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Hypothyroidism: A Silent Epidemic

Guest post written by Jill Grunewald

If you’re even loosely tuned into online health communities, it probably seems as though “thyroid” is all the rage. Everyone appears to be talking about it. But that doesn’t mean that addressing—or assessing—thyroid health is a fad or “the next big thing.”

In fact, although the thyroid is a tiny gland, it is a big thing.

Why? Because every cell has thyroid hormone receptors. This is why the symptoms of hypothyroidism can run the gamut from mild fatigue to pronounced depression, for example. Additionally, more and more women—and to a lesser but no less concerning degree, men—are being diagnosed with hypothyroidism or low thyroid function. The problem is even starting to affect young girls, for reasons discussed below.

Hypothyroidism as a condition isn’t new. Lab testing for thyroid function has been around since the 1950s. You may have had a grandma or great aunt who had a “glandular problem,” which often meant they were hypothyroid.

What is the Thyroid?

This little butterfly-shaped gland in our neck is the maestro of our endocrine (hormonal) system. I like to refer to it as the spoon that stirs our hormonal soup.

Thyroid hormones—primarily T3 and T4—play a significant role in energy and metabolism. This is why the thyroid is often called “the master gland of metabolism.” These hormones also influence the brain, gallbladder and liver function, body temperature regulation, the gastrointestinal tract, our reproductive and cardiovascular systems, red blood cell metabolism, steroid hormone production, and bone metabolism.

The thyroid takes a mineral and an amino acid, iodine and tyrosine respectively, and converts this combination into T3 and T4. T3 is the most biologically active thyroid hormone—it’s what helps keep us lean, sharp, and warm.

Familiar symptoms of hypothyroidism include:

  • Fatigue
  • Brain fog
  • Constipation
  • Depression
  • Weight gain/weight loss resistance
  • Hair loss, including outer third of eyebrows
  • Dry skin
  • “Thyroid hair” (dry, brittle hair)
  • Weak reflexes
  • Feeling cold when others are comfortable

Symptoms often not recognized as being associated with hypothyroidism include:

  • High cholesterol
  • Edema/fluid retention (often present around the eyes/face)
  • Recurring infections
  • Going prematurely grey
  • Low libido
  • Anxiety
  • Headaches
  • Infertility
  • Miscarrying
  • PMS
  • Pronounced morning fatigue
  • Being stiff and achy upon waking
  • Digestive issues
  • Irregular menstrual cycles
  • Parched mouth
  • Gravely voice

One of the reasons that hypothyroidism is a silent epidemic is that too many of the above symptoms are viewed in isolation—too often, an underactive thyroid isn’t suspect. If you’re depressed, you may get a prescription for an antidepressant. If you’re constipated, a laxative. If you’re gaining weight or weight loss resistant, a recommendation to eat less and exercise more. If you’re struggling to get pregnant, a suggestion to try IVF.

To complicate matters, even when thyroid function is tested, it’s often not evaluated thoroughly—doctors often run a simple TSH (thyroid stimulating hormone) test, which only tells a small part of the story. TSH should always be taken in the context of other thyroid hormones, especially considering that TSH can be within normal limits in the face of hypothyroidism. These additional labs include Free T3, Free T4, Reverse T3, and thyroid antibodies that could show the presence of Hashimoto’s (autoimmune hypothyroidism): thyroperoxidase antibody (TPOAb) and thyroglobulin antibody (TgAb).

Hypothyroidism: Root Cause?

Hashimoto’s is the most common form of thyroid dysfunction—it’s estimated that over 90% of people with low thyroid function have the autoimmune form of the condition. In fact, Hashimoto’s is the most universal autoimmune disease and it’s estimated that 30 million women alone have it, whether they know it or not.

Historically, iodine deficiency has been considered the culprit, but this too tells a small part of the story. Today, iodine-deficient low thyroid function, without the autoimmune component, is unusual, but that’s not to say that those with Hashimoto’s can’t be low in this important mineral.

Other, “modern” causes of hypothyroidism/Hashimoto’s include:

  • Exposure to environmental toxins (including heavy metals and pesticides) *
  • Unrelenting stress, which can result in adrenal dysfunction/HPA axis dysregulation
  • Systemic/cellular inflammation
  • Intestinal permeability
  • An infection
  • Nutrient deficiencies

* Environmental toxins in the form of chemicals added to skin care and cosmetics products is why we’re seeing Hashimoto’s—and other forms of autoimmunity—much more frequently in the female population, including younger and younger women. As Dr. Susan Blum states, “. . . every chemical you are exposed to adds to your toxic load. Having a high toxic load makes it harder for your liver to handle pesticides and environmental estrogens, toxins that we know will affect your immune system.”

Spotlight: Nutrition for the Thyroid

Perhaps you’ve already been diagnosed with hypothyroidism or Hashimoto’s. You may be on thyroid hormone replacement—or maybe not. Regardless, the thyroid is extremely nutrient dependent and being mindful of your diet is critical for managing Hashimoto’s and giving your thyroid the nutritional love it so depends on.

Eating minimally processed foods with naturally occurring vitamins, minerals, amino acids, and phytonutrients is one of the best ways to support the thyroid—and immune system.

Genetically modified foods (GMOs), artificial sweeteners and additives, toxic oils, and antibiotic- and hormone-laden foods—all part of the standard American diet (SAD, and yes, it really is sad), trigger oxidative stress, which in turn affects how our cells communicate. Knowing that every cell has receptors for thyroid hormone, it’s not difficult to recognize how a diet deficient in key nutrients can disrupt this cellular communication.

So, what are these key nutrients?

I spent many weeks digging deeply into thyroid- and immune-supportive nutrition and then identifying foods rich in those nutrients. This meticulous research and subsequent ranking system became the foundation, the “nutritional springboard” for my best selling cookbook, The Essential Thyroid Cookbook.

This first-of-its-kind cookbook will leave no trace of doubt that our recipes are uniquely beneficial to your thyroid and immune system. They’ll support you for a lifetime of peak thyroid function no matter where you are on your wellness journey.

And finally, as for the multi-faceted nature of hypothyroidism symptoms, often, they no longer need to be seen as silos warranting individual treatment. Support the thyroid and immune system, and likely, you’ll see far-reaching improvement with these previously maddening symptoms.

Jill Grunewald, HNC, is an integrative nutrition and hormone coach and best selling author of The Essential Thyroid Cookbook.

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3 Steps to A Healthy Blood Sugar Level

Here’s a common scenario: You see your primary-care doctor for your annual physical, and you are told your sugar is a little high, and you may even have “pre-diabetes”….and you think, wait, what?  And the news keeps on coming. Your insulin may be “a little” high as well, or your cholesterol markers show a less than perfect balance.  If the numbers are mild, you’re usually told to “eat better, lose weight, exercise”, and if the numbers are really bad, you’re told to start medication.

Without a clear understanding of what these markers mean and how these early imbalances in your sugar system can eventually become full-blown pre-diabetes and then diabetes, you might have little motivation to do the work to change them.  And while yes, lifestyle change can feel like work sometimes, you might be surprised to find that some simple changes will do the trick. Perhaps you are a little overweight, are a little stressed out, and/or you aren’t exercising much.  Addressing these things with some simple suggestions, can really make a big difference, and that’s why it’s important to take these early abnormal numbers seriously, because now is the best time to reverse the direction that you are heading in.  

My goal for our discussion today is to first make it clear that if you ignore these first subtle changes, you will likely find yourself with a bona-fide disease down the road.  But even now, the high sugar in your blood is inflammatory and damages your blood vessels and organs. This is a huge issue!  There are 84 million people currently diagnosed with pre-diabetes (and rising!) and you don’t want to end up with type 2 diabetes, which is a major contributor to heart and vascular disease —  the leading cause of death in the developed world.   

That’s why, now is the time to do something about it.

And the good news? High blood sugar, pre-diabetes and yes, even if you already have diabetes, these are all reversible!

4 Steps to Reverse Pre-diabetes

Step 1: Recognize the implications this has on your health.

The first step is to listen to your body and understand what it’s trying to tell you.

Here is what you need to know to tune into your blood sugar system:

  • Know your risk: At Blum Center for Health we generally screen everyone for early blood sugar abnormalities and diabetes using a simple blood test. I screen for insulin resistance and pre-diabetes in patients who are older (over 45), overweight, physically inactive, have family members with diabetes, gave birth to a baby over 9 pounds (or had gestational diabetes), have PCOS, and/or have other risk factors for heart disease – like high cholesterol or high blood pressure.  

 

  • Check these labs:  The list of labs includes fasting glucose, fasting insulin, and hemoglobin A1C (a measure of the average sugar in the blood over a period of time). We do advanced cholesterol testing, because higher triglycerides and lower “good” cholesterol gives clues to insulin resistance.  Sometimes we do glucose tolerance testing, where we look at the amount of sugar and insulin in the blood after drinking a sugary drink. This tells us how hard the pancreas is working to produce enough insulin to decrease sugar in the blood.

Step 2: Make impactful changes to your health.  

Here is the good news.  Catching diabetes before it manifests and treating insulin resistance is relatively straightforward, although you do have to commit to some permanent changes, which for some people can be difficult. The lifestyle changes that improve the entire spectrum of metabolic and blood sugar issues are tried and true. In fact, lifestyle changes have been shown to improve numbers in these early stages of diabetes more than medication.

Focus on these 3 lifestyle behaviors to improve your personal glucose system:

  • Diet –  Eating a higher protein, higher fat and lower simple carbohydrate diet is key.  There are many nuances to this, and we suggest working with a nutritionist or health coach to help you figure this out, because it is the quality of the protein, fat and carbohydrates that counts as much as the amounts.  Also, losing weight helps – even a 5% drop in weight (about 8 pounds for a 150 pound person) will improve insulin resistance. I refer nearly all my pre-diabetic patients to our Functional Medicine nutritionist or our Health Coach to create a personalized food plan that dovetails your individualized treatment plan. Learn More If you live far away, you can also work with our Health Coach online!  Sign up HERE.
  • Exercise – Physical activity allows muscles to use up the sugar from the blood which lowers blood glucose and improves insulin sensitivity. Just 30 minutes of exercise, 5 days a week will help. Brisk walking after meals recruits muscles to move glucose from the blood.
  • Sleep – Getting plenty of restful sleep is good for us in so many ways, metabolizing sugar being one of them. Disturbed sleep and sleep apnea is correlated with the spectrum of sugar dysregulation.

Step 3:  Get the support you need!

Once you begin to make changes to your daily habits, you might need support to keep you focused and in the game!  What can this look like?

  • For some people, support is letting everyone around you know what your health concerns are, and why you’ve decided to work on new food and exercise goals. Having your family, coworkers and friends on board can make it less likely for you to slip up.
  • Enlisting others to do it with you is another option that can be very satisfying for all involved.
  • For others, being mindful and collecting data about your food, activity, and sleep is what is key. Fitbits and other tracking devices, food diaries, and keeping careful logs of sugars can be very helpful for you and your doctor.  
  • Make sure you have a supportive medical team, including a doctor who is invested and spends time with you to encourage and follow your progress.  
  • One of the most powerful ways you can create positive change is by working with a Health Coach who will help you overcome obstacles and keep you focused on the prize. Learn More

Step 4: Monitor markers and observe progress.  

Keep track of your markers and notice when things change. I guarantee that if you make the changes above, to diet, movement, and rest – the numbers will move in the right direction.  If not, something else is brewing and needs our attention.

  • Tracking progress:  As I discussed above, there are many ways to track insulin sensitivity, prediabetes, and type 2 diabetes. Glucose and hemoglobin A1C are not the only biomarkers playing into this metabolic orchestra. Ask your physician to do more in-depth diabetic screening, advanced lipid testing and hormone testing. If you see a functional medicine doctor, adrenal testing can be telling, as can stool testing for a look into the gut microbiome. Further investigation into inflammatory markers, toxins, and nutrient status can also help guide overall health.

Live in the NYC metro area and want to learn more?

Join me for a community talk An In-Depth Discussion on Diabetes on Wednesday, November 15th at 7pm. Register Now! I will review how we treat these conditions from a functional medicine perspective – dietary guidelines, supplements, and medications that work.

Are you interested in meeting with me or one of my colleagues? We would be happy to help. People travel from all over the world to work with us. Come join our family!

If traveling to us is not possible, you can work with our Director of Nutrition or Health Coach by phone or Skype. Call 914-652-7800 for more information.

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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Surviving Menopause: Hormones, Herbs, and More

Woman practicing yoga for self-care

A common question from patients is: “Should I take herbs or hormones for menopausal symptoms, and if so, which ones?”

This is a huge topic and the truth is there is no “right answer.”

Treating menopausal symptoms needs to be based on each woman’s unique situation accounting for her personal history, family history, current health goals. Without question, estrogen replacement is the most effective treatment for hot flashes and other menopausal symptoms.

While hormone replacement isn’t for everyone, there IS a lot of buzz right now around bioidentical hormones. For you to make an educated decision, it’s important to understand the difference between bioidentical (often compounded) and non-bioidentical hormones (conventional), and when you might consider using them.  In my upcoming talk at Blum Center, and further down in this blog, we will review all of this information.

But, not everyone wants to take extra hormones or can’t take hormones for health reasons.  Well, hope is not lost!  I will review several herbal remedies and lifestyle changes that women can use successfully.  This is a meaty topic, so let’s dive in!

“Hot Flashes?  No Hormones?  No problem!”

Many women come to me seeking strategies to address things like hot flashes, vaginal dryness, sleep disruption, and mood changes without hormones. In this case we have SO much to offer. Conventional medicine offers several antidepressants that have been found to work for hot flashes: paroxetine and venlafaxine are some examples. Gabapentin is another option.  Unfortunately, these drugs do tend to have other unwanted side effects such as sleepiness, headache, nausea, dizziness, and more. Rest assured, this is NOT our approach at Blum Center!  You don’t have to take an antidepressant to get you through menopause!

Here are just a few of the options that we can offer you:

St. John’s Wort has been shown in multiple studies to improve women’s sense of wellbeing, decrease hot flashes, improve sexual wellbeing, and reduce overall menopause rating scores (Grube, 1999 and Abdali , 2010).  Studies show that improvement was seen after 2-3 months and dose is typically around 300 mg taken three times a day.  St. John’s wort is metabolized in the liver and can interfere with the metabolism of many other drugs, so always tell your doctor if you are taking it.

Panax Ginseng has been shown to improve menopausal symptoms of depression and well being, increase energy, decrease insomnia (Wiklund, 1999 and Tode, 1999).  The dose is typically a standardized extract of 200mg a day.

Sage has been shown to decrease sweating by up to 64% in women who have hot flashes (Bommer, 2011).  If you are using dried leaf in capsule or tea take 1000mg twice a day.

Soy, Red Clover, Kudzu all contain various isoflavones such as daidzein, genistein, and puerarin. These compounds act as weak estrogen receptor modulators. Data on isoflavones for hot flash relief is mixed. Some studies show a benefit, others do not.  The tricky thing about some of these compounds, like daidzein, is that it turns out your gut bacteria have to convert it into equol to have the biggest impact. But it is estimated that only 30-50% of humans are “equol producers.” This may account for why soy seems to help some women more than others when it comes to hot flashes.My suggestion is to try it for about a month and if you see no improvement then stop. For soy, I would rather see patients eat whole, organic soy foods such as edamame, tofu, soy milk instead of taking a pill. Food is always better than supplements and foods with whole soy proteins (not soy protein isolate) are better for you. As always, any food or herb that has estrogenic qualities, you must use with caution in the setting of an estrogen-related cancer. Additionally, soy in large quantities (three times a day) can impact your thyroid function, so ask your doctor if you need to limit it. Also, these could interact with platelet/anticoagulant medicines.

Black Cohosh has shown mixed results in studies for menopausal symptoms. Many studies look at Black Cohosh along with a few other herbs. This is common practice in botanical medicine, taking advantage of the synergistic effects that herbs can have when taken together. It does make it more difficult to know if individual ingredients are beneficial. Black Cohosh is generally well tolerated and I mention it because it shows up in a lot of supplements that are geared for women’s health, menopause in particular. It is unclear if Black Cohosh directly interacts with estrogen receptors in humans, but to be on the safe side, I would avoid this one if you are an estrogen receptor positive cancer.

Clinical Hypnosis can decrease hot flashes by 55% compared to 13% in one well designed randomized study of 187 women (Elkins GR, 2013).  Hypnosis also helped with improvement in hot flash interference, sleep quality, and treatment satisfaction.

Acupuncture has been shown in multiple studies to improve sleep disruption (Chiu, 2015).  Researchers did a summary review of 31 studies involving over 2400 patients and found there was significant improvement in sleep as well as changes in blood hormone levels of estradiol and follicle stimulating hormone. And the larger the hormonal changes, the bigger the improvement on sleep. Data on acupuncture for hot flashes, however, is mixed. It appears that when acupuncture is compared to no acupuncture, there is a significant improvement seen. But when researchers compare real acupuncture with sham acupuncture, they don’t see a difference. This indicates that at least for hot flashes, acupuncture probably has a strong placebo effect. In my opinion, when the placebo effect works in our favor, it is a wonderful thing and I think we should take advantage of it!

Yoga has also been shown to be beneficial for hot flashes and emotional symptoms like stress in multiple studies (Joshi, 2011 and Chattha, 2008). Yoga has so many health benefits that I recommend it to almost all of my patients. In this fast-paced world, the practice of yoga slows down our sympathetic nervous system which is integrally involved with hot flashes. One caveat: I don’t recommend hot yoga as that will most assuredly make hot flashes worse!

“I’m Fine with Hormones – Bring Back the Estrogen!”

There has been a lot of research in the past few decades looking at hormone replacement for menopausal symptoms and the field is constantly growing. As with most medicines, there are risks and benefits to consider when deciding if you want to take hormones and it is important to have that discussion with your healthcare provider, or come and see me to discuss, because your personal and family history influences this decision enormously. In general, we do believe that hormone replacement therapy, especially bioidentical therapy, in low dose for the first few years of menopause is safe for most women.

My approach?  I always use bioidentical hormones and aim for the lowest effective dose, and prefer topical or local estrogen to limit unwanted effects.

“Bioidentical, Synthetic, I’m Confused…”

Bioidentical hormones are compounds that exactly mimic the hormones that we have circulating in our bodies. Those bioidentical hormones may be synthetic, in the sense that they were made in a lab, and that is not necessarily bad. Two of the most common hormones prescribed in this country are not bioidentical: conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA). These compounds act similarly to our own estrogen and progesterone, but nevertheless, have actions in our bodies that are distinct.

Historically, we assumed that CEE and MPA would be equivalent to bioidentical hormones, but as researchers have begun to compare the two in head-to-head studies, we now know there are differences especially in the progestogens (Stanczyk, 2013). Consensus is now building that bioidentical progesterone is probably safer than MPA. Although CEE and MPA are the most commonly prescribed hormone replacement regimens in this country, there are plenty of FDA approved bioidentical options for us to choose from including estradiol pill, patch, or gel form as well as micronized progesterone in pill form.

“So What is Compounding?”

Compounding medicine is the practice of taking one or more individual ingredients and mixing them together in the lab and creating a new compound that isn’t otherwise sold as a brand name product. The new medicine can be specially formulated for an individual patient to avoid allergenic ingredients, create new doses, convert a pill to a cream, combine medicines into one, etc.

Having access to high quality compounding pharmacies is extremely valuable in expanding the range of pharmaceutical offerings to the public.  For example, one FDA approved bioidentical progesterone product on the market in the US. contains peanut oil which some women are allergic to. This is a prime example of when compounding progesterone is a life saver!

There are pros and cons to using FDA approved drugs vs compounding drugs. The advantage of using an FDA approved medicine is that the approval process is stringent in terms of demonstrating safety, appropriate dosing, and efficacy. Additionally, the FDA drugs and facilities are highly regulated. Also, since the majority of research has been done using FDA approved drugs, physicians feel more comfortable prescribing them as they have been thoroughly vetted in clinical trials.  [A side note: the drug companies are the ones that fund the bulk of research since they can afford to do so. It costs millions of dollars to carry out a large clinical trial and very few entities can fund those studies.] The disadvantage is that sometimes we might want to give a drug in a different form than is available. In terms of compounding, the advantage is the ability to tailor a medicine specific to the needs of an individual patient.  The downside is that there is not as much safety and efficacy data on individual formulas, nor as much regulation on the actual compounding pharmacies themselves.

My approach to menopause is to get to know my patient, figure out what her goals are for the menopause transition, determine her risk profile, and come up with the best treatment plan together.

Meet Dr. Fitz:  Bronwyn Fitz, M.D. is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.

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How Chasteberry Supports Women’s Health

Vitex agnus-castus, also known as Chaste Tree or Chasteberry is a powerhouse herb in women’s health. Indigenous to Central Asia and the Mediterranean, it has been used for thousands of years for menstrual irregularities, premenstrual syndrome, premenstrual dysphoric disorder, breast tenderness, infertility, and more. The Latin root: agnus castus means “chaste lamb” purportedly alluding to the ancient culinary use of Vitex (also “monk’s berry”) to curb libido in monks!   

Historical uses aside, what we DO know about Vitex is that it contains glycosides, flavonoids, essential oils, essential fatty acids (oleic and linolenic). It works at the level of the brain to decrease prolactin levels, increase progesterone levels, and bind opiate receptors — which might be how it improves anxiety, food cravings, physical discomfort associated with premenstrual syndrome (PMS). Vitex is approved by the German Commission E for use in menstrual cycle irregularities, premenstrual disturbances, and mastodynia (breast pain).

3 Reasons To Consider Taking Chasteberry

Do you have PMS?

There are multiple studies that validate chaste tree for gynecological problems including PMS. One well-designed study of 170 women compared Vitex to a placebo pill during three consecutive menstrual cycles and women who got the herb reported 52% improvement in symptoms compared to just 24% in the placebo group. Specific symptoms looked at in this study were irritability, mood changes, anger, headaches, breast fullness, bloating and ALL had significant differences between Vitex and placebo pills1.  

Heavy Bleeding

Many women suffer from heavy bleeding during their periods.  This can be especially true for women who have a copper containing intrauterine device (IUD). One prospective study of 84 women looked at Vitex compared to mefenamic acid (an anti-inflammatory medicine) to reduce heavy bleeding in IUD users over the course of 4 menstrual cycles. Researchers found that women in both groups had significant improvement in symptoms, 52% in the anti-inflammatory group and 46% in the Vitex group2. I look forward to seeing additional studies with more subjects and that include a placebo group to fully understand the role for Vitex.

Irregular Periods

Many women have irregular periods and are often prescribed progesterone to help regulate their period, either in the form of birth control pills or sometimes progesterone alone.  Since we know that Vitex increases one’s one progesterone production, it makes sense that we would use it to help regulate an irregular period. Additionally, chaste tree works by decreasing prolactin, which for some women is the culprit in causing too few periods. I always lean towards supporting your body’s ability to make its own hormones over prescribing additional ones, especially if the ones we give are synthetic progestins. After all, synthetic progestins (the type of progesterone in birth control pills) can cause side effects such as weight gain, bloating, acne, moodiness, hair loss: not what you are looking for when suffering already from period problems!

Chasteberry and Infertility: A Word of Warning

Some people take Vitex for infertility due to irregular periods since it increases progesterone. Adding progesterone during infertility treatments is quite common. The studies on Vitex for infertility are mixed, leaving us without firm conclusion that it will help you get pregnant. While historical use supports this approach, there is no safety data on Chaste tree during pregnancy or lactation. For these reasons, I do not recommend starting it specifically for fertility and I DO recommend stopping the herb if you become pregnant.  

How to Take Chasteberry

Chasteberry does take time to see full impact, so stick with it for at least three months before deciding if it is working for you.The dose is usually 200-500 mg a day of dried fruit or 20-40mg/d of extract standardized to agnuside or casticin. At Blum Center for Health, we use Chasteberry Plus, at the dose of 1 tablet in the morning and 1 in the evening, with or without food.  Because Chasteberry has an impact on your body’s hormone production, it is wise to avoid if you have a hormone sensitive cancer, are pregnant, or are nursing. It could potentially impact hormonal birth control. It could interfere with dopamine-related medicines, such as some medicines used in Parkinson’s and some antipsychotic medicines. Side effects are not common but include GI upset, headaches, fatigue, increase in menses, hair loss. Rarely women with a history of depression may see a worsening of their symptoms.  Before starting herbal remedies, if you are taking other medications or have any hormone related health issues, remember to always check with your doctor, or come and see me at Blum Center.

Live in our neighborhood and want to learn more about using herbs for women’s health? Make an appointment with Dr. Fitz!  In her practice at Blum Center for Health she takes a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. For more information, call 914-652-7800.

Meet Dr. Fitz:  Bronwyn Fitz, M.D. is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.

 

References:

  1. Schellenberg R BMJ. 2001 Jan 20;322(7279):134-7.
  2. 2. Yavarikia P, Shahnazi M, Hadavand Mirzaie S, Javadzadeh Y, Lutfi R. J Caring Sci. 2013 Aug 31;2(3):245-54.
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The 5 Most Common Food Sensitivities And How to Avoid Them

Trigger Foods

Food sensitivities result when undigested food slips through gaps in an unhealthy (leaky) gut and triggers an immune response, which can cause inflammation, pain, and swelling in the joints. Food sensitivities are extremely common, though little known, in those with arthritis, autoimmune disease, and chronic ailments.

Since food sensitivities activate the immune system they can aggravate and even cause symptoms in chronic conditions. Thus, eliminating certain foods prevents a great opportunity to reclaim wellness.

In My Practice, I’ve Identified 5 Major Culprits

Gluten

You need to read food labels and look at the ingredient lists for the words wheat, barley, kamut, rye, or spelt. For example, did you know that soy sauce is made from wheat?  Or that beer is made from barley?  Probably not and you’re certainly not alone. Because it is not possible to list all the foods that contain gluten here, reading food labels is key. Oats are only okay if the label says “gluten free oats.”

What to Eat Instead: Look for grains made from quinoa, millet, buckwheat, and rice.

Dairy

This includes any milk product made from cow, goat, or sheep such as yogurt, cheese, milk, kefir, and butter. Often after doing an elimination diet test, many patients realize that milk is causing other symptoms that go beyond their stomachs. These include chronic congestion and sinusitis, post nasal drip, ear infections, and more.

What to Eat Instead: almond, rice, hemp, or coconut milk.  These milk substitutes are also made into yogurt, kefir, and cheese so you can get your fill, without having to settle for dairy.

Corn

When I say corn I don’t just mean corn on the cob. It is used for other purposes, like making an ingredient called high fructose corn syrup that is used in many, many foods because it tastes sweeter and is cheaper than sugar!  Remember, you need to remove whole corn whether on the cob, in a can, or frozen, and popcorn, too. You also need to be careful about reading labels, look for the word corn, which can often be found as corn starch, corn syrup, corn syrup solids, and high fructose corn syrup.

What to Eat Instead: Look for natural sweeteners or stevia (though, keeping sugar consumption down is a good idea too!).

Soy

Soy is on the list here because it causes digestive upset and inflammation for many people, something I’ve seen in my practice over and over. Soy is also used as an additive in many foods, especially packaged processed foods so you must read labels and avoid anything that lists soy protein, soy lecithin, or soy oil in its ingredient list.  When you start reading labels looking for these words, you will be shocked at how many foods contain them!

Eggs

Eggs are usually the food that people are the most upset that they have to give up!  Unfortunately, eggs have proteins that are common allergies and that’s why they are also common triggers for food sensitivities, too. Eggs are often found as ingredients in other foods, and again, you must read labels to make sure you eliminate it completely.

To read more about how to do an elimination diet see my article on conducting an elimination diet.  

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5 Tips To Control Your Allergies From An Integrative ENT

Tips to beat allergies

Allergy season is upon us, and for those of us troubled by seasonal allergic symptoms, it’s still not too late to find help.  While nothing substitutes creating a pre-season allergy plan, here are some useful tools that might give you relief.

Stay Indoors.  Check pollen counts on the radio or internet before you leave the house in the morning. (Great source: www. Pollen.com). Though pollen levels vary over the course of the day, a pollen count (the measure of pollen levels and type in a given area over the preceding 24 hours) can tip you off when it’s particularly hazardous outside. Many people start having trouble when the count reaches the 20 to 100 grains per cubic meter range. Note that the time of day when levels are highest is from 5:00 to 10:00 am and early evening. The time of day when levels are lowest is from mid- to late-afternoon.  If you must be outdoors, shed your clothing before you bring the allergens into the house, and immediately jump into the shower.

Try Nasal Irrigation.  Cleaning the nose with saline spray will decrease the amount of allergen that gets into your system. I like the squeeze bottle variety, such as the Neil Med brand – simply mix the enclosed packets with distilled or boiled water. Then, bend your head forward, and while squeezing the bottle into one nostril, pant like a puppy – it will keep the solution out of the back of your nose, so you can avoid that drowning feeling. You can find nasal irrigation kits at your local pharmacy.

Take Herbs or Supplements that Reduce Inflammation. Inflammation is one the biggest contributors to the allergic process in the body right behind repeated allergen exposure. Probiotics, Omega-3 and -6 fatty acids, herbal blends, such as Natural DHist or Histaeze, and homeopathy, such as Sabadil and Histaminum, can all be used to control and prevent symptoms. For dosing, check instructions on the package – some need to be given in higher doses first to attain a loading dose. Also check for any interactions with medications that you may be using.

Consider Immunotherapy. Allergy shots are a conventional option that can be useful, however, there is a new hot option for the allergy prone: Sublingual Immunotherapy. You simply place drops under the tongue that act like allergy shots, which reduces the immune response to the allergen. Like allergy shots this kind of treatment requires weeks to months to become effective. The great thing is that making allergy drops the foundation of your pre-season allergy plan changes your potential to have allergies for years to come. These can be useful for adults or children with allergies, and no shots in the arm! And for children, it can prevent the “allergic march” – the tendency for children to progress from eczema to allergies and then asthma later on in life.

Leverage Diet to Reduce Allergy Symptoms. Even if you don’t have food allergies, eating a healthy diet keeps inflammation at bay – and makes you less prone to an allergy attack even if it’s your worst season. The Mediterranean Diet is a great anti-inflammatory diet. It is a sensible way to eat overall — reducing your animal based proteins, increasing your grains, vegetables and plant based proteins.  Of course, be sure to avoid foods that you are allergic to.  And remember, the body recognizes certain foods as the same allergen that is produced by certain trees.  If you have birch allergy, for example, you might find that you get an itchy mouth to “stone fruits” – apricots, cherries, plums, peaches – as well as to apple and pear.  These symptoms can be worse if the birch tree is in bloom.  You can find lists of cross-reactive foods at:

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergies-and-food-allergies-can-be-relate

Wondering if you have food sensitivities? You might want to follow our 21-Day Simply Detox Plan. With our program you will discover, through a process of elimination and reintroduction, exactly which foods you have sensitivities to. You’ll detox your body and walk away with your own personalized food plan. The Do-It-Yourself E-Guidebook helps you every step of the way with daily instructions, a healthy eating food plan, and easy-to-follow recipes. Learn More 

 

Meet Dr. Gereau: Sezelle Gereau, MD, is an integrative ENT/Allergist with more than 20 years of experience. She uses an integrative and functional medicine approach to conditions such as allergies, chronic sinusitis, sleep apnea and headaches. She is one of the few physicians in the New York City metro area certified to prescribe allergy drops.

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Protecting our Youth from Colorectal Cancers

cancer

By: Pamela Yee, M.D.

A photograph of a beautiful, vibrant, 22-year old woman with the following headline recently caught my eye: Colon and Rectal Cancers Rising in Young People (1). As reported by The New York TImes, the American Cancer Society cites an increase in the number of young adults developing colon cancer, a disease most associated with that of an aging population.

Interestingly, researchers are at a loss to explain this rise.

The connection is obvious to me.

I strongly believe our diet foremost, and plethora of toxic environmental exposures, cannot be ignored. These exposures, both food and environment, begin in the womb and continue throughout childhood.

The larger question is, how can we collectively get our children to develop good eating habits to set the stage for optimal health?

FOOD

What’s Changed? The MEDIA!

As a kid of the 70’s I witnessed the early blossoming of processed foods.  Doritos, Lucky Charms, Kool Aid and Twinkies were common kids’ staples and few spoke of organic food. But, coming from a family that immigrated from China, these foods were kept at bay since my Grandma home-cooked almost all meals. There was no need, or pressure, for convenience foods — they were seen as treats.

Also, the art of corporations marketing to children had just began taking off. The allure of characters beckoning children to sample their spaceship-shaped waffles or cookies bathed in food coloring could not readily reach children through TV and other media. I believe the kids I grew up with benefitted from this relative media innocence.

A crucial point in 1980 changed everything.  The Federal Trade Commission had been trying to set restrictions on advertising to children. Their argument was that young children could not discern commercials from entertainment programs and older children could not understand the long-term health consequences of eating lots of sugar.  But pressure from the sugar, toy, candy and cigarette industries and farmers growing wheat for sugared cereals, all swooped down to prevent this from happening.

In 1980, Congress passed an Act that “mandated that the FTC would no longer have any authority whatsoever to regulate advertising and marketing to children, leaving markets virtually free to target kids as they saw fit,” wrote Anna Lappe, author and food advocate.

This one act launched the onslaught of marketing to children, and morphed into the complex state it is today where movies create characters which then show up on cereal boxes, plastic toys and candy wrappers.  [To read more about this pivotal act in detail, you can read Anna Lappe’s take on it here.

It’s surprising there was no extended commentary on the New York Time’s report on why this increase in colorectal cancers are being seen in young adults, and that the reasons are “baffling.” To me it all boils down to the environmental change that has occurred over the last four decades. And if food is the “medicine” that we put in our bodies all day, processed by our gut and microbiome, it seems that there would be an association between diet and incidence of disease.  Of course we can wait and wait for further studies to elucidate or we can do something about it now.

HOW TO HELP OUR CHILDREN

ROLE MODELS

From a preventative sense, one of the most potent things we can do for ourselves, and for our children, is to set a behavior we want modeled.  The younger you start with children, obviously the better. But, discussions with older children about why and how food impacts how they feel are powerful. They may not take to them right away, but you are sending a verbal message that you then reinforce by walking the talk. If mom and dad are eating sugar or convenient processed foods on a regular basis how can you expect your children to take you seriously?

MEDIA

Another way we can help our children is to limit media.  Easier said than done, I know as tech is the easy babysitter we employ so that, as parents, we can do chores around the home or placate an angry toddler on an airplane.  But the more we rely on that easy solution the more detriment it imposes on our children, not only because of the advertising and marketing, but also on the very relationships parents have with their own children.

Catherine Steiner-Adair Ed.D, a clinical psychologist and expert in child development and education, wrote the book, The Big Disconnect: Protecting Child and Family Relationships in the Digital Age after extensive interviews with children and parents on how social media and technology change the way children learn, grow and make connections with others.  She also gives advice to parents and educators on how to deflect the detrimental effects of media on our children.

These suggestions can all translate to better eating — not only because of the reduction of media influences — but because it will force us to pause, parents included. When both parents and their children employ awareness and make conscious choices surrounding food, media and their relationships with one another, family health automatically comes to the forefront. Suddenly you will find that you’re at the dinner table, without your devices, and enjoying a meal together, conversation included.

Reference:

(1) https://www.nytimes.com/2017/02/28/well/live/colon-and-rectal-cancers-rising-in-young-people.html?smid=fb-share&_r=0]

Meet Dr. Yee:

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

CLICK HERE  to learn more about Dr. Yee.

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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.