Evolutionary Success vs Child Free Living

Posted on September 18, 2017 by Masina Wright ND

As you know, I have been struggling with my biological clock: my age and stress level tick louder than ever. Weighing the cost of motherhood against my career in medicine has never been an equal balance with scales always tipped in the favor of my seemingly insatiable appetite for knowledge. And yet – I’ve been studying fertility since 2004, seeing fertility docs since 2008, and froze my eggs in 2013. I am always scheming to figure out “when is a good enough time”. Yes, I know there “is never a good time: but as a lesbian with a choice, isnt there a “better time”? And here I am, child free, finally happily coupled, and in my third year of medical school in 2017.

I just completed 6 weeks working with newborns and doing well-baby checks to mostly women under 30 in my first pediatric rotation. I I couldn’t help thinking about the definition of evolutionary success as progeny. Many moms I worked with had 4-8 other babies. Some were on opioids, many smoked pot and tobacco or even took buspirone and SSRIs throughout their pregnancy and had sick/addicted babies. Some were very very young. But evolutionarily, each of them had already surpassed me even with my 2.5 degrees, $500k of education, and diverse, privileged, happy life. I realized I am currently an evolutionary failure.

I am an archetype of my Generation X. I don’t have many excuses for child-free living left, having had a bacchanalian and free-spirited 20’s and 30’s. Is it time for me to “settledown”? Who am I if I choose NOT to have a child of my own?

My primary reasoning for not spawning includes RESPONSIBILITY – towards my career/education and more importantly, to the kid. Who brings a child into the world who is guaranteed a mom who is away from home 12-18 hours a day (unavoidable in medical school -residency)? Where is the evolutionary success in that? Generationally, I do not have the same programming my parents had to marry/reproduce, and as a lesbian it didn’t happen by accident. Also, as a kid myself who had a high ACE score, I don’t want to perpetrate even a privileged neglect into another generation. So, here I am: struggling with my generational expectation to break the glass ceiling, achieve my highest ambitions, follow my dreams … and shouldering the unspoken price of doing that.

Maybe I could redefine evolutionary success. Not “survival of the species” but survival of the…planet? Conscious eco-systeming? Or maybe even the more complicated redefining of family/familial success – what if evolutionary success was a life well-lived and well-loved, and a small carbon footprint; a kinship network of peers, lovers, and lifelong friends instead? Children no longer live to serve their elder parents, and even if I had a child, I would not be promised a safe and well-cared for death. Still, at the end of the day, even though I have many cousins with beautiful babies carrying on the family line in all directions, my personal lineage of Wright-Larson will not be carried on unless I have a kid. That feels sad. That does feel like failure.

I stand with my aching feet and my scrubs and pager, knowing raising my own babies is not likely going to be the life I get to live this time around.

I have always been an outlier. I chose Naturopathic medical school in the 90s, chose the urban underbelly in the 2000s, and chose osteopathic medical school in the 20-teens. I’m 92% reconciled that I will enjoy my child-free life and travel to Tokyo, Vatican City, Barcelona, and live in expensive, romantic urban centers. Because I consistently choose career, love and adventure over a baby and domesticity I will be able to live a certain kind of lifestyle. But that doesn’t make it easier when I come home smelling like babies from a day at work, or when I see my cousins achingly beautiful creative charming kids. There is no consolation prize for evolutionary failure. Only the small faith that I am making the right choice for the kid I would create and maybe a for this planet, and hopefully for, myself and my love.

Balancing with Ayruvedic Medicine – from Womens Power to Heal

Posted on January 1, 2017 by Masina Wright ND

I am doing an Integrative Medicine Scholars program through the AMSA and we have to do a project to explore some aspect of Integrative Health. Ayurveda is a practice of medicine I don’t know much about, so I decided to do a personal practice incorporating lifestyle, nutrition and herbal medicine principles for the month of January. My friend Cathleen Miller helped me to figure out what my Dosha is (constitutional type) and lent me this amazing book, and …. here we go! Below is an outline taken directly from this text for (my) Pitta-Vata type.

Balancing Pitta-Vata Rhythms –

Rise with the sun and go to bed by 10 pm – maintain steady eating and sleeping routines
Ease yourself out of all stressful activities and maintain only those projects that create ease – allow adequate time to complete projects
Take ample rest
East wholesome, fresh, moderately warm, moist substantial and calming foods.
Avoid bitter, cold, raw, hot, spicy, oily, salty, fermented or stale foods and stimulants.
Shield against hot, wet, humid, cold, damp, or stressful environments.
Embrace serenity, love, warmth, healthy rituals and calmness.

Nutrition Principles

AVOID: caffeine, refined sweets, alcohol, saturated fats, excess salt, oily and spicy foods, and commercial dairy projects, as well as highly processed junk foods, meats, additives, frozen, canned, commercially grown, bioengineered, transgenic refined salts, sugars, flours and hydrogenated oils.

CHOOSE:

VEGETABLES	Broccoli	Brussel sprouts	cabbage	Cauliflower
Artichokes	Asparagus	Bamboo	Bitter greens	Black olives
Celery	Cucumber	Green beans	Dark greens	Parsnips
Peas	Potatoes	Sprouts	Summer squash	Sweet potato
Winter squash	yams	Watercress	Bok choy	Carrots
Daikon	Beets	Leeks

FRUITS	Apples	Apricots	Coconuts	Dates
Fresh figs	Oranges	Pears	Pomegranate	Tangerines
Mango	Plums	Raisins	Quinces	Limes
pineapple	Avocado	Banana	Grapefruit	Kiwi
Lemon	Peaches	Tamarind	Rhubarb

LEGUMES	Aduki beans	Mung beans	Kidney	Lima
Lentil	Navy	Pinto	Chickpeas	Tofu
Black beans

NUTS	Coconut	Roasted sunflower seeds	Roasted pumpkin seeds	Poppy seeds
Water chestnuts	Macadamia nuts	Sesame seeds	Pecans	Walnuts
Pine nuts	Pistachios

DAIRY	Unsalted butter	Cows milk	Cottage cheese	Sweetened yogurt
Buttermilk	Whole cows milk cheese	Cream	Ghee	Sour cream

OILS	Sunflower	Almond	Olive	Coconut
Dark sesame	Light sesame

SWEETENERS

Maple syrup

Dates

Sucanat

SPICES	Coriander	Cumin	Cardamom	Cilantro
Curry leaves	Dill	Fresh basil	Fennel	Turmeric
Saffron	Peppermint	Spearmint	Ginger	Anise
Mustard seeds	Sage	Nutmeg	Thyme	Ginger
Cloves	Rosemary	Tarragon	Oregano	parsely

Practices

New moon journalling with saraswati mantra – Aim Sarasvatyai Namaha
Ginger compress one week before the new moon (unless bleeding)

1 gallon water

1 handful grated fresh ginger

1 lg stainless steel pot with cover

2 stainless bowls

Bring water to a boil, and add ginger secured in a ouch with a drawstring. Squeeze the pouch to release the ginger juice and drop into the water. Simmer 30 minutes. Let sit 5 minutes before uncovering when taken off the heat. Create a compress towel and apply to lower back for 4-5 minutes or until lukewarm. For full instructions, see text p. 264.

Rose Oil Pichu – for headaches, hair loss, pain in the eyes, poor vision, mental fatigue and nose bleeds. Pichu: a powerful lubricating and loving therapy that helps maintain mental calm, emotional equanimity and helps balance the doshas. Best time: waxing moon phase. C/I bleeding. Best time: morning or early evening.

¼ cup dried roses

1 c sesame oil

Bring to boil over low heat and remove from heat, Add rose flower, cover and let steep 4-6 hours. Strain and use.

PICHU instructions: need pottery bowl, 12 “ clean cotton square and cotton hand towel.

Wash hair a few hours before
Release all stressful thoughts and details from the mind
Assemble the supplies on the floor close by
Soak the cloth in oil and lie down; place the cloth ear to ear. Press down on the cloth and wipe away excess oil
Rest quietly for 30 minutes and rise slowly, use hand towel to wipe away excess oil and maintain a peaceful attitude for the rest of the day.

Shakti Mudra – should be daily but 3 times per week seems doable – enhances sense of self, reinforces femininity, self esteem and restores vital energy to the womb.

Sit facing east

Bring palms together and separate slowly

Form the Shakti mudra hand position – see p. 192 text

Breathe deeply into pelvis and breathe out slowly, tracing the exhalation from the base 0f the perineum, circulating through the uterus and belly

Maintain for 15 minutes

Take a deep breath and make a commitment to a life of non-hurting

Yoni Mudra – 3 days before the new moon and full moon to revise Shakti prana.Not when bleeding.

Sit in meditative practice with palms facing up

Create the yoni mudra hand positions – see p. 155 text

Hold the hand gesture for 5 minutes

Allow breath to flow freely throughout the body, keeping the mind centered

HERBAL MEDICINE

Herbal Teas for PMS – Vata type predominant – take for 3 days of the new moon as well as the 5 days before menses

Helpful herbs: nutmeg, valerian, triphala, ashwaganda, shatavari, cinnamon, turmeric, fennel, dill and wild yam.

CINNAMON, CLOVE AND CARDAMOM DECOCTION (VATA) for PMS

2 c water

2 c organic milk

1 tbsp cloves

1 tsp cinnamon

1 tsp cardamom

½ tsp ginger

1 pinch saffron

LAVENDER FENNEL GINGER TEA DECOCTION (PITTA) for PMS

I c water

1 c organic cows milk

1 tso roasted fennel seeds

1 tbsp lavender petals

1 tbsp hops

½ tsp ginger powder

1 pinch saffron

bring water and milk to a boil. Toast the fennel seeds, then add all herbs and spices and simmer on medium for 15 minutes. Remove from heat, add saffron and stand 3-5 min before drinking.

Heartbreak and Heart Failure

Posted on November 25, 2016 by Masina Wright ND

Sometimes 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.

If 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.

I 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.

Our 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.

I 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.

The Pitfall of Alcohol

Posted on September 26, 2016 by Masina Wright ND

I’ve been avoiding writing this post for at least a week, probably two. Mostly because it has personal meaning to me as alcoholism runs in my family on both sides – My mothers father was one of the “Mad Men” of the 50’s, worked in advertising and died of liver failure due to alcoholism. I guess he got pretty ugly in the end. My paternal grandparents didnt drink at all (which leads me to wonder if their parents were alcoholic) but all of their children have a penchant for the sauce.

Before I was a medical student, I thought the damaging effects of alcohol could be traced directly by measuring liver enzymes – and as long as those harbingers of hepatic cell death stayed within a reasonable limit, one was “getting away” with whatever one was doing. Enter: neurology. Boy was I wrong. Oh and Ps. Dead liver cells cant release ALT or AST, so good liver enzymes in the face of chronic alcoholism is actually a pretty bad sign.

The blood brain barrier is an effective barrier to most things except: nonpolar and lipid soluble molecules. Enter: CO2, O2, and ETOH (alcohol.) This means that as soon as alcohol is in your blood, it is seeping into your brain. And brain cells/ neurons are permanent cells – they don’t have the ability to divide, so they don’t replicate. You get what you started with – some axons can be regenerated, but once the cell body dies, your numbers start to decrease.

The cerebellum is one of the parts of the brain most affected by alcohol cell death; this is why people become unsteady and clumsy when drunk – inhibition of cerebellar function! There are multiple and complex inputs to this lower brain region from almost every aspect of the nervous system, so it can compensate for loss of neurons (when sober) for a long time. Up to 80% of cell death can happen before symptoms become noticeable! Unfortunately, once this is happening in the sober state, the cells are dead and there is no ability to recover balance or coordination.

I didn’t know that memory loss is also a component of chronic alcoholism. There are two halves to the cognitive decline that will happen eventually called Wernicke-Korsakoff syndrome, and these are from alcohol related destruction to two more areas of the brain.

The first set of symptoms is reversible, and is related to a deficiency of vitamin B1 aka thiamine. The mammillary bodies are wee nubs on the underside of the brain that are part of the social and emotional brain. They take information from the hypothalamus and hippocampus, and run it to the anterior nucleus of the thalamus.

This is a critical loop in emotional and social behavior integration at a cognitive level. I guess this is partially where the numbing effect of alcohol on the emotions could occur? With a deficiency of B1, the mammillary bodies hemorrhage and cause Wernickes encephalopathy, characterized by confusion and your eyes not tracking properly, as well as the unsteadiness from the damaged cerebellum. This is why in hospital treatments, alcoholics are first given thiamine/ B1 to see if it can reverse the symptoms. From a prevention standpoint, taking a good quality capsule (not tablet) daily multivitamin seems like a good idea for anyone drinking on a regular basis.

This condition can progress to irreversible memory loss for the past, with an inability to make new memories, plus psychotic symptoms. This is called Korsakoff psychosis. As people lose their ability to remember, they start making things up to fill in the blanks called confabulation. This can be really depressing for friends and family members as it becomes clearly evident that the damage is permanent.

and THEN, there is the metabolic damage that is occurring below the neck. (This next section is biochemical mumbo jumbo, but since this is my review exercise, I’m going to include it for my medical interest:)

Ethanol/ your drinks/ are 80% broken down by cells (cytosol) of the liver. 15% of alcohol is broken down by microsomes in the brain and liver, and this pathway is upregulated in chronic alcoholism. The remaining 5% are converted to fatty acids and phospholipids that are thought to play a role in tissue damage. Both primary pathways break down ethanol to acetaldehyde, which is metabolized down to acetate…..Acetate, where have you heard that before? yes, NAIL POLISH REMOVER, flooding your liver and brain.

The major metabolic consequence is from the elevation of NADH that occurs in the cell and in the mitochondria in steps one and two with excessive and continual amounts of alcohol intake, because this NADH will inhibit the TCA cycle from running. No TCA = no glucose metabolism = no fuel for the cells. The brain will still need fuel, so the liver cleverly shifts the glucose from the alcohol (which can no longer be metabolized) to ketone production + free fatty acid synthesis (aka fat storage.) This explains, in painful detail, why alcohol makes you gain weight and affects blood sugar levels.

Finally, I wanted to add this last slide for an important prevention note. This is the process of the 15% microsomal pathway that is upregulated with chronic high alcohol intake. Note the second step produces ROS – this is reactive oxygen species aka free radicals which are known to cause cell damage and cell death. Higher levels of ROS are bad in general and associated with greater inflammation and cellular damage across the board. This points to another potential place for prevention – with use of high dose antioxidants like CoQ10 200-300mg, resveratrol (500mg), alpha lipoic acid (200mg) and vitamins C (1000mg) and mixed tocopherol E (400IU).

When alcohol intake gets high enough to start causing brain damage, obviously the primary treatment goal is to reduce the intake. Our first case study had a 37 yo male drinking 12-16 beers PER DAY. How many drinks, realistically speaking, are you having per day? How many does that add up to per week? Does that seem reasonable to you?

I don’t know enough about addiction to know how to address real chronic alcoholism. I imagine it is incredibly hard to quit, and even to reduce daily intake without a pure and strong internal directive to do so – no one can be told to do it, the drive Must Come from Within. Treating underlying depression, anxiety, or life stressors are surely part of the picture, but what if you just drink to have fun? Sometimes, the party needs to stop, or gets out of control. I guess we all need to grow up sometime and learn to tolerate whatever it is we harbor inside our minds (before they get destroyed.)

Alcohol is a depressant, so withdrawal symptoms are the opposite – agitation, irritation, worse case scenario people can have seizures. Benzodiazapines, some sleep drugs and alcohol all work on the GABA-A receptor in the brain. Chronic alcohol use downregulates the expression the neurotransmitter GABA, one of the “off switches.” Once high levels of alcohol start to lower, it takes time for the brain to start making enough GABA again, resulting in foul moods, irritability and general unpleasantness.

There are medications like naltrexone and acamprosate that can help reduce the cravings for alcohol, and medications to treat the side effects of withdrawal, mostly aimed at these same parts of the brain. These are definitely worth exploring with a psychiatrist or addiction specialist to figure out what approach will work best for you. Complete abstinence does not need to be the goal. GABA as a supplement is not absorbed well, but is readily available and might be worth a try for someone who is just cutting down on daily intake, and has addictive enough a personality that switching to benzos instead of alcohol could exacerbate rather than relieve the problems. However, it is unlikely GABA alone would be enough to support sobriety. Making the very personal and often terrifying choice to look at one’s habits and face trauma/addiction is the place to begin. A comprehensive medical assessment with an empathetic and respectful health professional who has experience in addiction is next step. (if you are in Maine, I highly recommend Dr. Merideth Norris!)

Will Power

Posted on August 16, 2016 by Masina Wright ND

I am two weeks into second year medical school, and the majority of our content has been NeuroAnatomy and Brain Diseases. As a physician it is pretty darn important to be able to figure out when someone is having a life threatening stroke impinging on brain tissue, versus a flare up of a genetic disorder that is starting to show neurological signs and symptoms. Knowing the anatomy of the brainstem, and the arrangement and progression of the long tracts of nerve fibers throughout the spinal cord, medulla, pons, brainstem and beyond can create a Cartesian like diagram where one can fairly accurately isolate the nature and location of the lesion. That is, if you can remember where and how everything goes.

I never quite knew where the medulla was even located, and now I know more than I probably ever will again about the arrangement of nerves, radiations and nuclear cell bodies in its little bulbous body. This tiny part of the body has nerve fibers that do cardiorespiratory regulation, the trigeminal cranial nerve nucleus, tracts, and radiations for face sensation, ascending dorsal column and spinothalamic sensory tracts for the entire body, descending corticospinal and pyramidal motor tracts for the entire body, and some complicated cranial nerve regulating nucleii that coordinate the eyes and hearing. As you go up fun things show up like the olives, and the solitary nucleus and nucleus ambiguous (both associated with the vagus nerve.) And, the tongue. Problems with the tongue can be from a medullary lesion including slurred speech and not being able to stick your tongue out at someone very effectively, because it points wiggly off to the side the damage has occurred. There is probably more things in this tiny medulla oblongata, but I cant remember them right now.

Starting back into school is also an exercise in letting go. I am fairly certain this is a cerebral condition, and not a brainstem function. Letting go of free time, of relaxation, of life without an alarm clock. It takes a lot of will power to focus for so many hours at a time. I personally also find myself needing to cut back on alcohol, Netflicks and social time with the advent of academics. I have been having a lot of conversations about this topic of will power lately, as in, do I have enough, or am I lacking? I have such restricted foods from all of my food sensitivities that I feel like I have pretty good will power overall but maybe, just maybe I could work on a higher level control of some of my more primitive impulses (stay tuned for amydala updates next week.)

Back to the topic of stroke. And willpower. Smoking is a huge risk for stroke, especially intraparenchymal stroke. 45% of people die within the first 30 days of having a stroke. Why? Because the brain is special. And when you put pressure on it, by adding more fluid (blood) into a closed small area (the skull, or calverium as I love calling it) then, the brain tissue simply LIQIUIFIES in an effort to make more room. Disgusting right?! When your brain liquefies, you get signs and symptoms associated with damage in that place – if you hit a small area and just nerves and radiations of nerves, your body can often recover loss of sensation or muscular weakness on one side of your body. When you hit a nerve nucleus, like the facial nerve cell body nuclei, you probably wont recover those functions because the cells themselves are dead.

Apparently I still need to learn more about strokes, especially the ones that can kill you. What I do know, is high blood pressure, diabetes and smoking are huge risk factors for stroke, and those are all related to will power. So, you do have a choice, like I do, about how to live on a day to day basis. I am choosing to decrease my daily alcohol content to improve my studying. What will your choice be?

(Least)* Complicated

Posted on June 6, 2016 by Masina Wright ND

Walking the tightrope between being a current MSII medical student and a Naturopathic Doctor is a delicate balance sometimes. I never know whether my career as an expert in alternative medicine is going to be a blackball or a gold star because of the very mixed opinions people have about my former profession in the medical world. My plan, heading into the first day of medical school was not to tell anyone my (second) degree when I started (my third degree) at UNECOM, but it was announced in orientation so my cover was blown.

Being a ND in general is pretty complicated – working outside of insurance in most states is a financial challenge for patients as well as doctors, and public knowledge about the profession is highest on the west coast of the US and Canada, and in more affluent areas of the NorthEast. Many people get excited when I say I am a doctor, then look back blankly when I tell them what kind of medicine I practice(d). People who know the field have reactions that are pretty love: hate. Lots of lovers, quite a few haters, and an ever-growing population of quiet converts who realize that, as one anonymous Twitter medical student said in my recent Twitter Flaming on the topic: people who are interested in alternative medicine are usually trying to take care of their health and make themselves feel better.

I have recently been made aware of a woman who attended a west coast Naturopathic Medicine College who has turned against the profession “with an inside view” and who is engaging in aggressive muckraking. She is getting recognition and validation as an “insider” to Naturopathic Medicine as she did complete our 4-year postgraduate degree before she quit and moved to Germany. She has started a petition to defame the profession worldwide. The unfortunate thing is she lives outside the US and is not accountable for US or CDN slander laws. What she is doing is poignantly effective because she has inflamed the haters. One doctor in particular is a physician and educator with the influential Doctors in Training Boards Exam Review Series. He has a large Twitter following and has enthusiastically joined in the slander of the Naturopathic Profession. I worry about how his “expert” personal opinion will effect future generations of physicians who have not considered their professional opinions of Naturopathic Medicine due to lack of exposure.

Big media like Forbes has jumped on the “tin foil hat” bandwagon by supporting her claims that botanical medicine, nutrition, physical medicine, homeopathy, mind/body practices and stress management are invalid sciences without evidence. The American and Canadian federal Naturopathic associations have both started a counter-petition against these muckracking efforts.

All of this is personally upsetting for me. It stirs a complicated turmoil of emotions, injustice, pride, and frustration that mixes my own choices with a very clear working knowledge of the weight that “the big lie” technique can carry in the world of propaganda. All of this comes at a time when “Functional Medicine” and “Integrative Medicine” are the new darlings of allopathic medicine alongside epigenetics and the microbiome.

Newsflash: Functional Medicine and Integrative Medicine ARE evidence based Naturopathic Medicines, researched by and for NDs originally.

Naturopathic Doctors are systematically being defamed and slandered while our actual practice techniques are being picked up and renamed and celebrated for their effectiveness.

I feel helpless in the face of this complicated adversity. I made my personal choice to add an Osteopathic Degree to my knowledge base because there was more to medicine I wanted to know – pharmacology, emergency medicine, psychiatry, and other facets of transgender medicine I need additional training on. I know the great value of Naturopathic Medicine and so do a great number of North American consumers. I suppose I need to trust that the greater good will prevail in the end…. but that may not help me or my career path when I am placed in a hospital as an MSIII or resident with an attending like the Internist above who hates everything alternative and Naturopathic medicine stands for.

Insomnia is the Worst!

Posted on February 17, 2016 by Masina Wright ND

I was on vacation with my sweetheart this past week, and spent two long nights in a hotel room when I could.not.fall.asleep! What to do? It was so exhausting, and of course set my mood and energy levels off for the remainder of the trip.

When I evaluate sleep from an Integrative Medicine perspective, I usually break it into –

unable to fall asleep
unable to stay asleep.

The former tends to have a different set of causes and therefore medications than the latter. Sleep is complex and involves multiple body systems working together including endocrine, neurological, immune, musculoskeletal, and mental/emotional at the very least! Each person with chronic insomnia will benefit most from individualized treatment, but here are some generalizations to improve sleep.

First, as boring and arcane as it sounds, sleep hygiene is important. Hygiene is a strange word to associate with sleep, IMHO. It sounds weird and uncomfortable, but “sleep hygeine” is a general concept that encompasses the environmental and behavioral aspects that are known to improve sleep quality and promote restful sleep. For example, my hotel room was too hot both nights. Maintaining a comfortable room temperature preferably cool with fresh air, is known to improve sleep quality. A darkened room without blinking or other lights within eyesight and a peaceful bedtime routine are also examples of sleep hygiene.

To fall asleep, sedatives are the key. Valerian is the strongest herb for sleep support. This herb was mentioned by Hippocrates in his writings, and is one of the oldest sedatives known. It has numerous studies supporting its use for sleep. The essential oils in valerian appear to provide its sedative activity, while the valepotriates exert a regulatory effect on the autonomic nervous system. Although more than 150 constituents have been identified, none appear to be solely responsible for valerian’s effects, suggesting many compounds may act synergistically. Valerian’s mechanisms of action are not completely understood. Valerian interacts with neurotransmitters such as GABA and produces a dose-dependent release of GABA. Valerian also inhibits the enzyme-induced breakdown of GABA in the brain.

GABA is my other secret weapon for falling asleep. There are two on switch neurotransmitters (dopamine and acetycholine) and two off switches (gaba and serotonin.) When the off switch is stuck on, sleep becomes difficult. Taking GABA as a supplement improves GABA levels in the brain, quieting the mind. Benzodiazepenes like Attivan and hypnotics like Ambian also work to increase GABA levels, as does Valerian. *Don’t use these all together as they can depress respiratory function as a cocktail.

Difficulty staying asleep can be more complicated to treat than falling asleep. Taking sedatives at 2 – 4 am can result in morning grogginess. From my experience, early waking (3am) is often related to a dysregulated cortisol clock, or, put simply, stress. Cortisol is the primary stress hormone produced by the adrenal glands. It runs on a 24 hour clock, and should be highest at 8am, and slowly drop during the day and rise at night. With emotional and/or physical stress, travel to different time zones, or shift work, the cortisol clock can become dysregulated, peaking earlier and earlier, creating an too-early wake up signal. Adrenal support is key. I often use herbs like ashwaganda, L-theanine, rhodiola, relora, and more to help regulate adrenal hormone production and heal imbalances. Cortisol is complicated, and balancing requires an in-depth look at ones lifestyle, mental health, stress coping techniques, exercise patterns, blood sugar and more. Therefore, treating stress and adrenal health in relation to sleep is best with an individualized approach, as “cookbook” medicine rarely gives optimized results.

For really tough sleep cases, NeuroScience labs makes a neurotransmitter panel to assess what is causing the night time wakefulness. Blood sugar disorders, sympathetic nervous system activation, cortisol dysregulation, hormone imbalance, anxiety, depression, grief, and more can all be part of the “perfect storm” of insomnia. Find a Naturopathic Doctor in your area to unravel the depths of your sleep mystery.

Finally, energetic medicines like acupuncture and homeopathy can be invaluable for unlocking sleeps depths. We are quantum physics humans, we do not operate in straightforward paradigm. Sometimes sleep issues go back to childhood dysregulation or other “never been well since” life events. These more energetic medicines can work to correct these deep imbalances by integrating unresolved issues that plague your subconscious when your guard is down. Psychotherapy and cognitive behavioral strategies can also be used to unravel sleep and stress mysteries.

I was lucky: once I was able to come down from the stress before my trip, and relax into my holiday my sleep improved, and I even got to sleep in for a change! What do you need to get that beauty sleep you so desire?

Eat, Sleep, Wait, Repeat.

Posted on October 6, 2015 by Masina Wright ND

I recently read an article that most Americans eat for 15 hours a day. Apparently, the body needs a 12 hour fast daily to clear liver glycogen, thus switching metabolism to utilize the body’s stores (fat) to fuel the basic metabolic rate. Without this 12 hour fast, the liver does not get to ever fully utilize glycogen stores, and food/fuel aka glucose gets stored as fat.

Ive been tracking myself, as I always do when I am trying out a new metabolic theory, and I usually get about a 9 hour fast in. I’m one of those people that likes to eat at night, and with my new academic schedule, I need my 7am morning toast to soak up the coffee that makes my 6am wake-up call possible. Also, beverages counts as food/fuel in this context. Therefore, the last drink of alcohol, milk or juice you have before bed also counts towards the fasting timeline.

The 12 hour fast biochemistry is probably the source of the “dont eat after 7pm” dogma. That, and most of the snacking that occurs after dinner is high calorie and high deliciousness.But what if, like me, you are someone who likes to graze after 7am, eat dinner late, and/or cant sleep with an empty belly?

The moral of the story is: if you are trying to lose weight, make it a priority to fit in a 12 hour fast that includes your hours of sleep (hopefully 8+. Read how more sleep helps you lose weight here.)

For example: If you snack until 10pm, don’t have breakfast, coffee with sugar or cream/milk, juice, or anything over 5 calories or sweet tasting until 10am. (Ps. Even artifical low calories sweeteners may be linked to weight gain says Harvard med.) This will allow your body to “empty” its reserves, making room for a day of metabolic synergy and a delicious, satisfying 12 hours of food after your overnight fast.

Hint: learn to love black tea or coffee, green tea, and/or hot lemon water before your 12 hour fast is over if you are honestly wanting to lose weight. If, like me, you are too busy to make changes right now, just think about it, watch your patterns, and see if you can do it every once in awhile or on weekends.

Gluten Free Living

Posted on September 23, 2015 by Masina Wright ND

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 also on gluten sensitivity, a mlder form of systemic immune response to the gluten molecules. It is easy to find gluten free recipes, resources, and restaurants in almost any geographical area.

So, what is all the hype? The bottom line is that gluten sensitivity begins with the immune system of the digestive tract becoming hypersensitive to gluten proteins like gliadin. 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 causing symptoms in a diverse set of body systems.

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. Eliminating the offending foods or doing tests 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 are safe for gluten allergies & sensitivities 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 be enjoyed by those who are gluten free.

For more 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 people with gluten sensitivities. For this reason, it is best to start 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….. buy rice pasta, corn pasta, or some of the newer legume (bean) based pastas. Must say “gluten free”
Soups – commercially canned – read labels for “flour” or wheat
Desserts – most contain wheat – so read labels 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 easy to find. Mary’s Gone Crackers are a great 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.

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

Mediterranean Diet Explained

Posted on July 21, 2015 by Masina Wright ND

The 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.

Many 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.

Nuts 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.

Fish 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!

Longevity 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.

A 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/