Low Dose Naltrexone (LDN)

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If you suffer from an autoimmune condition, a central nervous system disorder, or cancer, you may want to explore the option of LDN for treatment. I am particularly fond of LDN because of its low side effect profile and affordability.

What is Naltrexone?

Naltrexone was originally approved in 1984 for the purpose of helping heroin or opium addicts. By blocking the opioid receptors, the person cannot get high when they take heroin or opium. Dosages for this effect is prescribed in the 50-300 mg range. 

LDN for Autoimmunity:

In 1985, Dr. Bernard Bihari discovered the effects of much smaller doses, around 3 mg per day, on the immune system; hence Low Dose Naltrexone. He found that this low dose, taken at bedtime, enhanced a patient’s response to infection by HIV. Over the next decade, Dr Bihari found benefits in autoimmune patients as well. LDN has been useful for a myriad of autoimmune conditions and cancers (please see lowdosenaltrexone.org for a more exhaustive list):

  • Autoimmune Disease
  • Ankylosing Spondylitis
  • Celiac
  • Chronic Fatigue
  • Crohn’s
  • Dermatomyositis
  • Endometriosis
  • Fibromyalgia
  • Hashimoto’s
  • IBS
  • Psoriasis
  • Rheumatoid Arthritis
  • SLE
  • Ulcerative Colitis
  • ALS
  • Autism
  • MS
  • Parkinson’s
  • PTSD

As you can see, LDN treats a wide range of diseases, with a particular benefit seen with autoimmune conditions. LDN works by temporarily blocking endorphin receptors in the brain. Endorphins can be thought of as a natural pain killer, with a ‘feel good’ effect. Because the endorphin receptors are being blocked by LDN, your body reacts by producing more endorphins, and this reduces painful symptoms and produces an increased sense of well being. While the mechanism of use in autoimmune conditions is not fully understood, increased levels of endorphins stimulate the immune system and are anti-inflammatory.

How to Take LDN:

I like to begin on an ultra-low dose and gradually increase over a period of weeks until you are stable and side effect free. I tend towards a more conservative titrating schedule, and we can use a faster protocol on an individualized basis.

Side Effects:

Many patients who start LDN do not experience side effects. Occasionally, during the first week of use, you may have difficulty sleeping or experience vivid dreaming. If this is the case, we can titrate up slower, or back down on dosage. Initially your symptoms may become worse before they improve. Please note that if you are taking opioid medications, LDN can interfere with its efficacy.

When I use LDN:

I like to prescribe LDN in patients who need immediate symptom relief. These patients will typically have an autoimmune condition such as Hashimoto’s thyroiditis or Crohn’s. LDN is typically part of a comprehensive and individualized treatment plan targeted to address the underlying cause of your disease.

References

  1. https://www.ldnresearchtrust.org

  2. http://www.lowdosenaltrexone.org/index.htm#What_is_low_dose_naltrexone

 

 

Skip The Scars: Holistic Acne prevention and Treatment

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Acne is the most common skin disorder affecting adolescents and young adults(1). Acne can cause significant anxiety and psychological stress, and may lead to disfiguring scars that are life long. Acne occurs when cells produce too much keratin (a protein), too much oil, unwanted bacterial buildup, and inflammation.

Conventional treatments include: topical retinoids, peroxides, and antibiotics that can leave the skin dry, red, and peeling. Oral medications like retinoids are teratagenic (cause fetal deformity) and can cause liver damage. Oral antibiotics can lead to dysbiosis and drug resistance. There are various diet and lifestyle recommendations that are supported by evidence to have a positive effect on acne, and with better side effect profiles.

Let’s begin with the diet. Inflammation plays a role in acne, and our diets contribute our overall inflammatory load. There is convincing evidence that dairy consumption is linked to acne. First of all, dairy consumption stimulates the hormone insulin-like growth factor 1 (IGF-1), and just as its name implies, this hormone makes things grow; like acne. IGF-1 also stimulates androgenic hormones, and these hormones stimulate oil production, which is one of the factors associated with acne production. The dairy itself contains hormones known to stimulate oil production and acne formation (2). The mechanisms connecting dairy and acne are convincing enough to recommend the elimination of dairy in acne treatment.

Acne treatment should include a diet that has a low glycemic load and glycemic index. This means that you need avoid sugary, starchy, white colored foods. When we eat foods that raise our blood sugars, our pancreas releases insulin and elevated blood levels of insulin stimulate androgenic hormones. Androgenic hormones stimulate acne. Elevated insulin also stimulates IGF-1, which we already know is involved in the process of acne formation (3). Work by Cordain et al, supports the notion that high glycemic diets contribute to acne production. Looking at 1,315 people of non-western societies in Papua New Guinea and Paraguay, NOT ONE single case of acne was observed! Compare this to 79-95% of westernized teenagers suffering from acne! This dramatic difference cannot be contributed to genetics alone, and it is reasonable to attribute, at least in part, this outrageous acne occurrence to the western diet, high in cereals, packaged, and starchy foods.  

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Now let's talk nutrients. Zinc is a micronutrient that been shown to be an effective acne treatment in several trials(4). In a double blind study, 91 participants were given either 400 mg of oral zinc sulphate or placebo for 12 weeks. Significantly better results were demonstrated in favor of the zinc group (5). Zinc is an essential nutrient for the development and function of human skin and it has been shown to be effective at killing the bacteria associated with acne (2). Consider zinc in your acne plan, and keep in mind that zinc should be taken with food to avoid nausea. When we are exposed to toxins and stress our cells undergo oxidative stress and this plays a key role in acne progress (6). Exposure to free radicals happens from eating too much sugar/refined carbohydrates, exercising too little or much, drinking too much alcohol, smoking, air pollution, stress, etc. Since oxidative stress is implicated in acne, then treatment of acne warrants anti oxidants. And in fact, when given vitamin E and selenium for 12 weeks, both of which are antioxidants, skin improved (7).

Fish oil is abundant in essential fatty acids and benefits acne, especially mild to severe types (8).  Consuming a lot of omega-3 fatty acids, as found in fish oil, can stop inflammation, and inflammation is foundational in acne production.

Acne sucks, and the majority of us have, at least at some time in our lives, experienced it. Eating a dairy-free, whole foods diet that consists mainly of veggies, fruits, whole grains, legumes, and quality-sourced proteins and excludes packaged, sugary, and starchy foods are key to regulating the hormones involved in acne. Several nutrients are worth trying, such as zinc, omega 3 fatty acids, and antioxidants before using antibiotics, hormones, or Accutane.

For a customized plan that includes a comprehensive gut cleanse to address your acne, schedule now for a new patient visit. I take most insurance plans!

Reference:

  1. https://www-uptodate-com.nunm.idm.oclc.org/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-acne-vulgaris?search=acne&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884775/#CIT0024

  3. https://www.ncbi.nlm.nih.gov/pubmed/12472346

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120804/#B23

  5. https://www.ncbi.nlm.nih.gov/pubmed/146511

  6. https://www.ncbi.nlm.nih.gov/pubmed/24795060

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884775/

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543297/

Preventing Cellular Aging: Tips, Recipes, & Maximizing Food Nutrition

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For the past month or so, I’ve been speaking around the Portland area on preventing cellular aging.  Below is a compilation of the presented material. Each recommendation has been substantiated through research to support the aging process through cancer prevention, neurological preservation, and/or cardiovascular protection.

Sulforaphane (SFN) is a chemical found in cruciferous vegetables. Cruciferous veggies: broccoli, broccoli sprouts, cauliflower, brussels sprouts, green and red cabbage, collard greens, mustard greens, kale, bok choy, swiss chard, watercress, turnips, rutabaga, and radishes.

There is a lot of research that supports the use of SFN in supporting healthy aging.

  • SFN has been shown to reduce cancerous activity in mice (1)

  • Slowed the doubling rate of CA biomarker (PSA) by 86% (2)!

  • SFN reduced extent of brain damage post epilepsy by protecting brain mitochondria

  • SFN given daily x 10 weeks lowered inflammation (4). These markers IL-6 and CRP are predictors of physical and cognitive performance (5)

  • SFN helps us excrete toxins, therefore preventing the buildup and potential DNA damage (6)

 

Instructions for growing broccoli sprouts (7):

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  1. Add 2 tablespoons of broccoli sprouting seeds to a wide mouthed quart jar.

  2. Cover with a few inches of filtered water and cap with the sprouting lid.

  3. Store in a warm, dark place overnight. I use a kitchen cabinet for this.

  4. The next morning, drain the liquid off and rinse with fresh water. Be sure to drain all the water off.

  5. Repeat this 3-4 times a day. Continue to store your seeds in a warm, dark place. After a few days, the seeds will start to break open and grow.

  6. Eventually, the sprouts will be an inch or so long and have yellow leaves. Now you can move the sprouts out into the sunlight.

  7. Continue to rinse them 3-4 times a day until the leaves are dark green. Now they are ready to eat!

  8. This whole process will take about a week. Patience is key!

  9. Once they are ready, replace the sprouting lid with a standard mason-jar lid and store in fridge.

Serve on top of salads, stirred into soups, or however strikes your fancy!

Vitamin D is actually a steroid hormone that controls the expression of over 1000 genes. Vitamin D levels that are too low and too high are associated with increased incident of death from all disease (8).

  • Low levels of vitamin D reduced the risk of cancer by 67% (9)

  • Mice with both deficient and excess vitamin D levels exhibited shortened lifespan and premature aging (10)

  • Vitamin D effects brain cells by modulating brain inflammation that is associated with neurodegenerative and neuropsychiatric diseases with an inflammatory component (11)

Vitamin D comes from UVB radiation from the sun. Factors that reduce our levels of vitamin D include: wearing sunscreen, darker skin color, aging, and obesity. Get your levels tested! This is a simple blood test that your doctor can order. In the meantime, get outside in the sun let your skin be exposed. Food sources of D include mushrooms that have had sun exposure and oily fish such as salmon, mackerel, sardines, and herring.

Folate: required B vitamin to replicate DNA when a cell replicates itself. Also required in a pathway that inhibits the buildup of homocysteine. Elevated homocysteine levels are associated with increased risk for cardiovascular disease.

  • Folic acid affects mood and cognitive function, especially in older people. Adult patients with anemia due to folate deficiency, approximately 2/3 have neuropsychiatric disorders (12)

  • A study using mice showed that a diet sufficient in folate resulted in less cancer expression as compared to a diet deficient in folate (13)

Top 10 Folate Rich Foods (14)

  1. Garbanzo beans, ½ cup: 557 mcg

  2. Liver, 3 oz, 221 mcg

  3. Pinto Beans, ½ cup, 146 mcg

  4. Lentils, ½ cup, 179 mcg

  5. Spinach, 1 cup, 56 mcg

  6. Asparagus, ½ cup, 134 mcg

  7. Avocado, ½ cup, 61 mcg

  8. Beets, ½ cup, 68 mcg

  9. Black eyed peas, ½ cup, 112 mcg

  10. Broccoli, 1 cup, 57 mcg

Magnesium: an abundant mineral in the body that is a cofactor or more than 300 enzyme reactions. Magnesium involved in everything from protein and energy production to cell replication. Low Mg is associated with a decline in memory, poorer muscle and bone integrity, and some forms of cancer (15). Recommended intake is about 400 mg for an adult and increases as we age.

Here are the top 10 Magnesium-rich foods (taken from the USDA) (16)

  1. Spinach, cooked – 1 cups: 157 mg

  2. Swiss chard, cooked – 1 cup, 150 mg

  3. Dark chocolate – 1 square, 95 mg.

  4. Pumpkin seeds, dried – 1/8 cup, 92 mg

  5. Almonds – 1 oz, 75 mg

  6. Black beans – ½ cup, 60 mg

  7. Avocado – 1 med., 58 mg

  8. Figs, dried – ½ cu, 50 mg

  9. Yogurt or kefir – 1 cup, 46.5 mg

  10. Banana – 1 med., 32 mg

Microbiota and Microbiome: there are more bugs than there are cells in the human body, and the microorganisms in our gut encode genes and are involved in metabolic reactions. Having a robust and diverse microbial makeup is associated with decreased levels of inflammation (17). This is important, because most age related diseases are associated with increased inflammation. Incorporate foods that have probiotics such as kimchi, kombucha, sourkraut, natto, pickles, yogurt, kefir, tempeh, etc. These foods add bugs to our environments. In order to keep these bugs alive, we need to eat foods that are high in fiber. It is the fiber that feeds the bugs. Foods high in fiber include: vegetables, fruits, legumes, and whole grains.

Sauna Use: regular use of the sauna has been shown to benefit the aging process. Moderate to high frequency (4-7 days per week) is associated with lowered risks for dementia and Alzheimer’s (18). Frequent sauna use is associated with lower systemic inflammation (19). And the more you use the sauna the better!  In one study, the rate of death from cardiovascular disease and stroke decreased as sauna frequency increased (20).

Fasting: Prolong caloric restriction,that is reducing your calories while maintaining proper nutrition, has been found to extend life span. Rodents whose calories were restricted by 55-65% had a 36-65% greater mean lifespan and results were also seen with a 20-40% reduction in calories (21).
 

References:

  1. https://www.fasebj.org/doi/abs/10.1096/fj.05-4785fje

  2. http://cancerpreventionresearch.aacrjournals.org/content/8/8/712

  3. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/26365487

  4. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/29573889

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891873/

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125483/

  7. http://www.urbanorganicgardener.com/2015/11/how-to-grow-broccoli-sprouts-at-home-super-healthy/

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/

  9. https://www.sciencedaily.com/releases/2016/04/160406165254.htm

  10. https://www.ncbi.nlm.nih.gov/pubmed/19444937

  11. https://www.ncbi.nlm.nih.gov/pubmed/24934545

  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123448/

  13. https://www.ncbi.nlm.nih.gov/pubmed/29546304

  14. https://draxe.com/top-10-vitamin-b9-folate-foods/

  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790427/

  16. https://draxe.com/magnesium-deficient-top-10-magnesium-rich-foods-must-eating/

  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257741/

  18. https://www.ncbi.nlm.nih.gov/pubmed/27932366

  19. https://www.ncbi.nlm.nih.gov/pubmed/29209938

  20. https://www.health.harvard.edu/blog/sauna-use-linked-longer-life-fewer-fatal-heart-problems-201502257755

  21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919445/

Everything you need to know about Sunscreen: A Full Spectrum Guide

Summer is here!

Summer is quickly approaching and so is our exposure to the sun. While sunlight is essential for vitamin D production, it’s also responsible for sunburn, photoaging, and skin cancer. There are two types of ultraviolet (UV) radiation that reach the earth’s surface: UVB and UVA. UVB is responsible for sunburn, freckles, and cancers, while UVA is responsible for photoaging, tanning, and skin cancers as well.  Protecting yourself against UVA and UVB radiation includes: avoiding the sun during peak hours, wearing sun-protective clothing, and sunscreen(1).

When it comes to sun exposure, smart, common sense knowledge can be used here.  To avoid skin damage and sunburn, avoid spending extended time in the sun and seek shade, avoid tanning beds, and tan gradually, without burning.  Wear brimmed hats, protective clothing, and use extra caution near water, snow, and sand. We want to avoid sunburns because history of severe sunburns is associated with an increased risk of melanoma, the most deadly skin cancer(2).  UV exposure may account for up to 80% of visible signs of aging of the skin(3).  

What to Look For in Sunscreen

When extended sun exposure is unavoidable, it is recommended that you protect yourself with sunscreen(4).  There are a few details to look out for when purchasing a sunscreen:

  • Broad-spectrum protection: protects us against both UVA and UVB rays.  

  • Look for a mineral based product with ingredients such as zinc oxide, avobenzone(5), or Mexoryl SX because these are the only ingredients that provide true broad-spectrum protection.  AVOID products containing oxybenzone and retinyl palmitate.

  • SPF (sun protection factor) of 30 or higher.

  • Water-Resistant

  • Sunscreen Cream is superior to spray because they do not pose an inhalation risk and are more likely to provide a thick and even coating on the skin.

How to Appropriately Apply Sunscreen

Studies show that you are likely not applying sunscreen sufficiently7.  According to the American Academy of Dermatology(8):

  • Use enough sunscreen to generously coat exposed skin

  • Mantra “1 ounce, enough to fill a shot glass,” which is considered the amount needed to cover exposed areas of the body.  Adjust according to your size.

  • Apply sunscreen to dry skin 15 minutes BEFORE going outdoors.

  • Skin cancer can also form on the lips to protect your lips with a lip balm of 30 SPF or higher.

  • Reapply every two hours or after swimming or sweating.

Avoiding Oxybenzone and Retinyl Palmitate

According to the Environmental Working Group, 2/3 of sunscreen products contain worrisome ingredients such as oxybenzone, a hormone disruptor, or retinyl palmitate, a form of vitamin A that may harm skin(9).  In fact, government data shows more skin tumor and lesions on animals treated with vitamin A and then exposed to sunlight10.  We want to avoid use of oxybenzone because it has been shown to cause damage and deformation of coral by acting as a hormone disruptor and damaging DNA of coral larvae.  It has also been shown to cause coral bleaching and even coral death. Oxybenzone is widely used in non-mineral sunscreens despite these findings. I do not recommend using any type of hormone disruptor on your skin, and especially not on the skin or your baby.  

A Word on Vitamin D

To ensure that you are getting proper vitamin D levels (because sunscreen blocks vitamin D synthesis), I recommend that you know your levels!  In the meantime, enjoy about 20 minutes of sun exposure without the sunscreen, integrate fish into your diet, and supplement appropriately. Please note that too much vitamin D is just as bad as too little.  

Thank you for reading!

References:

  1. UpToDate: Selection of Sunscreen and sun-protective measures by Elma D Baron MD.  Last updated 4.10.2018

  2. https://www.ncbi.nlm.nih.gov/pubmed/27045074

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344124/

  4. https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs

  5. https://www.ncbi.nlm.nih.gov/pubmed/20806994

  6. https://www.ncbi.nlm.nih.gov/pubmed/18717957

  7. https://www.ncbi.nlm.nih.gov/pubmed/24313722

  8. https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs

  9. https://www.ewg.org/sunscreen/report/executive-summary/

  10. https://www.huffingtonpost.com/2011/08/18/vitamin-a-for-skin_n_927450.html

The Benefits of Sauna Use

Sauna Bathing Benefits

Sauna bathing has been used throughout the world and for thousands of years, with a substantial amount of supporting evidence.  Using the sauna can enhance your physical performance; while reducing your risk of cardiac, all-cause mortality, Alzheimer’s disease, and dementia.  

In a crossover study, six male long-distance runners completed three weeks of sauna use after exercise, three weeks without, and with a three week washout period.  Relative to the control weeks, sauna bathing increased run time to exhaustion by 32%. Plasma and red cell volumes increased by 7.1% and 3.5% respectively. The authors concluded that three weeks of post-exercise sauna use produced a worthwhile improvement in endurance, likely by increasing blood volume. Having more blood cells is advantageous because more oxygen gets to the tissues.

Men who engaged in frequent sauna use had reduced risks of fatal cardiovascular events and all-cause mortality!  2,315 middle-aged men living in eastern Finland over a 21 year period were put into one of 3 categories: those that used the sauna 1 time per week, 2-3 times per week, or 4-7 times per week.  The risk of sudden cardiac death, fatal coronary heart disease, and all-cause mortality was greater in the group that used the sauna one time per week as compared to the group who went 4-7 times per week.  The more the men used the sauna, the greater the protection.

Sauna use is also protective against dementia and Alzheimer’s disease.  Using the population above, after follow up at 20 years, 204 men were diagnosed with Alzheimer’s disease, and 123 were diagnosed with dementia.  After adjusting for compounding factors (like age, diabetes status, smoking, etc.) compared with men who only used the sauna once a week, the men who used the sauna 2-3 times per week had a lower rate of these neurodegenerative diseases and the men who used it 4-7 times had an even lower rate of these diseases. Using the sauna in this Finnish population lowered the risk of dementia and Alzheimer’s.

As for the amount of time needed to achieve benefit, it looks like a good estimation is to stay in for at least 20 minutes.  The temperature used in the endurance enhancement study was about 195 degrees F. We are all individual though, so use common sense and listen to your body.  


References

  1. https://www.ncbi.nlm.nih.gov/pubmed/16877041

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824146/

  3. https://www.sciencedaily.com/releases/2015/02/150223122602.htm\

  4. https://academic.oup.com/ageing/article/46/2/245/2654230

Male Pattern Baldness and the PRP Solution

The most common form of hair loss in men is termed androgenic alopecia, affecting 30-40% of men by the age of 50 (1).  The pattern typically affects the temples, top of the head, and the frontal hairline. While this is considered a minor condition, hair loss can impact self-image and cause anxiety and depression in some men.  Heredity plays a huge role in male pattern hair loss.

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Hair growth occurs in a cycle and broken into 3 different phases: growth, regression, and resting. These phases are regulated by internal and external factors throughout ones life.  Baldness occurs when the resting phase of the hair follicle gets longer and the growth phase of the hair follicle gets shorter. Before a growth phase is initiated, stem cells surrounding the hair follicle become active.  When hair follicle cells regress, or return to their less developed state, cells surrounding the follicle are seen dying. And during the resting phase, hair follicle cells are basically in a state of inactivity (2).

Platelet-rich plasma has shown remarkable beneficial effects to treating hair loss in men without any major adverse reactions.  The patient’s blood is used to extract their own platelets and then the platelets are injected into the area of baldness. The basic idea behind PRP injections is to deliver a high concentration of growth factors to the scalp, with the hope of stimulating hair growth and improving the function of the hair follicle (3).  Under microscopic evaluation, the hair follicles increase in numbers, more blood flows to the follicle, and there is increased cellular activity (4).

In a review of literature looking at twelve studies conducted from 2011-2017, and using a total of 295 subjects, most of the studies reviewed showed effectiveness of PRP in increasing hair density and diameter (5).  Another study, using 20 people, revealed a mean increase of 33.6 hairs in the target area and a mean increase in total hair density of 45.9 hairs per cm2,5.  Using PRP therapy for male pattern baldness has been proven to be effective. Many products like Rogaine must be used continually throughout one’s life, and when treatment stops, the hair falls out again. With just a few treatments of PRP, you’ll see more lasting results without any major side effects.

For more info on how PRP can help, contact my office.

  1. https://www.ncbi.nlm.nih.gov/books/NBK278957/

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762894/

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562137/

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622412/

  5. https://www.ncbi.nlm.nih.gov/pubmed/29457005

Female Pattern Hair Loss: What it is And what to do about it

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Female pattern hair loss is a condition that is characterized by the loss of the thick, long, and dark hairs mainly on the top and frontal parts of the head, resulting in a visible reduction in hair density. This process of the thick hair being replaced by thinner hair is called follicular miniaturization. Hair loss among women is common, with some studies finding a prevalence of 19% (1) - about 20 women for every 100! This occurs in adult women of all ages, but mostly to those postmenopausal. Why this occurs is not fully understood and may be from genetics, a hormone imbalance, or both. Female pattern hair loss does not cause discomfort or disability, but can contribute to significant psychological distress.

If you are experiencing hair loss, go see your doctor! There are a few conditions that should be evaluated for like iron deficiency anemia, thyroid disease, and sex hormone imbalance. In a series of 109 women with moderate to severe hair loss, there was evidence for elevated male sex hormones in 39% of the women (2).

Left untreated, female pattern hair loss results in a slow, progressive decline in the density of scalp hair. Traditional first line therapy includes topical minoxidil for one year, however this does not work for everyone. Shedding of the hair commonly occurs during the first 2-8 weeks of treatment with minoxidil with other potential side effects of scalp itching, flaking, and facial hair growth.

I’m excited to be offering a treatment for female pattern hair loss that utilizes your own body’s growth factors to stimulate hair growth. Platelet rich plasma (PRP) has been used for the treatment of hair loss in both men and women. A placebo-controlled, randomized, half-headed trial that included 12 men and 13 women with androgenetic alopecia (hair loss) found greater increase in hair density in sites treated with PRP compared with control sites six months after the first of three monthly PRP treatments (3). Another study looked at 10 people who were not responding to topical minoxidil or antiandrogens and concluded that PRP had a positive therapeutic effect on hair density and diameter with no adverse events reported (4).

 (a) A 51-year-old female with female androgenetic alopecia Ebling III, (b) excellent improvement at 3 months using PRP and (c) further improvement after 6 months, with a decrease of one grade in Ebling's scale (Ebling II). See  more pictures. 

(a) A 51-year-old female with female androgenetic alopecia Ebling III, (b) excellent improvement at 3 months using PRP and (c) further improvement after 6 months, with a decrease of one grade in Ebling's scale (Ebling II). See more pictures. 

This is an in-office procedure that involves taking a sample of your blood, spinning it down in a specialized centrifuge, activating your platelets with specific nutrients, and injecting this into the scalp. The solution contains your very own growth factors that act to stimulate the hair follicles for hair production. A complete treatment includes one treatment per month for a total of six months.  

Stay tuned for next week's blog post where we'll be discussing how PRP can help with hair loss in men. For the month of May only, all PRP services will be 20% off. Contact my office for full pricing details.

1.  https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed?myncbishare=ncnm&holding=ncnmlib&term=11231244

2.  https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed?myncbishare=ncnm&holding=ncnmlib&term=3192772

3.  https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed?myncbishare=ncnm&holding=ncnmlib&term=27035501

4.  https://www.ncbi.nlm.nih.gov/pubmed/29707872

5.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655625/

 

The Magic of Sulforaphane

Sulforaphane (SFN) is a compound found in cruciferous veggies such as broccoli, cabbage, cauliflower, and kale.  It has been shown to stop tumors from growing in mice (1), it helps our bodies defend itself against reactive oxygen species (2), and has anticonvulsant/epileptic effects by protecting the brain.  SFN has been shown to enhance mitochondrial (the energy making part of the cell) function and it significantly decreases inflammation(3), both of which are linked to the aging process.

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SFN and Tumor Suppression

When mice were fed SFN, within 6 hours, there was a positive genetic change in the colon tumor cells.  There was a 50% reduction in the cancer cells ability to replicate itself. Further, dietary SFN in mice for 10 weeks resulted in suppressed tumor multiplicity as compared to mice fed a control diet.  After the 10 weeks, the average tumor yield was lowered by 50% in all regions of the intestine. Based on this data, it is reasonable to say the SFN rich foods, namely cruciferous vegetables, have anti cancer effects.

SFN as an Anticonvulsant and Mitochondrial Supporter

SFN has been shown to active nuclear factor erythroid-2 (Nrf2).  This is worthy because NrF2 proteins regulate the cell’s capacity to defend its DNA from oxidative damage. NrF2 activation can occur in brain tissue, where oxidative damage occurs, thereby protecting the tissue.  SFN treatment reduced the extent of brain damage in post-epileptic state 24 hours after the epileptic episode and protected the brain’s mitochondria. SFN has been shown to protect our mitochondria! Mitochondria decline is associated with normal aging and is correlated with the development of a wide range of age-related disease (4).

SFN and Inflammation

40 healthy overweight people were given 30 g of SFN everyday for 10 weeks with a follow up phase of 10 weeks without SFN.  There was a significant decrease in inflammatory markers IL-6 and CRP. Elevated IL-6 and CRP are indicators of inflammation, and chronic, low-grade inflammation is a risk factor for the development of age-related diseases\ and frailty (5).

Yet another reason, or many reasons,  to include broccoli, kale, cauliflower, mustard greens, watercress, and all the other cruciferous veggies into your diet.  The research speaks for itself.

 

Reference Links:

  1. https://www.fasebj.org/doi/abs/10.1096/fj.05-4785fje

  2. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/26365487

  3. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/29573889

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779179/

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891873/

Vitamin D: A Requirement for Healthy Living and Longevity

Vitamin D is a fat-soluble vitamin that acts as a steroid hormone and controls the expression of many genes. Our primary source of vitamin D occurs through UVB radiation by the sun onto our skin. To note, mushrooms that have been in the sun also have the capacity to make vitamin D with sun exposure.

Several factors predispose us to vitamin D deficiency and these include: skin pigmentation, aging, obesity and sunscreen use (1). In fact, using sunblock with SPF 15 or higher blocks 100% of vitamin D production in the skin. And if you have more skin pigmentation, then you require 3-5 times longer exposure to make the same amount of vitamin D as a person with white skin tone because melanin is a natural sunscreen. A 70 year old produces 4 times less than a 20 year old. And lastly, it is possible that deficiency in this vitamin is more prevalent among obese individuals because the vitamin gets diluted throughout the body (2). Other sources include oil-rich fish such as salmon, mackerel, and herring and mushrooms that have been in the sun.

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Having adequate levels of vitamin D is very important because it regulates calcium, phosphorous, and bone metabolism. vitamin D deficiency is associated with Alzheimer’s disease, Parkinson’s, cognitive impairment, and cancer. Actually, there is an increase in all-cause mortality associated with D deficiency (1). There is a lot of research emerging in this field supporting the optimization of D levels. For example, high-dose vitamin D supplementation improves visual memory (3), vitamin D deficiency during pregnancy has been linked to autism (4), and vitamin D supplementation (along with Calcium) is shown to prevent colon cancer, to name a few (5).

When it comes to longevity, vitamin D plays a critical role. In one study, vitamin D extended the median lifespan of a nematode by 33% by engaging in known longevity genes (6). In another study looking at stress, mood, and longevity, vitamin D (along with other compounds) may act on certain genes and promote longevity (7). Telomeres are a way to measure our cellular age. They exist at the ends of chromosomes and function to protect DNA.  Each year we age, our telomeres shorten until the cell dies (8). Individuals in the highest quartile between 40-60 nmol/L had longer lifespans (9). Further, mice that had both too little and too much vitamin D experienced premature aging (10).

Everyone should have his or her vitamin D levels checked at least once per year. Don’t just supplement blindly because too much vitamin D can be just as bad as not enough! Aim for levels between 30 and 80 ng/ml and keep in mind that vitamin D deficiency is VERY COMMON, especially to us living in the good ol’ Pacific Northwest where the sun don’t like to shine.

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/
  2. https://www.sciencenews.org/article/link-between-obesity-and-vitamin-d-clarified
  3. https://www.ncbi.nlm.nih.gov/pubmed/28167237
  4. https://newatlas.com/vitamin-d-autism-pregnancy/46956/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466388/
  6. https://www.eurekalert.org/pub_releases/2016-10/bifr-anl101716.php
  7. https://www.sciencedaily.com/releases/2016/05/160524085357.html
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2196219/
  9. https://www.ncbi.nlm.nih.gov/pubmed/19444937
  10. https://www.ncbi.nlm.nih.gov/pubmed/19500727
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912737/

All May Long: Detox Your Body

It’s become clear that our bodies are toxic. We expose ourselves every day through the air we breathe, the food we eat, and the products we clean with and put on our skin. In fact, at present, there are 80,000 chemicals in the US and it is estimated that 2000 new chemicals are created each year without Environmental Protection Agency’s regulation! Since we’re exposed to toxins daily, our bodies have to work hard to clear them. It’s therefore important to strengthen our ability to detoxify, and lower our toxic load. Check out the symptoms list on the right to see if you may be experiencing toxic buildup.

 Nettles are incredible at eliminating toxins in the body. Be aware that small spikes on the plant require careful handling and preparation. 

Nettles are incredible at eliminating toxins in the body. Be aware that small spikes on the plant require careful handling and preparation. 

For most of us, it’s the small exposures each day that can accumulate in our tissues and cause us to become toxic. In order to keep from building up this toxic burden, our body has to effectively break them down and eliminate them. This is why it’s important for us to undertake a specialized detoxification program to strengthen our ability to to clear these toxins.  By doing so we take the stress off our energy system.

Starting May 1st, I'll be running a detox program for the entire month of May. This program comes with all that you'll need to get your holistic detox underway, including a 30-day supply of all of the supplements you'll need, educational material, meal plans, recipes and four in-person group meetings facilitated by myself and Dr. Sage Dillon at The Bodhi Tree.

If you have always wanted to do a detox program, this is the one! I invite you to experience a program that will take you to your next level of health.  Whether you have a chronic health condition, want to clear toxins and feel good, or just want to lose weight, this is a great way to experience renewed vitality and start a new, healthy detox lifestyle.

 

About the program:

The cost of the full detox program is $450, but it's $399 if you sign up by Monday, 4/16. Sign up here or contact my office for more details! 

I'm looking forward to helping you on your journey to detoxification this May. I hope you'll join me. 

-Dr. Heather

 

Official flier: 

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Symptoms of Toxicity Include:

  • Runny nose
  • Nervousness
  • Sleepiness/Insomnia
  • Dizziness
  • Mood changes
  • Anxiety/Depression
  • Fatigue
  • Skin rashes
  • Nausea
  • Indigestion
  • Bad breath
  • Immune weakness
  • Allergies
  • Headaches
  • Joint pains
  • Cough/Wheezing
  • Sore throat
  • Tight or stiff neck
  • High blood fats
  • Backaches
  • Itchy nose
  • Frequent colds
  • Irritated eyes
  • Environmental sensitivity
  • Constipation
  • Weight gain

Problems Related to Toxicity Include:

  • Acne/Eczema
  • Asthma
  • Colitis
  • Diverticulitis
  • Hepatitis
  • Heart disease
  • High Blood Pressure
  • Parasites, bacteria, yeast worms, and fungus
  • PMS
  • Bronchitis
  • Drug addiction
  • Smoking
  • Neurological issues
  • Kidney Disease
  • Diabetes
  • Migraines/Headaches
  • Gallstones
  • Gout
  • Ulcers
  • Varicose veins
  • Fibroids
  • Cancer
  • Autoimmune conditions
  • Brain fog
  • Hemorrhoids
  • Eye problems
  • Stroke

The Power of Folic Acid

Folic Acid is a water-soluble vitamin, AKA vitamin B9, and is found naturally in plants such as dark leafy green vegetables.  Humans cannot make folic acid therefore we must get it through our diet or with supplements.  Why do we need folate? According to Dr. Rhonda Patrick, we need folate because it serves as a precursor to DNA nucleotide thymine, which we need to make new cells.  Without thymine production, uracil builds up and can cause mutations.  Translation: folate is needed to make new cells and to prevent cancer.  We also need folate because it serves as a precursor to create methyl groups which are used as an OFF (or sometimes on) switch for genes. This is important because it allows cells to adapt to their environments. Methyl groups created from folate can also convert homocysteine, which plays a role in stroke, vascular dementia, and cardiovascular disease, back into methionine.  Folate deficiency therefore increases our risk for heart disease, stroke, and dementia.

The recommended daily intake in adults is 400 mcg of folate per day.  If you are pregnant or nursing, make sure you are getting at least 600 mcg per day.  Below is a table with common foods and their folic acid content:

folic-acid.jpg

There are a couple ways to assess your folate levels. If you are interested in knowing your folate status ask your doctor to test.  You can ask for a red blood cell folate concentration and this will give you your long term folate status.  You can also have your homocysteine levels checked as a way to asses folate levels as well.  This is a common amino acid that is used to screen for cardiovascular risk.  Lastly, we can look at your genetics to see if you have the capacity to metabolically use folate efficiently.   As a patient of mine, I walk you through the various testing options and together we choose the best option for you.

Resources:

  1. https://www.ncbi.nlm.nih.gov/pubmed/27008500

  2. https://thecompleteherbalguide.com/entries/vitamins-minerals/folic-acid-and-what-does-it-do/

  3. Dr. Rhonda Patrick <https://www.foundmyfitness.com>

Staying Healthy for Spring

Chinese medicine dates back over 2000 years.  This is ancient knowledge from classic texts and wisdom passed down through lineages.  

My goal for you is to be inspired to make healthy choices and have a basic understanding of Chinese Dietetics and recommendations for spring. Chinese medicine includes: acupuncture, cupping, moxabustion, exercise, and dietary therapy.

Chinese culture believes that we are a part of Nature and not separate from it.  We are subject to, and dependent on its processes. For example, in the winter months we see nature go inwards.  The trees lose their leaves and days are darker. Following the processes of nature, we go inwards too, taking time to reflect, sleep, and make stews around the stove.

As we enter spring, we notice that nature is coming alive.  There is movement upwards. The bulbs come to flower and buds double in size everyday.  Ancient texts tell us to ‘rise early’ and ‘take brisk walks.’ We spring into action with activities that mirror the ascending qualities of nature.  This is the time to start those projects you have been reflecting upon this past winter. Push the boundaries of comfort and grow as a human being.

In Chinese medicine, each season has an associated organ system.  In the summer it’s heart/fire, fall is lung/metal, winter is kidney/water, and spring is represented by liver/wood.  We are in the wood part of the year represented by the liver and the gallbladder organ systems. These are the executive organs, the organs that make decisions and make things happen.  

 Herbs like basil, oregano, mint &amp; rosemary can help stimulate blood circulation, and are pungent foods recommended for springtime by Chinese Dietetics.

Herbs like basil, oregano, mint & rosemary can help stimulate blood circulation, and are pungent foods recommended for springtime by Chinese Dietetics.

There are five flavors in Chinese medicine.  These include: bitter, sweet, pungent, salty, and sour.  In Chinese medicine, the energetics of foods in considered.  Some foods have an upward energy while other downward. Salty has a downward motion and pungent and sweet upwards.  Just as nature during the spring has an upward motion ie the bulbs flower and trees bud, so should we eat upward moving foods.  

During the spring we eat sweet and pungent foods.  Most vegetables are sweet: carrots, cabbage, cucumber, squash, and pumpkin.  As are most fruits, nuts, grains, meats, and seafood. Herbs exemplify the pungent flavor: basil, rosemary, mint, oregano, etc.  Mother foods like garlic and celery are both pungent and sweet!

There are a few rules indicated in Chinese texts regarding eating to stay healthy in the spring.  The first is to eat less. During the spring months, we eat the least amount of food as compared to any season.  This is cleansing time and a time for mental clarity. Next, we eat pungent and sweet foods such as young veggies (thinned from our spring gardens).  Lastly, food is cooked at high temperature and for short amount of time so that the veggies remain raw on the inside.

Being the liver time in Chinese culture, it makes sense to focus on detoxifying and cleansing.  The liver bears the burden when it comes to staying healthy. Any herbicide, pesticide, formaldehyde, and plastic have to be processed through the liver, not to mention medications as well.  The liver functions as a detoxifier and its cellular processes are dependent on nutrients retrieved from the food we eat. This is why it is so important to eat REAL food and avoid processed and packaged food because these foods contribute to the liver’s burden.  Vegetables and whole foods help the liver. Vegetables are excellent sources of antioxidants which scavenge for toxic chemicals that damage our cells. The liver also is responsible for digesting fats and this process is dependent on nutrients such as carnitine, choline, and inositol.  Some examples of these foods: fish, avocado, eggs, cauliflower, lentils, cabbage, molasses, nutritional yeast, and brown rice to name a few. Integrating a variety of herbs and spices such as ginger, turmeric and dandelion all aid in liver support.

MORE ON DETOXIFYING:

Just as nature is moving, so too should we.  The emunctaries are our organs of elimination.  We eliminate by sweating through the skin, movement through the colon, urine through the kidneys, breath through the lung.  There are a few detoxification activities that aid the emunctaries.

  • Dry skin brushing: using a loofah or washcloth gently rub your dry skin with the dry sponge.  Start at your hands and work towards your chest. Then rub from your feet, up your legs, abdomen, and work towards your heart.   This moves the lymph and exfoliates your skin.

  • Castor oil packs: Place a dime size amount of castor oil in your hand and over your liver.  Put on an old t-shirt followed by a hot water bottle. Let this be for 30 minutes,

 

References:

Maciocia, Giovanni.  The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists.  Elsevier, Churchill, Livingston. London 2005.

Kasner, Joerg.  Chinese Nutrition Therapy: Dietetics in Traditional Chinese Medicine.  Georg Thieme Verlag. Germany 2004.

Pitchford, Paul.  Healing with Whole Foods: Asian Traditions and Modern Nutrition.  North Atlantic Books. Berkeley, CA. 2002.

Small Daily Changes to Improve Stress Response

We now know that the adrenal glands, which sit atop our kidneys, are responsible for responding to stressful situations by releasing cortisol into the bloodstream. Over time, this system can be become tired and our stress response suffers. A maladaptive stress response may be an underlying cause of your health concerns. If you answered yes to at least 3 of the questions on the quiz at the bottom, I highly recommend the following lifestyle recommendations. You can refer back to last week’s blog for insight into testing options. I find better outcomes in-clinic when we have the information from labs to work with.

1.  Increase your exposure to light. After moving from a dark room into a room full of daylight, individual cortisol levels increased by 50% or more within minutes!

Try getting outside in the first hour of waking, as this can potentiate your Cortisol Awakening Response, and that is important in setting your daily clock. Our bodies thrive on rhythm.

2.  Avoid exposure to toxins. Among the endocrine (hormone producing) organs, the adrenal cortex appears to be the most vulnerable to chemically induced injury. Here are a few strategies to mitigate toxic exposure:

  • Eat organic. Especially when it comes to meat and dairy because toxins are stored in fat, and these foods have the most fat. According to the environmental working group, the most heavily sprayed produce in the US includes: strawberries, spinach, nectarines, apples, peaches, pears, cherries, grapes, celery, tomato, and sweet bell peppers. Be sure to buy these foods organic!

  • Use ‘Green’ cleaning products.

  • Avoid plastic water bottles, use glass whenever possible, and avoid consuming products that have been exposed to heat in plastic.  

3. Consume high quality protein and fat in your diet! A few studies have shown that cortisol levels are elevated by a protein rich meal. For the average person, with moderate physical activity, I recommend around 60 g of protein per day. Aim for 20 mg at breakfast.

4. Move your body. Exercise has positive effect on health. If your cortisol levels are low, then it is not recommended to use high intensity exercise on a daily basis because this can further potentiate the dysfunction. Instead, use moderate exercise like long walks, yoga, swimming, etc. It is not advisable to chronically over exercise, as this can lead to negative health outcomes such as chronic fatigue.

Find out if you may have low cortisol: 

  • Fatigue or Burnout
  • Loss of stamina
  • Typical negative point of view
  • Crying for no reason
  • Can’t problem solve like you used to
  • Feel stressed all the time
  • Insomnia, or difficulty staying asleep
  • Low blood pressure
  • Dizzy when you stand
  • Difficulty fighting infection
  • Allergies/Asthma
  • Low blood sugars
  • Excess sweating
  • Muscle weakness
  • Nausea, vomiting, diarrhea
  • Hemorrhoids or varicose veins
  • Easy Bruising
  • Thyroid problems and heart palpitations

If you answered yes to at least 3 of the items above, you may be experiencing low cortisol levels. If you're concerned about your health, schedule an appointment for further consultation.

Sources: 1) Leproult, R et al. Transition From Dim to Bright Light in the Morning Induces an Immediate Elevation of Cortisol Levels. January 1, 2001. The Journal of Clinical Endocrinology and Metabolism 2) Colby, H.  Adrenal Gland Toxicity: Chemically Induced Dysfunction. January 1, 1988. Sage Journal. 3) Anderson, K, et al. Diet-Hormone interactions: Protein/Carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man. Elsevier. May 4 1987. 4) Brooks, K et al.  Overtraining, Exercise, and Adrenal Insufficiency. Novel 3/1/2013. Physiotherapies.

What are your Cortisol Levels?

Last week I took a deep dive into the physiology of our stress response. In short, when our bodies experience stress, there is a cascade of events that begin in the brain and ultimately lead to the release of cortisol from our adrenal glands. This system is an evolutionary tool that has allowed the human species to survive. Back in the day, this cortisol response is what allowed us to run from bears in the wild. Fast forward to modern times where we’re under constant stress; there are bears everywhere: sitting in traffic, listening to the news, at the office, in our relationships. Our bodies are not designed to have this constant cortisol exposure and so disease ensues. Our blood sugars are uncontrolled, we have high blood pressures, fat around our bellies, and we crave sugar. Even more, constant stress can cause communication between the brain and the adrenals to go haywire; some of us have too much cortisol and some of us not enough.

No need to wonder if this is a factor in your health, because testing your cortisol levels is easy. There are four ways that we can evaluate your cortisol levels. These include: blood, saliva, urine, and hair. Each of these methods have proven efficacy and the method of testing is based on your individual needs.

   Cortisol levels should be highest upon waking and slowly decline throughout the day.

Cortisol levels should be highest upon waking and slowly decline throughout the day.

Salivary: I use this method the most in practice. Cortisol is a diurnal hormone, meaning there are fluctuations throughout the day. With this method, it’s easy to collect samples of your cortisol levels throughout the day. Ideally cortisol levels should be highest in the morning and lowest in the evening, but it’s common to see dysfunctional cortisol levels at night. Even more reason to get tested! For more about this method, check out this study.

Blood assessment: This is the second most common method I use in my clinic. If blood draws are a stressful event for you, I would recommend other testing methods, as cortisol could be falsely elevated because of the perceived stressful event. I use blood to measure cortisol when my patient has excellent lab coverage, otherwise I prefer salivary or urinary testing because we can gather the cortisol levels throughout the day.

Urine Analysis: I have yet to employ this method in my clinic, however my research in this area leads me wanting to offer this ASAP. In fact, at the time of this writing, I have joined forces with Precision Labs and am proud to be offering DUTCH (Dried Urine Test for Comprehensive Hormones). I like this method because it is easy to collect and we actually get more valuable information as compared to the salivary testing alone.

Hair: I do not currently offer this testing method in my practice, however there are studies exhibiting its efficacy.

If you haven't yet taken the short quiz to see if you should get your levels checked, head on over to last week's blog post.

~Dr. Heather

Welcome to my first blog post! This week: Could It Be Your Adrenals?

As a naturopathic physician and practitioner of functional medicine, it is my intention to identify the root cause of your symptoms.  Evaluating the hypothalamic-pituitary-adrenal axis, or HPA-axis, is fundamental in my approach to your care. Let me tell you why:

When our bodies experience a stressful event, there is a cascade of biochemical processes beginning in the brain and ultimately leading to the stimulation of your adrenal glands. Stress can take the form of pain, trauma, low blood pressure, low blood sugar, exercise, fear, loss, anger, bereavement; all of these stimulate the adrenal glands to release cortisol.

Cortisol raises blood sugar and retains water. Keeping our blood sugar elevated ensures that our brains remain fueled and retaining water ensures our organs maintain blood perfusion during times of stress.

Under normal circumstances, our bodies have an innate feedback system that ‘turns off’ the cortisol switch. However, chronic stress causes the ‘switch’ to remain on and cortisol levels to remain elevated. This leads to health problems: blood sugars remain high, fat gets distributed to the belly, we become resistant to insulin, retain fluid, have high blood pressure, proteins break down, hormone production is inhibited, and the immune system is suppressed! Not good.    

Take this quick quiz to assess your adrenal function:

stress_hypothalamus.png
  • Cannot Fall Asleep?

  • Cannot stay asleep?

  • Crave salt?

  • Slow starter in the morning?

  • Afternoon fatigue?

  • Dizziness when standing up quickly?

  • Afternoon headaches?

  • Headaches with exertion or stress?

  • Weak nails?

  • Perspire easily?

  • Excessive perspiration or perspiration with little or no activity?

  • Under a high amount of stress?

  • Weight gain when under stress?

  • Wake up tired even after 6 or more hours of sleep?

If you said ‘yes’ to more than three questions, HPA-axis dysfunction may be an underlying imbalance. Schedule an appointment if you are interested in assessing your adrenal gland function, and stay tuned! Next week I’ll be discussing our available testing options.

~Dr. Heather