Heartbreak and Heart Failure

screen-shot-2016-11-06-at-2-48-11-pmSometimes life, work and study all seem  to dovetail and everything makes sense for just a few glorious moments. Cardiology was like that for me, in between the Frank Starling curves.

Last year we had a case study of a woman with congestive heart failure (CHF.)  Her husband had renal failure and needed dialysis, and she worked at a job she didnt love. She slowly developed worsening heart failure over the course of the case, with  shortness of breath, edema, high blood pressure, and poor circulation, eventually dying from it. I was impacted by the apathy she displayed in her efforts to recover – unwilling to eat more grains and greens, decrease salt,  get outside, exercise regularly, investigate psychotherapy, or better her personal life in any way. Instead, she just declined in health, adding a new prescription per year to mange her symptoms until she  – drowned. In her grief. Of heart disease.

This. Story. Happens. Every Day.

And not only in the US, or Canada or Europe. World-Wide.

The multitudes of meta-analysis risk factor evaluations like the Framingham, Whitehall and Rekjavic studeis have concretely illustrated important evidence about the facts of heart disease: atherosclerotic fatty streaks in arteries, high blood sugar, and  inflammation are the undeniable Holy Trinity of heart disease. What is not being avidly reported is the rate of divorce, or mood disorders in these same subjects. The sexual dissatisfaction. The childhood trauma. Socioeconomics and race are sometimes studied, and African Americans and Latinos have higher rates of heart disease. Nobody is surprised. Russia has the highest rate of ischemic heart disease in the world, along with some African nations and Indonesia. These countries also have horrible human rights records, with well documented transphobia, homophobia and police brutality.

screen-shot-2016-11-09-at-9-01-58-pmIf we are going to turn around heart disease, do we not need to acknowledge the humanity of the heart? The same  epidemiological study quoted deep within the content:

“Additional reports from this study have shown inverse associations between fair and respectful treatment at work and CHD [Congestive Heart Disease],and job control with future CHD risk.

Similarly, hypertension, which is the harbinger of heart disease through its effect on cardiac structure and function,  is hugely mediated by the stress response.

screen-shot-2016-11-09-at-9-11-31-pmI was talking to Dr. Stein, an internist specializing in HIV and also our OMS II course director, about this theory that heart failure is so rampant because we have no real medicine for soul-problems like dissatisfaction, grief, sorrow, envy, loneliness and such. He said the links between depression, elevated cortisol, hypertension and CHF are well documented and clearly evidenced.

He reiterated that it is known that People of Color have higher blood pressures because their lives are more stressful due to systemic and personally experienced racism aka “stress.” It is also well evidenced that African Americans with CHF respond better to different medications than other races – Hydralazine, a vasodilator that decreases resistance,  improves survival with  isosorbide dinitrate rather than the ACE inhibitors and Beta Blockers commonly used. Ha, decreasing [systemic institutionalized] resistance as a keystone in improving survival? I need to know more about the MOA of these drugs to understand why decreasing the catecholamines isnt enough for this population; maybe its because of the deleterious and constant push and pull the sympathetic blockers have on the heart receptors of someone living in the actual adrenergic rut of an unsafe society.

3f0a8388-0078-4c4f-88ef-36078365eae5Our cardiologist professor Dr. Glass stated that the average person with hypertension is on 3.4 medications to manage it. These are usually layers of diuretics to decrease the blood volume and drain edema (decreasing preload), and beta blockers to decrease cardiac work and improve cardiac output,  and/or other meds like diphydropyridines and nitrates. But guess what – it just came out recently that hypertensive medications may be CAUSING depression/ mood disorders while working to decrease blood pressure.  What a double whammy.  This was a big study from a database of a single hospital containing 525,046 patients over 5 years. This 2016 article stated:

Major depressive and bipolar disorders predispose to atherosclerosis, and there is accruing data from animal model, epidemiological, and genomic studies that commonly used antihypertensive drugs may have a role in the pathogenesis or course of mood disorders.”

  • Patients on angiotensin converting enzyme inhibitors or angiotensin receptor blockers had the lowest risk for mood disorder admissions
  • those on β-blockers (hazard ratio=2.11; [95% confidence interval, 1.12–3.98]; P=0.02) and calcium antagonists (2.28 [95% confidence interval, 1.13–4.58]; P=0.02) showed higher risk
  • those on no antihypertensives (1.63 [95% confidence interval, 0.94–2.82]; P=0.08) and thiazide diuretics (1.56 [95% confidence interval, 0.65–3.73]; P=0.32) showed no significant difference.

To summarize the findings,  calcium antagonists and β-blockers may be associated with increased risk, whereas angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be associated with a decreased risk of mood disorders. (Hypertension. 2016;68:1132-1138. DOI: 10.1161/HYPERTENSIONA HA.116.08188.)

It appears, the drugs that most directly affect the heart muscle itself are thus linked to more mood disorders, while those that work indirectly and decrease the work for the heart seem to have less impact on mood.

This is such a broad topic and there are so many layers to heart failure – blood pressure, kidney regulation of blood pressure, nutritional effects, blood lipids, blood volume, inflammatory mediators, free radicals and antioxidants, sleep quality and more – but I think that too often we lose sight of some of the most basic truths of happiness and heart health. And we also forget the deeply sensitive creatures that most of us are and fool ourselves that pharmacy could possibly be enough to cure a heart that is systemically broken, or the effects of a chronically hypervigilant nervous system.

imagesWIDJJQD2I am going to need to become proficient at cardiology as an Internal Medicine doc. But without a degree in psychiatry, or soul medicine, or archangel intervention, how can I possibly hope to help people recover their failing hearts when the intersections cut so deep? I am scared of all of those people that have no willingness, or ability, to look deep within and make the simple and profound choices towards life. This is the part of being a physician I most fear. The medical failures; the broken hearts.

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Gluten Free Living

How to Eat Gluten Free

 Gluten Free is the new Vegetarian – almost every grocery store now has gluten free breads and products in their freezer sections, and crackers and baking mixes in the  aisles. Websites abound on not only celiac disease resources (a disease caused by severe gluten allergy) but on gluten free recipes, resources, and restaurants in almost any geographical area.

So, what is all the hype? Why go gluten free, and why are so many people changing their diets? The bottom line is that gluten sensitivity begins with the immune system of the digestive tract becoming hypersensitive to gluten proteins. The body creates antibodies to the sequence of amino acids, which enter the bloodstream and travel throughout the body. Whenever these antibodies see that same sequence (which is repeated as a small part of many tissues of the body exposed to blood i.e. thyroid, joints, brain, lungs, skin) they attack that tissue as if it was gluten. This creates “auto” or “self” antibodies, which are then produced in greater and greater numbers and cause disease.

Therefore, gluten has been linked to autoimmune diseases such as lupus, rheumatoid arthritis, Hashimotos thyroid disease and multiple sclerosis. These are end stage conditions that develop years after smaller warning signals such as headaches, digestive disturbance, asthma, allergies, psoriasis, alopecia, insomnia and various “undiagnosible” ailments. Sometimes eliminating the offending foods or doing testing to assess your body’s immune response is the only way to assess if food is an underlying factor in your ill health.

Gluten is a protein that is found in the following Grains:

  • Wheat
  • Rye
  • Barley
  • Kamut
  • Spelt
  • Oats is technically gluten free but very often contaminated in manufacturing.

Therefore, people with a gluten sensitivity or allergy cannot eat any of these grains, or products that contain them such as soy sauce, gravy, doritos or other gluten based products. Oats are technically not a gluten containing grain, but should be avoided unless it states “gluten free” on the package.

Non Gluten Grains which can be eaten by people with gluten allergies include:

  • amaranth: highly nutritious, tiny seeds available whole or as a
  • rice: including brown and white rice, Arborio, basmati and rice flour
  • corn: including cornmeal, cornstarch and corn flour
  • millet: small seeds, eaten whole or combined with other gluten-free flours
  • quinoa: small seeds that can be eaten whole, as a hot cereal or ground into flour
  • buckwheat: used whole, cracked or ground into flour
  • oats: gluten free oats and oat bran
  • tapioca: made from cassava root, often combine with gluten-free flours
  • teff: very small black grain, contains symbiotic yeast
  • arrowroot: a starch used as a thickener, superior to cornstarch, blends well with gluten-free flours

Potatoes, sweet potatoes, squash, and other starchy vegetables can also generally be enjoyed by those who are gluten free.

For the most thorough information on gluten allergy, see http://www.thedr.com./store.html and order Unlocking The Mysteries of Wheat and Gluten Intolerance for yourself. Dr. Tom DC offers eloquent and thorough evidence based information on why it is worth at least trying gluten free living for one month and then reassess.

Many people have a wheat sensitivity or allergy, but can tolerate other gluten grains like spelt and kamut. Some people with a wheat, but not gluten sensitivity will later develop a gluten sensitivity. Corn, potato, dairy and/or soy sensitivities are also common in addition to gluten. For this reason, it is best to start your food eliminations by eliminating all of the above products, and slowly reintroducing each gluten grain as well as corn, potatoes, and soy separately to judge your individual reactions.

AVOID FOR GLUTEN -FREE SHOPPING:

  • look for labels that say – wheat (or whole wheat) flour, wheat germ, bran, farina, graham flour, semolina, gluten, modified food starch, wheat starch, vegetable starch, vegetable gum
  • Pastas – spaghetti, vermicelli, macaroni…..
  • Soups – commercially canned
  • Desserts – most contain wheat – so read carefully
  • Cereals and breads – as with desserts – read labels carefully
  • It’s probably best to go to health food store in order to find alternatives. Most breads, bagels, wraps, pizza doughs, etc are kept in the freezer sections
  • For persons allergic to wheat, but not to gluten, you can use flour substitutes such as spelt or kamut (these are the most similar to wheat); rye, oats and barley can also be eaten.

TIPS FOR A GLUTEN-FREE DIET:

  • focus on protein, vegetables, fruits, and healthy fats like avocado 
  • Lots of delicious gluten free options abound: Tray various  pasta, breads, crackers, etc until you find what your taste buds prefer.
  • Avoid any food that contains wheat, barley, rye, oats – as well as spelt and kamut. Also, remember that gluten can be found in most processed foods, including soups, sauces, gravies, and of course in breads, cereals, and desserts.
  • 40% of people allergic to gluten are also allergic to soy and/or corn – which are often found in “gluten-free” breads, etc.
  • READ LABELS on everything the first few months to find hidden sources of gluten.

Eating Out and Travelling:

Most cream based soups and chowders are made with a gluten base. Boone’s in Portland has a gluten free chowder, bisque, crab cakes etc if you are craving those.

It is pretty easy being gluten free in restaurants once you get the hang of it. Focus on protein and vegetables, fancy salads and avoid gravies, pasta, gnocchi and sandwiches. If you are craving a burger, ordering it without the bun is pretty standard in today’s low carb world. Steak and arugula salad is always a good choice.

Sadly, fried treats are out the window like calamari, fried clams, fish and chips… once it gets battered it is almost always a wheat base. French fries are also often battered. Best to ask ahead of time instead of getting a delicious plate of inedible fries. Frontier restaurant in Brunswick has delicious GF fish and chips, and rice flour calamari.  Not cheap but delicious!

Fish options and mussels or raw oysters rarely have gluten unless they are fried or pan fried. Eating fish at home with rice and salad is a great nutritious option too.

Some places have gluten free sandwich bread but most places don’t. In a pinch on the road, subway will make a “chopped salad” which is basically a sub in lettuce/salad. Planning your food and having fruit, yogurts, nuts & seeds or trail mix, protein bars, and even leftovers or sandwiches on GF bread you make yourself before you leave become important while travelling.

What else? Gluten free breads and crackers abound.  I personally like Millet breads the best – available in Whole Foods GF freezer section. Rice breads tend to be very dense and gummy, but are the most common across the board. Mary’s Gone Crackers are the best GF crackers, followed by Nut Thins and Glutino brand. Glutino also makes a great pretzel. Rice cakes can have a bad reputation but are a quick tasty snack and great vehicle for dips, cheese, avocado and almond butter.

Sweets: Lots of gluten free cookies and treats are available! Any ice cream or candy without “cookie dough” or brownies or cones is usually GF. Many coffee places have at least one GF option. Flourless chocolate torte, chocolate mousse, crème brule or pannacotta are restaurant dessert options that are usually safe.

 

Tips for Gluten-Free Baking

FLOUR

GOOD TO KNOW

Equivalent to 1 Cup of Wheat Flour
 

Amaranth Flour

 

-best combined with other flours that  have more cohesion (arrowroot, tapioca, bean)

-add to baked goods, pancakes/waffle recipes

 

1 cup

 

Arrowroot Starch

 

-add 1tbsp to an equal parts of cold water before adding to dishes as a thickener

-combines well with gluten-free flours to give them cohesion

 

1/2 cup

 

Bean Flour

 can be gassy. Often used in Paleo cooking.  

3/4 cup

 

Buckwheat Flour

 

-makes a dark, heavy bread

-use with rice flour

 

7/8 cup (1 cup minus 2 tbsp)

 

Chestnut Flour

 

-used to sweeten baked goods

-adds lightness and creaminess

-use alone or mix w/ other flours

 

Chickpea Flour

 

-too dense and rich to use on its own

 

7/8 cup (1 cup minus 2 tbsp)

 

Cornmeal

 

-makes a light bread

-mix with equal parts of cold water before adding as a thickener

-best combined with small amounts of other flours

-stone ground is more nutritious

 

1 cup

 

Cornstarch

 

thickener

 

3/4 cup

1 cup corn flour

 

Millet Flour

 

-always combine with other flours

 

1 cup

 

     Potato Flour/Starch

 

-best combined with other flours

thickener

 

5/8 cup flour

3/4 cup starch

 

Quinoa Flour

 

-best combined w/ other flours. May have a beany taste.

 

Rice Flour

 can be grainy, does not rise.  

7/8 cup

(1 cup minus 2 tbsp)

 

Soy Flour

    -makes bread or baked goods more moist and smooth

-best if add small amounts to other flours

-u       -use only 20% soy flour in recipe, decrease temperature by 25 degrees

 

 

3/4 cup

 

Tapioca Starch

 

-thins if reheated

-combines well with gluten flours to give them cohesion, thickener

 

1 cup

 

Teff Flour

 

-do not add to yeast breads because it has its own symbiotic yeast

 

Flour Combinations: equivalent to 1 cup of white or whole wheat flour

1 cup soy flour + 1/4 cup potato starch

1/2 cup soy flour + 1/2 cup potato starch

5/8 cup rice flour + 1/3 cup potato flour

1/2 cup corn starch + 1/2 cup rice/potato flour

1/2 cup arrowroot + 1/2 cup potato flour

For 2 cups of flour good for baking cookies:

1 cup of brown rice flour + ½ cup of tapioca rice flour + ½ cup white rice flour + 1 tsp of xanthan gum.

Namaste company also makes a “Perfect Flour” gluten free mix of flours that you can buy and use with any recipe. Makes cookies really easy!! They also have a great pancake mix if you love pancakes.

Tips for substituting wheat flour:

  • do not be concerned if batter appear thinner than wheat batters, this is common
  • add 1/2 tsp baking powder per cup of substitute flour; add just before cooking because it loses its potency when mixed with liquid and allowed to sit
  • refrigerating dough 1/2 hour helps improve texture
  • do not bake anything thicker than 4 inches
  • when baking, lower the temperature a little
  • baking time is usually longer, especially if egg or milk is eliminated from the recipe
  • experiment with your options – buy small quantities from a bulk food store and make half recipes first

For thickening, the following quantities equal 1tbsp of wheat flour:

*Arrowroot 1 tbsp = 2 tbsp wheat flour

*Corn starch 1 tbsp

*Potato flour/starch 1/2 tbsp

*Rice flour 1/2 tbsp

*Tapioca flour 1/2 tbsp – my favorite

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Mediterranean Diet Explained

mediterranean_map-bigThe Mediterranean Diet (and Lifestyle)

This post was originally written for Apothecary by Design.

There is a lot of conflicting opinions about what style of diet individuals should choose for best health. Eating patterns can be based on ethics, habits, familial patterns, disease states, weight loss, convenience and more. The Mediterranean Diet is specifically known to correct heart disease, high blood pressure and high cholesterol. It is also used in cancer recovery. It is not a prescribed regimen of foods, but rather a way of eating based on the local foods of indigenous cultures that live around the Mediterranean Sea. People from this region tend to live longer, and have less chronic disease and obesity than the rest of Europe and North America. To understand why, scientists looked at the foods and lifestyle of the region which has been proven time and time again as superior for cardiovascular health and wellness.

Introduction: It is estimated that over 600 million people have high blood pressure. Heart disease is still one of the leading causes of death in the United States, and dietary interventions are first line therapies for prevention and treatment. The Mediterranean Diet, so called because it mimics classic eating patterns and ingredients from countries like Spain, Italy and Greece, has proven itself time and again as an effective therapy for hypertension and cardiovascular disease. A quick search of Medscape will show you that other conditions like Type 2 Diabetes, Weight loss, Alzheimer’s disease, Metabolic Syndrome, and Cancer are also being improved by adherence to this style of eating.

What it entails: The Mediterranean Diet is modeled after a traditional European “local” diet. Think small servings of homemade pasta or polenta, with fresh local herbs and vegetables like rosemary, basil, tomato, fennel, mushrooms and onions sautéed in liberal amounts of extra virgin olive oil. Add some white beans or fresh local cheese and handfuls of fresh arugula. Small fish like sardines and anchovies are added to meals regularly or served as a snack with walnuts, flatbread and cut up raw vegetables like cucumbers, cabbage, carrots, and broccoli. Fish is a regular staple, always cooked with olive oil and often marinated with lemon and fresh herbs. A couple times a week you may have free range eggs or chicken, again with liberal amounts of greens, cooked vegetables, beans and fresh herbs. And steak or lamb is eaten a couple times a month. Red wine is served with dinner most nights, and small amounts of homemade dessert like tiramisu or gelato a couple times a month.

2ac47164217c3a2b12eadd7a62b6ee78Many people use a triangle to depict the major Food groups for the Mediterranean diet.

Grains and pastas while frowned on by the low-carb crowd, are important for feeling full, serotonin production, daily fiber and vitamins and minerals. They are also essential for T3 thyroid hormone production. Grains are commonly used in their whole form for optimal nutrition although some homemade pasta and bread are implemented. Suggested Mediterranean grains include barley, buckwheat, bulgur, cous cous, farro, millet, polenta, rice, and wheat berries. Whole grain salads and porridges are great ways to have a daily grain in your menu. Portion sizes are conservative, with emphasis on the vegetable and olive oil.

Vegetables are an important staple in the eating patterns of all countries bordering on the Mediterranean, providing essential plant nutrients, vitamins, minerals and fiber. Cook with virgin olive oil, and drizzle whole pressed plant oils on raw vegetables. These plant nutrients and plant oils are thought to be the foundation of the beneficial effect from this way of eating as they provide essential fats and omegas daily. Commonly used vegetables include: artichokes, arugula, beets, broccoli, Brussel sprouts, cabbage, carrots, celery, celeriac, cucumber, dandelion greens, eggplant, fennel, greens of all kinds including collard, kale, Swiss chard and more, leeks, lemons, lettuce, mache, mushrooms, okra, onions, peas, peppers, potato, pumpkin, radish, rutabaga, scallion, spinach, turnips, yams and zucchini.

Whole fresh fruit provides sweetness and important nutrients, with juicy sweetness. Include apples, apricots, avocado, cherries, clementines, dates, figs, grapefruit, pomegranate, strawberries and tomatoes. Avoid juices, jams, and jellies as these are high in sugar without the antioxidants and fiber of whole fruit.

imagesNuts and Seeds are another key to the healthful oils that improve cardiovascular health. One study added only walnuts to a standard diet and exhibited cardiac disease improvement just from the omega 3 fats naturally contained in these nuts. Twenty raw almonds daily have also been suggested as a natural way to lower blood pressure. All raw nuts and seeds and raw nut butters except peanuts contain beneficial oils and add richness and flavor to vegetable based dishes. Once you “dry roast” or roast the nuts and seeds, the beneficial oils are lost or made into inflammatory trans-fats. If you prefer the taste, buy raw nuts and toast them yourself in a cast iron pan or a low heat oven for 10-20 minutes. You can add spices, soy sauce or honey before toasting for additional delicious taste!

Beans and Legumes are great source of protein and fiber and have a rich creamy texture. Cook with cannellini beans, chickpeas, fava beans, and green beans. Kidney beans, lentils, and split peas are also common ingredients in Mediterranean meals. Legumes provide a protein rich flavor note and nutritional support; in moderate amounts they are less likely to cause digestive upset. Think: brothy bowls of rich soup, light summer salads with olive oil and beans, or a Spanish fabada with pork and sausage. Use a digestive enzyme if needed to improve digestion and reduce side effects.

indexFish and seafood are prominent in the way of eating as it is based around sea cultures. Fish and shellfish are incorporated almost daily, providing high amounts of omega three fats essential for heart health. Little fishes like sardines, anchovies and mackerels are cheap and abundant and very high in omega 3 oils. Next time you are at a grocery store, pick up a tin of boneless, skinless sardines. Try eating them with crackers and sour cream, or top a nicoise-style salad with them (potatoes, olives and arugula.) They are quite delicious! Bigger fish like tuna, salmon and sea bass are featured regularly, as well as all shellfish, octopus and eel varieties. Fish and seafood are rarely battered and friend. They are often grilled, baked, steamed or pan-fried with olive oil.

Eggs, dairy, meats, wine and sweets are also part of this way of life, but in modest amounts, For example, cheese and yogurt may be eaten daily as tatziki yogurt dip, manchego , romano or feta; you do not see the consumption of large amount of industrialized cheese like a Domino’s pizza. Red meat is enjoyed every couple weeks as are cured meats like salami, carpaccio or prosciutto – used sparingly on homemade pizzas with a cheese like ricotta, or served antipasti with olives and vegetables.

As you can see, there is great diversity in this way of eating. There are no “bad” foods and “good” foods, but there is a plethora of vegetarian and pescatarian eating that results in high vitamin C, E and selenium, high levels of glutathione, balanced omega 6 and 3 oils, high fiber, and abundant antioxidants from fruits and vegetables including resveratrol from red wine and polyphenols from olive oil. These are the basic foundations of a heart healthy diet that any nutritionist or integrative doctor will recommend!

Henri-Lebasque-The-SiestaLongevity Lifestyle: There is more than just food to the Mediterranean success though. Lifestyle is almost equally as important for the longevity and happiness that contributes to this regions wellness. Meals are enjoyed in a social atmosphere, contributing to slower eating and improved digestion. Naps in the form of “siestas” are built into the regions lifestyle, allowing valuable down time and relaxation as well as sleep! Movement, in the form of daily walking and gardening, is an inherent part of an active lifestyle that also improves cardiovascular fitness. And finally, there is a strong sense of community, often centered around religion, which fulfills the esoteric or spiritual needs at an individual level.

Implementing Changes: The biggest hurdle to changing your nutrition is what you put in your grocery cart. As long as you have frozen meals and industrial cheese in your cupboards, that is what you and your family will eat. Start by purchasing olive oil, fruits, vegetables, raw nuts, and whole grains, and planning simple meals like soups and salads. Scope out your local Italian grocery store like Micucci’s in Portland, and go to the farmers market and fish market for inspiration.  Classic Italian, Spanish, Middle Eastern or Greek cookbooks or cooking classes can provide inspiration; however, this is inherently a simple style of eating. Some convenience may be lost as you cook a cannellini bean soup, but the preparation time can be made up by the abundance of delicious, easy leftovers and lunches. Enjoy your preparation time with music and a glass of wine and have your kids help – community and relaxed eating environments are two of the secrets to happiness! Get inspired by these simple recipes.

olive-oils-williams-sonoma-cooking-technique-classes-aug-2014A note on olive oil. Americans spend about 700 million dollars on olive oil per year. Low grade olive oil is rampant, and many cheap versions are cut with soybean oil or other inferior vegetable oils. Products branded as Extra Virgin Olive Oil (EVOO) are often not extra virgin (first press) and often not 100% olive. Choosing organic olive oil is a higher price, but ensures the quality and manufacturing guaranteed by organic standards. There are no regulations in place for non-organic oils at the moment. Using liberal amounts of soybean oil or other low grade, low quality oils, especially when stored in plastic, will NOT have the same beneficial properties like polyphenol antioxidants that real olive oil has. When I was recently in Spain, a good quality bottle of organic olive oil was about 15-20 Euros. I saw the same bottle of organic Spanish oil that I brought home from Spain in Williams-Sonoma this past weekend for $25 US. This is about the price that a liter or more of high quality extra virgin olive oil goes for (unless you find some on sale.) If you are paying significantly less, you are probably getting adulterated oils.

Consider shopping at an olive oil specialty store that lets you taste before you buy ~ Le Roux in Portland, Maine offers this option plus delicious balsamic vinegars to pair it with! Buying olive oil in larger amounts, like the metal cans sold at Italian grocery stores, often allows for improved quality and a lower volume price. Transfer some of the oil into a smaller table-friendly vessel for cooking and dressing raw greens! Read More about Olive Oil’s dark side.

References:

http://www.medscape.com/viewarticle/502409_5

http://www.ncbi.nlm.nih.gov/pubmed/24050803

http://www.medscape.com/viewarticle/504600

http://www.medscape.com/viewarticle/750564#vp_2

http://www.medscape.com/viewarticle/785895#vp_2

http://oldwayspt.org/resources/heritage-pyramids/mediterranean-diet-pyramid/traditional-med-diet

http://www.ciaprochef.com/northarvest/mediterranean.html

http://www.today.com/health/live-100-sardinias-secrets-longevity-blue-zones-2D80590693

https://www.bluezones.com/

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DETOX 2015: Start the New Year With A Clean Metabolic Slate

tabula rasa – the latin term for “erased slate” referring to the emptiness of a slate sheet that was previously written on by chalk.

 To start the New Year with a fresh clean slate we need to erase the old clutter from our internal metabolic “chalk board”, which means DETOXIFICATION.

Why detoxify? Intermediate metabolites build up like desk clutter from all of the work that our liver has to do to break down hormones, pesticides, pollution, cholesterol, medications, bacteria, viruses, alcohol, caffeine, and everything else that we inhale or ingest. Symptoms of this “clutter” include allergies, skin disorders, constipation or diarrhea, heartburn, irritability, fuzzy thinking, headaches, low energy, fatigue and many more low grade but uncomfortable signs of poor health.

I do not believe in crazy diets, water  fasting, purges, enemas, or other “heroic” efforts. An effective detoxification process can be simple, inexpensive, easy to accomplish and leave you feeling fresh, renewed and in many cases with less weight! The focus is on fresh, whole foods, clean water, daily smoothies and supplements to improve liver detoxification.

I will be offering an all-inclusive program for one week in January – The tentative dates are January 10-17, 2015. One week is enough time to begin the detoxification process in the liver, but not so much time as to interrupt our busy lives. This program will be a group event, with individual introductory sessions to troubleshoot potential obstacles during the detoxification process.  This program will consist of:

  • A 30 minute detox interview and consultation to assess your personal needs. (The interview can be bypassed for Dr. Wright’s current patients.)
  • A 60 minute group meeting to introduce the program, review the basics of detoxification, and get you ready to start!
  • One week of detoxification with daily email support and a Facebook group for recipe sharing, troubleshooting and cheerleading.
  • A 30 minute group program review at the end to assess the effects, with suggestions on supplements and lifestyle options to maintain the beneficial effects of the detox.

Some people may choose to repeat the detox cycle for 1-3 more weeks in order to really delve into metabolic restoration; however this is an independent option.

Call Age Management Center today at 207-774-1356 IMG_1420or email Dr. Wright at thewrightnd@gmail.com and find out how our New Years Metabolic Detox program can help improve focus, increase energy, decrease allergies and enhance metabolic balance.

Cost: $250 inclusive, prepaid new patients or those needing individualized 30 minute support session.

Cost breakdown: 30 minute consultation: $75, Core Restore Detox Kit $100, 60 minute initial group consultation $50, 30 minute review session $25. Administration, daily emails during the detox program, Facebook group monitoring and detox troubleshooting included.

Current patient & friend/family rate: $175. (Does not include the 30 minute individual consultation.)

Some patients may choose additional Integrative Medicine consultations for more personalized care; individuals who choose to become patients of Dr. Wright’s during or after the program will have $75 taken off her initial consultation fee.

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Foods to Enhance Detoxifcation

tortellini-soup6+srgb.What you eat and how well you take care of yourself will affect how well your liver works. Therefore it’s important that you choose foods that will help maintain and support your liver. Good nutrition can also help to rebuild some damaged liver cells and help the liver form new cells.

The liver has two detoxification pathways called Phase One and Phase Two. To work, each of these phases requires specific vitamins and minerals. These in turn need other nutrients called phytochemicals and amino acids to help them. The liver has a big job to do and as you will see, it requires a team effort.

Phase One changes a toxic chemical to one that is less harmful, and free radicals are formed. Free radicals are unstable particles that react within the body and damage cells. If too many free radicals are made, they can hurt liver cells. In order to get rid of or reduce free radicals, our bodies need foods high in antioxidants and phytochemicals. Antioxidants are beta carotene, vitamins C and E, and selenium; phytochemicals are found in fruits, vegetables and whole grains. One of the most important antioxidants is an amino acid called glutathione that cannot be taken as an oral supplement. Glutathione is made by the body and is also found in some foods. B vitamins including folate are also very important in the Phase One process.

In Phase Two the liver adds a substance to the now less harmful chemical to make it water soluble. It can then be moved out of the body in urine or feces. During Phase Two, sources of sulphur compounds are needed. Some of the foods with a lot of sulphur compounds are (you know the kind, they smell when you cook them) cabbage, brussel sprouts, and broccoli.

Following is a list of foods that have the nutrients needed to help Phase One and Phase Two work as well as they can.

Foods to Help Phase One Detoxification (choose 2 per meal)

Beets contain antioxidants such as beta-carotene, other carotenoids and healing flavonoids. They also contain folic acid which is necessary for Phase One detoxification. Enjoy these as fresh vegetable juice, grated raw on salads, boiled or roasted.

Broccoli contains B vitamins and vitamin C both of which help Phase One detoxification; it also is a source of folic acid. Use raw as a snack with dips, lightly steamed or stir fried.

Brown Rice provides B vitamins and the antioxidant selenium.

Carrots contain beta-carotene and other carotenoids that help to protect the liver. Enjoy as freshly juiced (with beets!) grated raw on salads, steamed, roasted, or in soups and stews.

Eggs supply B vitamins.

Garlic has selenium and glutathione, both of which act as antioxidants.

Spinach provides folate and other B vitamins.

Tomatoes have vitamins C and E which are both needed for Phase One detoxification. They are also a good source of the antioxidant lycopene.

Wheatgerm contains selenium and vitamin E and is an excellent source of phytochemicals.

Melons and peppers are good sources of vitamin C.

Tomatillos, papaya, plantains, carambola and guava are good sources of the antioxidants beta-carotene and vitamin C.

 

Foods to Help Phase Two Detoxification (choose 2 per meal)

Broccoli contains natural sulfur compounds needed to enhance Phase Two detoxification.

Cabbage like broccoli, contains natural sulfur compounds.

Eggs contain methionine, a sulfur-containing compound needed for detoxification.

Brazil Nuts contain selenium, an antioxidant needed for detoxification.

Garlic has high levels of methionine which is needed for detoxification; also contains glutathione, a powerful antioxidant.

Onions have sulfur compounds which are important in both detoxification pathways; also a source of glutathione.

Asparagus and Watermelon are rich, natural sources of glutathione.

Papaya and Avocado help the body to produce glutathione.

Mushrooms are high in glutamic acid which is needed to produce glutathione and aids in detoxification pathways.

 

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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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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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Resolving an Arthritis Flare – for My Dad

Chronic inflammation can cycle into snowballs of pain that catch us off guard. For those with a familial tendency towards rheumatism, arthritis can become quite severe. Joint inflammation usually takes the autoimmune form of rheumatoid arthritis or the inflammatory/ immune joint presentation of osteoarthritis.

An acute osteoarthritis presentation can be effective managed with Naturopathic Medicine. To follow is a recipe for resolution of an acute (meaning, immediate or aggressive) flare up of arthritis that may be causing moderate to extreme pain and inhibiting mobility.

1.You will need to rest as much as possible for 7-10 days. Plan to stay home and lay low whenever possible. Get up every 2-3 hours (except while sleeping) for 10-20 minutes of stretching and gentle exercises like walking in nature, Pilates, or gentle yoga. Wii Fit balance and core strength exercises are fun and support rehabilitation.  Plan your life accordingly. You may need to work from home if possible, reschedule activities, and modify your lifestyle during this time. Remember that this is necessary to address the pain. It is likely your pain and inflammatory levels will be up to 50% resolved by the tenth day of treatment. During this time, also take a daily bath, soaking the affected joints for up to 20 minutes.  I recommend using Epsom magnesium bath salts with 10-15 drops of lavender essential oil or a bath salt of your choice. Follow with 20 minutes of icing the affected joint.

This plan will not cure your arthritis. Your will continue all conventional medications used during the treatment although you may be able to decrease pain medication as needed. This does not replace the need for surgery or other scheduled plans prescribed by your physicians and specialists.

1. For the 7-10 days spent at home, you will follow an Anti-Inflammatory Diet. This is best continued until joint replacement is successful; however, it is crucial during the initial rest window. Studies have proven that nutrition is directly linked with inflammation. By eliminating foods known to increase systemic inflammation, you can reduce your own inflammatory load. This allows your body to begin healing. For more information on The Inflammatory Diet set up an appointment with Dr. Masina Wright ND. http://thewrightdoctor.com/contact-information/

2. Zyflamend Nighttime- 2 capsules 3 times daily. This is a modern formulation of 6-10 botanicals to treat inflammation, joint pain and rheumatism using herbal medicine. New Chapter has combined these into an effective and well researched formula called “Zyflamend.” http://www.newchapter.com/zyflamend The PM version also contains a small amount of relaxing herbs which are helpful for supporting a restful attitude during your healing. You may continue this for up to one year’s duration before a break is needed.  This product is safe to take with most narcotic and non-narcotic pain medication including Vicodin, Oxycodone, Ibuprofen, Tylenol 3 and Ibuprofen. However, do not drive while taking this formulation. If you must drive, use the Zyflammend original formula.

3. Nordic Naturals Omega Joint Plus – 3 capsules daily with or without food. This is a premium joint care formula containing the required daily 1500mg of glucosamine sulphate as well as anti-inflammatory levels of EPA and DHA. The product is expensive at ~$50/bottle for one month supply however, it is worth it. Switch to this product during your first month of resolution treatment for best results, even if you have other fish oil or glucosamine supplements. http://www.nordicnaturals.com/en/Products/Product_Details/514/?ProdID=1548

During your 7-10 day rest time, you can take your other supplements as well, or take a supplement vacation and focus on the above products only to streamline your protocol.

This is the skeleton treatment plan. This is a great place to start! As a Naturopathic Doctors, we individualize every treatment plan to fit each patient’s unique identity. If you do not get the results you are looking for or have trouble adhering to the program, consider seeing a ND in your area. In addition to the above protocol, specific neutraceuticals to address sleep, anxiety, digestion, or other issues may also be prescribed in a consultation. Classical homeopathy is also extremely useful in complex cases. It is safe with complicated pharmaceutical treatments and provides lasting results.

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Spring Wellness Shopping List

Spring! Winter skin comes out from under the covers, and the winter blues start to melt away…. Here are a few simple things you can do to feel and look your best!

Shopping List

£ Nettle Tea

£ Dry Skin Brush

£ Weleda Cellulite Birch Oil (or other good quality body oil.)

£ Flax Seeds

£ Sheep Yogurt

Instructions:

The key to Spring Wellness is getting the lymphatics moving and improving detoxification systems. The lymphatic channels run just underneath the skin, and are the highways of the immune system. Rough and bumpy skin is often from congested lymphatics – toxins literally surface to the skin when they cannot be eliminated properly. Nettle tea is an excellent and very safe lymphatic tonic that can used by everyone – for children, in pregnancy and breastfeeding, with multiple medications, and beyond!

Dry skin brushing is a physical medicine that sloughs off dry skin and stimulates lymphatic channel movement. It creats a youthful vibrant skin surface and helps to eliminate toxins released by the Nettle tea! Dry skin brush before every bath or shower. How? Using a specially designed brush, start at your feet and gently sweep upwards in big circles. Repeat from the wrists to the shoulders and across the chest.

Continuing topical care, nourish your skin with a rich organic oil when you are just out of the bath or shower. This improves dehydration and provides your cell membranes with the rich lipids it needs for optimal elasticity. Don’t towel off your extremities, instead just dry your trunk, face and hair. Generously apply your body oil, massaging your muscles and rubbing it in. Then, take a minute and lie back down wrapped in your towel to let the oils sink in. If you don’t have the time to rest, just wait a few extra moments before you get dressed (to let the oils sink in.) Weleda Birch Cellulite Oil is my favorite for Spring as it stimulates the dermal layers under the skin to continue detoxifying, and has no synthetic perfumes or chemicals that add to your body’s toxic burden.

Internally, adding 2 tbsp of ground flax seeds daily will have great health benefits. First, they are good source of fiber – this  will gently help your bowels to eliminate more effectively, without any laxative effect. Flax seeds also contain lignans, which support estrogen detoxification, which can help men and women taking any hormonal therapies. If you aren’t taking any hormones, lignans still help your body find its best state of hormone balance. And finally, flax seeds are a tasty source of vegetarian omega 3 oils.

I like taking my flax seeds in organic sheep yogurt, with fresh or frozen fruit and maple syrup. This makes a great snack! Its also an easy and yummy breakfast. The reason for using sheep rather than cow yogurt is threefold. First, Variety is the Spice of Life. Most of us eat a fair amount of cow dairy, so diversifying the food spectrum is good for the digestive health. Secondly, our body is made to absorb the small protein molecules in sheep and goat (and human) milks, not the large protein molecules from a cow. This is why many people with dairy intolerance can still have goat (and sheep) products.  Third, sheep yogurt is creamy and tasty! It doesn’t have the “farmy” flavor that many goat products have, so it is more like organic cow dairy in taste and texture. Yum.

Simple changes for simple wellness. Its not the drastic cleanses and restrictions that really make a difference to health in the long run. It’s the simple daily choices that add up to big results. Gently sweeping out the old and inviting in the new and fresh cells by stimulating lymphatics and nourishing the skin will have you feeling radiant.  For any questions or concerns about your personal health and health care, please contact me at http://thewrightdoctor.com/contact-information/

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