Category: Wellness & Health

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Viewing Depression Through a New Lens

Many people accept depression as natural or even earned.  But everyone deserves full access to their rich potential, which is why treating depression first starts with acknowledgement. Once acknowledged, the next step is searching out proper care for ailing self and loved ones.  

Careful diagnostics are necessary to identify the specific type of depression and what factors underlie it. Diagnosis drives treatment. We need root cause insight into why one is depressed.  Then a comprehensive and personalized treatment plan can be developed regardless of the cause, because there is always something constructive to be done to help.

In the case of major depression, medical assessment, psychodynamic interview, exploration of mental health history, and detailed psychiatric categorization combine to reveal sophisticated diagnostic conclusions. A thorough workup is productive. And a comprehensive treatment plan maximizes the likelihood for an optimal outcome.  

Orthodox, functional and holistic medical interventions often make a huge difference. Direct manipulation of brain chemistry by medicines – natural or synthetic or nutraceutical –  can be profound.  Various psychotherapeutic interventions can bring sizeable reward. A major facet of an inclusive strategy for managing depression is self-help and the nurturing of self-perception that emphasizes patient empowerment and health over passivity, powerlessness/valuelessness, and sick role. Healthy lifestyle also plays a key part in supporting optimal mental health. And an enriching doctor-patient relationship is a virtual prerequisite to push patient health forward.

Many Depressions, Many Treatments

There is depression like, “These hapless New York Knicks depress me.”  And there is depression like “I am ill, with overall dysfunction, and with loss of interest in things.”  This kind of depression can come wIth sadness, plus hopelesssness and worthlessness, with lethargy and apathy.  It can even come with changes in eating and sleeping or with suicidal thinking. Same word, two very different entities.  Different causes.

Depression can have many different root causes.  Once we determine the root cause, the treatment can be targeted and personalized.  Underlying causes include:

  • Bipolar disorder  
  • Various metabolic, neurological, immunological inflammatory and infectious diseases cause depression.  
  • Substance abuse is a prime culprit for depressive outcomes.
  • Traumas, catastrophes and maladaptations will fuel depressive reactions.
  • Environmental and interpersonal “toxins” feed depression.  
  • Certain Psychodynamic and personality features tilt one towards mood problems.  
  • A biochemical predisposition to depression  will result in episodic, seasonal, and chronic depressive states.  

Here’s the Great News: Depression Can Be Reversed

Sufferers with major depressive disorder and dysthymic disorder (chronic depression) alone represent the second most costly disease on planet Earth and number roughly one in seven of us! All forms of depression ruin lives and can be reversed. Major depression alone is a devastating illness but it is amenable to improvement.  Nothing works better than a comprehensive, integrative, game plan. Let’s make one for you.

 

Dr. Stephan J. Quentzel, MD, MA, is an Integrative Psychiatrist at Blum Center for Health.  In his practice, Dr. Quentzel sees teenagers and adults for the widest of psychiatric concerns. He integrates brain sciences and psychiatry with general medicine, psychopharmacology, psychology, philosophy, ecology, psychotherapies, preventive medicine, herbal pharmacotherapy and nutritional studies, self-help, lifestyle improvements,  and the healing strength of compassion,  all in pursuit of optimal broad health and happiness for each client, specific to their unique needs and interests.  Man an appointment with Dr. Quentzel at 914-652-7800.

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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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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.  

 

Check out my FREE 3-part video series! How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

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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.