Good Doctor, Bad Doctor- Call Someone that Cares

As much as most of us complain, it is truly a privilege to be a physician in the United States. There have been tons of articles and posts about “what it’s like to be a doctor,” but this submission focuses on what it takes to be a good (or a bad) one. The truth is that though we’re talking about physicians here, this can be applied to ANY type of worker, from doctors to cashiers, to accountants, to flight attendants, etc…

After a while, as much we’re taught not to judge, anyone in any medical community develops a sense of who’s “good” and who’s “bad” at their job. It’s fascinating to see how this happens as invariably, it is entirely subjective. His good is her bad and vice versa. Increasingly people are reaching for more formal resources as guidance; however, the criteria that are being used to pass judgment are inconsistent at best. From hard facts like readmission rate, LOS, and hospital-acquired infections to several years in practice, the prestige of medical school/residency program, and social status to hours the office is open, reviews of office staff, and office address. A patient even once told me that he chose his doctor because of the electronic health record that was being used in their practice*!! None-the-less, I take issue with all of these quality “metrics”- I say that none of them are as important as would seem at face value…

In my primary role, I feel very fortunate to be looking at hard data all day long. Much of this data is about physician performance, and it often takes an experienced eye to look past all the noise, deep into the data set to uncover the sometimes hidden truth. It is very troubling for me to see someone that I KNOW is a great doctor be labeled as marginal by (complex) data. Our organization’s Physician Status Reports are carefully presented as “point-in-time” assessments of physician performance because they are! Anyone can get better (or worse) at any given metric tomorrow. It’s a continual process of growth and a part of every doctor’s commitment to lifelong learning. Do you think in 2018 doctors have a varying commitment to lifelong learning? But again, all of this is trivial…

So What’s the Answer?

Allow me to explain using a clinical vignette. A 32-year-old female with a fever, no chills, body aches, rhinorrhea (runny nose) and anorexia (poor appetite).

What’s the diagnosis? Even my 9-year old would say, “Papa, this is a clear case of viral syndrome- antibiotics are not indicated here. Consider supportive therapy.” We should all be proud of his clinical acumen, for he is right! The point is that virtually anyone (or nowadays any connected device) can take a set of objective facts and perform a Bayesian analysis of the probability of any given diagnosis given signs and symptoms, but is that what a doctor is? I think we would all overwhelmingly agree- No. A “good” doctor is much more than the guts of a good AI-engine. But let’s be more specific about what we mean and maybe even come up with a single, overarching metric for determining quality… read on!!

Some say that a good doctor is a healer- one that heals the patient, i.e., makes them feel better. A good doctor evaluates much more than just the symptoms of the disease but is deeply concerned about the patient overall well-being. Fever and productive cough of rusty-colored sputum is likely pneumonia, but what about the mass in the lower abdomen that eventually suppressed the immune system enough to succumb to the streptococcus pneumonia (that we all have in our normal respiratory flora)? What about the distant history of STDs that exposed the patient to the virus that triggered cancer that led to the mass? Who would think that a patients sexual history would have anything to do with rusty-colored sputum? The answer is a doctor that CARES about her patient enough to spend more than the 30 seconds it would take to make the current diagnosis (and miss the real underlying root cause of the presenting illness). The rest of these findings would take even the most astute clinician a lot more time to elucidate from the average patient- time that they simply don’t have in today’s health care system (12 minutes on average).

Well, We’re All in the Business of Providing Care, Right?

Care is a word that is thrown around all the time, both in healthcare speak and in real life. Care in health care can mean any of the following (according to Google):

  1. Noun. The provision of what is necessary for the health, welfare, maintenance, and protection of someone or something.
  2. Noun. Serious attention or consideration applied to do something correctly or to avoid damage or risk.
  3. Verb. Feel concern or interest; attach importance to something.
  4. Verb. Look after and provide for the needs of.

We most often use the word Care as defined in #1. Apprehensively, I think we often assume that #2–4 are inherent in conversations, but I sometimes wonder if it really is- EVERY TIME. I mean, the majority of healthcare workers care most of the time, but I think there are only a few that care every. single. time. On every interaction, they #2-#4- for these physicians, #1 happens automatically… My friends, allow me to propose that it is these workers that are our BEST doctors, cashiers, accountants, and flight attendants. It’s the ones that #2-#4, every time. Conversely, those that only #1 and don’t actively assume #2-#4, are just having a bad day.

But is it anyone’s fault? Don’t we, as a nation, measure our desired outcomes? I have yet to come across the “CARE” measure in any of our most recent national policies or guidelines. Is Patient Satisfaction a surrogate of Care? Perhaps, but our current patient satisfaction metrics are only accurate for HOSPITALS, not individual doctors. Do we need evidence-based research to know that #2-#4 leads to better outcomes, less opioid-related death, increased patient satisfaction, better patient safety, and less physician suicide? Some would say we do. Do they really #2-#4? Wouldn’t it be great to measure how much they really care?

For most patients, modern medicine has made it easy to diagnose the medical condition, irrespective of the root cause. What modern medicine is increasingly failing to do is: heal the patient. It is my experience that irrespective of what type of #1 you provide, #2–#4 play a HUGE part in the healing process. By definition, Artificial Intelligence will NEVER be human and therefore incapable of providing #2-#4 for the masses, unless the masses change their definition of human first! This is more likely…

Let’s Ask the Right Questions

It turns out that we’re all just off on our frame of reference- it’s about every definition of the word care, #1-#4. The good news about what is being proposed here is that if you agree, you’ll realize that even the idea of “bad” doctors should be impossible… When ANY type of worker stops caring, isn’t that when they should seek something new? Sadly, no physician would disagree that the Care metric has been on a downward trend in the past decade. If it existed, the Care metric could help us all anticipate burnout and engagement waaayyyyy better, but what is really exciting is the potential effect it might have on our process improvement efforts!! How would our care environments look when every single worker #2-#4ed for every single task they performed?

If we all can agree on this proposal, the questions change for every one of our innumerable health care debates. The new question becomes: how can we enable doctors and health care workers to #1-#4 for their patients? Isn’t this what we all want from our health care system? I think we would all gladly pay for this type of care.

*Actually, the best determinant of health care quality is ACCESS to information, so this patient was actually smarter than the average bear.

Importance of Limiting Pesticide Exposure by Eating Organic

Eating fresh vegetables and fruits is all well and good, but there’s a catch. Most of us are not aware of the pesticides and chemicals that go into our food production process. Chances are that what you consider to be healthy might just be killing you. Commonly used pesticides like organophosphates are neurotoxins that can be terribly harmful to your body. Other chemicals like phthalates are endocrine disruptors that can also cause severe harm to your reproductive, nervous, and other body systems.

Unfortunately, it is extremely difficult to eat whole food that has zero exposure to these chemicals in today’s food supply, but a little is much better than a LOT.  Researchers have found that eating a completely organic diet can reduce your pesticide exposure by 90%. These pesticides have ghastly effects on your body. Some of which can be hard to shake while others can be managed by an altered diet.

Eating fresh vegetables and fruits is all well and good, but there’s a catch. Most of us are not aware of the pesticides and chemicals that go into our food production process. Chances are that what you consider to be healthy might just be killing you. Commonly used pesticides like organophosphates are neurotoxins can be terribly harmful to your body. Other chemicals like phthalates are endocrine disruptors can also cause severe harm to your reproductive, nervous, and other body systems.

Here are some frequently used pesticides and what they might be doing to your body:

Organophosphates and Carbamates

Exposure to these pesticides causes increased salivation and perspiration. It can also cause narrowing of the pupils, nausea, diarrhea, decrease in blood pressure, muscle weakness and fatigue. The symptoms fade after the exposure to these chemicals decreases. Some pesticides of this variety also have a delayed neurological reaction which causes weakness in muscles and arms.

Chlorpyrifos

Created in the 1960s, this pesticide has been around for a while. Once used in home gardening they have now found their way into cotton, almonds, oranges, and even corn crops. This pesticide can cause a number of ill effects in the body. From a mild headache to an increased risk for Attention-Deficit Hyperactivity Disorder (ADHD) to much more serious conditions like respiratory paralysis.

Pyrethyroids

Exposure to these chemicals can cause aggression, uncoordinated behavior, whole-body tremors, and seizures. Skin exposure can also cause allergic responses, cancer or even developmental defects.

Glyphosate

The active ingredient in the popular weed killer called RoundUp, glyphosate is designed by the seed makers for use on genetically modified soy, corn, canola, cotton and in parks. Its residue has become ubiquitous and has even been discovered in the Mississippi basin. Its ill-effects include neurological disorders, birth defects, infertility, and is a known carcinogen. There are some serious issues that one should be worried about when eating foods laden with pesticides. You should be aware of the following:

Memory Loss

A review from the University College London concluded that low levels of pesticide exposure can cause cognitive impairment. It can affect memory, the speed with which you process information, and higher brain functions like long-term planning.

Diabetes

Tolyfluanid, a fungicide used on crops, can increase insulin resistance in cells. This can accelerate the development of diabetes and may be contributing to the national epidemic that is happening right now.  It’s estimated that 1 in 3 people will be diagnosed with diabetes by 2020.

Cancer

There are more than 260 studies linking pesticides with cancer like lymphoma, leukemia, soft tissue sarcoma in a wide-range of tissues including breast, brain, prostate, bone cancers among others.  There are many resources explaining these risks and all of the package inserts of these pesticides have warnings about the potential of cancer from exposure to these chemicals.

Parkinson’s Disease

Over 60 studies have identified a strong correlation between long-term exposure to herbicides and pesticides with Parkinson’s disease. The only way to avoid this is to eat food that has no traces of pesticides in them at all.

Developmental Diseases

Leading autism researchers believe that there is a link between pollutants and genes causing autism. Insecticides usually kill bugs by disrupting their neurological functioning. The same thing seems to be happening in children. A 2010 Harvard study found that children with organophosphate pesticide breakdown materials are more likely to have ADHD.

How is Organic Food Different?

Organically grown vegetables, fruits, and grains do not use pesticides, chemical fertilizers or any other chemicals to support their growth. This means the growing food process utilizes natural fertilizers such as manure and compost. It is important that animal products are also organic as these animals should be reared on organic feed (not treated with growth hormones) and allowed regular access to the outdoors. Organic produce is clearly labeled, and this is regulated by the United States Department of Agriculture.

There is emerging research that organic food has a higher percentage of antioxidants. This is because plants produce a large percentage of their antioxidant compounds to fight against pest attacks. Supplementing their growth with chemical pesticides only inhibits their ability to grow the compounds we eat these food items for. Moreover, food grown this way is far safer for the environment while also being safer to consume. Be it plants or animals, organically reared food is undeniably better for the body and keeps you safe from ingesting harmful chemicals. Most would argue that it tastes much better as well.

Summary

Eating organic food is the best way for you to limit your exposure to pesticides and dangerous chemicals. While it may seem more costly, it is definitely a cheaper option to the health risks of ingesting chemical-laced food. There are a number of health risks that have been identified as being associated with pesticides as mentioned above. Many Americans are realizing the value of prevention being better than cure and shifting to an organic lifestyle in droves.

Unfortunately, it is extremely difficult to eat whole food that has zero exposure to these chemicals in today’s food supply, but a little is much better than a LOT.  Researchers have found that eating a completely organic diet can reduce your pesticide exposure by 90%. These pesticides have ghastly effects on your body. Some of which can be hard to shake while others can be managed by an altered diet.

Here are some frequently used pesticides and what they might be doing to your body:

Organophosphates and Carbamates

Exposure to these pesticides causes increased salivation and perspiration. It can also cause narrowing of the pupils, nausea, diarrhea, decrease in blood pressure, muscle weakness and fatigue. The symptoms fade after the exposure to these chemicals decreases. Some pesticides of this variety also have a delayed neurological reaction which causes weakness in muscles and arms.

Chlorpyrifos

Created in the 1960s, this pesticide has been around for a while. Once used in home gardening they have now found their way into cotton, almonds, oranges, and even corn crops. This pesticide can cause a number of ill effects in the body. From a mild headache to an increased risk for Attention-Deficit Hyperactivity Disorder (ADHD) to much more serious conditions like respiratory paralysis.

Pyrethyroids

Exposure to these chemicals can cause aggression, uncoordinated behavior, whole-body tremors, and seizures. Skin exposure can also cause allergic responses, cancer or even developmental defects.

Glyphosate

The active ingredient in the popular weed killer called RoundUp, glyphosphate is designed by the seed makers for use on genetically modified soy, corn, canola, cotton and in parks. Its residue has become ubiquitous and has even been discovered in the Mississippi basin. Its ill-effects include neurological disorders, birth defects, infertility, and is a known carcinogen. There are some serious issues that one should be worried about when eating foods laden with pesticides. You should be aware of the following:

Memory Loss

A review from the University College London concluded that low level of pesticide exposure can cause cognitive impairment. It can affect memory, the speed with which you process information, and higher brain functions like long-term planning.

Diabetes

Tolyfluanid, a fungicide used on crops, can increase insulin resistance in cells. This can accelerate the development of diabetes and may be contributing to the national epidemic that is happening right now.  It’s estimated that 1 in 3 people will be diagnosed with diabetes by 2020.

Cancer

There are more than 260 studies linking pesticides with cancer like lymphoma, leukemia, soft tissue sarcoma in a wide-range of tissues including breast, brain, prostate, bone cancers among others.  There are many resources explaining these risks and all of the package inserts of these pesticides have warnings about the potential of cancer from exposure to these chemicals.

Parkinson’s Disease

Over 60 studies have identified a strong correlation between long-term exposure to herbicides and pesticides with Parkinson’s disease. The only way to avoid this is to eat food that has no traces of pesticides in them at all.

Developmental Diseases

Leading autism researchers believe that there is link between pollutants and genes causing autism. Insecticides usually kill bugs by disrupting their neurological functioning. The same thing seems to be happening in children. A 2010 Harvard study found that children with organophosphate pesticide breakdown materials are more likely to have ADHD.

How is Organic Food Different?

Organically grown vegetables, fruits, and grains do not use pesticides, chemical fertilizers or any other chemicals to support their growth. This means the growing food process utilizes natural fertilizers such as manure and compost. It is important that animal products are also organic as these animals should be reared on organic feed (not treated with growth hormones) and allowed regular access to the outdoors. Organic produce is clearly labeled, and this is regulated by the United States Department of Agriculture.

There is emerging research that organic food has a higher percentage of antioxidants. This is because plants produce a large percentage of their antioxidant compounds to fight against pest attacks. Supplementing their growth with chemical pesticides only inhibits their ability to grow the compounds we eat these food items for. Moreover, food grown this way is far safer for the environment while also being safer to consume. Be it plants or animals, organically reared food is undeniably better for the body and keeps you safe from ingesting harmful chemicals. Most would argue that it tastes much better as well.

Summary

Eating organic food is the best way for you to limit your exposure to pesticides and dangerous chemicals. While it may seem more costly, it is definitely a cheaper option to the health risks of ingesting chemical-laced food. There are a number of health risks that have been identified as being associated with pesticides as mentioned above. Many Americans are realizing the value of prevention being better than cure and shifting to an organic lifestyle in droves.

Health Effects of the Myers’ Cocktail

Created by Dr. John Myers in the 1960s, the Myers’ Cocktail is a uniquely formulated nutrient drip. This intravenous (IV) vitamin blend was designed to treat a wide range of issues. Even though Dr. Myers passed away in the early 1980s without revealing the recipe, Dr. Alan Gaby was able to reproduce the concoction. The IV blend consists of a unique combination of magnesium chloride, calcium gluconate, thiamine, vitamin B6, vitamin B12, calcium pantothenate, vitamin B complex, vitamin C, and diluted hydrochloric acid. Though the results tend to remain relatively constant, doctors around the world can differ significantly in their own preparation of the infusion.

Myers’ Cocktail is a rapid way of providing your body all the critical nutrition and hydration it needs. This is why it has become a favorite among those that are volume depleted from infection, inflammation, poor dietary choices, intense workouts, post-procedure, and even veisalgia (hangover) among many others. Its administration through an IV makes it fast and easy for it to get directly into our bloodstream for its myriad of beneficial effects. This is particularly helpful for those that are nauseous or otherwise unable to drink massive amounts of fluid rapidly.

What are Nutrients?

We need some fundamental nutrients to drive almost every reaction that occurs in our body, from moving your pinky finger to choosing the right career to be able to have fun with your friends. These nutrients include elemental metals (calcium, phosphate, magnesium, selenium), antioxidants (glutathione, oxygen), vitamins (B12, C, D), and buffers (sodium bicarbonate, lactate).  There are countless others, and the field of biochemistry is the study of the way these nutrients interact with each other to powers our body.

Why Does Almost Everyone Need the Myers’ Cocktail?

The American diet stinks. There has been a marked increase in digestive issues over the last few decades. This has been in tandem with a national increase in the consumption of fast food and sugar. In fact, even our healthy foods have gotten less nutritious from some of the manufacturing and processing methods (Nutritional Inflation, Who’d a Thunk it?).

These and other, more sinister factors have led to a marked rise in the incidence of Leaky Gut Syndrome, which ultimately leads to a reduction in the body’s ability to absorb nutrients. This, in turn, causes a weakening of the immune system, which makes it harder for the body to fight infections and abnormal cellular mutations, like those of cancer. The lack of adequate nutrients in the body also has a direct effect on one’s mood and ability to function. Not being able to absorb nutrients from food, or not consuming the right diet, can also lead to obesity as most of these individuals are malnourished from eating foods that have low nutritional value.  All of these facts make it easy to understand the root cause of most of our serious chronic diseases and highlights the importance of having a good balance of nutrients available to your body.

How Does it Work?

Because of the aforementioned factors, it is virtually impossible to attain the concentrations of nutrients required by the body for optimal function through our typical American diets. Moreover, because of the leaky gut syndrome, merely increasing the oral intake of nutrients can not directly lead to an increase in that particular nutrient in the bloodstream. This not-to-mention that most people can not tolerate high doses of oral nutrients that are commonly associated with side effects. The Myers cocktail, however, is intravenously administered using a small IV catheter. The patient can relax comfortably in a chair during an infusion, which can roughly about 30-minutes. Especially when you are deficient in these vitamins and minerals, infusing them in this manner is an excellent way for managing problematic digestive issues or for providing an immediate boost in existing nutrient levels.

So, in summary, the Myers’ Cocktail helps restore the body’s nutritional balance by delivering essential nutrients directly into the bloodstream. The combination of vitamins and minerals are absorbed at a cellular level and show an immediate effect on the patient. Because almost none of us eat the recommended 12 servings of vegetables a day, this therapy is useful for nearly anybody. Not only for people suffering from ailments such as asthma, migraines, and chronic pain, but also for those battling many common chronic diseases.

Frequency of Administering a Myers’ Cocktail

For people that have healthy kidney and liver function, it is almost impossible to overdose on a Myers Cocktail.  However, administering this infusion depends on the patient’s overall condition and the specific ailment being treated. For conditions like sinusitis, muscle spasm, or upper respiratory infections, about two treatments would provide results. For those preparing for athletic events or in anticipation of high-stress events like surgery, even one administration can provide fast results, but this cocktail should generally be taken weekly for three to five weeks. Your specific frequency of administration is best decided by your physician prior to your first treatment. Chronic conditions need ongoing treatment with regular assessment according to the disease.

Side Effects of the Myers’ Cocktail

While there are no adverse effects of the Myers’ cocktail, there may be mild side effects for some people. The patient may feel a warming or a flushed feeling because of the magnesium in the infusion. Magnesium can also lower the blood pressure, and some susceptible patients may experience fainting. When coupled with high-dose vitamin C, GI symptoms like dyspepsia and nausea can occur. Unlike most pharmaceutical therapies, these cases are rare and hardly ever happen when your care emanates from experienced professionals.

Ailments Treated by the Myers’ Cocktail

From the common cold to more serious ailments, the Myers’ Cocktail has been used for a large variety of purposes. Here are a few:

Boosting Immunity

The high dosage of vitamins in your bloodstream is a great way to keep yourself safe from common ailments.

Asthma

Myers’ Cocktail is wonderful in reducing symptoms of asthma and allergies. As an additional “side-effect,” it also helps reduce anxiety during attacks as well as controlling blood pressure.

Pain Relief

Back pain, post-op pain, injury, and muscle aches can be rapidly relieved by the Myers’ Cocktail. It can also ease the widespread pain and muscle aches of fibromyalgia and common inflammatory conditions like arthritis.

Mental Issues

Lack of essential vitamins and minerals contribute significantly to mental ailments like anxiety and depression. When taken regularly, the Myers’ Cocktail modulates nutrient levels over time so that its beneficial mood and emotional effects help you deal with normal everyday stress as well as more serious mood disorders.

Almost anything and everything

The Myers’ Cocktail has also been found to be useful in treating Lyme disease, narcotic withdrawal, migraines, Parkinson’s disease, and many others. It is also used commonly as an antiaging treatment around the world because of the way it promotes collagen production and boosts energy. This unique treatment has often made patients report an immediate effect on their skin and energy levels.

Conclusion

The Myers’ Cocktail is a highly efficient and versatile treatment that can also be customized to the needs of almost any patient.  Several other IV infusions that have been modeled after it. No matter what your ailment, the Myers’ Cocktail will help balance your body’s nutritional status until you adjust your diet accordingly. Anyone that has ever received this treatment will want to thank Dr. Myer’s for introducing the modern world to this timeless treatment.

The Harmful Effects of Smartphone Blue Light

Chances are, you’ve spent pretty much all day staring at screens like the one you’re looking at right now. This highly advanced, beautiful display is designed with very powerful electronic lights that allow developers to present images and videos of any quality for your viewing pleasure.

Several studies are underway to determine the effects of the blue light emitted from smartphones, on your health. From the preliminary results, most experts are anticipating serious repercussions on your health.

What is Blue Light?

Without getting too technical, natural light is composed of ultraviolet, infrared, and visible light rays. Blue light has the highest energy wavelength and is a part of the visible spectrum. In fact, blue light is everywhere, and the natural blue light that we are exposed to in the daytime is beneficial for us.

However, the artificial blue light emitted from digital devices such as smartphones, computers, etc. can be detrimental to health, particularly during nighttime exposure potentially causing damage to your vision, sleep, brain functions, and overall health. The adverse effects appear to be many and are slowly being sorted out in the medical literature.

Adverse Effects of Blue Light

Disturbed sleep schedule

Our bodies follow a natural cycle that allows us to stay awake and alert during the day and helps us sleep at night. However, when you stare at these screens too long and especially before you fall asleep, it affects this natural rhythm, known as the Circadian rhythm.

This leads to a disruption of melatonin production, a hormone that provides your body with the cues for when to sleep. This can make it hard to fall asleep and can completely ruin your sleeping patterns. In turn, prolonged sleep deprivation alone can lead to several serious health issues as described next.

Cognitive impairment

If your sleep is disturbed over a long period of time, it leads to the buildup of neurotoxins, which can result in a vicious cycle making your symptoms worse and worse. Inadequate sleep will eventually affect your cognitive abilities and can affect school/job performance and any situations that require focus.

Memory loss

Sleep rejuvenates and refurbishes brain functions, and a repeated disruption of your sleep cycle will lead to impaired memory function during the day. Disruption in the production of melatonin is the root cause of the disturbance of sleep hygiene.

Impaired immune system

Your immune system produces protective, infection-fighting substances like cytokines while sleeping. Sleep deprivation prevents your immune system from building up cytokines, thus leading to an impaired immune system, thereby making you more prone to contracting infections and falling ill.

Increased risk of diabetes

Diabetes is one of our country’s most serious epidemics. One out of every three Americans will be diabetic by 2020. A Harvard study has potentially shown a novel connection between blue light exposure and diabetes. The disruption to the Circadian rhythm can result in a reduction of leptin levels that can cause an increase in blood sugar levels.

Obesity

Disruption in melatonin hormone production can also disrupt the functions of the hormones that control hunger. Coupled with poor dietary habits, consumption of highly-processed food with poor nutritional value will ultimately cause obesity.

Increased risk of cancer

Several studies have linked nighttime smartphones usage to some types of breast and prostate cancer. Again the reduced secretion of melatonin causes lower melatonin levels that have been linked to increased cancer risk.

Harms vision

Some studies have shown that constant staring into our smartphones can lead to damage in vision by harming the retina over time by contributing to age-related macular degeneration. Macular degeneration is a common and severe cause of permanent vision loss and blindness. Studies are also being conducted to evaluate the blue light effect on cataract progression. The thought is that staring too long at your smartphone can result in reduced blinking rates, which in turn causes digital eye strain. This kind of strain on the eyes can lead to irritation in the eyes, dry eyes, fuzzy vision, difficulty focusing, headaches, neck and back pain.

Can lead to depression

When your melatonin levels are disrupted or suppressed by blue light, the resultant disruption of your hypothalamo-pituitary axis has been linked to clinical depression.

Summary and Recommendations

Research on the effects of blue light on the human body is emerging and the results are unsettling. Disruption of your melatonin axis appears to be the mechanism of its detrimental effects, and poor sleep is the vehicle by which they manifest in your body.

Fortunately, there are several steps you can take to limit these effects. The most obvious is to abstain from looking at screens after sundown. This can be unrealistic for some in which case the use of blue light filtering glasses can significantly reduce its impact. If that’s not stylish enough for you, many smartphones come equipped with a “night-mode” which programmatically turns off the blue light after dark. Enabling this function is generally a pretty straightforward process and can be found online by a simple web search on the model of your phone with the search terms “blue light filter.” Finally, taking melatonin supplements may also be beneficial in tempering the potentially dangerous effects of blue light.

13 health benefits of a plant-based diet

A plant-based diet is primarily one that is based on plant products, which includes vegetables, fruits, whole grains, seeds, legumes, nuts, with minimal or no inclusions of animal products. There are many different types of plant-based diets but they all feature foods with great health benefits.

A plant-based diet is primarily one that is based on plant products, which includes vegetables, fruits, whole grains, seeds, legumes, nuts, with minimal or no inclusions of animal products. There are many different types of plant-based diets but they all feature foods with great health benefits.

Those who follow this type of diet also avoid plant fragments such as refined flour, sugar, oil or junk food and focus on consuming the whole plant or only minimally processed versions thereof.

Major health benefits

Lowers blood pressure

People following a plant-based diet have better control on their blood pressure as their diet consists of mostly potassium-rich foods. Potassium is an excellent nutrient for good blood pressure health.  Almost all whole grains, legumes, nuts, seeds, and all fruits and vegetables contain high amounts of potassium and Vitamin B6, which help lower blood pressure. On the contrary, meat and most animal foods contain little to no potassium and actually raise blood pressure and cholesterol levels when consumed regularly.

Euglycemia- control of blood sugar levels

A plant-based diet incorporates ingredients that are rich in fiber content, and the best and easiest way to fight high blood sugar is to consume more fiber. Fiber in your diet slows down the absorption of sugars in the bloodstream, which in turn helps to control blood sugar. Many dieticians are correct when they counsel patients not to drink fruit juices. However people that make their own fruit juices that include the fibrous portion of the fruit with no added sugar should be encouraged to continue doing so.

Lowers Cholesterol

Since “bad” cholesterol is primarily due to animal proteins, embracing plant-based foods is the simplest way to control cholesterol levels. Plants contain no cholesterol; not even the saturated sources such as coconut and cacao. If you don’t put it in, you don’t have to control it.

Weight management

Conventional approaches to weight loss like formal exercise programs and calorie counting are flawed in many ways- they don’t address the root causes of the weight problem. For people that can follow a plant-based diet, losing and managing weight is a cinch. Weight loss occurs naturally when you consume most of your calories more from fiber, vitamins, and minerals than animal fats and proteins. People that follow a plant-based diet can easily lose weight without depriving or starving themselves and don’t have to worry about taking on formal exercising programs if their existing activity level is vigorous enough. As the number of meat-substitutes increase and get tastier, our nation of meat-loving sick people will naturally become plant-loving healthy people!!

Improves heart health

Several studies and emerging research has shown that higher intake of plant-based foods lowers the chances of cardiovascular diseases. For those who are already suffering from heart diseases, switching to a plant-based diet can help reverse or get rid of heart disease completely. Atherosclerotic diseases are most common and there is no more effective treatment than a plant-based diet. Don’t want to take expensive pills anymore? Use the money you’ll save on prescriptions to buy good, clean, organic whole foods (fruits, vegetables, beans, and nuts) and watch your coronary artery disease melt away.

Good for your gut

If you follow a fiber-rich plant-based diet, and choose foods high in resistant-starches, which come mostly from whole foods like grains, seeds, and legumes, it facilitates the growth of healthy bacteria in your gut, thus helping you reap the benefits of a harmonious microbiome. If you’re not making nice fluffy, voluminous stool, your gut health is in serious trouble.

Healthy vision

It is a well-known fact that the vitamin A in carrots aids vision. Your eyes will definitely thank you for a plant-based diet rich in spinach, kale, corn, squash, kiwi and grapes. The lutein and zeaxanthin pigments present in these foods help to prevent cataract and macular degeneration. In fact, even colorful fruits and vegetables as well as leafy greens are packed with antioxidants that are vital for good eye health.

Excellent skin health

95% of common acne is due to your diet. When you cut back on chemical-rich foods and animal products, you stop clogging the pores that lead to acne. The vitamins, pigments, and phytochemicals present in fruits and vegetables in a plant-based diet leave you no choice but to have healthy skin. For example, the lycopene in tomatoes protects your skin from sun damage and the vitamin C in sweet potatoes helps smoothen wrinkles by stimulating collagen production. Your favorite skin-care companies cannot patent naturally occurring elements that are contained in whole fruits and vegetables.

Helps in cancer treatment

There is strong evidence that whole food and plant-based eating is the best protection and one of the best dietary choices complementing conventional cancer treatment. Your doctors should be strongly recommending plant-based diets as part of your cancer treatment.  Eating a whole-food, plant-based diet will give you the best chance to recover from even the rarest cancers.

Improves brain health

Emerging evidence is overwhelmingly showing that diets based on legumes, grains, and healthy oils are associated with better brain health in older adults.  Those who favored fruits and vegetables had less brain shrinkage, linked with a reduced risk of cognitive decline. We don’t commonly come across vibrant people in their geriatric years, but the next time you do, ask them what type of food they’ve been eating throughout their life.

Lowers risks of hypothyroidism

Plant-based diets can help lower the risks of hypothyroidism. Depending on the root cause of your condition, a plant-based diet can help control and even CURE this condition while also offering all of the other benefits listed here.

Improves hormone health

A plant-based diet helps improve hormone health and relieves symptoms of the premenstrual syndrome (PMS). This diet is also known to treat infertility naturally and help heal polycystic ovarian syndrome (PCOS). Trying to have a baby? Make sure your doctors are giving you proper nutritional counseling.

Protects the environment

What is the most common source of dangerous greenhouse gases that deplete our ozone layer? It’s NOT trains, planes, and automobiles… It’s cattle!!! Furthermore, it takes an incredible 660 gallons of water to produce one hamburger!! We are currently on an unsustainable path to permanently damage our ozone layer and water supply. If you love Earth as much as we do, please reconsider your fast food choices and give veggie burgers and black-bean burgers a try- they’re delicious!!

Conclusion

A plant-based diet presents a host of health and environmental benefits.  It also comes packed with nutrients. It can be the most powerful asset in your overall well being and can even help reverse any chronic health issues that may have been troubling you for long. So, reduce your meat intake and choose a delicious plant-based food at your next meal for a healthier you!

We salute Dr. Michael Greger for his tireless work in promoting the medical benefits of a plant-based diet. His non-profit website, nutritionfacts.org, is easily the most plentiful resource on the topic and we encourage you to check out his tremendous entertaining and informative videos on the latest evidence for great nutrition.

Those who follow this type of diet also avoid plant fragments such as refined flour, sugar, oil or junk food and focus on consuming the whole plant or only minimally processed versions thereof.

Major health benefits

Lowers blood pressure

People following a plant-based diet have better control on their blood pressure as their diet consists of mostly potassium-rich foods. Potassium is an excellent nutrient for good blood pressure health.  Almost all whole grains, legumes, nuts, seeds, and all fruits and vegetables contain high amounts of potassium and Vitamin B6, which help lower blood pressure. On the contrary, meat and most animal foods contain little to no potassium and actually raise blood pressure and cholesterol levels when consumed regularly.

Euglycemia- control of blood sugar levels

A plant-based diet incorporates ingredients that are rich in fiber content, and the best and easiest way to fight high blood sugar is to consume more fiber. Fiber in your diet slows down the absorption of sugars in the bloodstream, which in turn helps to control blood sugar. Many dieticians are correct when they counsel patients not to drink fruit juices. However people that make their own fruit juices that include the fibrous portion of the fruit with no added sugar should be encouraged to continue doing so.

Lowers Cholesterol

Since “bad” cholesterol is primarily due to animal proteins, embracing plant-based foods is the simplest way to control cholesterol levels. Plants contain no cholesterol; not even the saturated sources such as coconut and cacao. If you don’t put it in, you don’t have to control it.

Weight management

Conventional approaches to weight loss like formal exercise programs and calorie counting are flawed in many ways- they don’t address the root causes of the weight problem. For people that can follow a plant-based diet, losing and managing weight is a cinch. Weight loss occurs naturally when you consume most of your calories more from fiber, vitamins, and minerals than animal fats and proteins. People that follow a plant-based diet can easily lose weight without depriving or starving themselves and don’t have to worry about taking on formal exercising programs if their existing activity level is vigorous enough. As the number of meat-substitutes increase and get tastier, our nation of meat-loving sick people will naturally become plant-loving healthy people!!

Improves heart health

Several studies and emerging research has shown that higher intake of plant-based foods lowers the chances of cardiovascular diseases. For those who are already suffering from heart diseases, switching to a plant-based diet can help reverse or get rid of heart disease completely. Atherosclerotic diseases are most common and there is no more effective treatment than a plant-based diet. Don’t want to take expensive pills anymore? Use the money you’ll save on prescriptions to buy good, clean, organic whole foods (fruits, vegetables, beans, and nuts) and watch your coronary artery disease melt away.

Good for your gut

If you follow a fiber-rich plant-based diet, and choose foods high in resistant-starches, which come mostly from whole foods like grains, seeds, and legumes, it facilitates the growth of healthy bacteria in your gut, thus helping you reap the benefits of a harmonious microbiome. If you’re not making nice fluffy, voluminous stool, your gut health is in serious trouble.

Healthy vision

It is a well-known fact that the vitamin A in carrots aids vision. Your eyes will definitely thank you for a plant-based diet rich in spinach, kale, corn, squash, kiwi and grapes. The lutein and zeaxanthin pigments present in these foods help to prevent cataract and macular degeneration. In fact, even colorful fruits and vegetables as well as leafy greens are packed with antioxidants that are vital for good eye health.

Excellent skin health

95% of common acne is due to your diet. When you cut back on chemical-rich foods and animal products, you stop clogging the pores that lead to acne. The vitamins, pigments, and phytochemicals present in fruits and vegetables in a plant-based diet leave you no choice but to have healthy skin. For example, the lycopene in tomatoes protects your skin from sun damage and the vitamin C in sweet potatoes helps smoothen wrinkles by stimulating collagen production. Your favorite skin-care companies cannot patent naturally occuring elements that are contained in whole fruits and vegetables.

Helps in cancer treatment

There is strong evidence that whole food and plant-based eating is the best protection and one of the best dietary choices complementing conventional cancer treatment. Your doctors should be strongly recommending plant-based diets as part of your cancer treatment.  Eating a whole-food, plant-based diet will give you the best chance to recover from even the rarest cancers.

Improves brain health

Emerging evidence is overwhelmingly showing that diets based on legumes, grains, and healthy oils are associated with better brain health in older adults.  Those who favored fruits and vegetables had less brain shrinkage, linked with a reduced risk of cognitive decline. We don’t commonly come across vibrant people in their geriatric years, but the next time you do, ask them what type of food they’ve been eating throughout their life.

Lowers risks of hypothyroidism

Plant-based diets can help lower the risks of hypothyroidism. Depending on the root cause of your condition, a plant-based diet can help control and even CURE this condition while also offering all of the other benefits listed here.

Improves hormone health

A plant-based diet helps improve hormone health and relieves symptoms of the premenstrual syndrome (PMS). This diet is also known to treat infertility naturally and help heal polycystic ovarian syndrome (PCOS). Trying to have a baby? Make sure your doctors are giving you proper nutritional counseling.

Protects the environment

What is the most common source of dangerous greenhouse gases that deplete our ozone layer? It’s NOT trains, planes, and automobiles… It’s cattle!!! Furthermore, it takes an incredible 660 gallons of water to produce one hamburger!! We are currently on an unsustainable path to permanently damage our ozone layer and water supply. If you love Earth as much as we do, please reconsider your fast food choices and give veggie burgers and black-bean burgers a try- they’re delicious!!

Conclusion

A plant-based diet presents a host of health and environmental benefits.  It also comes packed with nutrients. It can be the most powerful asset in your overall wellbeing and can even help reverse any chronic health issues that may have been troubling you for long. So, reduce your meat intake and choose a delicious plant-based food at your next meal for a healthier you!

We salute Dr. Michael Greger for his tireless work in promoting the medical benefits of a plant-based diet. His non-profit website, nutritionfacts.org, is easily the most plentiful resource on the topic and we encourage you to check out his tremendous entertaining and informative videos on the latest evidence for great nutrition.

Why IV Nutrient Therapy is Effective

Intravenous nutrient therapy (IVNT) has found a lot of takers over the last few years and rightly so. IVNT is the process of infusing vitamins, essential amino acids, supplements, and minerals directly into the bloodstream. This treatment has been used to treat a range of diseases including migraines, fibromyalgia, acute asthma, viral infections, chronic fatigue syndrome, acute alcohol intoxication, and many, many others. Of late, it has gained favor to support the recovery of high-performance athletes and although retail clinics are opening up everywhere, there is significant variation in the quality and quantity of the services provided. There are many reasons for the variation including poor regulation, lack of adoption by major pharmaceutical companies, and level of training of IVNT providers.

What is IV Therapy?

The first attempts at IV therapy date back to the 17th century and it became a broadly viable practice with the advent of plastic bags for storage and transport of IV fluid. In a nutshell it is an effective method of supplying the body with the nutrients that are urgently required. IV therapy can be used for pain management, blood transfusion, medication administration, or to replete important essential amino acids and minerals the body may be lacking.

Vitamins and minerals function as the gatekeepers of the body, allowing for body reactions to slow down or speed up based on their relative concentration. Most Americans are severely deficient in vital nutrients such as vitamin D, B12, folate, or iron. Furthermore, the liver has trouble producing the highly oxidative substances (chiefly glutathione) which function as the “bouncer” of the body, clearing it of unwanted chemicals and toxins.

Myths about IV Nutrient Therapy

Myth: It is not commonly given by doctors, therefore it is unsafe

Fact: IV nutrient therapy is FAR from an experimental practice! With hardly any adverse reactions, it is the best way to provide the body the nutrients it needs safely in rapid fashion. The most common treatments are known as the “banana bag” and “Total Parenteral Nutrition” (aka TPN), this age-old treatment is done countless times in hospitals all around the globe.

Myth: Doesn’t help people with chronic illnesses

Fact: There is emerging evidence that supports the benefits of high-dose IV vitamin C therapy in patients with breast cancer. IV vitamin C therapy can be used with conventional treatment that can help improve the quality of life of the patient. It has also been shown to have benefit in a common hospital condition called sepsis. Previously with little hope, fibromyalgia patients have reported reduced symptoms after IV therapy. There are many more examples and the literature continues to evolve in this area.

Myth: It is only needed once

Fact: How many people eat once a day? Although some IV nutrients may only need a one-time infusion for a long-lasting effect, most others need to be taken regularly over a few weeks until levels have reached a steady state. Even still, if your diet and lifestyle are not modified to correct the deficiency, you’ll end up requiring additional treatments in due time. Regular use of IVNT should be guided by an experienced physician or medical provider whenever possible.

There’s no evidence, it’s a money-making scheme

Any experienced medical practitioner will confirm that less than 50% of the treatment commonly prescribed in any healthcare setting is actually confirmed to be grounded in evidence-based literature. Still, open any biochemistry book and you’ll find vitamins and minerals as catalysts in virtually every vital reaction in the body, from the detoxification of noxious substances to the production of energy in the cell’s mitochondria. Just like most things in clinical medicine, there is literature for and against the use of IVNT for specific conditions. However, the multi-billion dollar neutraceutical industry is only getting larger. Unfortunately, there also some bad actors. Products like energy drinks advertise their B vitamin content but contain stimulants like caffeine and significant amounts of sugar as well which virtually eliminates their clinical utility. Most importantly, IVNT has very low risk to cause harm when taken under the guidance of trained professionals.

Benefits of IVNT

Boosts Immunity

A concentrated blend of vitamins and minerals can boost the body’s immune system. The effects of it are immediate, unlike orally administered supplements or intramuscular injections. Nutrients like vitamin C are a natural immune booster and can be protective against the flu and cold. The IV blend should be tailored to the specific requirement of the patient to ensure the best outcomes.

100% Absorption

Absorption of nutrients is difficult for some patients when they take nutrients orally. Digestive problems are extremely common for people eating an American diet and is often the root cause of this issue. With IVNT, however, the process of absorption is bypassed and 100% of the infused nutrients get into the bloodstream. This makes cellular absorption a function of the dose administered rather than the health of the gut. Simply stated, this puts YOU in control of how much nutrient your body gets.

Detoxification

Over time the blood in our body can accumulate a number of harmful toxins. The process of infusing your blood with electrolytes, nutrients, and fluids allows the cleansing to begin. It aids the detoxification process of your blood and makes you feel healthy again. Balanced nutritional status is crucial when weaning people off of narcotics and can make all the difference in people who are struggling with chemical addictions.

Fights Fatigue

Chronic fatigue is generally due to lifestyle choices or disease. Poor nutrition commonly causes vitamin deficiencies, hormonal imbalance, or mineral deficiencies among other things. Unfortunately, these diagnoses are under-recognized by conventional practitioners who are generally more focused on diseases that have pharmaceutical interventions. IVNT is a nutrient-rich recharge for the body and can provide immediate improvement of fatigue no matter what the root cause.

Aids Recovery

Hydration is the key to recovering from cold, flu, and other infectious and inflammatory illnesses. IVNT replaces the lost nutrients in your body and it also hydrates you which is a tremendous part of its overall benefit. Even people that feel well get regular IVNT infusions because they quickly realize how much better they feel from proper hydration and nutrient balance. They modify their diet and lifestyle accordingly with the ultimate objective to feel good without having to supplement their health with IVNT, a very laudable goal.

Energy Boost

Many patients have reported an immediate increase in their energy levels after receiving an IV nutrient infusion. This is because of the absorption of essential nutrients directly into the bloodstream. Unlike food or medication, it does not require the digestive process for absorption and works much faster. B vitamins are commonly used as “energy boosters” in the supplement industry.

Summary

Intravenous nutrient therapy is a time-tested treatment that repletes vital minerals, essential amino acids, and vitamins in the body. When individualized to your specific requirements it can provide a tremendous number of benefits and is much faster than taking oral supplements which are not easily-absorbed from the gut. The science of IVNT is rock-solid and emerging literature is supplementing the list of clinical indications to include serious conditions like cancer, sepsis, and fibromyalgia. There are few things in modern medicine that are as cost-effective and have the tremendous benefit of IVNT. There are virtually none that have the amazingly sparse profile of side effects from treatment. Unlike most of the products you’d find in a retail pharmacy, IVNT is a natural treatment option that can not be patented.

Because of its low cost and high clinical efficacy, IVNT is the type of treatment that great medical practitioners crave for use in their patients when indicated.

9 Evidence-based Reasons Why Transcendental Meditation Is Great for You

Stress is something that nearly everyone is struggling with. Too many people complain of being stressed out, be it at work, in relationships, or with their own health issues. Transcendental meditation (TM) has been found to be one of the most effective ways to relieve stress and calm the mind. It has a myriad of benefits, including enhanced clarity of mind, better concentration and improved communication skills. With regular practice, it is believed that the physiology of our body changes and each cell is filled with more energy.  Here are some key benefits of doing TM regularly:

Boosts immunity

Our immune system is directly related to our brain. This means that the brain transmits our thoughts and moods to the immune system. So, the more positive your brain is, the stronger your immunity. This is helpful for patients dealing with major illnesses like cancer, who are struggling with compromised immunity. Regular TM enhances the body’s ability to fight against disease before it can make you sick.

Lowers blood pressure levels

The two most common stress-related diseases gripping our current generations are high blood pressure and diabetes. TM reduces blood pressure and blood sugar levels among many other beneficial effects not-to-mention it also increases the threshold for anxiety attacks. If not treated properly, high BP and sugar levels can lead to major health issues. It is therefore best to make TM a daily habit to help keep your body in its best state of balance through regular practice. The American Heart Association recommends TM as first-line therapy in controlling pre-hypertension and Stage 1 hypertension (pharmaceuticals should be considered for Stage 2). Very few primary care practitioners and cardiologists are aware of these recommendations, (Hypertension, Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure, volume 61, number 6).

Increases fertility

Increased stress is known to decrease sperm count and motility. Women who are under intermittent duress are said to produce hormones like cortisol and prolactin, both of which interfere with regular ovulation. Since TM helps alleviate stress, it is beneficial for couples who are looking to conceive.

Fights depression

The incidence of depression is rising higher than ever before American society. Many studies show that TM increases the serotonin levels in the body, which in turn helps to improve mood and behavior. Modern mental health practitioners are using a mindful meditation as treatment for their depressed patients with outstanding results. With the complicated side-effect profiles of conventional pharmaceutical therapy, TM is being recognized as increasingly effective in treating mental illnesses without any side effects. How often can your doctor prescribe a pharmaceutical drug without side effects?

Relieves tension-related aches

TM also helps patients deal with stress-related pain including migraine headaches, ulcers, muscles and joint problems. These conditions can even be cured in many cases by using TM. Emerging research shows that TM improves pain by modulating the parts of the brain that are responsible for pain processing.

Improves sleep patterns

Insomnia has gripped half the population and so many people out there struggle to sleep peacefully. Regular TM helps subside thought waves, which are responsible for sleeplessness. In addition to this, it also helps to relax the body and release tension, thus ensuring a peaceful state of mind in which sleep comes effortlessly.

Helps with inflammation

Stress leads the way to inflammation, a condition associated with heart disease, arthritis, asthma and skin disorders such as psoriasis. Evidence shows that TM can prevent and treat these symptoms by reducing stress. As crazy as it may sound, TM has been shown to reduce inflammation!

Relieves Irritable Bowel Syndrome (IBS)

If patients suffering from irritable bowel syndrome start to practice TM, their symptoms of diarrhea, bloating, and constipation can improve considerably. Studies show that relaxing the body with the help of meditation is an easy, inexpensive way to improve the clinical outcomes and general well-being of patients suffering from IBS.

Enhances focus and concentration

TM sharpens the mind by improving focus and attention. It is particularly beneficial for school and college-going students. Improvement in concentration and focus helps in reducing age-related memory loss, thereby making it important for the older ones of the population too.

Start today!

To experience the benefits of transcendental meditation, training and regular practice is a must. Remember, even a few minutes of deep relaxation daily can work wonders for your overall well-being.  It’s time to ditch the excuses and get meditating for a healthier and happier you! Visit http://tm.org for more information and to learn about certified training centers near you.

How to Deal With the Spring Sniffles

Spring is in the air!  While it means an end to dreary, cold weather and being cooped up indoors, for many of us it also means a start to seasonal allergies. The number of allergens has been on the rise in the last few years, increasing by nearly 50% every decade since the 1970s according to the World Allergy Organization. Before we get into some of the possible whys for this alarming increase or some of the ways to gain relief from them, let’s take a look at how allergies actually work.

Your Immune System is Overreacting

Although a huge oversimplification of the process, the above statement is essentially why we have allergies. Your immune system reacts to different proteins or molecules on the surface of anything that it perceives as a threat (aka allergens). These molecules and proteins are known as antigens, and most of the time your immune system is justified in activating itself against them. As an example, your immune system should react to surface proteins on viruses or bacteria that are trying to invade your body in an effort to destroy them. However, for a variety of reasons we’ll explore later in this post, sometimes your immune system gets confused and reacts against a normally innocuous substance, like peanut butter, pollen, or cat hair. When your body encounters these antigens, it activates its defense system through specialized cells (called mast cells), which release histamine in an effort to neutralize the perceived threat. This release of histamine causes the inflammation that leads to the symptoms we commonly associate with allergies: runny nose, itchy and watery eyes, coughing, sneezing, and many others. This is also the mechanism for how the common over the counter allergy medications called anti-histamines help you relieve symptoms. They are designed to block histamine receptors on your cells, preventing the inflammation from taking hold and making you sniffle and sneeze all day.  But for many, they are not addressing the root cause of your allergy in the first place: the improper recognition of antigens.

So why is my immune system overreacting?

The part of your immune system that activates in response to allergens is called the humoral immune system. This part of your immune system creates specific antibodies against pathogens and is the type of response that is generated by vaccines and protects you from future infection by that pathogen. However, it also creates the response that produces allergy symptoms. Humoral immunity involves two major cell types, B-cells and T-cells. T-cells work by activating the B-cells through a complex network of signaling molecules.  Then the B-cells, in turn, secrete antibodies against the pathogen. T-cells can activate two different types of responses, known as Th1 and Th2Th1 responses are generally directed against viruses or cancerous cells, while Th2 responses work against bacteria, fungi, and other pathogens that exist outside of the cell. The interplay of these two types of responses may explain some of the aggravating or relieving effects that certain vaccines may have for seasonal allergies which will be discussed shortly.

A number of complex factors relating to your environment starting back from even the time before you’re born can be the blamed for why you have seasonal allergies. Studies have found an association between mother’s reported seasonal allergies and the frequency with which their children will suffer from them. This may be due to the mother’s body priming the fetus to produce IgE (the kind of antibody that stimulates histamine release) in utero, making the child more likely to be hyperreactive to allergens that would produce IgE later in life. Studies looking at the prevalence of allergies in children raised on farms compared to children in cities or suburbs found that the children of mothers who worked on a farm had the least number of allergies.  This is thought to be due to their exposure to common allergens throughout their pregnancy.  This is strong evidence that the conditions the mother’s immune system can affect the function of her child’s immune system. Similar research has been done to review the effect of being around animals, both household pets and livestock.  It suggests that children who were exposed to animals from birth were half as likely to develop allergies as children who had no pets. It was also noted that close proximity to metropolitan areas were associated with higher risk of developing asthma and other allergies. This is likely due to higher pollution levels and the fact that pollution creates new allergens that our bodies have not evolved with over the years, making our allergic response to th

em much stronger. The effect of this is most evident

when comparing the prevalence of seasonal allergies and asthma in developed vs developing countries where the population tends to be more rural.

Relationship Between Vaccines, Antibiotics, and Allergies

Since vaccines work by priming your immune system, it’s not surprising that they can have an effect on the development of allergies. There’s some evidence that the BCG vaccine, which is used in many developing countries where tuberculosis is more prevalent, may produce lower rates of asthma and other allergic responses. The researchers believe this may be because tuberculosis falls under the Th1 category of immune responses and by activating that type of response lowers the body’s Th2 responses. Another study found that the vaccine against pertussis was linked with slightly higher rates of seasonal allergy development, this vaccine activates a Th2 response, which may also enhance any responses to allergies. Seasonal allergies are frustrating to deal with and can definitely decrease your quality of life when they are present, but there is much controversy of the growing number of vaccinations and their efficacy causing many countries to eliminate them from their healthcare system. These kinds of studies do definitely show the need for more research into the long-lasting impacts of vaccines.

Exposure to antibiotics early in life also increases the risk of developing allergies. Antibiotics can disrupt the gut microbiome which is just developing in young children and plays an important role in the development of allergies. The human body requires “good” bacteria to help prime a child’s immune system for what is and isn’t an appropriate reaction to antigens.  Its collection of “good” and “bad” bacteria is called the human microbiome and is the target of a frenzying amount of research of late. It’s implication on health are tremendous from its effects on digestion and obesity to certain mood disorders to its known impact on allergies.  Frequent courses of antibiotics clear out your “good” bacteria (along with the bad) and have been shown to deprive the immune system of this priming when given early in life, causing it to react more violently and frequently to neutral stimuli. If over 99% of the DNA in your body does not belong to you… are you really who you say you are??

Conventional vs Alternative Allergy Therapies

 A map of some traditional acupuncture points to control the flow of qi.

Unfortunately for most allergy sufferers, most of what’s been discussed so far in this post relates to factors we don’t have much control over, how stressed our mother is during pregnancy, where we grew up, whether we were exposed to household pets or livestock from birth, so for those of us who can’t pick up and move to the countryside and start raising goats, how can we get some relief from our already formed seasonal allergies? As previously mentioned, antihistamines are commonly prescribed for allergy relief. Speaking from personal experience though, these do not always alleviate allergy symptoms, especially if you only start taking them once you’re symptomatic and your immune system is already ramped up. Steroid based nasal sprays are another commonly prescribed conventional treatment which work by generally suppressing your immune system. This approach to care is like throwing the baby out with the bath water, especially for people whose immune systems are already suppressed by preexisting conditions like diabetes or cancer. Allergy shots are a different means of treatment which involves injecting a small amount of the allergen into the body over a long period of time to try to desensitize the immune system to the antigen and eventually stop the allergic response altogether. However, studies have shown these work better for year-round allergies than seasonal ones.  At best, these treatments can provide symptomatic relief (at least until next year), but almost none of them address the root cause.

Probiotics have been shown to relieve allergy symptoms and even cure allergies altogether! This makes sense as probiotics can also have anti-inflammatory effects by supporting the natural flora of the gut, if you’re interested in learning more about this and haven’t already check out our “Eat Poop and Live!” post which is all about the gut microbiome and its effect on your health. The mechanisms of how gut microbes may effect the immune system are still not completely known, and more study is needed, but they have been definitively shown to provide symptomatic relief and improve quality of life for those who take them.

Bee pollen and local honey are perhaps one of the most potent natural allergy treatments. Bee pollen naturally reduces the amount of histamine in your body, and should be purchased from local vendors so that it contains the pollen from the area you live in. When taken starting in small doses and gradually increasing, it can work in a similar way to the allergy shots mentioned earlier in this post, acclimating your body to the allergen so that it breaks down its response to the pollen. A few cautions go along with the use of bee pollen though, if you have an allergy to bees, it may cause a dangerous allergic reaction, and you should discuss with your doctor before using it. Additionally, women who are pregnant or breast feeding, or anyone on blood thinners should avoid bee pollen or have a conversation with their doctor before starting it.

Acupuncture is a form of Eastern medicine, which works by balancing the flow of “qi” (pronounced “chee“) in the body. Modern hypotheses believe it may work by stimulating the release of certain neurotransmitters by activating specific nerves, or in the context of allergy relief, suppressing proinflammatory molecules, which activate the Th2 response as discussed previously. A recent study showed that when comparing groups of allergy sufferers who were treated with anti-histamines alone, antihistamines and acupuncture at non-meaningful sites, and antihistamines and acupuncture at meaningful sites, the group that was given meaningful acupuncture reported the greatest relief of their symptoms, long-term cure was not studied, but training the body to respond in this way through acupuncture has been suggested to be curative by some experts.

Conclusions

The development and factors that influence the severity of allergies are incredibly complex and often difficult to untangle in the modern world where we’ve deviated so far from how our ancestors lived. Maximizing our exposure to common allergens, dirt, and animals early in life can help minimize the chances of developing allergies later, and even later in life, gradual exposure to allergens such as bee pollen can provide symptomatic relief that rivals or exceeds that of over the counter drugs. While the full interplay of all the factors contributing to allergies will need more time and research to unravel, it’s clear that our modern lifestyles play a huge role in how widespread they have become, and trying as much as possible to get “back to our roots”, so to speak, may help to reduce the prevalence of allergies in future generations.

References

  1. Baena-Cagnani C, Canonica G, Zaky Helal M, Gómez R, Compalati E, Zernotti M, Sanchez-Borges M, Morato Castro F, Murrieta Aguttes M, López-Garcia A et al. 2017. The international survey on the management of allergic rhinitis by physicians and patients (ISMAR). BioMed Central.
  2. Bee Pollen Benefits and Side Effects. 2017. WebMD.
  3. Berger A. 2000. Science commentary: Th1 and Th2 responses: what are they?. BMJ 321:424-424.
  4. Farooqi I, Hopkin J. 1998. Early childhood infection and atopic disorder. Thorax 53:927-932.
  5. Hicks E. 2013. Acupuncture May Help Seasonal Allergies. Everyday Health.
  6. Howarth P. 2017. Pathogenic mechanisms: a rational basis for treatment. PubMed Central (PMC).
  7. LaRiccia P. 2017. Acupuncture and Seasonal Allergies. Medical Acupuncture.
  8. Lester T. 2017. How Bee Pollen Could Cure Your Allergies. mindbodygreen.
  9. Marcus M. 2007. Alternative medicine helps with allergies. USA Today.
  10. Nierenberg C. 2015. Probiotics May Help Relieve Seasonal Allergies. Live Science.
  11. Palermo E. 2017. What is Acupuncture? | Does Acupuncture Work?. Live Science.
  12. Park S, Heo E, Kim D, Chung H, Lee C. 2015. The Association of BCG Vaccination with Atopy and Asthma in Adults. International Journal of Medical Sciences 12:668-673.
  13. Rindsjo E, Joerink M, Papadogiannakis N, Scheynius A. 2010. IgE in the Human Placenta: Why there?
  14. Rottem M. 2011. Vaccination and the Risk of Atopy and Asthma. World Allergy.
  15. Saarinen K, Jantunen J, Haahtela T. 2017. Birch pollen honey for birch pollen allergy–a randomized controlled pilot study. – PubMed – NCBI. PubMed.
  16. Sifferlin A, Sifferlin A. 2017. Is Acupuncture an Antidote for Allergies?. TIME.com.
  17. Smith G. 2017. Why So Many Allergies – Now?. Allergic Living.

Eat POOP and Live!! The Human Microbiome

Microbial Minions

When you think of the most important organ in your body, what comes to your mind? Probably the brain, or maybe the heart and lungs. If damaged, these are, after all, the ultra-sensitive organs that allow us to survive not even a few moments without. But what if there was an organ that affected our body in an even more systemic capacity, from the moment you’re born, throughout your life. This organ can change the course of your future health, affect the way you develop acute or chronic diseases, and help or hinder the digestion of every morsel of food you ever eat. And perhaps the most amazing thing about this organ is that it isn’t even human. It is the human microbiome, and it’s made up of the more than 30 trillion bacterial cells living in and on every surface of your body. Your excrement is a by-product of your microbiome and pretty much every time we take a breath or put anything else into our body, we are inserting more bacteria into it. An American’s greatest challenge is to eat healthy bacteria that can strengthen the microbiome.

Functions of the Microbiome

Germaphobic readers might be squirming in their seats right now, but the truth is, your microbiome or natural flora, is incredibly vital to the way your body works. Not only do they synthesize vitamins and break down complex carbohydrates in your gut, they also help train your immune system to recognize pathogens. They take up prime real estate in mucous membranes like your mouth, airways, and even your eyes to help prevent pathogenic bacteria from gaining a foothold and causing infection. A lot of research is now being done to look at the effects that the microbiome can have on our genetics. Increasing evidence is demonstrating that different populations of bacteria can toggle the genes and metabolic pathways that can raise or lower your risk for different diseases such as obesity, diabetes, cardiovascular disease, cancer, and even more mundane conditions like allergies and heartburn.

One of the things that makes the study of the microbiome very difficult is how individual each person’s microbiome is. The variances in populations and amount of the different species of bacteria from person to person are immense, and beyond the individual variances, the diversity in species varies greatly based on anatomy. This would be expected if you were looking at, say skin vs gut microbes, but studies have shown that even the difference between the microbes colonizing the forearm and elbow is significant. All of this complexity can make setting up experiments and studies extremely difficult. Fortunately, the recent advent of big data processing is helping scientists keep things straight and even the most nascent results of this work are revolutionizing our approach to managing health.

So What is Poop Anyway?

Poop, also known as stool, feces, defecate, manure, muck, poo, kaka and many more colorful names, has a vital role in your body’s function. It is produced primarily from the microbiome of the lower intestinal tract. When normal and healthy it is about 90%+ bacteria with the remainder being partially digested food suspended by water and soluble fibers.* It is an excellent marker of overall health and there are entire professions dedicated to the study of it. Understanding the Bristol Stool Scale can help you keep an eye on your stool health. Problems with defecation can lead to significant discomfort, pain, and even death. Simply stated, the flow of your poop is directly proportional to your very ability to stay alive and healthy, so don’t be too shy to take a look at it every time you go.

Microbiome from Birth

Research is being done, and although we’re only scratching the surface, what has been discovered so far about the effect that the microbiome has on our health and the health of our children, is nothing short of incredible. Starting with our mother’s microbiome this non-human organ has a huge impact on our health. Studies have shown that mothers with a healthier, more robust gut microbiome will pass some of this diversity on to their baby in utero. These children tend to have activation of metabolic pathways in the gut that lead to a healthier life with a lower risk of diabetes, obesity, and other metabolic diseases – this is of course ignoring any future lifestyle choices. Even the method of delivery of a child (C-section vs vaginal) can also have a tremendous impact on this.

A study conducted in Venezuela looked at the microbial populations of newborn babies who were born vaginally vs those born via C-section. The naturally born babies had larger proportions of microbes commonly found in the gut, which they had acquired while moving through their mother’s vaginal tract. The C-section babies were found to have mostly skin associated bacteria on them, since they were removed directly from the uterus and did not get to pass through their mothers’ microbial population. A later study followed children to adulthood and found that the babies born via C-section were more likely to suffer from childhood obesity, Celiac disease (gluten sensitivity), asthma, and allergies. While there are certainly many factors that contribute to this, the study was controlled enough that researchers believe the initial colonization of microbes is a significant part. A great TED talk by Robert Knight elaborates further on this and can be found here.

The Microbiome and Immunity

Not only does the microbiome play a role in chronic illnesses, it’s also essential during acute periods of infection as well. Clostridium difficile (C. diff) has become one of news television’s superstars in recent years. It is a particularly nasty bacteria that are resistant to most antibiotics and take up residence in the gut. When the normal microbiome has been disrupted enough (by antibiotics), they have a huge party in the gut overtaking a chunk of of it and eventually growing out of control. These infections are particularly difficult to eradicate, causing severe diarrhea, fever, nausea, and in severe cases kidney failure and even death. Even after the infection has been treated, it has a high recurrence rate (1 out of every 5 infected patients). For decades, standard treatment for C. diff infection has been antibiotics, however, fecal transplant is becoming increasingly common in the treatment of particularly stubborn infections. Yes, this is pretty much what it sounds like: fecal material is collected from a healthy patient (often a relative of the patient since microbiomes of those who live together tend to share more similarities) and transplanted to the affected patients GI tract by one of several methods (don’t ask). These treatments have had much more dramatic results than standard antibiotic treatment in many patients, relieving months of almost constant diarrhea in days or even hours. This relief is due to the reestablishment of a healthier microbiome, which can bring the out of control C. diff back in check. You should never underestimate the value of poop.

Steps for Good Poop Health

There are tons of articles on the web supporting this topic, but here is our “quick list” of recommendations:

  1. Water- stay hydrated
  2. Fiber- eat whole foods, stay away from processed foods
  3. Activity- ideally exercise, but even simply walking 40 minutes a day and moving around during your routine activities is better than being dormant
  4. Probiotics- are actually good bacteria: yogurt, kefir, fermented vegetables
  5. Prebiotics- support the growth of bacteria: kimchi, raw garlic, raw onions, green tea
  6. Organic – eat organic food sources as much as possible and avoid all GMO (genetically modified organisms) products, hormones, and antibiotic-laden food
  7. Magnesium- promotes muscle activity
  8. Take your time- don’t be hasty when defecating, give your body a chance to do it’s business
  9. Position- squatting turns out to be the best position for defecation. Check out the Squatty Potty.
  10. Anxiety and other emotional stress can reduce the nervous function of your gastrointestinal tract
  11. When necessary, use natural laxatives and not chemicals- flaxseeds, whole foods, prunes, psyllium husk, aloe vera, and many, many, many others. Most of which are significantly cheaper than the over-the-counter aisle in the grocery store.
  12. AVOID ANTIBIOTICS!!! Both from your doctor and in the food that you eat (see #6)
How to Help Your Microbes

So since it is apparent that having a healthy microbiome is so incredibly important, what are some of the things we can do to help support it? Good nutrition certainly seems to be a large piece of the puzzle. You’ve probably seen products in the store such as yogurts labeled “probiotic”. These foods contain either cultures of gut microbes, or compounds that help those microbes to grow and flourish in the gut, and are commonly found in fermented foods, like sauerkraut, kimchi, or increasingly popular kombucha and other fermented drinks. The biggest enemy of the microbiome is antibiotics. This is NOT to say that if you have a bacterial infection you should not take antibiotics that are prescribed to you. However, inappropriate use of antibiotics is impacting our microbiomes as a whole. Even in a non-medical sense, livestock are often fed antibiotics, not only to treat illnesses that crop up in populations, but also at very low levels to help fatten them up. Since the antibiotics keep the populations of microbes in the animals guts low, they are competing with less organisms for the nutrients they eat and are able to grow fatter more quickly. Despite guidelines from the FDA about the amount of antibiotics allowed in our food by the time it gets to us, the meat and dairy products we buy in the supermarket often have more than the allowable amounts, exposing us to more antibiotics without our even realizing. Yes antibiotics have been linked to increased obesity in humans too!!

Being cognizant of the effects that the foods we eat have on our microbiome is essential to preserving its function. The bacteria of the microbiome are far more than just a group of hitchhikers, they are an essential component of our body, without which we literally could not survive. We are already beginning to see the effects of the stresses being put on the microbiome in the form of rapidly elevating numbers of people with diabetes, obesity, allergies, asthma, and autoimmune diseases. As physicians, we often focus on the human factors that contribute to disease, but we have to make sure we don’t ignore the 50 trillion non-human factors as well. Help your doctor remember the importance of the microbiome in your care.

Only 1% of all the DNA in your body is actually yours. So the next time you’re standing at the mirror, take a really close look realize that you may not be who you always thought you were…

* Incidentally, insoluble fibers are not easily digested and often show up whole in your stool.

References

  1. Avril, Tom. “Hospitals Struggling against ‘C. Diff’ Bacteria.” Philly.com. N.p., 07 Oct. 2016. Web.
  2. Blaser, Martin J. Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues. New York City: Henry Holt & LLC, 2014. Print.
  3. Burling, Stacey. “Treatment of Last Resort for C. Difficile Infection.” Philly-archives. N.p., 07 Apr. 2014. Web.
  4. Enriquez, Juan, and Steve Gullans. Evolving Ourselves: How Unnatural Selection and Nonrandom Mutation Are Changing Life on Earth. London: Oneworld Publications, 2016. Print.
  5. Turnbaugh, Peter J., Ruth E. Ley, Michael A. Mahowald, Vincent Magrini, Elaine R. Mardis, and Jeffrey I. Gordon. “An Obesity-associated Gut Microbiome with Increased Capacity for Energy Harvest.” Nature.com. Nature Publishing Group, 21 Dec. 2006. Web.

We’re Spilling our Guts on the Leaky Gut Syndrome

by Sara Emslie
Rashida Ghauri, MD, ABIHM
Baber Ghauri, MD, ABIHM

The number of food allergies and sensitivities has been on the rise in recent years. Everywhere products are advertised as “Soy Free”, “Nut Free”, “Dairy Free”, “Gluten Free”, and the list goes on and on. While some of these allergies are related to inappropriate immune responses or recognized conditions like Celiac or Crohn’s disease, some have a more under-recognized pathophysiology known as Leaky Gut Syndrome (LGS).

What is Leaky Gut Syndrome?

 The human intestinal wall showing the impact of LGS on health.

Leaky Gut Syndrome has to do with the cells in your small intestine. The job of this tissue is to selectively absorb food particles that are of an appropriate size and nutritional value for circulation in your bloodstream. These particles are absorbed through spaces called tight junctions which are lined with immune cells designed to deal with substances that shouldn’t make it into your body. In individuals with LGS, these tight junctions are not as “tight” as they are supposed to be causing larger food particles to sneak through into the bloodstream. While these particles are innocuous enough on their own, they are seen as invaders by your immune system, which will then launch an assault on them. This causes the hallmark inflammation in your tissues causing the wide array of symptoms ranging from headaches and fatigue, to skin rashes, gas, bloating, and nutritional deficiencies.

Pathophysiology of Leaky Gut Syndrome

So now that you know the basics, you should also know that there isn’t one cut and dry explanation for why people get LGS. Research has shown that upregulation of certain genes in the gut can produce proteins that increase the permeability of these cells, causing the gaps in the tight junctions that can allow foreign particles into the bloodstream. This increase in protein production can be caused by a variety of factors, influenced by an individual’s diet, gut microbiome, lifestyle, and family history among others.

Microbial Neighbors

We’re taught from a young age that bacteria are bad. However, bacteria are a necessary part of human (and animal) life. Every surface in our body is covered with different species of commensal bacteria and they can outnumber our cells by about 10 to 1.  All the bacteria of a certain area together are called the microbiome and perhaps one of the most important microbiomes is in our gut. Not only do these microbes help us break down our food, produce necessary vitamins, and prevent other pathogenic bacteria from taking up residence, there is also evidence that they can help turn genes in our body on and off. Some of these genes activate metabolic pathways that can predispose an individual to be obese or healthy weight, diabetic or non-diabetic, and among many other factors, they can also influence whether an individual will develop leaky gut. Since diet, lifestyle, and any antibiotics or medications an individual may be on can greatly influence their gut microbiome populations, you can see how quickly changes to these factors can snowball into more helpful or harmful gut microbes.

I don’t want it- what’s up Doc?

Probably the most important way to prevent leaky gut is through a proper diet. Taking common-sense measures like avoiding processed sugars, dyes, and preservatives and trying to incorporate more fiber, fruits, and vegetables into your diet can help promote the growth of a healthy gut microbiome and keep your tight junctions closed. Avoiding meat that is processed or injected with hormones and antibiotics can also prevent irritation of the lining of the intestine that creates ideal circumstances for LGS to progress. Glutamine has also been shown to help promote good gut health, but always be careful when incorporating new supplements into your diet.  Increasingly, there are options for intravenous (IV) infusion of vitamins, minerals, and other supplements that can help fortify the various microbiomes of your body.

Leaky Gut, Autoimmune Disease, and Common Pain

Leaky Gut can be a major contributing factor in many autoimmune conditions. For individuals who have these conditions and are struggling to keep their symptoms under control using pharmaceuticals, those who are just having gastrointestinal symptoms, or even just those who want to prevent future problems, careful monitoring of diet, and how different food types make your body respond can make a huge difference in managing and even eventually reversing leaky gut. Most people look to corticosteroids to treat and manage autoimmune diseases, but what if we’ve been looking in the wrong place for the perpatrators of the inappropriate immune response all this time? What if instead of coming from the air, or the joints, or the tissues, it is coming from silent invaders through a leaky gut? And what if these disorders could be not only controlled but reversed? While each individual’s case will be different, more and more evidence is beginning to point to leaky gut as a trigger for autoimmune diseases, and just being aware of this fact is key in the prevention and management of these conditions.  Talk to your doctor about LGS.

Summary

Leaky Gut Syndrome is an under-recognized condition of the gastrointestinal tract that can cause a wide-range of symptoms including “stomach” pain, discomfort, skin rashes, headache, and even arthritis.  The pathophysiology is very interesting and only now being studied and treated by the conventional medical community.  If you believe you may be suffering from this condition, eliminate your consumption of meat, dairy, gluten, and processed foods as a trial and/or check in with your doctor to be tested.  The good news is that no one has to suffer from Leaky Gut Syndrome as it can be cured with proper nutrition.

References

  1. Drake, Daniela. “New Research Shows Poorly Understood “Leaky Gut Syndrome” Is Real, May Be the Cause of Several Diseases.” The Daily Beast. Newsweek/Daily Beast, 27 Mar. 2014. Web.
  2. Elkaim, Yuri. “Leaky Gut: What It Is and How to Heal It.” US News. U.S.News & World Report, 6 Mar. 2014. Web.
  3. Galland, Leo. “Leaky Gut Syndromes: Breaking the Vicious Cycle.” Foundation for Integrated Medicine. Foundation for Integrated Medicine, n.d. Web.
  4. Michielan, Andrea, and Renata D’Incà. “Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut.” Mediators of Inflammation. Hindawi Publishing Corporation, 25 Oct. 2015. Web.
  5. Mullin, Gerry. “Glutamine Helps You Lose Weight.” The Food MD. Dr. Gerry Mullin, 27 May 2015. Web.
  6. Reasoner, Jordan. “Leaky Gut Syndrome in Plain English – and How to Fix It.”SCD Lifestyle RSS. SCD Lifestyle, 11 May 2016. Web.

Don’t End Up as NASHty as I Was…

by
Baber Ghauri, MD

Don’t Tread on Me

American FlagI am an American.  I believe in democracy and freedom of speech and choice.  Like any American, I vote with my dollar and take advantage of all the liberties that having some dollars affords me.  I started medical school in 1997, giving me about 20 years in the noble field of health care, with over 12 of those years as a board-certified attending physician.  I also feel privileged to have had the opportunity to be recognized for many other honors and appointments, both clinically and otherwise.  My strong Punjabi heritage makes me a Foodie- like Americans, Punjabi’s can eat!  With the strong exception of pork, the Pakistani diet is pretty much meat, meat, and meat- sound familiar?  If you’d rather, stop reading right here, my Pakistani-American heritage is the double whammy that forms the basis of what I’m about to tell you.

I write this blog post today because I know I have friends, patients, and family members that are in the same boat.  Those of you that know me know that, like so many other physicians, my wife (also a board-certified physician) and I recently underwent a bit of a transformation.  I’m talking in excess of the clinical transformation that everyone in health care is going through.  The additional growth we’ve experienced is the underlying reason for the inefficiency and poor performance we are trying to correct in health care.  It is undermining our entire health system, and it’s my obligation and professional duty to share my experience.  Going through this has made me a better physician, a better father, a better friend, and a better member of our great society.  Maybe it’s a reverse mid-life crisis, either way; it started about seven years ago with the result of a routine blood test.

I Was Fine!

I had a very mild transaminitis, which means my liver chemistry was a little off- barely a smidgen above the upper limit of normal.  I felt fine.  I played basketball and tennis regularly and arguably in the best form of my athletic career.  I was 6′ 1″ and weighed about 170-ish lbs.  This translates into a body mass index (BMI) of about 23, which is well within a normal, healthy range.  Throughout my life, I’ve always been the skinny, lanky guy that could use a few extra pounds.  Having never been one that likes to nap during the day, I noticed here and there that I would feel drained and would often fall asleep right before dinner time.  Thinking back, I recalled that my father also often fell asleep when he came home from work, so I figured this was “normal.”  I saw my outstanding primary care doctor- he was mildly concerned about my findings and appropriately wanted me to get a liver ultrasound to see what was going on.  But I never did.  I was fine!  I decided I would recheck in 3 months- though not exactly supported by the evidence, and this was not entirely unreasonable for a patient that wanted to take a conservative approach, or at least that’s what I convinced myself.
ABIMThe diagnosis was already clear to me- lab error.  After all, I had nothing!  I was fine!  No complaints!  I was way too busy to worry about it.  Guess what else…  I never even got tested again- I was so sure.  Hey, I am certified by the American Board of Internal Medicine and licensed by the State of Pennsylvania to know what’s up!  Who knows better than me- no one!  Time went on, I changed nothing, and a couple of years later the drained feeling became more frequent (by this time my weight jumped up to near 190 lbs), but I was still performing at a high level and doing the things that I needed to do- I continued to sweep it under the rug.

Wake Up Call

It was my Integrative Medicine training that caused me to reflect on this experience, and after I sustained a moderate injury to my knee (in part due to the additional weight), I finally realized that I was in denial.  The results were suggestive of either NASH (non-alcoholic steatohepatitis) or NAFL (non-alcoholic fatty liver)*- both fancy words for liver inflammation.  It was mild, but I was genuinely astonished- it was tough for me to accept and maybe that’s why I never followed through with the definitive ultrasound that would have confirmed it in the first place.  The liver has a very high tolerance for insult, but once it’s mad, can cause serious misery.  Mine was JUST beginning to get annoyed with the drained feelings I was having.
Even after I finally came to grips with the diagnosis, it took me another 1-2 years to get to my current station- as of mid-2016, I’ve:
  1. Basically given up soda and sugary drinks, especially those with high-fructose corn syrup.
  2. Reduced my meat consumption to very little red meat
  3. Pretty much eliminated processed meat (the World Health Organization has classified all processed meats as class 1 carcinogens- yes this means they can cause cancer)

    Processed meat is a Class 1 carcinogen
  4. All but eliminated oxidized cholesterol consumption (fast food or foods cooked at high temperatures)
  5. Memorized the Bristol stool scale and try to keep track (the disgusting link, what do you want me to do?  I’m a doctor!  The funny thing is that my 8-year old knows it better than I do!)
  6. Increased fish and seafood intake (wild caught, not farm-raised)
  7. Essentially cut out dairy, but was never really a big dairy person in the first place
  8. Tremendously increased my fruit, nut, legume, and vegetable consumption (which I always loved anyway)
  9. Basically stopped using my microwave (microwaves can wreak havoc on the nutritional value of good food)
  10. Focused heavily on staying hydrated
  11. Perhaps most importantly, I tremendously reduced my intake of sugary foods (I actually read labels now)
Having just returned 12 lbs heavier from a 2-week long family road trip, I need to reiterate that I am FAR from perfect!!  This was an incredibly fun time eating primarily at restaurants but also making many trips to the markets to maintain that fruit and fiber intake.  If not for this, that 12 lbs could easily have been 18 or 20!  Even still, just one day afterward, I dropped 2 lbs and anticipate to shed at least another pound of water weight from all that salty restaurant food.  And I have no doubt that the remaining weight will also come off now that I’m back to my usual routine that is mostly based on whole foods and home cooking.  Even still, given the decreasing nutritional value of food, it is becoming even harder to consume the right amount of dietary nutrients, but I digress…
The best part of all this is that I really do like the way I eat now as compared with prior; therefore, I insist that I am NOT on a diet.  I still eat “bad” things like cookies, cakes, iced tea, hot dogs, and many, many others- BUT at least now I KNOW what these things are doing to me.  There’s a difference.  The brain is extremely powerful, and I believe that knowing allows the body to better combat the effects of these harmful foods.  For example, I recently noticed that I tend to crave more green leafy vegetables when I eat, let’s say a cheese-steak (see- I’m far from perfect).  This is probably because my BRAIN knows the fiber causes less absorption of the oxidized cholesterol and carbohydrates.  In other words, this was something I feel I did subconsciously and wasn’t “on purpose” per se- it was something I realized after the fact.  But now it is more purposeful.

Exercise? Not so much…

Now for the controversial topic- EXERCISE.  I don’t do it…  well, let me clarify, I exercise like crazy, but it’s not “going running” and “going to the gym” exercise, but more like playing with my kids, playing basketball, other cardiovascular activities, and doing my own home improvement projects type of exercise.  In other words, I don’t say I exercise, I say I’ve increased my activity- tomato/tomahto to some, but important for me- because I have never liked to “exercise”.  For those who DO like to exercise, they should exercise!!  They should just know there is increasing evidence that intense exercise more than 3-4 days a week (especially with no recovery days) increases MORTALITY!!  Yes, this means they die sooner than those who don’t!!  But I digress again…  It’s my opinion that exercise itself only has a mild effect on body fat and weight loss- I believe that when you’re spending 1-2 hours a day exercising, that Big Mac just doesn’t taste the same and you think twice about the next one.  It’s my opinion that every pound of fat lost or transitioned to muscle growth is 80% due to diet and only 20% due to exercise.  Here’s some evidence on diet vs exercise in weight loss.

Fast forward to 2016 (before my vacation), I was back to my 172 lbs, and although my weight has redistributed a bit, there is no question I have a bit more truncal obesity than I would like- I’m developing Metabolic Syndrome X which is a precursor to type 2 diabetes mellitus.  My Dad has been on years and years of drug therapy for type 2 DM, and until recently, I was taught that it’s primarily genetic and there was little to no chance that I would be able to avoid it- I thought it was inevitable for me…  But no longer!  Not only can type 2 DM be prevented, but type 2 DM can even be reversed if you do get it!!!  But why didn’t I know this before?  Why are we NOT teaching this to our medical students?  Ok, maybe I’m just out of touch- but why do almost none of my colleagues know what it is?  Why?  Could it be because frosted Lucky Charms are NOT “a part of a nutritious breakfast”?  They do magically create a delicious profit margin of over 40%- but I digress again.

Knowledge is Power

I DON’T HAVE TO BE DIABETIC- I have a choice!  What a great country!  It is this hope that has driven me to do better for myself.  I share my story with you today because I thought everything was fine- it wasn’t.  I thought grocery stores were there to provide food, not make as much profit as they possibly could.  I thought the nutritional powers that be were keeping an eye on the American diet and magically working behind the scenes so that I could not possibly buy food that was bad for me!  I was wrong.
If I hadn’t come to these realizations, I would probably be diabetic by now or worse.  I would be at high risk for cryptogenic cirrhosis (liver failure) if I really had NASH*.  Those that know me well know that this experience has been profound for me- I think it has saved my life.  I know now that it is NOT EXPECTED to develop high blood pressure, coronary artery disease does not need to be a normal thing that happens to everyone, dementia is not a “normal part of aging”- all of these things have reasons- some we know already, but many we do not.  Most significantly, it is NOT NORMAL to be on prescription drugs to counteract the effects of these diseases for the rest of your life.  Like any of my colleagues, for at least one decade I have prescribed a countless number of these drugs and told countless patients and family members that they will need to be on them for the remainder of their life.  With the help of our growing medical community of integrative practitioners, we need to now work on safely getting people OFF their chronic medications and shifting them to a treatment plan that is rooted in non-prescription interventions- we can’t afford them!  IT IS POSSIBLE!!!  I didn’t know it was before, but I feel blessed to have learned many of these strategies.

Food is Medicine

Pharmaceuticals will always be necessary for patients that are the sickest of the sick as well as for infections, symptom control, and secondary disease prevention.  But do we need them to poop?  Do we really want to believe that we should eat whatever we want and have to rely on pills to eliminate it from our body?  Who do you think benefits from this idea?

Drugs will have a place for people that can’t or otherwise don’t want to recognize that FOOD IS MEDICINE and that you can’t exercise off the detrimental effects of Kentucky Fried Chicken, you have not to eat it in the first place…  These poor patients are doomed to a lifetime of prescription medications and doctor visits- just like many of my now deceased patients and family members- even though I continue to have bad eating habits, I feel fortunate and even empowered that I now have the choice to remove this from my personal destiny.  But I also feel concerned that it took me almost ten years to get to this point.  As a physician, shouldn’t it have been much faster?  In many ways, I feel my original training made it HARDER for me to accept these realizations.  Had it not been for my integrative medicine training, there’s a near 100% chance that you would not be reading this right now.

I’ve learned that my Pakistani-American approach to eating IS the root cause of my health issues.  There’s a reason that immigrants from China, Africa, and Sweden die from the same coronary artery disease that kills every other American in our country- my friends, I’m extremely sorry to tell you it is our food choices that are making us sick.  I wish it wasn’t, but it is…  I’m not talking about the hamburgers and hot dogs, and I’m talking about everything!!  Even the dairy, the GMO vegetables, the concentrated animal feeding operation (CAFO) meat, and the “healthy” fast food!  Please prove me wrong if you think otherwise!!  I beseech you to convince me, and I love KFC!!  But until then, I need to do my best to set an example for my children, family members, patients, and all others around me- it has not been easy, but it has at times been quite fun.  I’m on a mission, and the good news is that I’m not alone…

It is reassuring that some of the smartest people I know are choosing not to look the other way and are independently coming to the same realizations.  The challenge is bringing this knowledge into today’s practice, which is becoming increasingly standardized.  This means we doctors need to understand the data and stop following the status quo if it doesn’t make sense- even if it’s a protocol.  With the current fiduciary position of our health system, reform, and adoption of the BEST possible means to increase the quality and reduce the cost of healthcare is inevitable.  Can the care of our sickest patients become a protocol?  I happen to believe some of it can, but we need to THINK creatively about each patient’s care BEFORE we institute protocols.  It turns out the sickest patients often require an individualized care plan.  This is the basic philosophy of Integrative Medicine- consider all evidence-based interventions, not just the ones that are traded during business hours on Wall Street.  The stakes are so high for pharmaceuticals now that increasingly we see trusted authorities looking the other way when it comes to sound process and logical reasoning to get the desired outcome, aka fraud.  Forget the human element, just thinking as an economist might, our health system has declared that we can’t afford to make these mistakes anymore- we just don’t have the money to pay for them.  But I digress again again again.

Summary

I have been extremely naive about the food that I’ve been consuming throughout my life.  There is increasing evidence that food that is processed or high in animal fat can be deadly to the human body- duh?!?!  Even being in relatively great shape, I probably started to develop a potentially very serious condition of my liver that can eventually lead to diabetes and serious health issues.  It’s my opinion that not only my patients but also a large percentage of my friends and family are also at extremely high risk to have NAFLD.  I share this personal message with you today because I’m concerned.  I’m concerned about how this happened to me so insidiously.  I also feel it is my duty and responsibility as a physician and a member of our society to share the knowledge that can benefit others.  If you have a family history of diabetes, have transaminitis, or are starting to have truncal obesity- see your doctor NOW.  Most of us doctors are not well-trained to discuss how your nutrition can very often reverse your illness- that’s OK, MAKE THEM learn or seek assistance!!  Finally, we all need to rethink our food choices- vote with your dollar, stop buying foods that have ingredients that you cannot pronounce and buy organic whole foods that are locally sourced.

More to come, this is important stuff- thank you for reading my story, your comments (yay or nay) are welcome…

*NAFLD stands for non-alcoholic fatty liver disease which is subdivided into NASH and NAFL.  As much as I would LOVE to talk about the pathophysiology of all the diseases mentioned in this post, others have already done a much better job than I could, and I encourage you to reference your favorite medical knowledge base for more information.

The Truth about them French Fried’ Potaters?

by
Sarah Emslie
Rashida Ghauri, MD, ABIHM
Baber Ghauri, MD, ABIHM

How Healthy are Potatoes?

Russet Potatoes

Potatoes are the most commonly eaten vegetable in America with the average American eating over 50 lbs a year! We use them in hundreds of dishes and prepare them in dozens of different ways, from chips and fries to baked, mashed, and roasted, and the list goes on. As a result, the potato industry is a multi-billion dollar business, with the value of potato crops grown in the US valued at around $3.73 billion dollars in 2013 alone. As with any other industry this results in a push to produce more and bigger potatoes, which as discussed in our Nutritional Inflation post, often leads to potatoes that have less nutritional value. Although inexpensive, commonly eaten, and with wide variety of recipes, potatoes contain much less nutritional value than many other vegetables in your produce isle, and even less than their ancient ancestors. We’ll tell you how to squeeze the most value out of your favorite spuds!!

A Brief History of Potatoes

The Incas and other native tribes have grown potatoes in South America for thousands of years. They served a wide variety of uses, ranging from healing broken bones to measures of time. Another wild ancestor of potatoes in North America known as an apio contained high levels of cancer fighting compounds and was used as a paste to treat skin tumors by the Sioux. The potatoes that were discovered by the Spanish explorers and were brought back to Europe, however, did not retain many of these medicinal uses and quickly became one of the most important staple crops in the Old World, so much so that countries like Ireland became primarily dependent on them for food. Heck, we’ve even seen potatoes powering small lights at the local science fair- potatoes can do almost anything!

Pot-uh-oh: Glycemic Index

Nowadays potatoes are commonly associated with the starch family of foods than as a vegetable, partially because we have bred them for their starch. Compared to their ancestors, which were much higher in protein and cancer fighting compounds, modern varieties of potato can contain over 28 times less phytonutrients. In addition, starchy foods like potatoes are rapidly becoming a contributing factor in the exponentially rising incidence of type 2 diabetes. This trend has to do with how quickly a food releases sugar into the blood stream, also known as the glycemic index.

Some foods release small amounts of sugar over a longer period of time, these are low-glycemic index foods. These foods more closely resemble the diet that our ancestors ate, and the diet that our bodies have evolved to handle. With the increases in sugar and starch content in modern foods, and larger amounts of processing that go into creating pre-made food products, a large majority of foods in the typical American diet are high-glycemic index foods. The largest common contributor to high-glycemic index foods is the now infamous high fructose corn syrup (HCFS). The sugars in these foods are released very quickly in a shorter amount of time into the bloodstream. Because of this overload of sugar, the body (particularly the pancreas) has to quickly produce larger amounts of insulin to deal with it and the brain has a very hard time determining how to counteract the effects of HFCS. If this cycle of massive dumps of sugar into the bloodstream triggering a corresponding response of insulin release can eventually desensitize muscle and fat cells against insulin, putting even more strain on the pancreas to produce yet more insulin. This quickly turns into a vicious cycle that is the pathogenesis of Type II diabetes. This wouldn’t be so bad if insulin was not an anabolic hormone that in excess will lead to deposition of fat into your body starting with the midsection (trunk) and rapidly spreading throughout.

High-glycemic index foods raise blood sugar much more than low- glycemic index foods. This requires the pancreas to work harder to produce enough insulin to counteract the effects of these foods.

Fixing the Phytonutrient Problem

There are ways to combat the loss of phytonutrients and the high-glycemic nature of potatoes.

Bring Down the Index!

Not all potatoes have high-glycemic index, but for those that do, with a little planning, you can take matters into your own hands and reduce your intake of high-glycemic potatoes. The smaller potatoes in grocery stores with smoother skin, which are often billed as boiling potatoes or new potatoes are actually have low-glycemic index because of their immature composition makes the sugars less available to those that eat them. These potatoes are harvested earlier in the season and have a blunted rise in blood sugar than their larger more mature counterparts, which are often advertised as baking potatoes.
But what if you or your loved ones are really craving baked potatoes, but still want to avoid the blood sugar spike that comes with them? This is where the planning comes in. By cooking the potatoes a day ahead of time and chilling them for a day, the blood sugar response to the potatoes can be decreased by up to 25%. The heating of the potatoes followed by chilling modifies the sugars in the potato into a form that is released more slowly into your bloodstream, turning it into a food that your body and pancreas are much more equipped to handle and lowering your risk for diabetes and cardiovascular disease for the long-term.

Go Purple

Purple Potatoes

You may have noticed some strange looking purple potatoes in the corner of the potato display in your local supermarket, maybe you even tried them one time as a novelty. As it turns out, despite their strange appearance and compared to their more conventional brown, red, and white cousins, these colored tubers contain 28 times more phytonutrients than our usual Russet potatoes, and an incredible 166 times more phytonutrients than some varieties of white potato! This is not a small number by any means, so while purple mashed potatoes or purple hash browns would certainly take some getting used to, they are more than worth their weight nutritionally. 

NOTE: Your smaller eaters may require a special sales pitch- it can be done…

Choose Brightly and Cook Wisely

Another trick, which can be applied equally to all varieties of potatoes, is choosing the brightest colors possible and eating the skins of the potatoes. Using both of these parameters to buy and eat your potatoes will ensure the greatest phytonutrient content possible, and preparing or eating them with a healthy fat like olive oil will make these nutrients more accessible to your body.

Never GMO!

As potatoes are stem tubers that come out of the ground, they are very susceptible to carry pesticides and other chemicals that can concentrate in the soil. Fortunately, the cost of organic potatoes is not that much more than their mutated friends due to their ubiquity.

Conclusion

While potatoes can only dream to be as nutritious as vegetables like kale or brussel sprouts, their low cost and versatility will keep them as a superstar among Americans. Luckily, you can take some simple steps at the grocery store and in their preparation at home to enhance their nutritional value and lower any long-term risks associated with their high-glycemic index. Following these simple guidelines will help you and your loved ones get more nutritional value out of your favorite foods!

References

  1. Allan, Barbara J. “What Is the Glycemic Index? – Nutrition to You.” Nutrition to You. Nutrition to You, 08 Apr. 2014. Web. 10 Aug. 2016.
  2. Bosse, Alena, and Michael Boland. “Potato Profile.” Agricultural Marketing Resource Center. USDA Rural Development, Apr. 2014. Web. 10 Aug. 2016.
  3. Khazan, Olga. “The Most-Eaten Vegetable in the U.S. Is the Potato.” The Atlantic. Atlantic Media Company, 11 June 2014. Web. 10 Aug. 2016.
  4. “Potatoes.” Washington State Potatoes. Washington State Potato Commission, n.d. Web. 10 Aug. 2016.
  5. Robinson, Jo. Eating on the Wild Side: The Missing Link to Optimum Health. New York: Little Brown, 2013. Print.