I have a radio show that airs every Wednesday at noon Pacific Time on RadioMD.com called “Mindful Medicine”. It is simply another format for me to hopefully “knock ‘em alive” with empowering information that can help people be their own PCPs “primary care providers” and have their homes be their own HMOs “Health Maintenance Organization” Get it?
I am fortunate to have a fascinating and amazing regular contributor, Dr. Jacob Tietlbaum MD, join me every week to talk about easy, effective, natural ways to help people take back control and manage their health. Jacob and I were talking very passionately about the newest recommendations, handed down from a government agency, which suggested (based on a faulty calculation) that many more people would be candidates for taking statin medications. We both were fairly incensed about this notion, knowing that statin medications come with serious risks and side effects and research has shown that there are many common lifestyle choices that are far more likely to be associated with a lower risk of heart attack and heart attack death than taking statins medications. Some of these include eating chocolate, participating in regular exercise, getting adequate nutrition and having cats. YES, having cats, check this out:
Cats More Effective Than Cholesterol Meds for Preventing Heart Disease Deaths:
A research study found that having a cat can reduce stress in people’s lives, and consequently lowers the risk of having a heart attack or stroke or developing a heart disease. The findings are based on a 10-year study, carried out by the researchers at the Stroke Research Center at the University of Minnesota. The study, which looked at 4,435 Americans, aged 30 to 75, showed that those who did not have a cat had a 40 percent higher risk of having a heart attack and a 30 percent greater risk of dying from other heart diseases than those who have or have had a cat. The study was presented at the American Stroke Association meeting in New Orleans. Unfortunately, in this study owning a dog did not have the same heart protective benefits. Several studies have confirmed that owning a pet reduces stress, decreases blood pressure and cholesterol, and reduces risk of depression. This makes cats (and other natural alternatives) much safer, cheaper, and more fun than cholesterol lowering medications!
If cats aren’t for you….rest assured there are still SO many more ways that are clinically proven, effective and devoid of serious side effects to help prevent and treat heart disease!
YOU ARE YOUR OWN PRIMARY CARE PROVIDER! Stay informed and… MEOW!
When I was in medical school, living on a shoestring budget, one of the treats I used to give myself was a trip to the day spa. Even though I lived in a very warm climate, there was nothing more invigorating and soothing to me than being able to sit in a sauna and sweat out my stress.
The use of heat and traditional sauna therapies in healing goes back for centuries. The Native America’s have been using sweat lodges for ceremony and medicinal purposes for over 40,000 years.
New sauna technology has proven much more effective for cleansing the body than the traditional sweat lodges of the past. Heat produced from infrared wavelengths is much more thorough than conventional heat produced from hot rocks or steam. Infrared light—which is the invisible part of the sun’s spectrum—can easily penetrate tissue to about three inches deep. Because infrared light heats the body directly (not just the air around you), it raises the core body temperature increasing central and peripheral vascular circulation, respiration and sweating. This is awesome for the body as an increased cardiac output and heart rate are accompanied by a decrease in blood pressure. The increase in respiratory rates raises oxygenation and lowers carbon dioxide content and sweating assists the excretion of toxins stored in body fat and organs. Who knew I was doing so much more than sweating out my stress J! My trips to the day spa where indeed a treat and something I couldn’t afford to do regularly! The good news is that infrared saunas are surprisingly affordable and energy efficient for any home saving me future trips to the often-expensive day spa. The most recent full spectrum infrared technology has also lead to an increase in research and benefits beyond increasing circulation, lowering blood pressure and assisting with detoxification. Infrared sauna therapy also has been proven to assist in weight loss, decrease pain, rejuvenate skin and heal skin conditions like acne, psoriasis and eczema. For example, a single infrared sauna session can burn up to 200-600 calories and researches have been tracking the incredible results of using infrared therapy on lower back and upper body pain. The even better news is that you can actually have this extraordinary comprehensive healing therapy in your own home! Companies like Sunlighten (www.sunlighten.com) are empowering wellness by offering safe, affordable and effective infrared saunas. I experienced this particular brand recently while visiting a friend in Santa Fe. How nice it was to come in from a hike after a long night of reconnecting, eating and drinking and sit in the sauna and “passively” heal the damage from the night before and restore my vigor and vitality.
I was so motivated and inspired that I am purchasing one as soon as I can. Not that I am trying to put myself out of business but I do believe that a sauna a day will keep the doctor away!
One of my biggest passions in this life is to be helpful in people using their own minds and thinking about what is good for them regarding health, wellness and medicine. There are so many confusing messages, ideas and advice available. I feel it we can just slow things down and really utilize are minds, we can truly find out what is best for each individual.
I have tag line I use often: “Let’s think this through”. I didn’t actually come up with it, it more or less came to me. You see, I would catch myself each day that I was in my clinical practice saying to a patient during our visit ……”lets think this through”. Because in my mind, that is what practicing good medicine and partnering with a patient is all about!
I start by taking a comprehensive medical and social history as primary tools to begin to understand someone’s story and from there I will conduct any physical exams and select laboratory tests to help pull other pieces of the clinical puzzle together. The sweet spot for me is being able to take all the information about someone, their habits, their history, their behaviors, their relationships, their results even their self beliefs and knowledge and simply think things through as how it is or has contributed to how they are feeling and presenting clinically.
This “thinking things through” is the sweet spot because it helps me to understand contributing factors as to why someone got to where they are with their health in the first place and even better what we need to do about it. What we need to prioritize and strategize to help that person reach their optimal health. It also is very empowering to my patients to identify and then be able to control contributing factors that are affecting their health adversely. When you take the time to get to know someone’s story and simply help them “think things through” even the most complicated health conditions start to show a simple path towards healing.
Too Much of a Good Thing can certainly be BAD!
When there is an excess of any hormone in relation to the whole intricate system we call the “endocrine system”, an overall imbalance develops, and health problems can arise. When there is too much estrogen and not enough progesterone to counteract its effects, the situation is called estrogen dominance.
Estrogen dominance is a multifactorial situation and is caused by such things as exposure to excess environmental xenoestrogens, use of synthetic estrogens such as the birth control pill and hormone replacement therapy (HRT), anovulation (lack of ovulation during menstrual cycle, which is not uncommon among women older than 35), digestion issues (which tax the estrogen- detoxification process in the liver), unrelenting stress (which strains the adrenals and the thyroid), unresolved emotional issues, poor diet and negative lifestyle factors such as smoking and alcohol use.
How does estrogen dominance specifically alter women’s health? It has been linked to a wide range of conditions, including increase in PMS symptoms, uterine fibroids, and endometriosis, as well as symptoms including allergies, decreased libido, fatigue, fibrocystic breasts, headaches, infertility, irritability, and fat gain around the abdomen and on the top of the thighs. In addition, numerous studies demonstrate excess estrogen can cause breast, uterine, and ovarian cancers (which are all considered estrogen dependent cancers) cervical dysplasia (a precancerous condition characterized by abnormal changes to cervical tissues) and even contribute to menopausal symptoms.
It is easy to see how in our contemporary lifestyles estrogen can begin to dominate the hormone scene. The prevalence of xenoestrogens form the environment; the use of HRT and oral contraceptives; diets skewed in favor of nonorganic fruits, vegetables, meats, and dairy products (which frequently contain xenoestrogens); stressful lifestyles; and increased estrogen production because of anovulation, imbalanced ovarian function and hysterectomies all contribute to this ultimate inbalance.
Cancer is one of the most disconcerting of the possible outcomes of estrogen dominance. Because cancer rates are increasing every decade, it is likely that cancer has touched your life in some profound way. I know I am seeing more women with estrogen-dependent cancers in my clinical practice than ever before. The American Cancer Society (ACS) estimates one in three women will develop some type of cancer in her lifetime. Breast cancer rates have increased from one in 20 in 1960 to one in eight today, though the rates have slowed since the 1990s. But the ACS says breast cancer incidence rates have increased lately in women older than 50.
Among the risks the ACS lists for breast cancer are long menstrual history (early onset of menses and late menopause) and use of oral contraceptives and postmenopausal estrogens and progestin. These risk factors increase the lifetime exposure to estrogen.
Harmful estrogens are difficult to detoxify and are stored in fat. In a recent study published in the Journal of the National Cancer Institute, researchers linked obesity to breast cancer. Women with a higher body mass index (BMI), which equated to higher levels of body fat, also had elevated hormone levels, particularly of estradiol, which is the more potent of the estrogens produced in the body. The researchers concluded, “The increase in breast cancer risk with increasing BMI among postmenopausal women is largely the result of the associated increase in estrogens”
According to a study featured in Cancer Causes and Control, women can reduce their breast cancer risk by maintaining a normal weight, because that reduces the amount of hormones stored in fat.
Other things that are extremely important to remember to protect your tissues from an excess of estrogen and begin to restore function in your hormonal system are:
- Eat a diet full of organic whole foods and fiber and get at least 5-9 servings of fruits and vegetables each day.
- Identify and decrease any unrelenting chronic stress and support your adrenal and thyroid glands with proper rest and supplementation.
- Restore any digestive imbalances and make certain that you have plenty of good bacteria on board to crowd out any over growth of yeast or bad bacteria.
- Decrease exposure to xenoestrogens by wearing and using safe products free of hormone disruptors such as parabens and phalates.
- I recommend Theo Colburn’s book “Our StolenFuture” and www.ewg.org for further reading.
- Search for a practitioner that will offer safe and natural relief for symptoms during hormonal transitions and decrease your use of HRT. Try visiting www.naturopathic.org .
- Decrease your use of alcohol and if you smoke, please stop.
With today’s stressors being multiple, constant and prolonged, it is quite easy to lose one’s cool which, unfortunately, just makes any situation worse. I call it “having a short fuse syndrome”. So, how can you keep your cool and “lengthen your fuse” during times of strife such as your commute in terrible traffic or interactions with angry clients, terrible customer service agents, aggressive co-workers or that fussy family member? Believe it or not, the answer is in your brain. Yes, your brain! Our brain is equipped with two sides of the nervous system. The sympathetic nervous system is that which control our response to these multiple, constant and prolonged stressors. Our “fight or flight” is carried out here. On the other side, the parasympathetic rules our ability to rest, relax and repair. One of the biggest problems we are having in our modern day is the imbalance in the activity of these two parts. This simply means that the sympathetic part of your brain is getting way too much action and the parasympathetic part is being completely left in the dust. However, you can successfully balance out this situation by purposefully engaging in powerful parasympathetic behavior (PB). PB is different for everyone. It is that certain person, place or thing that helps you unburden. For some people, it is taking a bath, for others it is spending time with their grandchildren and, for me, it is being outdoors near any type of wild life. The key is that you need to do it daily. Yes, that is right … daily. I have noticed that in order to break this cycle and work towards creating a balanced nervous system and therefore longer fuse, it isn’t the quantity of time spent in PB but the quality and consistency. I have a patient who lives on the west coast yet works on the east coast. Every morning when he turns on his computer he is greeted with 3 hours of work (due to the time difference) and it was making him a stress ball. So, we initiated a “power pause” for his PB. Each morning, before he turns on his computer, he stops, breaths deeply, reflects on his gratitude and purpose, reminds himself of what is really important and centers himself for his day. He started out doing this for only 3 minutes at first, but he is now up to 20. He does it daily and reports that it has helped him in all stressful situations because he feels more in “control”. WOW! I love that! It doesn’t take long to have the powerful parasympathetic part of your nervous system activated again to help you grow your fuse, balance your brain and keep your cool!
Oh boy do I care! When I first began practicing over a decade ago, my boundaries with my patients were flimsy at best. I was so motivated and passionate about them doing well and following through with my recommendations that I would end up walking them to their cars while still educating, still explaining, well after our visit had ended. I think if I could have gone home with a few of them to help with implementation of the plan, I would have! Of course, upon the return visit, if I learned that the plan wasn’t followed or that my patient hadn’t progressed, I took it personally and wondered what I could have done better. Thankfully, with time and practice, my boundaries firmed up and I began to trust deeply in my work. It was helpful to remind myself that I truly am only part of the equation in this partnership and cannot be successful without my patients doing their part as well. However, I was still craving some re-assurance that after the visit was over and they had left the supportive, almost “cheerleading” environment of my office that my patients could comply with my recommendations. One of the tools I incorporated to assist in assessing this issue is called the “adherence loop”.
Adherence can be defined as taking prescribed action to gain maximum benefit. It is exactly what I want from my practice! In order for people to adhere to a plan there are certain action points that they need to move through almost in a loop type fashion:
Believe: People need to believe that they have the condition, that the recommendations will work, and that they can be successful.
Frame: They need to build a mental model, or framework, of how the recommendations will work on their condition.
Know: They need to know the rules and what to expect.
Prompt: Knowing what to do is often not enough. People need cues and reminders to prompt action.
Act: Action requires resources: physical, cognitive, emotional, social, and financial.
Reinforce: Feedback reinforces belief to strengthen and drive adherence.
If, upon our follow up visit, I notice that this loop has been broken somewhere and compliance has become an issue, here are some diagnostic questions I use to help figure out where:
- Do patients want to change or is someone else telling them they need to change? – - Do patients believe there is really a solution that will work for them?
- Do patients believe they can have success?
- Do patients have an accurate understanding of their condition (degenerative, chronic, asymptomatic)?
- Do patients have an accurate understanding of how the recommendation works (preventative vs. curative)?
- Do they know what to expect from carrying out the recommendations?
- Where are the misunderstandings? (past experience, stories, fear, hope)
- Do patients understand the rules of the regimen?
- Are patents overwhelmed by information?
- Are patients not getting information?
- Are patients getting misinformation?
- Are patients forgetting to take doses?
- Is the regimen hard to keep track of (inconsistent, not memorable, alien to the patient’s other routines)?
My friend and mentor used to say all the time to me “be careful what you think”. I would in turn say WHA??????? Like what the heck does that mean? Well throughout my years of practice and teaching, I began to understand! You see, I don’t think a week goes by that I don’t have to explain to someone that eggs aren’t dairy.
I have some of the most extraordinary, educated and lovely people in my practice who look at me when I enlighten them to this fact and say “WHA?????, they’re not, why did I think that”? My answer to that is reminding them of the original four food groups, which by the way was a marketing tool created by the American Dairy Association. If you remember, the groups were breads and cereals, meats, fruits and vegetables and then dairy.
And if you also remember, the 3 little eggs sat in the corner picture along with the stick of butter and the glass jar of milk denoting the dairy group, alas, in our minds it was then imprinted…EGGS ARE DAIRY! Right…..??? Well, now we know and we also know just how impressionable we can be.
Sometimes I feel this “information era” should actually be deemed the “mis-information era”! In an attempt to get a sale, a “like” or a “follow” I have seen some of the most ludicrous claims. It is a marketing jungle out there and I think you truly do have to be careful what you think. Be careful of what you allow in.
Trust yourself, let common sense make a come back! Be your own primary care provider and don’t be seduced by the syrupy sweet sound bite that is usually just too good to be true!
An example of secondary succession is the development of new inhabitants to replace the previous community of plants and animals that has been disrupted or disturbed by an event (e.g. forest fire, flood, harvesting, epidemic disease, pest attack, etc.)
I have always been fascinated by this concept. The fact that something so precious as life itself could be completely destroyed only to “succeed” again and again and again is, well….FASCINATING!
“Succeed” is exactly what these (pictured) little tree buds did after a fire ran through the Mill Creek River bed near Big Sur years ago. Check them out! While hiking near this area over the weekend I was captivated by these darlings and it prompted a pondering: we, each and every one of us, have the capability for secondary succession. The winds of change and the fires of our lives can rip through what we once knew to be true and precious and we can recover. Actually, we can do more than recover. We can begin again, we can grow, and we can SUCCEED!
Whether it is a relationship gone sour, the loss of a loved one, unexpected health issues, financial hardships, disappointing career events or anything else that feels difficult, destructive and completely burdensome, please know you can and will get through it!
As a Naturopathic Doctor, I live by these laws of nature and when my human mind can’t see straight or have the faith that things will always and in all ways be ok, I rely on symbols like these little buds to remind me of what is possible. I invite you to do so as well!
KEEP ON BECOMING!
Much love and hail Mother Nature~
Wow, summer sure is heating up! Hope everyone is taking time to stay cool and still have some fun in the sun!
A new patient recently called my office to say thank you to me for writing my first book, Creating and Maintaining Balance, a Women’s Guide to Safe, Natural Hormone Health. as it had helped her so much.My dear, I thought to myself, that was published in 2004, I had almost forgotten about it. I immediately went over to my shelf, dusted off a copy and re-read it! LOL
Then I thought…hey….this story and this information is still relevant. The book mostly outlines the tale of ESTROGEN DOMINANCE in our modern day society and what we can do to get back to balance! So, I decided to add the book to my new e-store and you can purchase it by clicking here now!
1. Cruciferous veggies: Cruciferous vegetables such as broccoli, cauliflower Brussel sprouts and cabbage contain several powerful nutrients that detoxify bad estrogenic molecules. These nutrients include Indole-3 Acetate, Indole-3 Carbonyl and Diindolylmethane. These cruciferous veggies also contain sulfur containing nutrients such as Sulfuraphane and Phenyl Isothiocyanates that enhance liver detoxification processes and destroy cancer cell formation.
2. Healthy fat-rich foods: These are foods that are rich in saturated and omega-3 fatty acids. It includes plant-based fats such as coconut oil, extra virgin olive oil and avocados. Raw nuts (other than peanuts) and seeds contain anti-estrogenic plant sterols. Organic poultry, wild-caught salmon, wild game and 100% grass-fed beef are great for healthy hormone function.
3. Alium family: The aliums include garlic, onions, scallions, chives and leeks. These are all rich in sulfur-containing amino acids and the powerful flavone anti-oxidant quercetin that both help the liver detoxify at a higher level and reduce the production of estrogen.
4. Flavone rich herbs: Dietary flavones and flavonones have been demonstrated to be the most potent aromatase-inhibitory flavonoids. The most powerful flavones include chrysin which is found in passionflower and apignine which is found in chamomile. Several brands of herbal tea can be purchased that feature both organic passionflower and chamomile. These teas are typically marketed for healthy sleep but they are also powerful anti-estrogenic activity.
5. Flavonones: These are found in citrus fruits and in particular lemons and limes. They are classically called citrus bioflavonoids and they include diosmin, hesperidin, rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin, nobiletin and quercetin.
6. Antioxidant-rich herbs: Herbs such as oregano, thyme, rosemary, sage and tumericare loaded with volatile oils that promote liver detoxification. Turmeric has a potent ability to destroy estrogen receptor positive cancer cells, which are the most commonly found cells in breast, uterine, ovarian and prostate cancer.
7. Chlorophyll: One of the most powerful life-giving substances on the planet is chlorophyll. This is the pigment that gives green foods their color. Chlorophyll-rich foods have a very deep green color and they are extraordinarily useful in purifying the body of toxins.
8. Fermented foods: These contain organic acids, anti-oxidants, enzymes and probiotics that enhance gut function and eliminatory channels. Fermented veggies include sauerkraut, kimchi and fermented soy. Fermented raw dairy from 100% grass-fed cows is amazing for the body. Fermented drinks such as apple cider vinegar, kombucha and herbal botanicals are great estrogen detoxifiers.
The Doctor Is In! As always you can make an appointment by clicking here.
Office: THE BODY WELL
*Parking available in back*
7235 Santa Monica Blvd.
West Hollywood, CA 90046
I competed in a charity Crossfit competition this last week called “Barbells For Boobs”, a non-profit organization who provides funding to breast centers globally through their Mammograms in Action ® Grant Program as a “last resort” resource for thousands of people who do not qualify for government funding or other charitable resources in the detection of breast cancer. My workout a partner and I took home first place for the best costume, I was “Dr. WOD” and she was “Nurse No-Rep” J and we didn’t do too badly on the work out either.
The “Barbell For Boobs” story, which was told at the beginning of the day along with our movement standards, got my head shaking in a confirmatory YES way and brought me to tears. Sara, the woman who started this charity explained that her best friend at the age of 26 presented to a breast clinic because she had little funds but had noticed a lump on her breast. The clinic sent her away and told her to come back when she was 40 years old because that is when you have your first mammogram. Sure enough, this young lady was soon diagnosed with breast cancer within weeks. Sara wanted to help her friend raise money for her treatment so she turned to her Crossfit community and they threw a fund raising event at a local Crossfit affiliate gym. They raised over 4,000 dollars and Sara happily presented it to her friend. Her friend said, “thanks but I don’t want it. What I want is for anyone at any age to have access to early detection and treatment of breast cancer”! With that, the first “Barbell For Boobs” was born.
When it comes to medicine, our modern day insults of chronic stress and environmental toxins, NOTHING IS TEXTBOOK. Too many patients have presented to my clinic after being dismissed by another practitioner because they didn’t fit the “textbook” presentation of the disease. They were too young, too old, too small, too healthy or the wrong gender. The best textbook you have when it comes to detecting something that is wrong with your body is YOU AND YOUR BODY. Stay awake to the signs, pay attention and know your body is always communicating with you. That is what I believe symptoms are; little tugs and whispers that something needs attention.
Be gentle and trust~