Advanced Maternal Age

IMG_0560I did not think I would be single and 41. I was pretty sure at 25, 27, 33, even 35 that kids were unconditionally on the horizon. I was not concerned that I would have kids later – after all I didn’t even graduate from medical school until I was 27. Then, I broke up with my long term love at 35. A quick trip to the fertility clinic at that time told me I was still good to go, and gave me info on my options.

I have been a lesbian for most of my adult life,  so assisted reproduction was  a necessary part of the planning. I  had considerable time to collect information on the legalities of sperm donors vs sperm bank options, and to become familiar with the insemination options that both gay and straight couples use in the quest for pregnancy. As a fertility specialist, I have supported many people through natural conception, IUI, and IVF. Now, well, lets say it could happen accidentally as I have switched teams. But, at my “advanced maternal age” natural conception is quite unlikely. So, after a second trip to the fertility clinic to confirm my continued fertile-ability, I am 3 days away from cryopreserving my eggs.

What this means, is I am doing the first half of an IVF cycle, and then instead of fertilizing  and transferring them, the eggs are put on ice for a later date. I am choosing to suspend the eggs instead of pre-made embryos, because  as referenced above, I am not in a relationship ready for babies. Its a logical choice for a single woman who is reaching the end of the #fertile years. It is also exciting to foil time, and have the possibility of a young family in the next few years. The miracles of modern medicine 🙂

Fortunately,  I decided around 33 to become an expert in #enhancingfertility and Assisted Reproductive Technology (ART) as an Integrative Medicine doctor. I studied  TCM/ acupuncture and fertility support from 2005-2011, and switched my focus to botanicals, endocrine function and anti-aging medicines in 2012. Read my published article about Integrative Medical support for the follicular phase of #IVF here.

I have quietly been preparing for this date in case I did not end up with a kid on my hip during my rather tumultuous 30’s. I will gracefully accept a child-free lifestyle if that is what is meant to be, as it has a freedom I value and I have wonderful children in my life. I may also choose to foster and adopt locally in Maine. The point of this cryopreservation is not only to end up with a child,  it is to preserve my choice to work towards conceiving within the next few years.

IMG_0672For those in the know, I am on day 8 of a stimulation cycle. I took 450 IU of Gonal-F for the first 6 days, and have ramped down to 300 for the next 2 days. I started 0.25 mg Cetrotide yesterday and will be continuing that for the next few days. Then, the trigger shot and retrieval Tues or Wed. My response is good and side effects minimal, which I am very grateful for. It really does pay to prepare for an event like this even years ahead. (PS. I had 21 eggs collected! 12 mature and 8 immature)

Here are my Top 5 steps for Fertility Preservation in Women over 35

1. CoQ10 preserves the quality of the eggs mitochondria  – essential for replication and good “egg energy” aka ATP for cell division. 100-400 mg daily prevention, 400 mg twice daily during a stimulation cycle.  ( The use of mitochondrial nutrients to improve the outcome of infertility treatment in older patients. Fertility and Sterility 2010; 93:272-5. )

2. DHEA is a lipid antioxidant and youth-reviving hormone precursor. I suggest 10 mg daily for prevention,  25 mg daily 6 weeks before stimulation cycle. Up to 75mg daily is evidenced to improve egg and embryo quality and enhance spontaneous conception. (Addition of Dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod.  2010; 25(10): 2496-500 Accessed September 13 2013)

3. This is your individualized medicine step – what do you need to tonify your specific reproductive patterns and enhance the chances of conception?

4. Fertility Massage is key for addressing muscular and ligament stress lodged deep in the pelvis that could mechanically impair the ability to maintain pregnancy. Concomitant castor oil packs clear debris from the ovaries and fallopian tubes, flushing lymphatic channels for a more balanced local immune response. The self massage/ hands on aspect maintains a connection between the cerebral, medicalized experience of ART and the physical sensations of the lower belly while reducing emotional stress. http://natural-fertility-info.com/fertility-massage.

5. Optimize your nutritional status with: extra leafy greens on a regular basis; superfoods especially in smoothies;daily  fresh vegetables; and choosing clean meat and dairy whenever possible. Reduce or eliminate sugar during high intensity hormone treatments including birth control pills.

It is the grit of everyday living that builds the pearl of one’s career. In the process of enhancing my own fertility, I have learned as much from the patients I have treated and supported as they learned from me. This primal biological drive has helped me to become a much better doctor in this field as I experience the nuances of treatment myself. I look forward to continuing to support all patients seeking conception, especially those of us above 35 that have lived full complicated lives and have had to balance the biological desire to have children with the real-life tensions of sex, gender, career, finance, and relationship.

 

 

 

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The Lost Art

I am sick in an invisible way that people cant really see, and I don’t really feel – much. I can take a pill and make it mostly unnoticeable. Except for the fact that my hair falls out in handfuls with a certain kind of stress…

I consider myself an expert in self-care. And yet, I can hardly find the time to do the “little” things that I know could help. Like, nettle hair rinses, getting at least 8 hours of sleep every night, taking my fish oil, and eating more protein. Instead, I keep myself too busy and dull myself with things that make me feel better for a few hours, but never in the long run. I have fallen into the mindlessness of  modern health care where I want a pill to do the work of healing for me. Dammit!

We all have levels of health maintenance we are willing to do on a regular basis. Vitamins, exercise, water, organics, therapy, whatever. We each have a certain degree of self care required to maintain the status quo of daily function. But, what happens when that balance is tipped and we need to actually recover from an illness, injury, or accident?

I offer you an invitation to step off the rat wheel of everyday living, and create a luminal space for healing. A luminal space is an anthropology term that refers to a period of time “outside of time” – a step out of everyday living. Some health crisis force this through body fluid effluvia that ties one to the bathroom, or physical disability that prevents mobility. Too often we are able to power through a cold, or anxiety attack or injury and do not engage in the art of self care to allow actual healing. This is what snowballs into chronic illness / disease or chronic pain.

I have been “sick” for at least 9 months, but I haven’t made more than a few half-hearted efforts to engage in deep self care. I have taken lots of prescriptions and had lots of blood tests, but is that truly healing medicine? I finally broke my baby toe last week, and have been suddenly forced to slow down by immobility. I am doing hydrotherapy, making castor oil packs, cooking and eating good food, meditating, saying no to social engagements I don’t deeply want to do, and getting sleep. These are some of the cornerstones of deep self care.

It is very difficult to give ones self approval to close the door on society and expectations and family, and friends, and chores, and domestic duties, and distractions, and choose to do something solely for the self instead. We are culturally programmed to take care of business, pleasure, family, kids, dogs, and our homes before we take care of the inner self. If you are sick, at any level, you will heal faster, and better if you take the time to practice deep medicine by taking the time to take care of your self.

I am here to help you do that. And, I give myself permission to offer that same wisdom and practice for my self. The pills and the maintenance are not enough. We must engage the luminal, lost art of deep self care for complete health and healing.

 

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Ideal Weight Program

photo 3Welcome to a new way of working with body image, metabolism, eating patterns and ultimately, weight management. This is not a diet. Let me repeat. This is not a diet.

Study after study have shown that only 2% of people who lose weight by dieting are able to keep it off for life; 98%  of dieters gain back the weight they have lost plus more. This endless cycle slowly but surely adds pounds while eroding your sense of self worth. It also creates chaos within the blood sugar, hormone and neurotransmitter system that leads to further metabolic disruption.

Now is the time to change the old patterns. With awareness and a commitment to change, you can rewrite the story of your body. Your cells are constantly regenerating themselves; with direction from your mind and an individualized, functional medicine approach to improving structure and function you can reach your ideal metabolism, energy, and physique.

This program is divided into four phases. Each phase is at least 90 days long. Some people will need more time in an individual section, and can stay in each section as long as needed. The four sections are like a wheel, and where you start depends on your health, area of interest, and life circumstances. Some people will move in a linear direction through each step, and others will hopscotch from one area to the other. The secret to success is that we follow your body, your life, and your needs to unlock your ideal.

The four treatment sections are: FOOD, DIGESTION, STRESS, HORMONES

FOOD:  It only makes sense to work with food when addressing weight. Food is actually a very complicated topic, and one that most people have layers and layers of  complex conditioning around. We will start with a comprehensive 200 food ALCAT sensitivity test that will empower and educate you to make food choices based on YOUR immune system reactions to food (food sensitivities.) There are so many diets, so much information, so many food gurus and opinions out there! This test allows you to claim your own power around food choices based on your body’s unique message. In this section we will also teach you how to identify when you are hungry, and when you are full. These simple intuitive eating approaches build awareness and compassion, connecting you to your own primitive need for food as fuel.

DIGESTION: Effective food breakdown and waste elimination is crucial to a healthy body. Nausea, bad breath, appetite fluctuations, heartburn, indigestion, gas, cramping, bloating, constipation, hard stools, soft stools and diarrhea are all signs that your body is not digesting effectively. We will use a CDSA (Comprehensive Digestive Stool Analysis) to investigate all parameters of digestion including beneficial and pathogenic flora levels to truly repair and restore your digestive tract. This will have multiple health benefits including a more balanced immune response, increased energy,  regular bowel movements, potential pain relief and much more. As your digestive system is renewed you will be able to maintain your ideal weight more effectively as the body processes the food you eat with ease.

STRESS: Our brain decides when we are hungry, and when we are full. It also decides when we will eat. These two actions are not neccessarily in harmony. By looking at neurotransmitter levels that are intricately linked to food and well-being, we can understand some of the complexity of the mind-body-food relationship. During this time we will assess the stress in your life, and build stress management skills. Using botanical medicine we will tonify your endocrine system, enhancing your capacity to experience stress with ease and resiliency. At the same time, awareness exercises continue the weight-related exploration of finding and maintaining your ideal physical body with a healthy, relaxed mind.

HORMONES: Most people gain weight when their hormones begin to decline. This usually refers to reproductive hormones like estrogen, progesterone and testosterone, but  thyroid and adrenal hormones are also crucial to a vibrant and efficient metabolism. Finally, Human Growth Hormone levels dictate the speed at which we age.  This section utilizes the Age Management comprehensive hormone blood work panel to thoroughly investigate the state of your hormones. Using cutting edge anti-aging therapies and Bioidentical hormone treatments we will optimize your hormones, rejeuvenating your sex life, cognitive function, energy levels and more.  Some participants may also choose to do a 26 day HCG diet as part of this personally tailored hormonal wellness program for more radical weight loss.

Each of these components make up the whole that is your living body and each have a profound effect on weight. Whether you want to lose 10 lbs or 100lbs, or even want to learn how to maintain your current weight in a more relaxed fashion, our Ideal Weight Management program will bring you closer to that which we all seek – your ideal Self. As your awareness of the triggers behind your disordered eating patterns come clear, your need to medicate with food will shift. Functional issues like constipation, heartburn, and nausea will transform into easy, successful elimination of your body’s waste, allowing a more effective fuel-burning metabolism to emerge. And, you will feel more energized and better able to handle the stresses of everyday living without food as a crutch.

This program is not for the faint of heart. It is for people who have dieted all their life. It is for all genders and all ages. There is no standardized program that you must sacrifice and change to be accepted into – this is a truly individualized series of sessions that unearths the inner you …that you will adore.

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Counter-Response to the Multivitamin Controversy

This post was originally written for Apothecary By Design in December 2013 http://www.apothecarybydesign.com/blog/

Stop Wasting Money on Vitamin and Mineral Supplements! 5 medical doctors cried out in an editorial piece first released in the Annals of Internal Medicine, and then circulated through all major newspapers and social media outlets early this week.  The articles released in the New York Times, Wall Street Journal, LA Times, and countless other newspapers pointed out that multivitamins have failed to show benefit in several large scale studies; however, the evidence reviewed was not as clear as we were led to believe. As with every evidence based study, it is important to look at the information behind the research, the studies cited, and the actual information the studies gathered.

The quality of multivitamins IS a true concern for consumers. The studies supporting multivitamins have been mixed, and we acknowledge this. If you are going to take a multivitamin it is not an effective use of money to buy a low quality product (like the one illustrated below) that is not well absorbed and/or is coated in toxic chemicals and fillers. A very good diet may reduce or eliminate the need for a daily dose of essential nutrients. Some multivitamins may be a waste of money, not because studies illustrate a lack of benefit, but because of the abysmal quality of the product itself. Choosing an appropriate multivitamin is another question – one that Apothecary by Design’s wellness specialists welcome.

The following studies were used to support the evidence that multivitamins are not worth taking:

fmgt4Yi09-XGE8j8WdSI0z2key4wGe5glRyJ-QC8wH2_S3x8dxi0mHnxUERU0zmV047v=s1001.     Multivitamins and cognitive decline in men 65 or older

For example, in the first study on cognition, the multivitamin assessed was a well-known  common multivitamin that provides low level nutrients in the cheapest, least bioavailable forms. These poor quality minerals generally include  oxides and sulphates. For example, magnesium sulfate is epsom salt, like you would use in a bath. Magnesium citrate is a better quality, more absorbable mineral. (See label) Check out the “other ingredients” as well – 3 artificial colors including the noxious FD&C Red #40.

Regardless of the supplement quality, cognition issues are not primarily related to vitamin/ mineral deficiencies, but are a long term response to heavy metal toxicity, poor cerebral perfusion (not enough blood to the brain), omega 3 deficiency, hormone deficiency, environmental contamination, stress and elevated cortisol levels, head trauma, prescription medication side effects and many more individual variants.

For example, how many of the physicians studied were also taking statin drugs? These ubiquitous prescription medications are known to have memory impairment, loss of memory and amnesia as potential side effects.

When presenting strong statements like multivitamins are a waste of money, it is responsible to use evidence that considers a straighter line between cause and effect.

2.     Multivitamins failed to reduce cardiovascular events in men and women with previous myocardial infarction

The second study cited as proof that multivitamins are a waste of money was a 2012 study evaluating the effects of chelation therapy on men and women over 65 with history of a heart attack.

This study had significant setbacks.  Chief among them were the high drop-out rates due to the strenuous protocol of 30 weekly chemical chelation infusions followed by 10 maintenance infusions two to eight weeks apart.

It is difficult to assess the effect of a multivitamin on long term health with such invasive chemical and vitamin therapies being administered at the same time, and it certainly clouds what is presented as a black and white result.

Antioxidants, nutritional counseling and botanical therapies are also first line treatments in the Integrative health world to repair myocardial function. Once again, the true nature of the study being cited is obscured by the dramatic headlines.

2.     Multivitamins did not prevent the development of chronic disease or death.

If only a simple, cheap, low dose, poor quality multivitamins could save the world from chronic disease….

Quality matters in the food we eat, the medications we take and the supplements we buy. Chronic disease is a complex, multifactorial health concern whose cure cannot be reduced to oversimplified statements like these.

Finally – the original article states “….beta carotene, vitamin E and possible high dose vitamin A supplements increase mortality.” What they leave out, is that high dose beta-carotene increases risk of … lung cancer in smokers (only.) And alpha-tocopherol vitamin E increases the risk of heart disease …but full spectrum vitamin E with both tocopherols and tocotrienols reduce the risk.  Limiting the information sensationalizes the story, obscures the evidence and limits its relevance.

The great thing about this editorial is that it exposes the poor quality multivitamins out there for what they can be: a sense of false security. No one can eat fast food regularly, take a poor quality low dose multivitamin, not practice any preventative measures, and not develop chronic disease eventually. That much IS true.

A multivitamin needs to be able to be absorbed, with high quality minerals and therapeutic dosages of vitamins at the very least to offer prevention and protection. These remain a worthwhile investment for people wanting to maximize their nutritional value. Furthermore, high quality children’s multivitamins remain a good nutritional adjunct for picky eaters and kids with behavioral or health issues. Multivitamins are not a substitute for a healthy lifestyle with good quality food choices, exercise, and stress reduction.

http://www.mayoclinic.org/medicalprofs/trial-to-assess-chelation-therapy-cvuv10n4.html

http://www.ncbi.nlm.nih.gov/pubmed/10359235

http://www.medscape.org/viewarticle/501471

http://www.nleducation.co.uk/resources/reviews/the-next-generation-vitamin-e-how-tocotrienols-benefit-the-heart-brain-and-liver/

Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements. Annals of Internal Medicine. Eliseo Guallar, MD, DrPH; Saverio Stranges, MD, PhD; Cynthia Mulrow, MD, MSc, Senior Deputy Editor; Lawrence J. Appel, MD, MPH; and Edgar R. Miller III, MD, Phd p. 850

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Navigating the Holidays with a Special Diet

This blog post was originally written for Apothecary By Design – a premium quality specialty, retail and compounding pharmacy in Portland, Maine. http://www.apothecarybydesign.com/blog/

I remember when I was a kid going to my Aunt’s house for Thanksgiving, my mom would always show up with a box of special food for us with brown rice, special breads and other jars of rattling, unappealing looking things. I always felt slightly embarrassed, wishing we could just blend in with everyone else. Now, I am that person. I always travel with special bread, usually my brown rice pasta in case of dinner emergency, and other ingredients and snacks that I know I can eat.

Food allergies are on the rise world-wide. It is estimated that 15 million Americans have food allergies, and this potentially deadly condition affects 1 in 13 children. Another study found that 3 out of 4 children had a food reaction. Symptoms can range from an itchy mouth or runny nose, to asthma attacks, skin eruptions, behavioral changes, anaphylaxis and more.  The Center for Disease Control released a study in 2013 stating that food allergies increased 50% between 1997 and 2011. With these kinds of numbers being evidenced in clinical studies, it is likely that many of our readers will be figuring out how to manage this holiday’s season with at least one family member on a restricted diet. For more information on food allergies, please see the following links:

http://newsinhealth.nih.gov/issue/aug2012/capsule1

http://www.foodallergy.org/facts-and-stats

So, what is your plan for managing these holidays that are full of delicious foods that don’t work for you? The first step is to strategize. Complete restriction is unlikely for most of the population, and can lead to binge eating behaviors as a reflexive backlash. This is the “no-strategy” strategy that usually fails. Instead, make some educated choices, and make a plan. Some people can get away with small amounts of some allergenic foods, and can’t get away with others. So, making choices to suffer a little on some fronts so you can stay strong on others may be a safe plan. If you need to stay on a strictly narrow regime for health reasons, it will be more important than ever to plan ahead and bring tasty alternatives to the traditional choices so you have a meal you can enjoy as well.

For example: You really suffer when you eat gluten, but you can get away with eating dairy occasionally.

Thanksgiving Plan: Bring gluten free crackers for the crackers/cheese hour. Bring Imagine brand gluten free turkey gravy (not incredible but good enough.) Bake a gluten-free apple crisp. Plan on skipping the stuffing, but eating the mashed potatoes and dessert with ice cream.

Some families are willing to substitute key ingredients to make some elements of the meal safe for the whole family. For example, mashed potatoes could be made with Earth Balance margarine and an alternative (unsweetened) milk option to be dairy free. Again, a gluten free gravy could be used in addition to the traditional recipe, and a small amount of oven baked stuffing could be set aside for the vegetarians.

If you or a family member has an anaphylactic response to a particular food, it is best to inform all guests ahead of time. Make sure you have an epi pen available as well if you or your child has this kind of severe allergic reaction. There are some supplements that can help balance the overindulgence for mild to moderate food reactions . Gluten-ease was mentioned in our last newsletter as a simple occasional digestive support. This product contains high potency enzymes that ensure complete digestion of gluten, gliadin and casein proteins, reducing allergenic effect and potentially reducing symptom onset. This product is not recommended for celiac disease or people with severe gluten or dairy reactions.

Other products that help quiet an inflammatory food response are quercetin, bromelain, and nettles. These products can often be found combined together in products like D-Hist and D-Hist Jr by Ortho Molecular, and are best taken for 2-3 weeks before the food is introduced to minimize systemic inflammation.  Quercetin is not safe in pregnancy, but nettle tea is a safe, simple remedy that everyone can use. Carminative teas like peppermint, fennel, and ginger can also help ease digestion for everyone after a large meal.

 

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Nutrition, Herbal Medicine, Homeopathy

Naturopathic medicine is not a single kind of healing, but is an array of healing practices. I think of Naturopathic Medicine as a wheel, and what we do as the different spokes that make up the whole. These “spokes” are called modalities, and include acupuncture, counseling, herbal medicine, functional medicine, homeopathy, massage, minor surgery, nutrition and in some states/provinces, prescription medications and/or IV therapies. Naturopathic Medicine is diverse – each doctor chooses what areas to focus on.  Many N.D.’s choose one specific modality, like acupuncture, functional medicine, or homeopathy. Others, like myself, are eclectic and utilize many of the modalities, depending on the individual case.

Acupuncture, counseling and massage are not as applicable for self care; however, nutrition, herbal medicine, and homeopathy are very important ways that people can take care of themselves. There is only so much help that Dr. Google can offer. If general information basics are not resolving the issue, or you have complex health concerns with multiple medications involved, having a licensed ND assist you in recovery is going to be the most effective and safest utilization of natural medicines.

NUTRITION is the philosophy of using food as medicine. Nutrition can be used therapeutically to treat specific conditions – such as eating beets and dandelion leaves for liver cleansing, or cabbage juice for ulcers. The foods that we eat in 2013 are very different from what our grandparents were eating. The soils are stripped of minerals (or toxic like on Munjoy Hill, ) many foods are genetically modified, and the preparation and processing of foods radically alters nutritional values. Supplementation is generally included with nutrition as it is often necessary, given today’s food choices, to supplement some nutrients that are no longer found in food.

HERBAL MEDICINE is an excellent way to treat the whole family. In theory, it is similar to using pharmaceuticals – specific components within each herb cause specific actions in the mind, body and spirit. Herbs can have a powerful action or a gentle action. Generally, the best herbs for self care are simple, common and safe for everyone in the family. If there are any specific contraindications such as interactions with medication, I would be sure to mention those.  The general dose for herbal medicine for an adult is 1 teaspoon of tincture (alcohol extract) in a small amount of water, 3 times a day. Teas are drank hot 2-3 times a day or as needed. Children’s dosage can be determined as follows:

Patients weight in lb divided by 150 = percent of dose

ie) 70 lb child / 150 = 0.46 so child gets slightly less that ½ adult dose.

If is 1 tsp 3 x a day for adult, give ½ tsp 3 times a day to child.

Herbs are generally best taken on an empty stomach, to maximize absorption.

HOMEOPATHY is a very complex system of medicine that gently supports the body’s ability to heal itself through the use of “remedies” and the philosophy that “like treats (or cures) like.”  The specific remedy chosen is one, which, if given to a healthy person, would elicit the very symptoms of an illness. Therefore, the remedy is known to cure that illness. Homeopathic treatment can be a profound journey of self-discovery as old wounds are healed and our true potential is illuminated. Explaining the mechanism of homeopathic medicine is difficult as it operates on the quantum level rather than the commonly understood Newtonian mechanism of action.  Symptoms are seen as effective reflections of compensation on the  mental, physical, and emotional levels. For example, when a warning light comes on in your car,  we investigate what was wrong with the engine, not just disconnect the light! Seen as warning lights, symptoms are the body’s way of showing the outside world that something is wrong or not working properly. The constellation of symptoms points the Homeopathic Doctor to understand the bigger picture overall, and which remedy is indicated to effectively treat the underlying condition. A Naturopath practicing Homeopathy gives a homeopathic remedy to stimulate the body’s defense systems to complete the healing process. This is the concept of the vital force: the body is always trying to move towards health.  This medicine is an extremely safe and effective method of eliminating disease.

 

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Beauty Medicine: VariLite

I had a VariLite laser treatment this week at the Cosmetic Enhancement Center of New England to treat my facial veins. And as I lay twiddling my toes and breathing thru the mild burn, I mused on how long I have had the purple and red lines and from whence they came…. Nose veins and rosacea run in my family, as does fair skin that burns easily. I started getting my redness as soon as I hit the ski slopes with my Dad, and continued to insidiously develop them throughout my twenties. As my eyes watered and Dr. Ollila erased my venous congestion, I thought about how Chinese Medicine correlates the areas being treated with the stomach and large intestine, and my own struggles with digestion. And I promised myself that because I have the good fortune to be able to eliminate these physical signs of my own genetic faults and dietary excess, I will do what I can to prevent this same congestion, stagnation and dis-ease from developing again.

8949_7Traditional Chinese Medicine maps the body with meridians or channels that carry the energy of each organ along the arms and legs. Many of the meridians also run on the face. Areas of physical imbalance in specific areas reflect deeper organ health issues. In my case, the large intestine area at the side of the nose was an obvious place of congestion, reflecting a chronic issue of constipation that was finally resolved in my thirties when I identified and removed food allergies.

The stomach area near my mouth also had faint signs of congestion and stagnation. This area is less of an obvious problem for me – I have a so called “iron stomach.” On the other hand, I do worry. And the stomach is one of our primary organs that is effected by stress, anxiety and rumination. From a mind-body perspective, it makes sense that my stomach area would show signs of strain after years of academia, life’s lessons,  and all the personal stresses that happen. Removing the veins will not remove the underlying strain I put on myself, but I can (and will)  do more to improve my stress management and coping skills to prevent them from resurfacing.

Beauty medicine is a valuable component of modern medicine. With healthy living, exercise and great nutrition, many people’s biological age is younger than their chronological age.  Cosmetic treatments allow us to defy our years and erase the physical evidence of our earlier mistakes. However, it is important to delve deeper and work beyond the superficial level. I am grateful for the opportunity to diminish the signs of aging and look as young as I feel inside. I am also more aware now that I am older (and wiser) to include nutrition strategies like daily fiber ( raw vegetables, ground flax seeds) and probiotics to maintain long term large intestine health.  (For some people,  deeper digestive issues will need to be resolve before a simple maintenance regime is enough.) Stress insists on wreaking its havoc on my face, so I can find better ways to metabolize stress or wear the consequences!  And, of course I will also be aware of the critical damage that sun, wind and cold can have on the sensitive visage – only mad dogs and Englishmen go out in the noon day sun!

If you are interested in beauty medicine, contact The Cosmetic Enhancement Center of New England at http://www.cecofne.com/.

To find out more about how Integrative Medicine can complement your treatments for long term effects and internal wellness  call 207-774-1356 to book an appointment today.

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FACEBOOK: www.facebook.com/thewrightdoctor, www.facebook.com/agemanagementcenterTwitter: @thewrightdoctor

For more information on Dr. Wrights clinical practice see: www.agemanagementcenter.com

Dr. Wrights website: www.thewrightdoctor.com

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Naturopathic Trans Health 101

** This is a handout from PTHC June 2013 – Please email me at thewrightnd@gmail.com with your experiences using natural medicines in transition! **

Naturopathic Medicine is: licensed in the state of Maine and many other states and Canadian provinces. We provide primary care using medical and alternative medicine. Naturopathic philosophy is based on the premise your body knows how to heal itself, and medicines from nature can help you overcome obstacles to health.

Naturopathic Doctors tools are: Botanical Medicine, Homeopathy, Nutrition, Lifestyle Counseling, Stress Management. Some ND’s also provide hands-on treatments (Chiropractic, Massage, CranioSacral Therapy,) Prescription medication (thyroid and female hormones, antibiotics, some Lyme medications, topical products),  Acupuncture, Traditional Chinese Medicine and IV Therapies.

FOUNDATIONAL NATUROPATHIC SUPPORT – FOR ALL GENDERS

  • Green tea 1-2 cups daily– anti-cancer, antioxidant, immune system support
  • Adrenal support – adrenals are a major source of hormone production when the gonads are taken out of the picture as is evidenced in menopause and andropause. B5, vit C, Siberian ginseng, Ashwaganda, Rhodiola, Licorice.
  • Probiotics – the digestive tract is the seat of our vitality and overall health.
  • Cruciferous vegetables, fresh ground flax seeds, green tea, sprouts all enhance excess (endogenous and environmental) estrogen elimination – important for every body!

GENERAL TRANSMALE SUPPORT

–       Support adrenals with herbs known to increase testosterone production.

–       Testosterone metabolizes into Dihydrotestosterone (DHT) – a biologically active metabolite of testosterone 30x more potent because of its increased affinity for T receptors. DHT is known to promote hair loss. This conversion can be modulated with SAW PALMETTO – stops the conversion of T –> DHT. PLus ZINC 10-30mg daily.

–       Nettle Tea – decreases bound T/ increases free (active) T, lymphatic support.

–       Reservage Keratin Booster  – prevention of baldness.

GENERAL TRANSWOMAN SUPPORT

–       Breast health! Reduce methylxanthine chemicals found in coffee, black tea, caffeine, and chocolate. At least monthly breast massage for lymphatic health using herbal oils.

–       Aerobic exercise.

–       Freshly ground flax seeds help the body eliminate excess estrogen – add to smoothies or yogurt with fresh fruit and maple syrup. Cancer prevention.

–       What is a phytoestrogen? Plant compounds that bind to estrogen receptors throughout the body.  Soy Isoflavones, Alfalfa (Medicago Sativa), Burdock (Arctium Lappa), Dong Quai (Angelica Sinensis), Evening Primrose, Pau D’arco (Tabebuia Avellanedae), Red Clover (Trifolium Pretense), Saw Palmetto (Serenoa Repens.)

–       Organic non-GMO soy 1-3 times week if tolerated.

–       HRT Companion by Vitanica** Great prevention product for long term use.

–       Reduce systemic inflammation for optimal long-term health – estrogen is protective for heart and bone health, but it can also be inflammatory. How to reduce inflammation? (CRP, homocysteine measures on bloodwork.)

SEXUAL TONIC HERB REVIEW– from The Male Herbal by James Green

Ashwaganda – WITHANIA SOMNIFERA Withanaloid chemicals resemble steroids biochemically. They are classified as an adaptogens to enhance libido and restore fertility and sexual potency.

PANAX QUINQUEFOLIUM – American ginseng.  PANAX GINSENG – Asian Ginseng. All ginsengs provide ginsenoside compounds that effect hormonal balance. Their overall chemistry supports strong sexual function through tonifying activity. They can also increase nitrous oxide levels, improving blood flow where needed. Panax ginseng is classically only used for men as it is too Yang for women’s health unless specifically prescribed.

Horny Goat Weed – EPIDEMIUM SAGITTATUM, EPIDEMIUM GRANDIFLORUM Exhibits moderate androgen-like effect.  Contains flavonoid ICARIIN which is a cGMP-specific PDE-5 inhibitor (like Cialis, Viagra and Levitra)

Muira Puama  – PTCHOPETALUM OLACOIDES Increases circulation, nervous system tonic, improves sexual weakness and diminished sexual desire in all genders.

Maca – LEPIDIUM MEYENII, L. PERUVIANUM ** Nutritive tonic for all genders. Simulates ovarian and erectile functions. **  – Could restore fertility for FTM’s who decide to want to conceive after testosterone use.

Gokshura  – TRIBULUS TERRESTRIS ** Prostate and urinary system tonic. Contains saponin, a steroidal plant chemical to improve libido with impotence. Improves sexual desire, fantasy life and sexual self-confidence. May prolong duration of intercourse before ejaculation. Increases endogenous LH levels. May stimulate endogenous testosterone production in men and women.  ** May also stimulate ovarian or testicular action in ways that are not desired. Use with caution.

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Mediterranean Adventure II

We were concerned that traveling Gluten Free would be tough. And not even just gluten free – I can’t eat potato or corn, and my sweetheart can’t have rice. So, we were both headed abroad knowing that food choices could be tough. We had the good fortune of staying with family, so for most of the journey we had a kitchen and fridge to stock with staples we could rely on. For me – mostly eggs, rice cakes, delicious olive paste, incredible fresh green olives. For my sweetheart – she had the bonus of finding gluten free bread, plus corn cakes, jam, and yogurt. Then we  shared fruit, veggies and local cheeses. She brought her own corn pasta, and I had no trouble finding rice pasta as needed in the local “Veritas” (organic) market for family dinners. We even found quinoa! Local markets and/or supermarkets also had lovely fresh meats, fish and produce for family dinners. We both brought some snack bars (Kits Organics for her and Luna Protein for me) as well as trail mixes. Of course, there were also lots of delicious treats we could both have. Europe has an impressive array of yogurts, puddings, and other cold delights in small jars. (Less ice cream though, in the freezer sections.)

Overall, food turned out to be less of a problem than we feared. When going out, my sweetheart was invariably able to get “patatas bravas,” a local dish of fried potato with a yummy spicy mayonnaise. Tapas (or pinxtos as they are called in San Sebastian) were harder for me to navigate, so often I just didn’t. Dinners out were easier – I could almost always find some delicious fish or chicken and vegetable options in the Menu del Dia – a 10-15 Euro daily menu with 3 courses and wine and coffee included. As my sweetheart is more sensitive to gluten and cant get away with any exposure, she usually stuck to Ensalada Mixta (salad, tuna, olives, and hardboiled eggs) with a potato side dish. All in all, it worked out well. We weren’t able to sample the breadth of Spanish gourmet cuisine, but we still had some flavorful dishes and local delicacies.

As a Naturopathic Doctor, I was constantly assessing the Mediterranean Diet and to see how the classic reputation of the region matched the real fare. As I suspected, there was plenty of bread, cheese, sugar, and packaged foods available as in the Standard American Diet (SAD.) There were a few noticeable differences though that may account for some of Europe’s lower body weights and improved life expectancy. First, there was no bacon. Yes, “bacin” was on some menus, but it was peameal-style bacon, pan-fried and not the true “bacon” of North American fame. Second, beef was rare to see on a menu or in the supermarkets, and was quite expensive. This made sense as we drove across the country, as there were very few cows. European terrain is not made for grazing the way Texas is.

Finally, and perhaps most impressive to me was the rest stops for food along highways. Each one was set up like a classy buffet restaurant, complete with chefs behind the food casing presenting grilled vegetables, roasted chicken, and a wide arrays of sandwiches, jambon, fruit and cheese choices. There were mini bottles of wine and cans of beer at every register, as if instead of being on a roadtrip one was intentionally stopping at that location for a meal. And stop everyone did, even for coffee. The American in me was shocked that people were literally getting perfect little iced espressos and walking to sit down and drink it before they got back on the road. We are such a to go culture! The contrast was very strong, and was I think the best illustration of the differences between our SAD diet culture and that of the Mediterranean. They sit down and savor a meal, a coffee, and a moment in time. It’s a lifestyle, a way of thinking, and a paradigm. We eat on the go, “para llavales”. We Rush, wolfing down food, eating mindlessly as we multitask and gulping down our beverages while we push on ahead. And we pack on the pounds and generate chronic disease as we go along, coercing our nervous systems into simultaneously digesting and running at the same time.

I am still filtering through layers of impressions, photos and reflecting on the whole experience of world travel. I highly recommend Spain to anyone – Barcelona is the second most popular tourist destination in the world, and well worth the hype. Traveling gluten free was not a problem; we were able to find great local resources and food options, especially for a food adventurist. For those who can eat gluten, there is an incredible world of tapas out there just waiting your arrival! But do yourself a favor – eat like you have all the time in the world.

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Mediterranean Adventures

We are traveling in Barcelona and parts of Northern Spain for two weeks ~  visiting ex-pat family and having a European vacation while Spring comes to the Northern US. As many Americans have often commented while traveling in Europe, the difference in body weight here is remarkable. Simply put, very few people are overweight. And, despite the smoking, wine consumption and late nights, it is known that Europeans live longer than Americans on average. So what is the big difference? Eating patterns, Diet, and Lifestyle.

By Diet, I do not mean calorie restriction, portion control or eating plans. I mean, a style of food intake linked to cultural patterning and local food options. The Mediterranean Diet has been a source of scientific study for several decades because European countries centered around the Mediterranean Sea have statistically lower levels of heart disease, diabetes, and other chronic diseases. It is a nutrition pattern that includes a foundation of olive oil, fruit, vegetables, fish, seafood, whole grains, pasta and potatoes. This is complemented by smaller amounts of eggs, dairy and chicken. Red meat and sweets are eaten occasionally. It is also a practical nutritional plan – meat is expensive, tomatoes and olives are not! The “Mediterranean Diet Pyramid” is a famous illustrated depiction of the basic concepts. (See Resources below for a great downloadable version.)

We noticed a few real differences right away.

1. There is no To Go – people sit to eat their food and drink their coffee.

2. There is no half and half or cream for coffee. There are no Grande or Venti coffee options. A coffee is a small cup of strong brew with or without steamed milk and sugar.

3.  The cities are made for walking and biking! With bike lanes and mazes of small windy alleys and wide picturesque boulevards the cities inspire pedestrian activity.

We haven’t quite adjusted to the concept of siesta time yet. In fact, between jet lag and our American ways, we have almost invariably set out right as the shops roll down their doors and the streets close up for the afternoon 2-5pm rest. This is our goal for the trip – to learn the fine art of Siesta. What an ultimate luxury!

US life expectancy links https://www.wsws.org/en/articles/2013/01/11/life-j11.html and http://www.economist.com/blogs/buttonwood/2013/01/life-expectancy

Mediterranean Diet Research: http://jama.jamanetwork.com/article.aspx?articleid=199485

http://www.mayoclinic.com/health/mediterranean-diet/CL00011

Practical Resources: http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview

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