Myintegrativehealth Blog – Adrenal Fatigue – Natural Hormone Therapy – Thyroid Dysfunction – Pain Relief – Digestive Health

If there is one thing women fear, it is breast cancer. Perhaps it is the fact that breasts are such a feminine attribute, strongly associated with attractiveness and fertility, that women associate breast cancer with a loss of sexuality and even a loss of self. Some women are afraid of the various treatment modalities such as surgery, chemotherapy and radiation. These treatments may cause pain, sickness, or physical changes such as hair loss and even breast loss. I have had many patients state they feel that the treatment is worse than the disease.

Everyone knows someone who has had it – family, friends, or coworkers. According to BreastCancer.org, 1 out of every 8 women will develop invasive breast cancer in their lifetime. And our risk of getting breast cancer increases as we age.

Many women do not go in for regular screening because they do not want to hear bad news. The idea is that “no news is good news.” But nothing could be further from the truth. Breast cancer, like most cancers, is completely treatable if caught early. Regular screening and follow up with your doctor is extremely important, but what can we do to prevent breast cancer?

Research shows that the way our bodies break down estrogen can increase our risk of breast cancer. Estrogen is metabolized in the liver and the metabolites, or byproducts of metabolism, are a key to developing breast cancer. There are six metabolites that we look at – four metabolites are considered “bad” and only two are considered “good”. And although all six metabolites may be present, it is the ratios of these metabolites to one another that are important. One of the most reviewed ratios is commonly called the 2:16 ratio. If this ratio is less than 2, meaning that you have too much of the bad estrogen (16) and not enough of the good estrogen (2), studies show that you are at an increased risk of breast cancer, as well as other estrogen driven cancers such as cervical cancer and ovarian cancer.

How can you find out how your liver is breaking down estrogen? A simple morning urine sample can be sent to the lab for evaluation to determine your estrogen metabolism ratios. Once we have that information, we can assess your risk and take steps to mitigate that risk. This test can also be used to monitor current treatment plans to reduce breast cancer risk, as well as to monitor hormone replacement therapy. It is a great test to determine a woman’s osteoporosis risk as well.

What can affect the balance of this ratio? Diet and exercise have a strong impact on the 2:16 ratio. Adding flax seeds, cruciferous vegetables, and soy products into your diet can increase this ratio. Likewise obesity and alcohol consumption can have a negative impact. Definitely kidney function and fluid consumption can affect this ratio so I recommend a basic CBC and CMP with the estrogen metabolism test. Your doctor will be able to interpret your labs, determine how you metabolize estrogen, and create a plan to shift your metabolism to a different pathway if necessary.

Mention the phrase “food allergies” and most of us imagine those poor kiddos who get near a peanut butter sandwich only to have massive swelling around the eyes and throat, followed by difficulty breathing and hives.  The constellation of these symptoms make up what’s known as an anaphylactic reaction which, unfortunately, has become more and more frequent in the general population over recent years.  In fact, some newer studies suggest that approximately 3-8% of Americans run the risk of anaphylaxis when exposed to any number of foods, although tree nuts, milk and shellfish are at the top of the anaphylactic list.

Even more, we are seeing a less severe variation of these dangerous food allergies, called “allergy sensitivities” that don’t typically cause life-threatening symptoms, but can still be quite uncomfortable nonetheless.  If you have symptoms like indigestion, gastritis, eczema, asthma, celiac disease, arthritis, and even depression, anxiety, and chronic fatigue, it could be a result of a “food sensitivity.”  Additional reports suggest that at least 60% of Americans suffer from symptoms due to adverse food reactions as a result of food sensitivities.

Food allergies/sensitivities may be a reaction to a protein, a starch, a contaminant found in the food (e.g., pesticide residues) or a food additive (e.g., colorings, preservatives, flavor enhancers, etc).  Once the body decides it’s uneasy with a food, a complex cascade of events takes place that can result in either a life-threatening situation (anaphylaxis) or simply the aforementioned unpleasant symptoms.

Driving this reaction is the immune system’s production of multiple types of antibodies.  For example, during an anaphylaxis response, IgE antibodies are produced within two hours of exposure.  These antibodies then bind to specific cells called mast cells and basophils which release their inner contents–histamine.  This is why an anti-histamine, like Benadryl or Quercetin, is often prescribed for allergies.

Yet, it’s the more delayed allergic response found in food sensitivities, one that can take up to 72-hours after exposure, that causes the aforementioned “uncomfortable” symptoms.  This response is usually driven by IgG antibodies and although it can stimulate the release of some histamine, it usually recruits many more players of the immune system, further complicating the reaction in the body.

Studies suggest that dairy, wheat and eggs are the three biggest sources of food sensitivities in people.  How is this determined?  In the past, the skin prick test was used where small amounts of foods were injected into the skin either on the back or forearm.  Now a simple blood test does away with this antiquated test.  These blood tests can measure for both IgG and IgE antibodies and help guide you and your provider in a direction for food avoidance, which is the mainstay of treatment.

So if you suffer from indigestion, asthma, eczema, etc., simply avoiding problematic foods could be your ticket to feeling well.  In addition to elimination, I recommend rotation of food families (e.g., veggies, fruits, meats, etc.) along with assisting the body with its normal digestive processes through the use of pancreatic and stomach enzymes.  Probiotics can be quite helpful as well.

Living in fear of foods because of their potential to make us sick is unnecessary when you recognize there are easy ways to identify possible sources of food allergies/sensitivities.  Combined with practical and realistic interventions you can take to calm the reaction and subsequent symptoms, you can alleviate a multitude of health conditions.

Hi everyone,
Just did a radio show yesterday on adrenal fatigue and tricks to counter the evils of modern life Enjoy: http://goo.gl/Vu79B
In good health,
Dr. C

On the way in to the office this morning I dropped off my daughter at middle school and my son at elementary school.  Over the course of the drive I saw children, adolescents, teens, parents, cyclists, and workers all drinking what I call the ‘new soda’ – Gatorade.

There is a scary new disease identified as ‘Orthorexia Nervosa’.  It is a somewhat tongue-in-cheek attack on the elaborate web of food rules we find ourselves trapped in.  ‘Ortho’ refers to right or correct.  The ‘rexia’ is of course taken from anorexia, meaning suppressed appetite.  Interestingly the origin of anorexia is the same origin as the term rack, meaning to straighten.  We straighten our arms when we reach, therefore reaching became tied to appetite as in reaching for food.

Over the years I’ve heard so many versions of what to avoid.  If I avoided every food that I’ve ever been told to I would literally have nothing left except perhaps a few types of lettuce.  Oh, wait, the Chinese medical texts do recommend against raw vegetables.  OK, so cooked romaine.  That would get old fast.   We have to eat something.

Many current researchers and public health experts are realizing that telling someone not to eat something bad may be less productive than encouraging them to eat something good.  The best things to go out of our way to eat are the foods that give us the greatest benefits (number of important nutrients) for the least harm (calories).

Several authors have embraced the term ‘superfoods’ to describe certain foods that are especially high in nutrients and low in calories.  Although there is no formal list, some of the superfoods are tastier and more readily available than others.

Variety is certainly important in the diet, but with modern foods the idea of variety is misleading.  Rotating your morning Pop Tarts between cinnamon and cherry does not count as variety.  If you are talking about foods as great as the superfoods, don’t be afraid to find a few favorites and eat them everyday!

So why don’t we eat well?  The biggest concern I hear is that people don’t have time.  Between my family, practicing medicine, training and writing, believe me, I understand about time constraints.

The problem is that many have an idea of shopping daily and making every dish from scratch.  Mind you it’s a blast to spend a few hours puttering around in the kitchen, but that is not realistic for our workdays.  Bear in mind that anything you eat from wherever you get it will take some time.  If all of your meals are drive throughs, heaven forbid, you’ll still be spending at least 15 minutes per day just waiting in line.

Below are my top 20 easy to find superfoods.  Stay with me and I’ll show you how you can get most of these in a day with under 15 minutes of work, I promise!

1. Spinach
2. Broccoli
3. Blueberries
4. Carrots
5. Edamame
6. Black beans
7. Tomatoes
8. Turmeric
9. Grass-fed beef
10. Salmon
11. Mushrooms
12. Celery
13. Walnuts
14. Almonds
15. Greek yogurt
16. Avocado
17. Green tea
18. Pomegranate
19. Steel cut oats
20. Brown rice

When you wake up, make a 5 a day drink.  If you haven’t tried it yet, here’s the

videoon how to do it.    So far we’ve invested 3 minutes.

For breakfast, warm some pre-cooked steel cut oats from Sprouts or Whole Foods, just 1/4 cup if you’re watching your weight, add a dollop of non-fat plain Greek yogurt, some blueberries and a few almonds.  Now is also a good time for a cup of green or white tea.

So, 2 minutes to warm oatmeal and assemble, our tally is at 5 minutes.

Before you leave for work, pour together a nice salad.  Shop right and you’ll have zero prep work to do.

Mix into a large bowl:

• Washed spinach leaves
• 2-3 ounces smoked salmon
• Sliced mushrooms
• Prepped pomegranate seeds (you can now buy these already cleaned and separated!)
• Broccoli florets
• Black beans, canned – rinsed
• Walnuts, small handful
• 1 – 2 tbsp natural guacamole

The guacamole also works as a ‘dressing’ and flavoring for the salad.  This whole process should not take more than 2 minutes so we’re at 7 minutes.

For dinner, sauté some lean grass fed ground beef, add in Thai curry paste (Turmeric and lots of great flavor).  Stir in your favorite frozen mixed vegetable blend and serve over pre-cooked brown rice.  Have 1/4 cup of rice only if you’re watching your weight.  Allow 5 minutes for this and we’re at 12 minutes of cooking for the whole day and we ate every single superfood!  How awesome is that!

Many of my patients declare their soda consumption as safe by explaining how they “only drink diet soda, without any of that sugar,” while others state “I only drink regular soda, none of that diet stuff.”  Everyone seems to have the belief that one type of carbonated drink is healthier than another.  With so much information out there on the virtues of sweeteners, it is easy to justify your choice. So which is really better, regular or diet? Well, let’s compare and contrast the two.

Regular Soda Pros and Cons

Pros:  Tastes good.

Cons:  The sugar in regular soda causes your blood sugar levels to spike which can lead to insulin resistance, high cholesterol, high blood pressure, heart disease, diabetes, weight gain and premature aging.  Over time, soda can also erode tooth enamel and weaken your bones increasing your risk of osteoporosis.  It can also cause gastritis and acid reflux.

Hmm, that’s pretty heavily weighted on the negative side.  Let’s look at diet soda.

Diet Soda Pros and Cons

Pros:  Tastes good.

Cons:  Ok, diet soda won’t cause your blood sugar levels to spike and crash, but it does contain a lot of harmful chemicals including aspartame. The use of aspartame has increased to replace high fructose corn syrup (HFCS). Like HFCS, aspartame can have many negative effects on all parts of your body.  Neurologically, aspartame can lead to migraine headaches, memory loss, seizures and numbness and tingling in your arms and legs.  Psychiatrically, aspartame may cause depression, anxiety, irritability and aggression.  Your digestive tract will also suffer the consequences of aspartame by causing nausea, vomiting, diarrhea and abdominal pain.  As if these reasons weren’t enough to turn you off of diet soda, it may also cause weight gain, blindness, tinnitus, PMS, thinning of hair and menstrual changes.  And it, too, erodes tooth enamel and weakens your bones.

It looks like we have a tie and no winner.  Both diet soda and regular soda are equally bad for us.

Is it ever good to drink soda?

Yes, if you are stranded in the desert with no other source of hydration, you should drink soda to stay alive. But, short of that or a similar scenario, it is a bad idea to pour all of that sugar and chemicals into your body, especially when there are numerous healthy choices available.

What can I drink that tastes good and will quench my thirst?

First and foremost, learn to love water!  I am always amazed at the number of patients who tell me that they cannot stand the taste of water.  If you fall into this category, try cutting up a piece of fresh produce like lemon, lime, strawberry, cucumber, or mint leaves and put it into a pitcher of ice water. This is a healthy way to add a mild flavor to the water and make it more palatable.  If that’s not enough flavor enhancement for you, Capella and Yum Drops make naturally flavored drops for your water with the good sweetener Stevia. Give them a try, you might love water again.

What should I do with all of my leftover soda?

Apparently it actually can be used to remove corrosive acid off a car battery – diet or regular soda.  Can you see what it does to your body now?  Kick the soda habit, you’ll be happy you did!

I recently had the pleasure of enjoying an afternoon at the  Musical Instrument Museum  in Phoenix.  If you haven’t made it to the museum yet, I encourage you to do so.  Not only can it be a great way to get out of the summer heat, but you can hear some fantastic music and get an impressive cross-cultural experience.  There’s also a large “hands on” department where kids and adults alike can try for themselves a myriad of unique instruments from around the world.  There’s no other museum in the world with the approach the MIM is taking, and we’re lucky enough to have it in our own backyard.

During my recent visit, one particularly striking feature about the MIM is how quiet the whole place is.  You would expect a musical museum boasting over 10,000 instruments to be quite the cacophony but, in fact, it’s easy to confuse the building as a library.  They achieve this feat through personal headphones that guests wear and, as you approach each exhibit, a sample of music from the displayed instrument is played wirelessly to your own headphones.  Walk away, the music fades out and you’re once again brought back to the silence of the museum.

The whole experience got me thinking about the concept of listening.  I have the honor everyday of listening to my patient’s stories, and I take for granted the listening requirement that my profession entails.  The concept of “conscious listening creates understanding” consistently comes up in the research done in the field of effective listening.  It made me wonder if there are ways to improve our abilities to consciously listen, especially in an ever-increasingly noisy world around us.

Most data suggest that we spend 60% of our time listening but only 25% of that information is retained.  We are simply exposed to so much information that it’s impossible to remember it all and, unfortunately, our listening abilities have been deteriorating over time.  More specifically, with the capacity to record our thoughts in the form of written words or recorded sounds, we can “listen or read it later,” thereby removing the need to pay attention now.  We’re also more impatient, looking for ever-shorter and shorter sound-bytes to summarize ideas.

Yet, there is hope!  I challenge you to take the following three simple steps for the next 30 days and you’ll be on your way to becoming a more conscious listener.  First, take three minutes a day in complete silence (or as close as you can get it).  There are excellent studies demonstrating that as little as three minutes in complete silence actually “recalibrates” your ears and their ability to filter out the noise.  It’s a little like hitting the “reset” button when there is so much stimulation that the brain is overwhelmed.

Next, most of our environments are a complex mixture of sounds, even the seemingly most peaceful ones.  Take for example a city park: children playing, people talking, birds chirping, nearby traffic, etc.  Just try and focus on “one channel” of sound.  In our park example, focus on just the birds.  How many are there?  Where are they?  Try to eliminate all the other background noise.  You’ll be amazed at the subtleties you’ll hear and your ability to truly focus on what’s important in other situations.

Finally, when listening to others, the acronym RASA (Receive, Appreciate, Summarize and Ask) can be a highly effective tool.  In other words, “receive” the words being said to you.  Then “appreciate” what’s being said by saying things like, “uh-huh” and “I see.”  By “summarizing” what was just said, not only do you get a better understanding of what was actually said, the person you’re talking to will truly recognize your ability to listen.  Along that same line, “asking” further questions can solidify your listening experience and create true conscious listening.

The ability to hear is one of our greatest senses but truly listening takes practice.  Use the next 30 days to improve your listening skills and not only will you see improvements in your relationships, but also in your outlook of the world around you.

The sun affects our body’s internal chemistry in two main ways. First it causes loss of fluids and electrolytes, second it induces free radical damage.

Have a great time this summer! Stay properly hydrated and I promise you’ll be able to do more and recover better. Maybe you won’t even mind the heat as much!

By now most of you have read or heard directly from me about my bicycle crash two weeks ago.  I’ve been overwhelmed by the deluge of positive thoughts, emails, cards and well-wishes from everyone.  For those of you who missed the story, I shattered my collarbone into six pieces two weeks ago following a crash during a Saturday century ride.  This photo is right after the crash as my ride-mates loaded my broken bike into the car before my ER visit.  Thirteen screws later, the bone is back into one “piece” and the pain is improving everyday.  With my doctor/patient roles reversed and this being my first broken bone and surgical procedure, it’s been an emotionally eye-opening educational experience for me.  The constant pain and the mental lows lead to my inability to perform my daily work and home responsibilities requiring major adjustments.  No fun.

Yet with the help of my wife, I made some powerful insights that have been invaluable to me and, I believe, to my future practice with my patients.  Maintaining good physical and mental strength through a medical challenge can be, well, challenging.  But with all my down time (I felt like I visited every website ever created) I was able to pour over the research and I think I’ve discovered three approaches that seem to apply to nearly anyone with any difficult medical situation.  If you can implement these three tenets, you should be able to overcome most challenges.  They are:  1) keep moving, 2) monitor your daily progress, and 3) design a healthy environment.

There’s a lot to consider in those three tenets and that last one may sound intimidating, but I promise, they’re all very simple.  First, keep moving.  Our bodies are designed to stay in motion.  In no other time during our history as humans on this planet have we been able to survive through our daily routines with so little physical movement.  From desk jobs to nearly limitless access to goods and services, we physically work much less than we should.  Most studies suggest as little as 30-minutes of dedicated briskly-paced walking can do the trick although upwards of 60-minutes a day is even better.  Even with my busted shoulder, I made it a point to keep moving with walks around the neighborhood to waist-deep plunges in the pool.  Make it a point to move around and your body will thank you for it.

Next, monitoring daily progress.  With half of 2011 already over, you too might see how easy it is to let the days slip by without recognizing both positive and negative changes you make to your lifestyle.  There is nothing more powerful than frequently tracking your progress throughout each day in order to take control of your lifestyle.  I constantly recommend to patients “Diet Diaries,” or writing down everything you eat and drink, along with fitness achievements.  Studies have shown time and time again that this simple approach is more effective than any other strategy at evaluating and modifying basic lifestyle behaviors. With my collarbone, I measured the angles surrounding my shoulder’s range of motion daily, along with slow but daily additions of gentle strengthening exercises.  Sprinkle on multiple cryosauna applications and my surgeon, during a recent follow-up visit, couldn’t believe my progress in two short weeks.

Third, create an environment that is conducive to better health. Surround yourself with positive influences like people who have healthy lifestyles–studies show it will motivate you to do the same.  Think of it as a healthy dose of peer pressure.  Also, build into your daily routine healthy food choices at home and work that are readily accessible. More specifically, if healthy food choices are not easily available at home, when you’re hungry, your concept of what’s healthy quickly becomes skewed.  In addition, when it comes to a healthy diet, use smaller plates (which decreases portion-sizes), serve yourself a healthy portion and then store left overs before eating.  One last strategy I discovered is to consider eating in front of a mirror, which seems weird, I know, but a great German study last year showed it dramatically decreased the amount of calories test subjects ate.  You have incredible control over the environment in which you live.  Take the time to make it conducive to better health.

Finally, after doing all that you can to implement the first three tenets, be sure to be kind to yourself.  Don’t be hard on yourself if you have a tough day and “fall off the wagon.”  Studies show that the stress hormones released as a result of this added pressure on yourself is much more harmful than simply moving back to your healthy baseline. Life isn’t about being perfect.  Do the best you can, strive for your best, but allow yourself to recover from expected and unexpected setbacks.  On the day of my crash I was in great physical shape through great strides I had made during my training.  Instantly I was forced to “slow things down” and quickly have lost my physical stamina.  But, by taking proactive and preventative steps now, including the above ideas, my recovery has been relatively quick.

A major health issue can very quickly derail you from a healthy lifestyle.  But by following the above three tenets, you can regain control of your health, your surrounding environment and treat yourself better than you ever have before.

Money does not buy health or happiness but struggling to survive all but guarantees you won’t reach either.  Ironically, weight gain and diabetes are worse during times of economic uncertainty.

Here’s a really good discussion between Suzie Orman and Jillian Micheals:

http://www.everydayhealth.com/healthy-living/jillian-michaels-interviews-suze-orman-on-health-and-wealth.aspx

In good health,

Dr. C