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Counting carbs? Carbohydrate density matters most

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If you are counting carbs to stabilize your blood sugar, lower inflammation, balance hormones, or lose weight, experts say looking at carbohydrate density is a more important strategy. Carbohydrate density measures how many carbohydrates are present per 100 grams of food. Low carb density foods don’t raise your risk of chronic disease.

Research shows eliminating dense carbohydrates from your diet improves health, prevents disease, and can even improve periodontal disease.

While many diets focus on how many calories or how many grams of carbohydrates you should eat per day, the carb density diet instead focuses on how many grams of carbohydrates are in a food once you subtract the fiber.

Ideally, you only want to eat foods under 23 percent carb density. More importantly, avoid carb dense foods.

Foods with low carb density include meats, vegetables, fruits, and whole nuts.

High density carbs include flours, sugars, breads, chips, rice cakes, granola bars, French fries, popcorn, and other fast and processed foods.

In a nutshell, if it has been processed, it’s going to be more carb dense.

Carb density in foods

Foods with low carb density contain the carbohydrates within cell walls. In these foods, carb density won’t go much beyond 23 percent.

In foods that are carb dense, however, such as flours, sugars, and processed grains, modern processing breaks apart cell walls so that carbs are much more concentrated, abundant, and hit the bloodstream more quickly.

Why high carb dense foods make us sick and fat

The human body was not designed to eat processed foods in which carbs and sugars have been busted out of their cells, concentrated, and able to quickly raise blood sugar.

Carb dense foods overwhelm the body’s cells with too much glucose. This causes cells to become resistant to the hormones insulin and leptin, both of which play a role in blood sugar regulation.

Insulin and leptin resistance in turn promote obesity, inflammation, accelerated brain degeneration, heart disease, diabetes, autoimmunity, and hormonal imbalances — in essence, the foundation to the many chronic diseases of western civilization.

Why regular diets don’t work and the kinds of food you eat matters most

These days, plenty of research has demonstrated why diets don’t work in the long run for so many people. Calorie counting, exercising more but going hungry, extreme diets — these approaches may work in the short term but they pit the individual against primal survival mechanisms and can be metabolically and psychologically damaging.

Although opting for a diet that is made up of healthy meats, fats, vegetables, fruits, and nuts may seem severe initially, it quickly adjusts hormonal responses to food. This reduces cravings, boosts energy, and reverses inflammation — the diet makes you feel so good you no longer feel deprived. You may also find processed foods make you feel terrible, so they lose their appeal.

Ask my office for more advice on how you can manage and even reverse chronic health conditions through diet, lifestyle, and functional medicine protocols.

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Antacids raise stomach cancer risk; address the root cause

Antacids stomach cancer

A recent study found regular use of proton pump inhibitors (PPIs) for acid reflux raises the risk of stomach cancer. PPI users (Prilosec, Prevacid) in the study had twice the risk for stomach cancer compared to those who used H2-receptor acid reducing drugs (Tagamet, Pepcid).

About 20 percent of Americans suffer with acid reflux and heartburn. Most people attribute acid reflux to excess stomach acid. However, the problem is too little stomach acid. How does low stomach acid cause acid reflux?

The stomach is highly acidic by design so that it can quickly break down foods and kill bacteria, fungi, and other pathogens. Good stomach acidity also helps absorb minerals and signal the rest of the digestive tract to release the right hormones, enzymes, and emulsifiers. Sufficient stomach acid is an important first step in ensuring overall digestion runs smoothly and that you are less susceptible to heartburn, indigestion, belching, gas, food allergies, bacterial infection, and abdominal pain.

What causes low stomach acid?

Common factors that cause low stomach acid include stress, bacterial infection, poor diet, and nutritional deficiencies. However, an H. pylori infection, which is linked to stomach ulcers, is the most common cause of low stomach acid.

Other factors that play a role in low stomach acid include hypothyroidism, pernicious anemia, and deficiencies in zinc B12, magnesium, or chloride. People who have been vegetarians or vegans for a long time may be deficient in zinc and B12, which are abundant in meats.

How low stomach acid causes acid reflux

In order for the small intestine to receive food from the stomach, the contents must be acidic enough to trigger that passage. When this fails to happen, the food shoots back up into the esophagus.

Although the food is not acidic enough for the small intestine, it is too acidic for esophageal tissue. This is what causes the burning of acid reflux, or heartburn.

Why antacids worsen acid reflux in the long run

Antacids or acid blockers bring temporary relief but can cause bigger problems in the long run. Without stomach acid to trigger the release of enzymes, digestive hormones, and emulsifiers, nutrient absorption suffers and the digestive tract is more prone to infection, inflammation, and damage.

How to improve low stomach acid

The first thing to do with low stomach acid is address the root cause. As we age, stomach acid naturally decreases. You can boost stomach acid by taking a supplement that contains betaine hydrochloric acid (HCl). However, if you have stomach ulcers or stomach autoimmunity (when the immune system attacks and destroys tissue), supplementing with HCl could make you worse. In these situations you need to address the existing condition first.

Ask my office how to correct low stomach acid, safely supplement with HCl, and improve overall gut health.


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Anemia is a deal breaker to managing autoimmune disease

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When people are working to manage an autoimmune or chronic condition, they typically focus on an anti-inflammatory diet and protocol. However, one often overlooked dealbreaker to getting better is anemia. Anemia as is a deal breaker to recovery because it means your cells are not getting enough oxygen. Without oxygen, recovery and repair can’t happen.

Anemia typically causes fatigue, weakness, brain fog, depression, lightheadedness, dizziness, irregular heart beat, cold hands and feet, chest pain, headache, and pale skin.

There are several different causes and types of anemia. Not all anemia is iron-deficiency anemia. It’s important to know this because you don’t want to supplement with iron if you don’t need it. In excess, iron is more toxic than mercury, lead, or other heavy metals.

Types of anemia

Iron-deficiency anemia. This is the most common form of anemia and is caused by insufficient iron. What is less well known is that gluten intolerance and celiac disease can cause iron deficiency anemia. This is because these conditions damage the gut so that it can’t absorb iron. It is also caused by internal bleeding, such as from ulcers. This shows up on a blood test as low iron and low ferritin.

B-12 anemia. Like it sounds, this is caused by insufficient B-12. This could be due to a diet low in B-12. You can screen for B-12 deficiency with a urinary methylmalonic acid and serum homocysteine test.

Pernicious anemia. Pernicious anemia is an autoimmune disease in which the immune system attacks a compound in the stomach called intrinsic factor, which is necessary to absorb B-12. Many people with autoimmune diseases such as Hashimoto’s also have pernicious anemia. This appears as B-12 anemia. Screening for intrinsic factor and parietal cell antibodies can identify pernicious anemia.

Anemia of inflammation or chronic disease. This type of anemia results from the breakdown of red blood cells. You may have symptoms of anemia but serum levels are normal. However, serum ferritin levels are typically high, indicating iron is not being used correctly by the body. Sources of inflammation that can cause this type of anemia are disease, toxicity, infections, gut damage, over training, and more. It’s important to rule this out because taking iron with this kind of anemia can exacerbate the inflammation.

Other types of less common types of anemia include aplastic anemia, anemia associated with bone marrow disease, hemolytic anemia, and sickle cell anemia.

Too much iron in the bloodstream

On the other end of the spectrum from anemia, some people have a genetic disorder that leads them to absorb too much iron. It’s a relatively common condition, affecting about one million people in the United States. Symptoms include joint pain, chronic fatigue, heart flutters, and abdominal pain. If left untreated, it can increase the risk of diabetes, arthritis, liver inflammation (cirrhosis), sexual dysfunction, and other diseases.

Hemochromatosis is managed through regular blood draws and a diet that minimizes iron intake.

Ask my office about getting tested if you have symptoms of anemia.


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Are you a sedentary athlete? Small movements all day add up

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A weekly workout routine including high intensity intervals, spin classes, running, weight training and other sports offers us many health benefits. However, recent studiesshow that even if you get a solid hour or two of exercise daily, it may not be enough to counteract the effects of sitting for hours at a time. The good news is you can do something about it — right now — by simply standing up and moving.

Exercise doesn’t compensate for too much sitting

With our convenience-centered, computer-based lifestyle, today’s recreational athlete gets less daily exercise than non-athletes of the past. The average person — even athletes — spends a whopping 7 to 9 hours every day either sitting at work, watching TV, or driving.

Sitting this much puts us at significant risk for health concerns such as diabetes, heart disease, cancer, increased risk of dementia, and early death, and the risk increases the more you sit.

Sitting too much also promotes joint stiffness, back pain and disk damage, digestive issues, insulin resistance, flabby muscles, and poor circulation.

Simple lifestyle changes create big strides

Studies show sitting for more than 2 hours at a stretch is unhealthy, and researchers recommend getting up to stand and move every 30 minutes for maximum benefits.

Low-intensity “non-exercise” activities such as standing and walking are more important than most people realize. They play a crucial metabolic role, account for more of our daily energy expenditure than moderate-to-high intensity activities, and offer unexpected benefits.

By getting up and about frequently and standing more you will boost metabolism, improve circulation, regulate blood pressure, keep the muscles toned, keep chronic pain at bay, improve bone health, and increase your energy and vitality.

Following are some ways you can stand up against the sedentary habits many of our jobs require.

Create daily habits to reduce sitting risks

At work

  • Stand while on the phone, at breaks, or lunch.
  • Walk to communicate with coworkers instead of messaging.
  • Invite coworkers to walking meetings.
  • Use an exercise ball as a chair.
  • Try a standing desk, treadmill-ready desk, or a high table or countertop.
  • Move around for one to three minutes every half hour at work.
  • Use an app or quiet alarm to remind you to take movement breaks.
  • Do a few jumping jacks or pushups during breaks (great for mental clarity too).
  • Walk or bike to work.
  • Walk to the next bus stop.

At home

  • Stand to do chores.
  • Get up and move every 30 minutes.
  • Do stretching or easy yoga 10 minutes a day.
  • Limit your TV/computer sitting time.
  • If you watch a screen, stand periodically, and move during commercials.

Out and about

  • Take the long way around.
  • Walk your dog more often.
  • Don’t park so close.
  • Walk or bike instead of driving.
  • Take the stairs.
  • Plan active meetups with friends instead of sitting to socialize.
  • Do chores and yard work manually.
  • Drive less, walk and bike more.
  • Join a club or meetup focused on physical hobbies like frisbee, birding, or dog-walking.

To help you figure out if you’re actually increasing your daily metabolic output, try using this handy online metabolic calculator.


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Why a “biological clock” discovery is worth a Nobel Prize

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The 2017 Nobel Prize in Physiology or Medicine was awarded to researchers for their discoveries of molecular mechanisms that control circadian rhythm, our biological “clock.” This sleep-wake cycle helps us move between sleepiness and alertness at regular intervals, and regulates important functions such as:

  • Behavior
  • Sleep 
  • Mood Immunity 
  • Brain function 
  • Hormone levels 
  • Metabolism

Although we’ve long known the circadian rhythm exists, the Nobel laureates isolated the gene that controls it and identified the proteins that govern its cyclical function.

The importance of healthy circadian rhythm

Humans are similar to other animals in that our internal clocks are set to the rising and setting of the sun. A healthy sleep-wake cycle is critical for many aspects of our health. Circadian rhythm imbalances increase risk for heart disease, obesity, mood disturbances, diabetes, cancer, dementia, and Alzheimer’s.

Despite the circadian rhythm’s intuitive design, our modern lives tend to sabotage its critical balance. Some disruptive factors can’t be avoided while others can, but for most we have the tools to minimize the negative effects.

Daylight savings wrecks the biological clock each year

Daylight savings time changes throw a kink in our daily rhythm. The time change is minimal, but studies show rates of driving fatalities, workplace injuries, suicides, and heart attacks rise after the spring-forward change. And night owls take the longest to recover.

Prepare for daylight savings time by shifting your bedtime and waking time a bit every day the week before.

Traveling across time zones

Everyone laments how jet lag can wipe you out. Jet lag occurs when the time of day doesn’t line up with your body’s clock. Crossing two time zones should take you about a day of readjustment; crossing six could take three days or more. But beware; chronic time zone jumping can lead to a suppressed immune system, chronic fatigue, and memory issues.

Plan ahead by moving your body’s time clock toward the destination time zone during the week before.

Hydrate before and during the trip.

Choose a flight that gets to your destination in early evening and stay up only until 10 p.m. local time. If you arrive early and are exhausted, take a two-hour nap but no longer.

Once at your destination, expose yourself to the sun’s rays to help your body sync up with the new time zone.

Poor sleep habits

Twenty percent of the population is estimated to sleep too little (less than 6 hours a night); this can lead to changes in genes that regulate stress, our immune system, sleep-wake cycles, inflammation, and aging. Chronic sleep deprivation is linked to heart disease, diabetes, obesity, stress, inflammation, dementia, and depression.

The CDC says insufficient sleep is a public health epidemic and research has established that the constant exposure to blue light from electronic devices is a major culprit.

Blue light and screen time

Changes in the levels of the hormone melatonin in your body are what make you fall asleep. During a normal day, morning light stimulates the body to decrease your melatonin level, promoting wakefulness, then as the day darkens, melatonin increases to encourage sleep.

However, adults and children disrupt this cycle by using smart phones and tablets late into the night. This can cause chronic insomnia because the blue light these devices emit is perceived by our brains as daytime light, which suppresses melatonin and keeps us awake.

Minimize blue screen time. Read a book instead. Turn off all screens (phone included) two hours before bed. If you can’t do that, get a pair of orange safety glasses.

Improper daytime and nighttime light exposure

Proper patterns of light exposure during the day are a major factor affecting how well we sleep.

Start each day with as much bright light as possible. Eat breakfast with as many lights on as possible to stimulate serotonin production, which helps melatonin production later in the day.

Get light during the day at home and work. Open the shades; turn on all the lights (try full-spectrum); sit by a window and look out often; take a walk outside during your breaks.

Minimize light in the evening by dimming or turning off unnecessary lights. Put orange bulbs in lamps you use at night, especially next to your bed and for reading. This helps to jump start melatonin production in preparation for sleep.

Lack of sunlight

Patterns of light during the day aren’t the only way light affects our circadian rhythm; exposure to actual sunlight is key for healthy function of the body and brain.

Research shows the average person spends less than an hour a day outside. Shift workers spend even less time outdoors. Lack of exposure to sunlight inhibits production of melatonin, affecting sleep and potentially affecting our ability to produce Vitamin D, key for bone health, mood regulation, and immune function.

Get direct sunlight every day. If you can’t get outside, use a quality light box early in the day.

Go sunglasses-free even for just 10–15 minutes, to provide beneficial sunlight exposure to your eyes and brain.

Respecting our body’s natural rhythm

Your body’s innate sleep cycle is largely controlled by the amount and pattern of light and dark you are exposed to each day. By managing the lifestyle factors that disrupt your circadian rhythm, you will support your body’s ability to function well and stay healthy. For help with sleep issues, please contact my office.


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Mystery symptoms autoimmune? How to find out

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Do you have mysterious health symptoms — such as fatigue, pain, brain fog, unexplained weight gain — that rob you of your quality of life, but lab tests and doctors keep saying nothing is wrong? Or maybe doctors tell you your chronic symptoms are depression and you need an antidepressant. Maybe you’ve even been accused of complaining too much.

Most people know when something is wrong with them, even if lab tests come back normal and doctors say you’re fine. This is because the standard health care model does not screen for autoimmunity — a disorder than occurs when your immune system attacks and destroys your own tissue. You can suffer from symptoms of undiagnosed autoimmunity for years and even decades before it is severe enough to be diagnosed and treated in the conventional medical model.

Fortunately, in functional medicine we can screen for autoimmunity against multiple tissues in the body at once. Knowing an autoimmune reaction is causing your symptoms can remove the mystery and bring significant peace of mind. It is confirmation your health symptoms are real and proof you are not a whiner or hypochondriac.

We identify autoimmunity by testing for antibodies in the blood against a particular tissue. For instance, we can screen for Hashimoto’s, an autoimmune thyroid disease that causes hypothyroidism, by testing for immune antibodies against thyroid peroxidase (TPO) and thyroglobulin (TGB). Positive results mean autoimmunity is causing your hypothyroid symptoms of weight gain, depression, fatigue, constipation, cold hands and feet, and hair loss.

Cyrex Labs tests for 24 different types of autoimmunity at once. The panel is called Array 5 Multiple Autoimmune Reactivity Screen. It is more cost effective than testing for each autoimmunity individually, and Cyrex Labs tests are highly sensitive. To do the test, simply ask us for the kit, take it to an approved blood draw center, and we will send you the results.

If your test results are “positive” or “equivocal,” it means your immune system is attacking that tissue. You may not even have symptoms yet. This is a best-case scenario because managing your health with functional medicine can prevent the autoimmunity from progressing.

Array 5 screens for the following autoimmunities:

  • Parietal cell and ATPase instrinsic factor: Stomach autoimmunity
  • ASCA, ANCA, and tropomyosin: Intestinal autoimmunity
  • Thyroglobulin and thyroid peroxidase: Thyroid autoimmunity
  • 21 hydroxylase (adrenal cortex): Adrenal autoimmunity
  • Myocardial peptide, alpha-myosin: Cardiac autoimmunity
  • Phospholipid platelet glycoprotein: Phospholipid autoimmunity
  • Ovary/Testes: Reproductive organ autoimmunity
  • Fibulin, collagen complex, arthritic peptide: Joint autoimmunity
  • Osteocyte: Bone autoimmunity
  • Cytochrome P450 (hepatocyte): Liver autoimmunity
  • Insulin, islet cell, glutamic acid decarboxylase (GAD): Pancreatic autoimmunity
  • GAD, myelin basic protein, asialoganglioside, alpha and beta tubulin, cerebellar, synapsin: Neurological autoimmunity

If you have no but a positive result, then you may be able to prevent the autoimmunity from expressing itself. If you have symptoms that correspond with a positive test result, other testing may help you track your condition. For instance, if you test positive for Hashimoto’s hypothyroidism, follow up with thyroid testing will track the severity.

Knowing you have an autoimmune reaction means you can halt its progression and prevent it from worsening. This can mean preventing or even reversing devastating and debilitating symptoms.

Ask my office for more advice.


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Stress can cause PMS, menopause problems, and more

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It’s not easy being female — the hormonal ups and downs each month through puberty and then menopause can range from mildly irritating to downright debilitating. Although many, if not most, women suffer from some degree of premenstrual syndrome (PMS), the extreme health and mood imbalances associated with PMS and menopause are a sign your system is out of whack, most likely because of stress.

Hormone balance is very sensitive to stress, inflammation, toxins, poor diet, sleep deprivation, lack of exercise, too little sunlight, and other common factors of modern life. Because the reproductive hormones play an important role in brain health, mood, and brain inflammation, when they’re off, brain function and mood suffer.

In women, imbalances are characterized by excess estrogen, insufficient progesterone, or too much testosterone. Stress and blood sugar that is either too low (hypoglycemia) or too high (insulin resistance) are the most common culprits of PMS symptoms and a miserable menopause transition.

Symptoms of hormonal imbalances in women include:

  • Frequent or irregular menstruation
  • Mood instability
  • Depression 
  • Problems sleeping 
  • Changes in weight or appetite 
  • Crying easily 
  • Irritability 
  • Poor concentration 
  • Anxiety 
  • Fatigue 
  • Low libido 
  • Migraines

Low progesterone from chronic stress

One of the more common reasons for hormonal imbalance is low progesterone caused by chronic stress. This is a mechanism called “pregnenolone steal,” when chronic stress robs the compounds needed to make progesterone in order to make stress hormones instead. This leads to PMS and sets the stage for a miserable menopause transition.

When it comes to stress, the brain does not know whether you are angry at traffic, soaring and crashing after snacking on a glazed donut and triple-shot caramel latte, or narrowly escaping being trampled by a bison. All it knows is to prepare for fight or flight and that reproduction hormones can wait until things have settled down. But for many sleep-deprived, over-stressed Americans fueled on caffeine and sugar, settling down rarely truly happens.

The fix isn’t necessarily in a tub of progesterone cream; first address the sources of stress. A primary stress-buster is a diet that stabilizes blood sugar. People often either eat too infrequently and too sparingly, or they overeat and eat too much sugar. Both are stressful for the body.

Here are some other common causes of chronic stress that lead to miserable PMS and menopause:

  • Sugar, sweeteners, starchy foods (rice, pasta, bread, etc.), too much caffeine
  • Food sensitivities (gluten, dairy, eggs, soy, corn, nuts, grains, etc.) 
  • Leaky gut and gut inflammation symptoms — gas, bloating, indigestion, heartburn, diarrhea, constipation, stomach pain, irritable bowel 
  • Sleep deprivation 
  • Pain and inflammation — joint and muscle pain, skin rashes, respiratory issues, brain fog, fatigue, depression 
  • Autoimmune diseases such as Hashimoto’s hypothyroidism 
  • Overdoing it, over exercising, not taking time for yourself 
  • Bad diet of junk foods, fast foods, processed foods

Restoring hormonal balance naturally

Ideas to halt pregnenolone steal include an anti-inflammatory diet, stabilizing blood sugar, restoring gut health, dampening pain and inflammation, and managing autoimmunity. These are functional medicine basics. Make sure you are eating the right amounts and kinds of essential fatty acids. Additionally, certain botanicals are effective in supporting female hormone health and the body’s stress handling systems. Ask my office for more advice.