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Archive for April, 2015

HbA1c glucometer copy

High blood sugar is ground zero for chronic disease: diabetes (obviously), heart disease, dementia, autoimmune disease, chronic pain, and hormone imbalances. Testing your HbA1c on a blood panel can tell you whether high blood sugar is setting you up for major health problems.

High blood sugar can:

  • Trigger chronic inflammation, thus setting the stage for autoimmune disease
  • Radically imbalance hormones, causing high testosterone in women, high estrogen in men, PCOS, PMS, hormone deficiency, and imbalances in hormones that regulate satiety so that you’re always hungry
  • Damage the walls of blood vessels
  • Damage brain tissue and accelerate brain aging, increasing the risk for dementia (some researchers call Alzheimer’s type 3 diabetes)

High blood sugar is also associated with eye disease, kidney disease, nerve damage, and stroke.

Getting a handle on your blood sugar can help you better manage or prevent these radical health imbalances. The HbA1c shows you your average blood sugar levels over the last three months and is a simple way to look at the influence of blood sugar on your health.

HbA1c stands for glycated hemoglobin, which refers to a protein in red blood cells that has bonded with glucose. The higher your HbA1c the higher your blood sugar and the greater your risk for disease.

Using standard lab ranges, an HbA1c less than 5.7 is normal; 5.7%–6.4% indicates pre-diabetes; and if it is 6.5 or higher this indicates diabetes.

However, in functional medicine, we shoot for optimal health and like to see an HbA1c in the range of 4.6%–5.3%. One study shows heart disease risk rises considerably when HbA1c is over 5%  and another shows risk is higher when it’s over 4.6%.

Although HbA1c is said to look at your average blood sugar levels over the last three months, not everyone’s blood adheres to a strict schedule  In fact, people with pre-diabetes or diabetes have a higher turnover of blood cells, while those with normal blood sugar have longer lasting red blood cells, so that an HbA1c can reflect the last 5 months.

It’s important to look at HbA1c along with a couple of other blood sugar markers. If you’re working to manage your blood sugar, a glucometer is very useful to measure blood sugar throughout the day.

Checking fasting blood sugar first thing in the morning before you eat or drink (except water) is a popular indicator of blood sugar health, with optimal ranges being in the low 80s. A fasting blood sugar of 100 mg/dL or higher indicates pre-diabetes in functional medicine (126 mg/dL is considered diabetes).

However, people on very low-carb diets or on ketogenic diets can also have fasting blood sugar around 100. If you’re fasting blood sugar is around 100 but your HbA1c and post-prandial (below) blood sugars are healthy, then you know this mechanism is at work.

It’s highly useful to look at your blood sugar two hours after meals. This is called post-prandial blood sugar. Optimal blood sugar two hours after a meal should be under 100 to 120 mg/dL.

Lowering blood sugar levels requires eliminating sugar and sweets, minimizing carbohydrate intake (especially processed carbs such as pasta and bread), eating plenty of fiber, avoiding inflammatory foods, and exercising daily. Certain herbs and nutrients can also help lower your blood sugar. Ask my office for advice.

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puberty happening earlier copy

In the 1800s the average girl didn’t hit puberty until she was 15. Today the average age of puberty is 12, while the numbers of children showing signs of puberty before age 10 is at all time high and rising. We have seen the age at which children, primarily girls, hit puberty drop in just the last generation.

The numbers are startling. Breast development and other signs or puberty are starting by age 7 in 10 percent of white girls, 15 percent of Hispanic girls, and 23 percent of black girls.

Early puberty not only may cause emotional pressures, but also may raise the risk of breast and ovarian cancer due to longer exposure to estrogen. Studies link early puberty with increased behavioral and mood disorders, low self-esteem, early sexuality, and increased risk of health disorders.

Why are girls going through puberty so early?

The research points to the abundance of estrogen-like chemicals in our environment and obesity as factors driving early puberty.

We live in an environment saturated with synthetic chemicals. They are in our air, water, food, household products and body products. Only a handful of tens of thousands of chemicals have been studied; we only learn about their effects after the fact. Researchers have drawn many links between environmental chemicals and reproductive hormones.

For instance, in 1973 cattle in Michigan were accidentally fed grain contaminated with flame retardant, which mimics estrogen. The daughters born to pregnant women who consumed meat and dairy from these cattle started puberty significantly earlier than their peers.

Chemicals that mimic estrogen include pesticides, flame retardants, BPA (in tin cans, baby bottles, toys, and other food packaging), phthalates (in cosmetic products, PVC, plastics, food packaging, and numerous products), and parabens (in shampoos and cosmetic products). Phthalates have also been linked with abnormal hormone development in boys, and prenatal exposure to these chemicals has also been identified as a risk factor.

One study showed 90 percent of infants tested showed BPA in their cord blood, meaning this is a problem that can start before a child is even born.

These chemicals are tied not only to early puberty, but also to multiple health disorders, including reproductive cancers.

Although we can’t totally escape these chemicals, it’s important to restrict their use as much as possible in your home and in your diet (i.e., don’t use cleaning or body products with synthetic chemicals and avoid drinking or eating from plastic containers).

Obesity and early puberty

Studies also link early puberty with obesity. Overeating and a diet packed with sugar and processed carbohydrates tell the brain conditions are safe to reproduce. Excess body fat also produces estrogen. Being overweight also typically causes higher insulin levels, which stimulates the production of sex hormones.

A diet high in sugars and processed carbohydrates can raise the risk of early puberty through chronic insulin surges, especially in ethnic populations more prone to diabetes and obesity.

Estrogens in foods and early puberty

It’s not just about obesity but also estrogenic chemicals in foods. For instance, one study showed infants fed soy formula had estrogen levels 13,000 to 22,000 times higher than normal (soy is a known estrogen mimicker). Also, sex hormones are given to beef and dairy cattle, and the antibiotics given to animals may be a factor.

Other factors linked with early puberty

Studies also show puberty begins earlier in populations who live further from the equator and more prone to vitamin D deficiency.

A whole foods diet that restricts sugar and limiting exposure to chemicals can help prevent early puberty.

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10 reasons hashis not better

For some, managing autoimmune Hashimoto’s is as easy as going gluten-free. For others, it requires trial and error to find the triggers. And for those with severe or multiple autoimmune disorders, symptom management requires a conscious, lifelong approach to diet and lifestyle.

Hashimoto’s is an autoimmune condition in which the immune system attacks and destroys the thyroid gland. Managing Hashimoto’s hypothyroidism requires a multi-faceted approach that addresses immune function.

If you are not getting the results you want, see if any of the factors is getting in the way:

1. Not caring about your thyroid care. If you leave your thyroid care to the standard health care model, you may never see optimal results. The conventional model is based on lowering TSH into lab ranges with T4 medication. The Hashimoto’s patient needs to invest in self-education for the best results. The guidance of an experienced practitioner may still be necessary, but in functional medicine, patient participation is integral to success.

2. Skipping meals. When blood sugar drops too low it triggers autoimmune flare-ups. Symptoms of low blood sugar include shakiness, blurred vision, irritability, being spaced out, fatigue, and loss of function. If you feel more energetic after eating it means your blood sugar was too low. Skipping meals promotes Hashimoto’s flare-ups.

3. Ignoring blood sugar stability. The blood sugar and insulin surges from eating sweets and starchy foods trigger autoimmune flare-ups. Symptoms include fatigue, energy crashes, sugar cravings after eating, insomnia, and waking up at 3 or 4 a.m. If you are not keeping your blood sugar stable it will be difficult to manage Hashimoto’s.

4. Ignoring brain health. Hashimoto’s is hard on the brain, causing symptoms that overlap with Hashimoto’s, such as brain fog, depression, and memory loss, and accelerating brain degeneration. It’s vital to support your brain health as part of your Hashimoto’s hypothyroidism plan.

5. Not truly gluten-free. Being gluten-free is like being pregnant. You either are or you aren’t. Gluten is a significant trigger for most people with Hashimoto’s. If you are cheating on your gluten-free diet, not being careful, or eating foods that cross-react with gluten  you may be sabotaging your recovery process.

6. Eating foods that cross react with gluten. If you eat foods that cross react with gluten, then you may not have success managing your Hashimoto’s. Gluten cross-reactive foods are structurally similar to gluten and can trigger reactions. The most common cross-reactive foods are milk (casein), followed by rice, corn, sesame, and gluten-free oats.

7. Too much stress. Stress is a potent inflammatory trigger, as many have learned through experience. Bad relationships, an unhealthy work environment, not enough down time, and even a persistent negative attitude are chronic stressors. It’s important to mitigate stressors as much as possible and schedule regular time off.

8. Not looking past thyroid meds. Many patients are looking for the perfect thyroid medication  Although finding the right med can make a huge difference, meds alone don’t always go the distance. Hashimoto’s is a complex autoimmune disorder that requires nutritional therapy and lifestyle approaches. If you’re still eating foods that flare your immune system, meds can’t do their job.

9. You are taking supplements that stimulate your immune system. Some supplements can make your Hashimoto’s hypothyroidism worse or better, depending on your immune system. Echinacea, green tea, acai, Astragalus, licorice, and others can either help or aggravate autoimmunity, depending on whether you have TH-1 or TH-2 dominance. It’s very important to be aware of this. Please refer to Why Do I Still Have Thyroid Symptoms? for more information.

10. You react to fillers in your thyroid meds. Many thyroid meds and supplements contain fillers you may react to. Some capsules can contain gluten, and some whole-food supplements may contain gluten or be contaminated with gluten. You need to make sure your thyroid hormones are gluten-free and free of corn starch if you react to corn. Investigate the filler ingredients in your medication or supplements in case they are causing a reaction.

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446 moody or just female copy

Do you feel you need anti-depressants or anti-anxiety medications, or has your doctor said you do? Although true depression or anxiety disorders need management, many women are misled into believing they need treatment for what is actually normal behavior. Women are designed to be sensitive to their environments, emotionally in tune with their children and loved ones, and intuitive — traits that ensure survival. Women are also wired to express emotions and to pick up on the emotions of others.

Unfortunately, emotionality is not socially acceptable despite being a sign of good health in women. What is not so healthy is the constant pressure to apologize for and restrain emotionality for fear of being regarded as weak or hysterical.

Pharmaceutical companies, astute in the psychology of selling, spin this into sales targeted at women. In ads for antidepressants  93 percent feature a woman, usually a lonely single woman or stressed-out single mom. One in four American women take an antidepressant compared to one in seven men.

Women are more likely than men to express negative feelings through sadness and worry, which can be interpreted as a psychiatric disorder requiring medication. Men are more prone to express negative feelings as anger or through substance abuse, which are not as easy to address pharmaceutically.

Furthermore, when we paint depression and anxiety as women’s problems, men truly suffering from these problems are more likely to go overlooked. Women are almost twice as likely than men to receive a diagnosis of depression or anxiety.

Is it a lifestyle issue or a true disorder?

Many women turn to prescription drugs to help them manage feeling that are actually natural responses to unnatural stressors: chronic sleep deprivation, too little time outdoors, unhealthy diets, social isolation, over exposure to toxins and electric light, and over packed schedules. The human animal simply wasn’t designed to live optimally in today’s highly artificial, stressed-out environment.

Again, this is not meant to dismiss or minimize genuine depressive or anxiety disorders. But is your state of mind a reasonable response to your situation or a mental disorder? For instance, crying  which is seen as a sign of weakness, is actually a healthy way for many women to express sadness, frustration, fear, or other strong emotions. Women who take SSRI antidepressants (selective serotonin reuptake inhibitors) find it’s difficult to cry. They also experience more apathy and indifference.

Natural approaches to sadness and worry

Unfortunately, we can’t wave a magic wand and remove the stressors from life. However, it’s helpful and important to prioritize basic biological needs: plenty of sleep, good nutrition, healthy socialization, physical activity, and time outdoors.

Also, many natural compounds can address brain chemical imbalances to help boost your mental well being and function. Adrenal adaptogens are herbs that help buffer the effects of stress on your body and brain. Dietary strategies that balance blood sugar and tame inflammation can also result in profound improvements in mood.

It’s also important, though, to know that what you’re experiencing may just be a part of being that finely tuned emotional instrument known as a woman.

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SIBO in elderly copy

Do you have an older loved one in your life who seems to be wasting away no matter what you do to keep them nourished and healthy? This may be due to a condition called SIBO, or small intestinal bacterial overgrowth. SIBO happens when bacteria that normally belong in the large intestine travel backwards to colonize the small intestine. The small intestine is where we absorb the majority of our nutrients. Because SIBO inflames and damages the small intestine, this prevents these vital nutrients from being absorbed. As a result, the body and brain cannot function efficiently and it is difficult to maintain weight.

Symptoms of SIBO

For most people, symptoms of SIBO are straightforward. One of the most common symptoms is bloating after eating, particularly after eating grains, desserts, or other starchy foods. Other SIBO symptoms include gas, belching, indigestion, heartburn, nausea, abdominal pain and cramping, and either constipation, diarrhea, or both.

Doctors often misdiagnose SIBO as irritable bowel syndrome (IBS), as the symptoms are so similar. In fact, SIBO has been found in more than 80 percent of patients diagnosed with IBS.

Wasting away in elderly is usually SIBO symptom

Most doctors and patients haven’t heard of SIBO and blame such a rapid decline in the elderly on aging. However, researchers have identified SIBO, which is treatable, as the leading cause of malabsorption, and thus wasting away, in older adults.

SIBO doesn’t always result in malabsorption and wasting away. People can fall anywhere along a range of symptoms, from asymptomatic to the severe. But those who fall in the middle of the spectrum can become progressively worse. That’s why complaints of bloating and gas after meals should be taken seriously and not thought of as normal.

As SIBO and malabsorption worsen, nutrition status can plummet. Levels of B vitamins drop, which impacts many functions in the body, including brain function. Inflammation may also increase as the body’s ability to regulate immune function deteriorates. Also, it seems no matter how much older adults suffering from SIBO supplement, they cannot improve their low vitamin D status or persistent anemia.

The most devastating consequence of untreated SIBO and malabsorption is that it profoundly affects brain health and function, increasing the risk of dementia. It also saps energy and vitality. When an older person complains of bloating and distention after meals, it should not be dismissed as a minor complaint but rather regarded as a red flag indicating for more serious problems down the road.

The cause and treatment of SIBO

A variety of things can cause SIBO, including antibiotic use, poor diet, and digestive damage, such as from a long-standing undiagnosed celiac condition.

In older adults (and in those who have sustained a concussion or brain injury), another cause to watch out for is declining brain function. The digestive tract depends on healthy brain function to work properly. When signals from the brain to the gut are inadequate, the ileocecal valve  which separates the large intestine from the small intestine, may weaken and allow contents from the large intestine to travel backward into the small intestine, where they colonize. It is not the bacteria themselves that cause SIBO symptoms, but the byproducts they produce. These bacteria also compete with the host for protein from food.

Treatment for SIBO includes a strict diet to starve the bacteria, as well as targeted botanicals to kill them. Doing specific exercises to improve communication between the brain and the gut can also help prevent SIBO from perpetuating.

Ask my office for more information.

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