good job of processing both every day toxins and metabolizing your hormones properly. Even after menopause you should have some healthy estrogens in your body, and these need to be processed. Faulty estrogen metabolism can result in more symptoms.

What can you do? Here are 5 tips to help make menopause a non-event.

  1. Eat for hormone balance. This means eating protein (vegetarian or animal) and plants rich in fiber with all meals and cut out the processed sugar. This will keep your insulin in balance. 
  2. Have your thyroid checked, including the hormone T3. If you are already hypothyroid, make sure you aren’t taking too much or too little medication. 
  3. Do an adrenal saliva test to make sure your adrenals are healthy. An integrative practitioner can help you do this.  Live in our neighborhood? You can have a consultation with one of our practitioners at Blum Center for Health for testing.  
  4. Improve your estrogen metabolism by eating cruciferous vegetables, rosemary. Consider trying the supplements DIM (Di-indole methane), methylfolate and methylcobalamin. 
  5. Beware of alcohol and caffeine. They can make your temperature system go haywire during this time of transition. 
  6. Consider a safe and medically sound liver Detox program.  Renew your body by eliminating your toxic load and resetting your hormones. Try our 14-Day Whole Life Detox. 

Try one or more of these steps and evaluate how you feel.  Let me know how you are doing! 

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The Functional Medicine Approach to Breast Cancer Prevention

Breast cancer is a health issue that most women will think or worry about at some point in their lives. One of the reasons is because we hear so much about breast cancer these days: in the media; through fundraising organizations; and from family and friends facing the diagnosis. Another is because it has become much too common. Perhaps you, or someone close to you, are a breast cancer survivor.

October is Breast Cancer Awareness Month, and we want to honor and support all women by highlighting our Functional Medicine approach to the prevention of breast cancer, whether the focus is on primary prevention, or prevention of recurrence. 

Because research shows that how you metabolize estrogen can increase your risk, we focus on supporting estrogen detoxification, a process that happens primarily in the liver.

HOW MUCH ESTROGEN DO YOU HAVE?

Many women believe that after menopause they aren’t making estrogen anymore.

This is not true. 

Before menopause, estrogen is produced in several places in the body, including the ovaries, adrenal glands, and produced from testosterone by the enzyme aromatase in fat cells. After your ovaries have been removed or you have gone through menopause, estrogen is still being produced, in low but measurable amounts, by these other tissues. 

You might wonder: since we all have estrogen, why do some women, and not others, end up with breast cancer? 

Well, it turns out that all estrogens are not the same, and these differences are influenced by genetics and the environment.

When estrogen is processed for elimination, the hormones are sent to the liver where they are metabolized, a process also called detoxification. During the estrogen detox process, you can end up with “bad” estrogens or “good” estrogens. The bad ones are considered “toxic” because they are very strong stimulators of estrogen receptors (causing more cell proliferation), and they can damage DNA, as opposed to the “good” estrogen metabolites that are weaker estrogens and not harmful to cells. Of course, the “good” estrogens are preferable!

Although our genetics influence how easily we make the good and bad estrogens, it turns out (no big surprise!) that food and other lifestyle factors have an enormous effect on the kinds of metabolites the liver will make. Influencing your estrogen detox pathways in a good way is what we focus on for breast cancer prevention at Blum Center for Health.

IMPROVE YOUR RATIO OF GOOD:BAD ESTROGENS

Our first step to help you reduce your cancer risk is to increase your good estrogens, and decrease the bad. 

Top 4 Ways to Reduce Your Breast Cancer Risk 

  • Eat lots of food that supports estrogen elimination and detoxification pathways, including:
    1. Lots of antioxidants and cruciferous vegetables like kale, broccoli and cauliflower
    2. Fiber from fruits and vegetables helps you excrete estrogens via the gut.
    3. Soybean that is organic and non-gmo, and in its whole form, like edamame or tofu. Or, fermented soy like tempeh or miso. Soy has a very gentle and positive effect on estrogen receptors and is actually good for most women.
    4. Ground flax seeds:  can block the conversion of testosterone to estrogen, thus lowering your levels.
  2. Consider taking the supplement Di-indolylmethane, or DIM, or it’s more powerful cousin, Sulforaphane, which are basically the active component extracted from cruciferous vegetables. This can improve the good:bad estrogen ratio with the goal of decreasing your risk of breast cancer. We also recommend it to reduce symptoms of too much estrogen, such as fibrocystic breasts, uterine fibroids or heavy painful periods. This condition is called estrogen dominance.
  3.  If you want to know more about your personal risk, genetic testing can be done to evaluate your probability for making bad estrogens, and urine testing can be done to assess your current ratio of good:bad estrogens. With these test results, we can determine how to use food, supplements and mind-body practices to increase good estrogen levels and lower bad ones. These tests are available from our Functional Medicine nutritionist or practitioners.
  4. Lower your total toxin load.  In addition to targeted support for detoxing and eliminating estrogens, keeping your general toxin load and exposure low is very important because environmental toxins like herbicides and pesticides can push your estrogens down the “bad” pathways. We recommend cleaning up your exposures, and supporting your liver with a general detox program. How to do this?  Read on!   

HOW TO REDUCE YOUR ENVIRONMENTAL EXPOSURES AND LOWER TOXIN LOAD

We always recommend doing a simple Liver Support Detox program in the spring and fall to help keep these toxins from building up in the body and causing problems. Check out our do-it-yourself 14-Day Whole Life Detox to get started!  Add a bottle of Broccoprotect (sulforaphane) if you are concerned about your estrogens and you’re all set.  

And if you are confused about what to do?  Make an appointment with our health coach, Melissa Rapoport! She will help you form a plan to reduce your toxic load and bring balance back to your body. Either call 914-652-7800 to set up an in-person appointment, or go to CoachMe to set up a video or phone appointment. 

Want to learn more about detoxification? Check out these detox blog posts.

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How Stress Effects Your Heart and What You Can Do About it

For those of you who know me, either personally or professionally, you know that Mind-Body-Spirit self care strategies are at the core of what I practice and preach for preventing and treating chronic disease.  I meditate every morning and spend lots of time in nature. But more than this, I teach others about how stress affects your health and offer tools to do something about it.

For this month, I offer a guest blog on this topic from my friend and colleague, Dr Alon Gitig, a gifted cardiologist who I work with to help my patients get the best care, including prevention and treatment of various conditions.  Mind-Body Medicine for too long has been the step-sister to conventional medicine, but now you can see for yourself that it’s not any more!

Enjoy this perspective from a traditional cardiology practice!

Susan Blum, MD, MPH

 

Guest post by By Alon Gitig, MD, FACC

Health blogs talk a lot about “mindfulness” these days.  Many of us have read claims that controlling our emotions can improve our health, and are left wondering whether there’s evidence to support this.  Research into mind-body techniques is accumulating, as investigators look for ways to lower the risk of chronic diseases above and beyond the proven—yet incomplete–benefits offered by medications.  In the field of cardiology in particular, despite major gains in the past 50 years, there is still an unacceptably high burden of heart disease, even when people are well-treated with evidence-based therapy.  Let’s take a look at the evidence base behind whether stress management might help tackle this problem.

Psychological stress can have profound effects on our bodies.  

Studies suggest that up to 60-80% of all primary care visits are related to manifestations of stress.  A Mayo Clinic analysis identified stress as the most powerful predictor of cardiac events, while other studies indicate that mental stress predicts cardiac death more strongly than cigarette smoking.  Depression roughly doubles the risk of heart attack. Both anxiety and anger have been linked to a 6-fold increased risk of cardiac events, including arrhythmias and sudden death.

Stress activates the sympathetic nervous system, with potential effects on blood pressure and heart rate.  There is also evidence that elevation in cortisol levels, increased platelet clotting, and abnormal reactivity of artery walls might be triggered by psychological distress.  What’s more, the brain may also directly affect the heart via descending nerve pathways.  Amazingly, recent research reveals that subjects who intentionally generate positive emotions, such as gratitude, influence the heart’s beating into a pattern that is associated with healthy cardiovascular function and decreased risk of arrhythmic death.

These observations prompted studies attempting to improve health outcomes via stress-reduction techniques, such as meditation, yoga, and biofeedback.  Results have been mixed, confounded by practical, methodological limitations inherent in conducting such trials. Not surprisingly, all of these modalities have generally led to significant improvements in psychological well-being, both in healthy volunteers and specifically in cardiac patients.

Some studies have demonstrated improved control of cardiac risk factors as well.  Statistically significant reductions in blood pressure or resting heart rate have been achieved in patients with coronary disease, congestive heart failure, and atrial fibrillation.  Interestingly, the magnitude of blood pressure lowering in some studies (i.e. 10 mmHg) mimics that seen in certain trials of hypertension drugs.

The data suggest that clinical symptoms and physical functioning can benefit from relaxation techniques as well.  Patients with established coronary disease randomized to a 24-day intensive stress-management program experienced less angina episodes compared to baseline (versus no change in the control group).  These patients also exercised longer on follow-up treadmill tests, and demonstrated improvements in blinded measurements of cardiac function.

Of note, a strict vegan diet was part of the experimental regimen, hence the impact attributable directly to the relaxation intervention is uncertain.  Several studies of congestive heart failure patients treated with meditation or yoga demonstrated improvements in symptoms of breathlessness and fatigue, along with improved walking distance on standard 6-minute walk tests.  Here too, the magnitude of the increase in distance walked was comparable to benefits seen in trials of drugs for angina and pulmonary hypertension. Three months of yoga therapy in atrial fibrillation patients resulted in less symptoms and fewer detected arrhythmia episodes on wearable heart rhythm monitors.

But do these techniques prevent heart attacks or prolong life?  Believe it or not, there are two studies demonstrating reduced long-term risk of death following 3 months of meditation training.  Since the magnitude of benefit observed was far greater than would be expected from the brief exposure to meditation, these results are intriguing, but far from definitive.

So what’s the bottom line on stress?

First, it’s clear that psychological stress, anxiety, and other adverse emotional states often cause or exacerbate a variety of symptoms, and that relaxation practices can offer symptomatic relief.  Furthermore, evidence supports that emotional-regulation tools are very safe. For these reasons, two separate American Heart Association committees have endorsed their use as “reasonable to consider” in the care of cardiac patients.

For many people, the benefits of improved emotional equilibrium are motivation enough to try out these practices.  If you’re hoping that your yoga class will control your palpitations, improve your exercise tolerance, or cut your risk of heart attack, there’s no guarantee.  But if you are struggling with persistent symptoms despite your doctor treating you with the best available, evidence-based care, then there’s reason to be optimistic that mind-body practice may offer you the extra relief you’re looking for, with little to no downside to giving it a try.

By Alon Gitig, MD, FACC
Mount Sinai Riverside Medical Group
Yonkers, NY

Do you suffer with stress and arthritis? If you are interested in learning how to become resilient to life’s stressors, and what your gut has to do with arthritis symptoms, join Dr. Blum for a FREE Arthritis Masterclass on 1/22.  Save Your Spot

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9 Easy Ways To Boost Your Health This Summer

When it comes to summer health care we often hear about the need to apply sunscreen, wear sunglasses to protect our eyes, and hydrate, hydrate, hydrate.

But the longer days of sunlight and warm weather create an opportunity to buoy our health in ways that impact our lives well into the Fall. Check out these summer health tips to deepen and expand the health of your body, mind and spirit.

9 Easy Ways To Boost Your Health This Summer

  1. Enjoy Summer’s Seasonal Bounty – Oh, the ecstasy of summer foods! Cherries, watermelon, peaches, tomatoes, corn, arugula, rhubarb, melon, berries — it is a feasting bonanza. Take a walk through any farmer’s market and delight in all the produce summer has to offer. Get it while you can!
  2. Deepen The Spiritual Awakening of Spring — We commonly “Spring Clean” our lives, cleaning out the cobwebs physically, mentally and spiritually with greater attention toward renewal. Deepen this “awakening.” For instance, did you declutter any part of your home? Think about the emotional and mental impact this had and delve into how incorporating a “no-clutter” attitude, replete with loving every item in your home, amplifies your overall wellbeing. Or, did you perhaps “Spring Clean” your body? Think about how well you felt after the cleanse and consider adapting a cleanse-like mentality to your everyday nutrition.
  3. Take Advantage of the Weather — In other words … be outside every moment you can! Don’t sleep away your weekends. Get up, get active, and enjoy every moment of the gift of long warm days.
  4. Try Something New — It’s a great time of the year to try out an abundance of activities. Landscape painting, trapeze school, any number of outdoor sports (have you always wanted to know how to play lacrosse? Join a summer beginner’s league.), surfing, bicycle touring, or whale watching. Make a list and go!
  5. Slow Down — Summer is chock full of delights for the senses. Meander through a botanical garden, plant an herb garden (even on your window sill!), or enjoy your local farmer’s market or take a sunrise walk before the hustle bustle of the day starts. See, smell, taste and the joys of summer. Take the time to notice the seasonal changes from day to day.
  6. Experience Nature — Research shows that walking in green spaces reduces stress and increases calm, creativity and productivity. But beyond the health benefits connecting with nature allows us to connect with the Earth. It serves as a reminder of our joined destiny, our interdependence, that we are connected to the trees, the plants and all the little creatures big and small that share it with us.
  7. Relax and Breathe — Create the time to hang out in a hammock, sit on a beach, find a shady spot under a tree in your favorite park and mindfully breathe. There’s something about summer that makes it particularly easy to cultivate a breathing practice. Breathe, stretch, read, write — all great ways to spread your wings, find your voice and connect to your source.
  8. Visit A Farm — Farms are aflutter with life! Baby animals, growing plants — visiting a farm gives us an opportunity to connect with our life source! We are accustomed to food arriving on our plate without giving thought (or thanks!) to its origin. When we become aware on a conscious level, our relationship to the food we eat changes. We slow down and appreciate all the work that went into the food we are about to consumer.
  9. Volunteer — With so many hours of daylight it’s a great time of the year to volunteer out of doors. Walking trails, nature trails, community gardens, farms, and conservancy organizations would all welcome your help. Meet other like-minded people, give back to your community and experience the boost in mood and wellbeing that service provides.

What summer health tips would you add to this list? Let us know!

Are you feeling the effects of too much summer fun — weekends full of parties, BBQ’s and cocktails? At about midway through July many people feel heavy, bloated and blah. Join our 10-Day HealMyGut Summer Reboot — it’s exactly what you need to bring your intestinal flora back into balance. Relief is on the way! (And, it’s on special for the month of July!) Get the Special Price Now

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.