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Supplement quality matters

December 16, 2015 by drchrista Leave a Comment

I recently started working with a new functional medicine patient. This person has a gluten-mediated autoimmune condition as well as a sensitivity to corn. After a review of their medical history & symptomology, my clinical experience lead me to believe that other grains may be causing an issue as well. In addition to recommending a trial removal of all grains, I suggested that they start on a basic anti-inflammatory supplement regime.

Due to multiple sensitivities, the patient had been wary of taking any supplements. In her experience many contained ingredients of dubious quality that may have been derived from corn. Often the people at the health food store could make recommendations about what she should take, but couldn’t verify that any given formula was safe for her.

Let’s just say she wasted a lot of money on those supplements, for not much benefit. She even reported that a few of them made her feel even worse.

Even though I am very careful about the quality of the products I carry and recommend, I went a step further and called the companies directly to verify exactly where all of their ingredients in each of the formulas I had recommended came from. (This was more for her benefit than mine. I have been using this line of products for quite some time and knew them to be of very high quality.) A company making a quality product will know exactly where all of their ingredients come from and use the highest-quality ingredients possible. They will also test their products and source ingredients regularly for purity, which is part of what drives up their cost.

Unfortunately, you just can’t say that about all the of supplement manufacturers. It’s sort of the Wild West out there in that there is very little regulation and oversight. A few recent studies have shown that samples taken from store shelves don’t have nearly as much of a given vitamin as stated on the label; in same cases, the formulas are contaminated with harmful ingredients. In this 2013 study, the authors concluded

Although there is considerable evidence of the benefits of herbal medicine, the industry suffers from the unethical activities by some of the manufacturers, which include false advertising, product substitutions, and contamination and use of fillers.

Because this problem is so widespread, some have even called for all vitamins & supplements to be regulated by the FDA. I don’t agree with this. These products in and of themselves are generally safe and I think these ‘folk remedies’ should remain in the hands of people to use at their discretion. Regulating them generally means that a gatekeeper will have to control access to them. It is too likely that that level of control will drive up prices and limit the ability of people to heal themselves of minor or self-limiting conditions.

To maintain access to these remedies and supplements, I think its important for patients to be conscious and use common sense when taking them. First of all, if your condition is getting worse despite the use of a formula to help it, seek out the care of a medical professional. Also, make sure to tell your doctor about any and all herbs and supplements you are taking. Better yet, tell your pharmacist when you are picking up your prescription medications, if you take them. Though herbs & supplements are generally safe, they can have problematic or even dangerous interactions with prescription medications.

The other thing is be conscious of the quality of the supplements you are taking. Yes, there is often a big difference in the quality of a supplement you get from a licensed healthcare practitioner and one you buy at the Big Box store and yes, that quality is often reflected in the price. I’m going to go out on a limb here and say that if you are taking herbs & supplements in the first place, it’s probably because you are trying to avoid developing a bigger and more costly health problem? So why skimp on that protection?

The difference in quality often means that the supplement is more effective as well. Going back to the patient I referenced at the beginning of this post, she’s doing significantly better on the anti-inflammatory protocol I put her on. The supplements have made a huge difference in her quality of life- she has more energy, fewer aches and pains and recovers faster from flare ups than she did before. The supplement protocol has helped her so much in fact, that she is afraid to run out! As functional medicine practitioner, its important to me that patients use the highest quality supplements not only for safety, but efficacy as well.

Fix your GERD for good!

December 9, 2015 by drchrista Leave a Comment

Are you ready to fix your GERD for good? Read on for functional medicine solutions that will help you get to the root cause of these issues so you can heal from GERD for good!

There it is again- that tight, burning feeling in your stomach or chest after eating a meal. It use to happen so infrequently that you didn’t pay much attention to it, but now it seems to happen a few times a week. It was merely uncomfortable at first, but now you’re getting concerned. Sometimes you can’t even get to sleep because of it. You’ve tried cutting back on the ‘usual’ triggers mentioned in that late-night internet search you did on one of said sleepless nights- coffee, spicy foods, and alcohol. That helped somewhat, but the symptoms are still there and on top of it, now you can no longer occasionally indulge in food or beverages you enjoy. You really don’t like the idea of living on a prescription antacid, but its getting to the point where you’ve got to do something.

Living with GERD (gastroesophageal reflux disease) is no fun. It’s uncomfortable, distracting and can even lead to scarier health problems like esophageal cancer. However, addressing the problem with acid-lowering medications (proton-pump inhibitors) comes with a whole new set of issues. For one is the acid-rebound effect that can occur when you try to discontinue the medication. The other problem with long-term use of these medications is that they can lead to nutritional deficiencies. Zinc, Vitamin B12, iron and calcium are just a few examples of micronutrients that need an acidic environment in the stomach for absorption. One of the many side effects of these drugs in an increased risk of bone fractures due to inhibited calcium absorption. (So please don’t think you can take something like Tums to get your calcium requirement, mmm’kay?)

To fix your GERD without living on acid-lowering medications and risking these nutrient deficiencies, you’re going to have to get to the root cause of problem.

1.) Hypochlorhydria. Yes, this seems like a paradox that low-stomach acid may be what is actually causing your acid-reflux symptoms, but here’s the thing- your stomach is supposed to be acidic. It’s designed for it- that’s why it has a thick mucosal lining found nowhere else in the body. The hydrochloric acid of the stomach not only helps break down proteins, but is also the first line of defense for killing food-borne pathogens. When there is not enough stomach acid, it takes longer for the food in your stomach to be mechanically broken down enough to continue on to the small intestine- the next part of the digestive system. So it just sits there…eventually pushing upwards on the diaphragm and the lower part of the esophagus and causing those familiar GERD symptoms. Other clues that hypochlorhydria maybe at the root of your GERD symptoms are that you have a hard time digesting dense animal proteins and that you feel bloated or burp a lot after a meal. (Bloating and burping can be signs of other digestive diseases as well, so make sure you work with a holistic physician or functional medicine doctor to make sure those aren’t symptoms of a different problem.)

2.) Food intolerances. If you have an intolerance to say, gluten, it can inhibit the release of a hormone that actually helps open the pyloric sphincter (the muscular ring between the stomach and the small intestine), allowing the digested food to move out of the stomach. When the food gets ‘stuck’ in the stomach it can lead to those acid-reflux symptoms you’re all too familiar with. I’ve had a few patients for whom we fixed their GERD simply by removing trigger foods that they were intolerant of.

3.) Hiatal hernia. This is a type of hernia where the top of the stomach slides up through the hole in the diaphragm for the esophagus. Symptoms can closely resemble that of GERD. Larger hernias can be seen on x-rays. Smaller ones, also called ‘sliding hiatal hernias,’ can be present and causing symptoms, without being large enough to see on an x-ray. What to do about it depends on how large and how problematic the hernia is. For most of my patients, they tend to have the smaller, functional version. In this case, a simple abdominal massage to ‘pull the stomach back down’ may be useful.

Armed with this knowledge, you may find that you can fix your GERD symptoms by simply changing your diet a bit and using some supplemental digestive enzymes to increase stomach acid. Once you are able to sufficiently digest & absorb proteins and micronutrients like zinc and B12, your stomach and pancreas will be better able to make enough digestive enzymes on their own and supplementation can be discontinued.

One important note here. If you have had GERD for long enough that it has progressed to Barrett’s esophagus, please do not try to discontinue your acid-lowering medications on your own. This is a serious pre-cancerous condition and you need to work closely with a specialist to make sure you aren’t inadvertently causing more damage.

Need some help or guidance to fix your GERD for good? We can help. Call my office to set-up your appointment today 845-687-6387.

The first step to achieving any goal

December 1, 2015 by drchrista Leave a Comment

Most of my patients come to me with goal. In fact, if they haven’t clearly communicated their goal to me by the end of our first visit, I will ask them, “What is your goal? What do you want to achieve in our work together?”

I do this for two reasons.

First, I want to make sure that we are on the same page with their goal. If they want to lose 20 pounds and I’m reviewing their case and thinking we need to work on chronic systemic inflammation first, there obviously needs to be a conversation that takes place about reasonable expectations and time frames given the bigger picture of their current health.

But the second reason I ask about their goals is that I want to know what motivates them and how committed they are to their goal. I very much view the doctor-patient relationship as a partnership. We work together. I provide the technical knowledge and know-how to help navigate toward the goal, but the patient must be willing to implement the plan. They must be willing to change their diet, cook more often at home, take their supplements regularly, do ‘homework’ exercises, etc.

In short, they must be willing to show up consistently.

Depending on how a person articulates their goal, I can get a sense very early on of what kind of results they might get. Inevitably, those who are clear about their goal and willing to show up consistently, get the best results and outcomes. Those who aren’t clear on their goals or express resistance at the changes suggested, unsurprisingly, don’t do as well.

It’s as simple as this: I explain how gluten may be causing leaky gut and leading to systemic inflammation or antibody formation. Patient A goes home and adheres to a strict gluten-free diet for 30 days. Patient B goes home and ‘tries,’ but gives in a few times to the bread basket at a restaurant or just has to have a slice of pizza. When I see both for their follow-up, guess who is doing better?

We live under the pervasive myth that change is hard. Its really only hard if you make it hard by resisting it. If you approach change with the simple willingness to show up consistently, its really not hard at all. “Showing up” for something is really just another way of saying “being present for.” When you are “present for something” you are directing your physical and emotional energy at that thing. Think of your energy as Miracle-Gro for whatever you direct it at- whether that be positive or negative! To take our plant analogy one step further, what happens to our plant if its not feed and watered regularly, consistently? It withers and dies eventually.

Most people fail at their goals because they want a quick-fix. They want to show up once and magically have what they want. That’s why all those 3-day crash diets, super-low carb introductory phase, fad diets don’t work in the end. Their real crime is that they let people think they only have to do the hard work for a little bit of time to get lasting results.

Note that “showing up consistently” is different than “being perfect and succeeding consistently.” Failure is inevitable on any journey- we learn more from our failures then our successes. When your focus is showing up consistently, then when you make a mistake or fail at something- you get right back to it. When you think that you have to be perfect and succeed consistently, then you’re ready to throw in the towel at the first failure. Have you done this before? You start a new diet protocol and the first time you eat a food that is “bad” for you, you think, “well, that’s it. I broke my diet. Might as well go eat some ice cream. And cake. And cookies.” Or “I ate 3 Girl Scouts cookies and broke my diet, might as well finish the box!” It’s OK if you have- we all have been there before. My goal is not to make you feel guilty, just to show you why you’ve failed at achieving other goals in the past.

Showing up, being present and directing your energy towards a goal is a practice. People who are good at showing up consistently got that way by doing it repeatedly- that is by committing to being present for their goal, everyday. The good news is that we know from neurology- each time you make that choice- you make that neuronal connection, that association of your goal with an action, stronger. That means it gets easier to make that choice over time as you practice making it consistently!

So that’s the first step to achieving any goal, whether it be to lose weight, get stronger, perform a bodyweight movement you haven’t done before, or regain your health after a period of illness. Commit to showing up consistently. Direct your energy positively toward your goal every day. It’s OK if you mess up sometimes, but keep showing up despite failures and missteps. Commit to the practice of showing up- make that your ultimate goal- and watch how quickly you achieve your other ones.

Celiac disease: What your doctor hasn’t told you

November 24, 2015 by drchrista 3 Comments

It can be difficult to adjust to a gluten-free life after being diagnosed with Celiac disease, especially if the only thing your doctor has told you about your new diagnosis and lifestyle is “don’t eat gluten.” Thankfully, now there are many groups and organizations to help the newly diagnosed find the information they need. There are also many more food choices available in the marketplace and they are more accessible now than ever. Even most large chain grocery stores have a gluten-free section now.

It wasn’t always this way. I remember when my mom was first diagnosed with Celiac disease. There were only one or two organizations providing reliable information. The ‘can have’ and ‘can’t have’ lists changed rapidly, especially regarding certain food additives like ‘modified food starch’ and its ilk. But the worst was the few gluten-free foods available. Pastas and breads made with brown rice flour that tasted like eating sand. I still remember attending a meeting of a local Celiac support group and a woman holding a gluten-free product in her hands, exorting the group “this is not a health food.” That stuck with me.

As I started to study more functional medicine, and learn more about leaky gut- what causes it and how to heal it, and why its such a key part of addressing all autoimmune disease, including Celiac disease- I finally started to understand what this woman meant.

If you have Celiac disease, going gluten-free may be enough to make your GI symptoms go away. You might not feel the bloating or have the constant diarrhea that you experienced before, but that doesn’t mean its enough to heal the damage caused by the Celiac disease in the first place. That’s the part your doctor probably left out. So if you really want to heal- to get to the root cause of the issue- these are a couple things you need to keep in mind.

Other grains can cause cross-reactions of the immune system that still lead to antibody formation.

In fact, its not uncommon to see patients on gluten-free diets develop sensitivities and intolerances to other grains. I’ve seen patients become sensitive to corn, amaranth, tapioca, even rice. In general, when I have a patient with Celiac disease report to me that they are stilling having symptoms of inflammation, even on a gluten-free diet, I have them do a trial elimination of ALL grains right away.

Gluten-free processed foods are no healthier for you than their wheat-laden counterparts.

I’m sure you’ve looked at the ingredients on the package of a gluten-free bread or pasta. (You do still read the ingredients even though its labeled gluten-free, right?) Potato starch and tapioca starch are often used because they have a finer texture than rice flour- which often gives the product that aforementioned ‘sand’ texture. The problem with these starches though, is that they are highly processed- most of the nutrients are processed out and what is left is the pure carbohydrate. This changes the speed at which the carbohydrate is digested and usually leads to a high blood sugar spike afterward. The higher the blood sugar goes, the higher insulin needs to go. Over time, this mechanism leads to insulin-resistance or what many refer to as “pre-diabetes.” Along the way, this increase in insulin may make it harder to maintain your weight, lead to increased cortisol production and belly fat, and cause imbalances in several hormonal pathways. It doesn’t matter that these products are gluten-free. Gluten is a protein; the refined and processed starches in these products are the often the real problem.

Your Celiac diagnosis is the end stage of a long process that has been going on in your body for years.

It is now accepted that gluten-intolerance and its symptoms are better represented by a spectrum. There are folks in the middle who have various negative symptoms when they eat gluten and feel much better when not eating it, but have not yet reached the threshold for a diagnosis of Celiac disease. Current research from Dr. Alessio Fassano’s lab (he’s the guy publishing a bulk of the research on Celiac disease today) suggests that if these people continue to eat gluten despite their reactions to it AND have the gene the express Celiac disease, they will eventually express full-blown Celiac disease. (Note here that even if they don’t have a gene for CD, but for perhaps another autoimmune disease, this gene may be triggered the same way). If you look back at your own health history, its pretty likely that you’ve known something wasn’t right for years before your diagnosis. Chronic depression, severe PMS, chronic diarrhea or stomach upsets, anxiety about eating out or whether there would be a bathroom nearby when you needed it, acne or chronic skin issues, headache or brain fog, unexplained neurological symptoms- you’ve known these things weren’t ‘normal’ but nobody could tell you what they were. Once you were diagnosed with Celiac disease, a lot of those chronic symptoms began to make sense. They were subtle ways your body was telling you something was wrong.

Because this has been a drawn-process, happening over years, true healing is going to take time to work through. And very likely it will take more than just going gluten-free. The damage in your gut has lead to poor nutrient absorption and there may have even been negative compensations that have developed over time in response to the lack of key nutrients. Vitamins and minerals will need to be replaced. They will need to be replaced in a smart and efficient way, not by just taking a multi-vitamin pill and calling it a day.

The best way to go about this is to work with a functional medicine practitioner who understands Celiac disease and will help you find an integrative, whole-body solution to healing. If you’re ready to start the journey to a deeper level of healing and want some experienced guidance, give me a call at 845-687-6387. I work with patients locally in the Hudson Valley region, but I am also available to consult with non-local patients via telephone or Skype.

Not sure if you’re ready to commit yet? That’s OK too- I still want to do what I can to help you.

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WHO links red meat to cancer- what you need to know

October 27, 2015 by drchrista 1 Comment

On Monday, the World Health Organization announced that processed meats like bacon & sausage were classified as “causing cancer” and red meat as “probably causing cancer.”

Let’s just say, its caused quite a stir. So does this mean that a Paleo or low-carb diet is going to kill you???

No. But there are a few things you should know before eating loads of bacon with impunity.

The risk is small

The report stated that 50g of processed meat a day (less than 2 pieces of bacon) caused an increase in colorectal cancer of 18%. What does that 18% increased risk really look like though? Let’s say 6 out of 100 people get bowel cancer in their lifetimes. And all of those 100 people eat an extra 50g of processed meat a day. An 18% increased risk means 7 people will develop develop bowel cancer instead of 6. That’s one extra case of cancer per 100 people eating 50g of processed meat every day.

The risk is still smaller than that from smoking or alcohol consumption

Cancer Research UK put it this way- 21% of bowel cancers can be attributed to processed and red meat consumption whereas 86% of lung cancer can be attributed to tobacco. In the larger context, 19% of all cancers can be attributed to tobacco, whereas just 3% of all cancers can be attributed to red and processed meat. So it would make no sense to stop eating red meat if you’re going to continue to smoke or drink alcohol excessively.

Red meat can cause cancer

There are several mechanisms by which it appears that red & processed meats can cause cancer. (And it should be noted that these mechanisms have NOTHING to do with whether the meat is of the grain-fed, feedlot-raised variety. That is, eating only grass-fed red meat will not protect you from these potential cancer-causing pathways.) One of those pathways is the digestion of the heme protein. Cytotoxic compounds can be created that damage the gut lining and can lead to cell proliferation- and increased cancer risk. Another mechanism is the metabolism of L-carnitine, an amino acid particularly abundant in red meat. Gut bacteria metabolize L-carnitine into a compound called TMA (trimethylamine). TMA crosses into the blood stream, goes to the liver and is metabolized into TMAO (trimethylamine-N-oxide). TMAO is strongly linked to cancer and heart disease. Another potential mechanism are mutagens that can be created when cooking red meat, particularly grilling and frying (heterocyclic amines and polycyclic aromatic hydrocarbons).

All these mechanisms are modified by vegetable consumption

Chlorophyll (the compound that makes plants green) and heme have almost identical chemical structures. Because of this similarity, chlorophyll can block the metabolism of heme into toxic, gut-destroying compounds allowing it instead to be metabolized to inert (inactive) compounds.

Indoles found in cruciferous vegetables like broccoli, kale, cabbage, and cauliflower have been shown to suppress the growth of tumors caused by heterocyclic amines and polycyclic aromatic hydrocarbons.

As for the link between L-carnitine and TMAO, that is a little more complex. In turns out that a particular species of gut bacteria, Prevotella, is mostly responsible for increased blood levels of TMAO from L-carnitine consumption, according to a 2013 study published in Nature Medicine. Conversely, gut microbiomoes that have more Bacteroides sp. instead of Prevotella converted significantly less L-carnitine into to TMA and eventually, TMAO. Prevotella specialize in fermenting polysaccharides in grains (but not those in fruits & vegetables), so they appear to predominate in the microbiomes of those with high consumptions of grains. Though we can’t say this conclusively yet, it appears from what we currently know, that eating a grain-free diet and getting most of your fiber from vegetables helps moderate the danger of processed and red meat consumption from this particularly pathway.

So I don’t think anyone needs to give up red meat or enjoying bacon from time to time. It comes back to the same, basic, intuitive advice: eat a variety of foods (mix in white meats & fish in for protein sources) and make sure to get at least 5 servings of vegetables a day. That means that there should be veggies on your plate at every meal. I encourage folks to think of building their plates around 4 ounce of animal protein (about 1/3 of their plate) and to fill in the other two-thirds of plate with vegetables. Not only is it a simple way of creating a meal, but it helps ensure that you get the healthiest balance of animal to plant foods.

For further reading check out here and here.

Calcium supplementation: more harm than good?

October 21, 2015 by drchrista Leave a Comment

Are you taking a calcium supplement or has your doctor recommended one? You might be surprised to learn that the latest research suggests that calcium supplementation is useless at best, harmful at worst.

A study in the online British Medical Journal found that calcium supplementation in patients over 50 years old had no benefit. Neither did increasing calcium intake from dairy foods. This isn’t the case of a single, controversial, contrarian study either. Dr. Ian Ried of the University of New Zealand at Auckland and his team performed a meta-analysis, where they looked at results from all the high-quality studies they could find, and found the same thing.

The bigger problem though is that since this extra calcium intake is not ending up in the bone tissue, its accumulating in the arteries where it can lead to atherosclerosis and heart disease, or it ends up in kidneys where it may lead to the formation of kidney stones.

And yet, a very real problem remains. The National Osteoporosis Foundation estimates that 54 million Americans are at risk for developing the bone-thinning condition and half of American women over 50 suffer from a bone fracture because of osteoporosis.

So if calcium supplementation and dairy foods aren’t the answer to the osteoporosis epidemic, what is???

1.) Vitamin D. Among other things, Vitamin D helps increase absorption of calcium by the bone tissue. Its also vitally important to the regulation of the immune system. If you have any sort of chronic inflammatory condition, work indoors and wear sunscreen religiously, you are probably deficient in the crucial pro-hormone. Almost everyone I test for Vitamin D that is not already supplementing it, is at or below 30 ng/mL, the lower cut-off for “normal” Vitamin D levels.

2.) Magnesium. This mineral is necessary for over 400 different enzymatic reactions in the body, including the absorption of calcium. And yet, magnesium itself is blocked from being absorbed by calcium. So if you are relying on the magnesium from your Cal/Mg supplement to supply you magnesium needs, you probably aren’t getting enough magnesium. Magnesium glycinate is the best assimilated form of this nutrient.

3.) Vitamin K2. One of this vitamin’s main jobs is to determine where calcium should go- into the bone tissue or into soft tissue. When a person is deficient in K2, more calcium ends up in the soft tissue rather than the bone tissue. K2 is found almost exclusively in animal foods, in particular the butter from cows grazing on lush, green spring grasses. The more deep yellow or orange your butter is, the more nutrient-dense it is.

4.) Weight-bearing exercise. Walking, running and lifting weights are the best options. Bone tissue operates according to Wolf’s Law, which is basically that the tissue will respond to the magnitude of the loads placed on it. More loading = denser, stronger bone tissue. This is one of the bigger problems with space travel; the lack of gravity means there is not enough loading on the skeletal system and astronauts quickly develop osteoporosis. Given the lack of exercise and even just movement required by most people to function these days, this might be the biggest piece of the osteoporosis puzzle yet.

5.) Posture. Or maybe I should makes this 4B instead of 5. Its not just how much you load the bone tissue, but also the vectors of those loads. Imagine a stack of blocks and how much load they could take if we pressed straight down in the same line as gravity- a compression force. Now imagine if we could put a curve in the stack of blocks how much less compression force the curved column of blocks could handle. Now remember from above, more loading = denser, stronger bones. So proper alignment leads to stronger, denser bone tissue.

And if you have been taking calcium supplements? It might be wise to talk to your doctor about having a calcium score test done. This can tell how much calcium has accumulated in the soft tissue of your arteries and is a much better assessment of heart disease risk then looking at total cholesterol.

Use the grey box on the right to sign-up for my newsletter before October 25, 2015 and get an exclusive 10% site-wide coupon at my Metagenics webstore. Metagenics carries an awesome Magnesium glycinate supplement as well as many other high quality supplements.

How to avoid death by sitting

October 8, 2015 by drchrista Leave a Comment

It’s almost old news now, but sitting is no good for you. Well, let me be more specific- chronic sitting in the same position (usually in a chair) is no good. Just in case you’ve been hiding under a rock for the last couple of years, here’s just of few of the negative impacts of prolonged sitting:

decreased metabolism in the core muscles
increased risk of chronic disease & death even if you exercise
weight gain and obesity
‘chair butt’ (a flat, but wide posterior)
shortened calf muscles
shortened psoas muscle
tucked pelvis
alignment adaptations that can lead to low back pain, knee pain, hip pain or even pelvic floor disorders
chronic neck tightness and headaches

You can also get caught up by reading more here, here and here.

In a nut shell, I’ve joked with many people that as a chiropractor, I have a job because people sit too much. I mean it light-heartedly, but sadly there is a kernel of truth to the joke.

So what to do to be healthier, extend your life and lessen your bill at your local chiro’s office? It may surprise you, but the answer is not to simply stand all day long at work either. Walking work stations utilizing treaddesks have become en vogue recently as well. This is certainly better from a ‘calories burned’ perspective, but it still misses the bigger picture. Kale is a superfood, but if kale is all you ever ate, you’d still end up with a nutrient deficiencies. Same with walking. It has a ton of benefits for your body- you should do a lot of it. But if its the only way you move your body on a daily basis, you’re still going to be deficient. For instance, walking won’t do much for the balance of muscles in the shoulder girdle that need to hang, grip and pull.

I could go on and write a whole big blog post about what you should do instead, but why reinvent the wheel? Katy Bowman has already written the book on the subject- literally. Her newest book, Don’t Just Sit There! is now available in paperback. Use the box below to sign up for my newsletter. You’ll get my free PDF 7 ‘Health’ Foods to Ditch to Lose Weight & Feel Great AND one lucky winner will be chosen to receive a copy of Katy’s book, on me. Giveaway closes on October 31, 2015 at midnight, so sign up today!

How to REALLY heal after surgery

August 19, 2015 by drchrista 4 Comments

Last week, my husband had a bad accident at work that resulted in an open compound fracture of the tibia and fibula. He was rushed to the hospital for emergency orthopedic surgery to place pins to internal fix his ankle. He will be fine, but has been instructed to not place any weight on the ankle for 5 weeks. He’ll need at least 3 months of physical therapy and rehab after that.

I am not surgeon, but I do know how to heal & grow new bone and recover from surgery. Several years ago I had to have a series of surgeries myself to remove a tumor from my jawbone. My post-op progress had to be measured with periodic x-rays. The prognosis was that it would take 3 years for the bone tissue I lost to fully grow back. I replaced the bone I lost from the surgery in about a year. I plan to employ these same therapies to help my husband heal and recover from his fracture and subsequent surgery as well.

If you have had surgery, or have an impending surgery, here are some of the strategies that you can use to help you heal quickly and recover fully.

1. MOVE. As soon as your surgeon gives the OK, start moving as much as you can within your pain tolerance. Tissues in your body undergo a process called “immobilization degeneration” that can be measured at the cellular level within 24 hours of immobilization. Many tissues, particularly the cartilage in your joints, rely on movement in order to pump nutrient-rich blood in, and waste-product-filled lymph, back out. Try to get out of bed and start walking around as soon as your doctors and nurses give you the green light. Use assistance if necessary (and those socks with the sticky little grips on the bottom. You might be a little unsteady on your feet due pain meds and lack of food. Expect your balance to be if-y.)

2. VITAMIN D3- Many people know that Vitamin D is important, but they don’t know exactly why. Vitamin D has many functions in the body, but one particular one is supporting the function of T-regulatory cells. If you think of your immune system as a symphony orchestra, than T-regulatory cells are the conductor. Vitamin D helps the conductor conduct- and having the immune system all reading from the same page of music is going to be important in recovering well. If you’re recovering from some sort of orthopedic surgery, I would recommend a good quality cod liver oil, something with Vitamins A, D, and K, which are all extremely important in proper synthesis of new bone tissue. The product that I took after my surgeries and that my husband is currently taking is the Blue Ice Green Pastures fermented cod liver oil/high vitamin butter oil blend. My research indicates that this is the highest quality cod liver oil supplement you can take. Unlike many cod liver oil supplements that process the natural vitamins out of the cod liver oil and then add synthetic ones back in, the Green Pastures product uses an ancient fermentation process that concentrates the natural vitamins. In addition to taking a product like this, get out and get some sunshine. The fresh air and sunshine will do wonders for the body. It’s no accident that before we had the benefit of antibiotics, patients with tuberculosis would go to sanitariums/solariums for rest and rehabilitation. Laying in the sun and developing a tan was a way to increase Vitamin D production. You have to do this without sunscreen however, as that blocks the production of Vitamin D (and never try to tan under glass either). So be smart about your sun exposure. If you are very pale or burn easily, start very slowly and work your way up as your tan deepens. Make sure you can go inside or get out of the sun as soon as you notice the first signs of pink on your skin to avoid overdoing it and getting a sunburn. I spent a very pleasant week at the beach in September healing from my last surgery. The Vitamin D I stored not only helped me heal, but also avoid a period of depression that winter that I had thought was normal.

3. BONE BROTH. Acai and goji and cocao get all the credit. Probably because of their rich, vibrant colors. Bone broth might not be much to look at it, but it is at least as much as superfood at those Amazonian juggernauts, maybe more so because it can be made from the leftovers & scraps. Its an excellent way to get the most bang for your buck from the grassfed and pastured meats you are buying. Not only that, but its is full of calcium and minerals for bone growth as well as collagen synthesis. I made a big batch of bone broth before my surgeries so that I could sip on it for the weeks after I recovered. I’m giving my husband a mug of broth just about everyday. The key to really nutritive bone broth is to let bones sit, covered with water for about an hour with 1/4-1/2 cup of apple cider vinegar. The acidity of the vinegar will help pull the minerals out of the bones and into the broth. Broth, especially if knuckle bones, chicken or pig’s feet are used, will also be really rich in gelatin, which helps with cartilage and soft tissue synthesis. A good quality gelatin supplement from grassfed cows can also be used. I have been using the product from Great Lakes, but I also just ordered the Vital Proteins Beef Gelatin and Collagen Peptides products for my husband and I. (So stay tuned and you may see a future post from me about my experience with the Vital Proteins products.) Another great thing about broth is that your system might not tolerate a whole lot of food after surgery. Broth is easy to get (and keep) down while providing infinitely more nutrition than sugar-laden ‘juices’ and saltine-type crackers with almost no nutrition whatsoever.

4. PROBIOTICS. You will have to take some amount of antibiotics after your surgery to reduce the risk of a post-op infection. Unfortunately, this can wreck havoc on your gut microbiome and lead to imbalances in your gut bacteria that may lead to the overgrowth of opportunistic parasites and a slow erosion of your health. Make sure to discuss this with your pharmacist and physician first, but start a course of probiotics as soon as you can. Either while you’re on the antibiotics if cleared to do so, or as soon as you finish them. Look for a good probiotic supplement that has a wide range of types of bacteria and yeasts in it and at least 30-50 million CFU in a dose.

5. MANAGE STRESS. Repairing from surgery is major stress on the body, a good and necessary one, but still a stress. Unfortunately, too much stress can cause the adrenal glands to output too much of a hormone called cortisol. Cortisol has several functions, but one of the things it does is suppress the immune system. Since it is the immune system that is helping us heal and repair after surgery, this is generally not ideal (unless we are talking about organ transplant surgery.) Do what you can to slow down and take it easy on yourself as you recover. My beach vacation after surgery was not just about Vitamin D, but decreasing stress as well (I’m generally not a lay on the beach and no nothing for my vacation kind of gal- I usually prefer to use that time to scale a mountain side somewhere). Take it easy when you first go back to the gym. Don’t expect to do a lot of high intensity work. Plan to walk, do yoga, tai chi or other gentler forms of exercise. Breathe, meditate, or just lay in the sunshine and take a mental break. Delegate tasks to those offering to help and take as much time off from work as you can afford.

Most importantly, take the time to be really nice to your body. Feed it good quality food, with lots of nutrient-dense, colorful fruits and vegetables. Use the time to hit a “reset” button on your system and do as much as you can to invest in getting as healthy as possible.

Your brain on Movement

August 3, 2015 by drchrista Leave a Comment

Our big, wonderful brains. Arguably what makes us distinct as humans. We like to think that our brains developed in order to give us the ability to think and to create- and therefore give us the advantage that allowed us to develop language, art and civilization.

But this is wrong.

Scientist Daniel Wolpert puts it best: “We have a brain for one reason only: to produce adaptable and complex movements.”

The largest amount of data coming into your brain at any given moment is coming from the musculoskeletal system and the smooth muscle of other organ systems like the digestive system. Mechanoreceptors in every joint, every muscle, every tendon of your body are constantly telling your brain about where your body, and each part of it, is in space, something we call ‘proprioception.”

This information comes in to the primary somatosensory cortex- a strip of the neocortex that runs roughly from the top of your ear to the apex of your skull on both sides. It is organized in a way that it reflects perfectly how the body itself is organized (the part that receives information from the hand is next to the part that receives information from the lower arm) and its weighted according to where we have the most nerve endings/receive the most sensory input (the areas receiving information from the hands, feet, lips and genitalia for example are much bigger than the areas receiving information from the low back or the buttocks.)

Directly in front of the primary somatosensory cortex is the primary motor cortex- it gets the information about where your body is in space from the primary somatosensory cortex and then uses that information to decide which motor pattern to use. In order to reach for a glass of water, your brain needs to first know where your hand, arm, elbow and shoulder are so that it can tell those muscles and joints exactly how much to move and in what directs in order to reach out and grasp that glass of water.

This all happens so quickly, so eloquently, so seamlessly that though we can create robots that can master the game of chess, they can’t move the pieces around the board as deftly as even a child can.

So what does this mean for our brains and brain health?

Well, to begin with, your brain works much like your muscles- if you use them, they get stronger. And if you don’t they get weaker and less useful. As we move, we get stronger (and smarter) because the movement of our bodies and the subsequent firing of neurons that that requires causes the release of a chemical called BDNF- brain derived neurotrophic factor, or as one author put it “Miracle-Gro for the brain.” Its whole purpose is to stimulate growth of brain cells- not just in the parts of the brain most concerned with movement- but throughout the entire organ.

In a formal literature review, researcher Frank W. Booth showed that lack of movement was a factor in over 20 different chronic diseases. But even more poignantly, he wrote in his review “[s]edentary lifestyle is associated with lower cognitive skills.” Further studies showed that cognitive skills do not decline simply because we get older, they decline because we move less.

Not only is movement a key piece of preventing and addressing dementia and Alzheimer’s, but it has also been shown to be as effective as SSRIs in treatment of depression, with longer lasting benefits and less side effects too.

In short, you need to move to have and keep a healthy, keen brain throughout your life.

Exercise is definitely part of this, but it is only a part. We generally think of exercise as any movement we do in order to stay healthy and fit. Movement is broader than this. Movement is anything that changes the loads on your cells and tissues. A simple changing of the load on your muscles will cause a change in the feedback an embedded mechanoreceptor will give the brain about where that muscle is in space. Therefore movement can be as simple as changing the focus of your eyes from near distance to far, getting goosebumps from a chill in the air, getting up from being seated on the floor, or even evacuating your bowels- there is a reason we call it a ‘bowel movement‘ and not a bowel exercise.

Movement should happen throughout that day, all day long, providing plenty of input to the brain and stimulus for new neuronal growth. In contrast, when we spend 8, 10 or 12 hours a day being sedentary, sitting in a chair, and then go to the gym for an hour, we may get enough exercise to keep our waistline from expanding, but we are not getting enough of the movement we really need keep our brains happy and healthy.

The best part about having a movement practice as opposed to ‘exercising’ is that it can be much easier to fit into what is probably already a busy life. Find errands you can do by walking instead of in the car. Growing a vegetable garden can provide more nourishment than than just from the food alone. Moving your positions through the day from standing to sitting on the floor and back again can provide plenty of novel movement and loads for your body. Working in the kitchen to cook can provide a nourishing meal and nourishing movement at the same time. Play with your kids on the playground instead of sitting on the bench and starring at your phone while they play. Walk the dog in the evenings instead of watching another hour of TV. Its not hard: walk, play, crawl, hike, lifting, bend, run, swing, hang- pretty much do anything but sit and watch TV or zone out in front of screen.

If you’ve read this far, thank you. But now, for the sake of your brain health, please get out there and move!

6 “hidden” sources of stress

July 21, 2015 by drchrista Leave a Comment

Stress. It is ubiquitous in this modern age, so much so that most of us consider it inevitable. However, our relationship with stress over the last hundred years or so is vastly different from our relationship with it for the vast majority of our evolution as a species.

For most of our time on this Earth, stress was a punctuated, limited experience. The saber-tooth tiger chased us, we ran away and once safe in our cave, we could rest, relax and repair wounds, tissue damage and even metabolic damaged incurred on our getaway.

Unfortunately, nowadays that ‘rest, relax and repair’ phase never comes and so the damage builds and builds. Even if we don’t feel ‘stressed,’ our bodies may be experiencing stress. Though most of us associate ‘stress’ with psychoemotional stressors, we can experience ill effects from physical stressors too- and the body does not distinguish between physical and mental stresses.

So what are some ‘hidden’ sources of physical stress that might be contributing to your overall stress and slowly eroding away your health?

1. Food intolerances. Intolerances are different immunologically than a true food ‘allergy’ so the symptoms can be a lot more subtle. Headaches, fatigue, joint pain, skin rashes, and other chronic conditions can be symptoms of a gut being assaulted regularly by foods it doesn’t tolerate. Since the majority of the your immune system resides in your gut, this can create imbalances that can set the stage for autoimmune disease.

2. Poor sleep. Not just a lack of sleep, which most of us have experienced as a stress, but a lack of quality, restorative sleep. Sleep apnea is an all-to-common manifestations of this. If your body is not getting enough oxygen and alarms are constantly going off in your brain to wake up and breathe, you can be in bed ‘sleeping’ for 8-10 hours and still be tired and fatigued throughout the day. Another thing that can negatively impact your sleep quality is electromagnetic radiation from any electronics. Current evidence suggests that EMR disrupts the circadian rhythms that govern our sleep-wake cycles deep in a part of the brain called the pineal gland. Set your phone to ‘airplane mode,’ turn off the wireless router and unplug whatever electronics you can at night. They draw a small current even if plugged, but ‘off.’ Put all bedroom electronics on a power strip so you only have to unplug one thing to kill the electricity to them all at night.

3. Nutrient deficiencies. Most of us have moved away from eating nutrient-dense whole foods for most of our calorie intake. Modern farming practices can often deplete the soil of important minerals like magnesium and selenium and because of this, even organic produce may not be as nutrient dense as the food our grandparents ate. Additionally, in trying to digest process foods, our bodies are often depleted of more vitamins and minerals that we receive from the food itself. In dealing with increased stress, we use up our stores of B vitamins, Vitamin C and magnesium.

4. Blood sugar imbalances. Have you ever experienced the feeling of being ‘hangry,’ when you are so hungry your mood tanks and you get mad at everyone and everything until you get something to eat? Or have you ever had that afternoon ‘food coma’ where all you want to do about an hour after lunch is take a nap? These are symptoms that your blood sugar is unbalanced. One way that your body deals with low blood sugar is to secrete cortisol, our stress hormone, which mobilizes stored glucose from the liver in order to make it available to brain cells. Though this is a key survival adaptation, particularly in times where food is scarce, when this leads to elevated cortisol levels on a daily basis, it can suppress the immune system and lead to problems regulating our inflammatory response.

5. Sex hormone imbalances. Cortisol is made primarily from progesterone, but can be made from estrogen, testosterone and DHEA as well. Poor libido, changes in menstrual cycles, changes in PMS, infertility and erectile dysfunction may all have their route cause in stress that robs of us of our sex hormone balance.

6. Exercise. Bet you didn’t see that one coming? Exercise is a stress, usually a good one. But too much, too frequently, especially ‘cardio,’ can overtax the adrenals and result in overproduction of cortisol. In a healthy person, this is not problematic, in fact, it helps the body be better prepared for future stresses, but if you have a chronic health condition, or any one of the hidden sources of stress listed above, it may useful to reevaluate what kind of exercise you are doing and for how long. Strength training workouts are less ‘stressful’ to the adrenal glands then long steady-state cardio workouts. Additionally, short, high-intensity interval workouts appear to be less taxing on the adrenals glands than a steady-state cardio workout as well. If a patient is suffering from stress from too much of the wrong kind of exercise, I will also recommend moving more and exercising less. Focus on things like walking, playing outdoors, standing instead of sitting, gardening, etc.- activities that are fun, can be fit into your daily routine (as opposed to having to carve out extra time in an already hectic schedule to go to the gym) and move your body in new and novels ways, instead of the repetitive motion of most cardio exercises.