Author Archives: Masina Wright ND

Essential Fatty Acids and Mental Health by Tori Hudson, N.D.

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~ This article was published in the Emerson Ecologics Womens Health Email update December 2011.

When it comes to the biological basis for mental health disorders, the presumption is an abnormality of neurotransmitters- whether it be excess, deficiency, or abnormal interactions with receptors or transporters. While the focus of current pharmacological therapy is the neurotransmitter and its proteins, the impressive role of lipids, particularly long-chain polyunsaturated fatty acids (LC-PUFAs), cannot be overstated. The weight of the brain is roughly 80% lipid, the richest source of fatty acids in the body and 15-30% of those lipids are essential fatty acids (EFAs) and LC-PUFAs. Nerve cell function, membrane fluidity, neuron membrane dynamics and the subsequent receptor, transporter and neurotransmitter function are profoundly affected by the lipids that we take in from our diet and supplementation. Considerable research including randomised controlled trials now demonstrate the role and efficacy of EFAs in numerous psychiatric disorders.

Depression

According to the American Journal of Psychiatry, depression is one of the 10 most frequent indications for the use of complementary and alternative medicine.1 While many nutraceuticals and botanicals have published evidence to their benefits, omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) are among the more commonly used.2

Epidemiologic studies in several countries suggest that decreased omega-3 fatty acid consumption correlates with increasing rates of depression. One researcher who studied the relationship of fish consumption and the incidence of depression correlated the annual incidence of major depression per 100 people in nine countries with the consumption of fish.3 He found a high incidence of depression in countries with low fish consumption. For example, New Zealanders have an annual fish consumption of about 40 pounds and they had an annual incidence rate of depression of 5.8%. Japan on the other hand, with a fish consumption of almost 150 pounds per year, had the lowest incidence of major depression, at .12%. His group also demonstrated that prevalence rates for bipolar affective disorder rise when the annual fish intake falls below 75 lbs of fish per person annually. In Taiwan for example, there is a 0.04% rate and their fish intake is 81.6 lb per person per year as compared to Germany, the rate is 6.5% at 27.6 lb of fish per person annually. In a survey of 3,204 Finnish adults, infrequent fish consumption was associated with depression in women and although not statistically significant, a trend was seen in men.4 Fish intake also appears to have an influence on suicide with a reduced risk of death from suicide in individuals with daily fish consumption.5

In a study of 20 patients with moderate to severe depression, the relationship between depression and levels and ratios of omega-3 and omega-6 fatty acids in plasma and erythrocyte phospholipids was studied.6 Using two commonly accepted scales and methods of evaluation depression, researchers found a significant correlation between the ratio of phospholipids arachidonic acid to EPA and the severity of depression. The greater the omega-6 to omega-3 ration, the greater the severity of the depression.

In 2010, researchers found that patients with major depressive disorders, exhibited significantly lower erythrocyte DHA composition compared to healthy controls and those with bipolar disorder appeared to have an even lower DHA level.7

Other investigations have confirmed that a high concentration of blood plasma of docosahexanoic acid (DHA), an essential fatty acid found in fish, has been linked to increased serotonin turnover with lower rates of depression and even suicide. Switching to a cholesterol-lowering diet may also result in reductions in measures of depression,8 although not all studies demonstrate this. It appears as though there is a consistent positive association between depression and coronary heart disease and heart attacks.9 They may in fact carry a common cause, that of elevated cholesterol. Since there is such a strong correlation between depression and coronary artery disease, and a predictive correlation between elevated cholesterol and heart disease, elevated serum cholesterol should also predict increased depression.

Depression, secondary to alcoholism, is quite common and occurs in up to 59% of alcoholics. Alcoholism is certainly a complicated illness with social, psychological, hereditary, physiological and physical factors to consider. We know that alcohol is a pro-oxidant that leads to increased lipid peroxidation and a consequence of increased lipid peroxidation may be a decrease in the concentrations of the more highly unsaturated species of fats. Several studies have demonstrated that chronic alcohol abuse depletes long-chain n-3 polyunsaturated fatty acids from neuronal membranes.10 It is hypothesized that the subsequent effect on the membranes may promote the development of depression.

Higher intakes of fish, EPA or DHA did not have a protective role against suicide in more severe situations and has not been associated with a lower risk for suicide in Japan, but women in Japan with very low intakes of fish, did have an increased risk of suicidal death.11

A search of the literature examining the therapeutic efficacy of essential fatty acids for depression was published in 2006.12 One double-blind placebo controlled RCT examined the use of omega-3 fatty acids in 30 men and women.13 The intervention group received 9.6 gm of omega-3 fatty acids from fish oil in addition to their standard pharmacological treatment for 4 months. A Kaplan-Meier survival analysis found that the fish oil group had a significantly longer period of remission than the placebo group and performed better than the placebo group in other outcome measures. Three case control studies of adults with major depression and non-depressed healthy adults all showed a definite difference in omega-3 polyunsaturated fatty acids (PUFAs) between depressed and non-depressed adults.14, 15, 16 A review article suggests that DHA is beneficial for depression as well as several other conditions.17 Another review article discussed the effects of dietary intake patterns on fatty acid balance and potential effect on mood.18

Other intervention studies have been done since the initial literature review that concluded in 2001. The only intervention trial up until that point was the Stoll study on bipolar disorder. Since then, RCT trials have been done that assessed the role of omega-3 PUFAs in the treatment of major depression. 2/g of DHA or placebo in 36 depressed patients found no significant difference between the DHA and the placebo, although there was a better overall response rate in the DHA group.19 In another of 28 patients with major depression, 9.6 g/day showed significant improvement compared to the placebo group.20 In a study of EPA, 1gm/day demonstrated significant improvement in two different depression scales compared to placebo and no further improvement was seen in higher doses of EPA than 1gm/day.21 A combination of EPA or placebo and conventional pharmaceutical antidepressant treatment in unipolar depression demonstrated that those in the EPA group had significantly better effects by the third week. In an eight weeks, single-blind placebo trial, peri or postmenopausal women with depressive disorders and hot flashes were given 6 gm/day of EPA and DHA. The response rate was 70% and a decrease of 50% or more on the Montgomery-Asberg Depression Rating Scale (MADRS).22

Several probable mechanisms may explain the link between EFAs and depression. EFAs can modify 5-HT receptors, serotonin and dopamine metabolism, lower monoamine oxidase B, modulate cytokine production and enhance signal transduction. The composition of cell membranes, neurotransmission and prostaglandin metabolism are all affected by the amounts of EFAs and while clinical trials are few, there is substantial laboratory and observational evidence of the correlation between low essential fatty acid levels and depression.

Bipolar disorder

It is generally thought that bipolar disorder involves an overactivity in the signal pathways of neurons. Omega-3 fatty acids are known to dampen this overactivitiy and a previous hypothesis was confirmed in a landmark study at Harvard Medical School. The double-blind placebo controlled study of men and women with bipolar disorder were given either seven fish oil capsules twice a day or a placebo of olive oil capsules.23 Each capsule contained 440 mg of EPA and 240 mg of DHA. More than twice as many individuals in the fish oil group completed four months of the study without a major episode of mania or depression than those in the placebo group. In addition, nine individuals in the placebo group had worsening depression during the study compared to none in the fish oil group. The average decline in depression rating was almost 50% in the fish oil group compared to an increase of 25% in the control group.

Schizophrenia

Research is limited but intriguing regarding the hypothesis and evidence that symptoms of schizophrenia may result from altered neuronal membrane structure and metabolism. Several studies have shown that individuals with schizophrenia often have low levels of particular EFAs necessary for normal nerve cell membrane metabolism.24 Although the evidence is small, one initial open label study indicating efficacy which led to two small double-blind pilot studies is encouraging. In the pilot study, EPA showed a statistical superiority over DHA and placebo on the total Positive and Negative Syndrome Scale (PANSS).25 In the first small study, 45 schizophrenic patients who were stable on antipsychotic medications but still symptomatic were treated with either PEA, DHA or placebo for three months.26 The EPA group’s PANSS was significantly superior to both DHA and placebo, and EPA was significantly superior to DHA for positive symptoms using the analysis of variance (ANOVA). In the second placebo-controlled study, only EPA was used, although antipsychotic medications were permitted if necessary.26 By the end of the study, 8 of the 14 patients on EPA were taking medications and all had improved PANSS scores, while all 12 on placebo were taking antipsychotic drugs.

It is surprising that EPA was the most therapeutic in the first study, given that DHA is a major constituent of neuronal membrane phospholipids. The positive results of these pilot studies and the observed abnormal PUFA and phospholipids metabolism in individuals with schizophrenia is supportive of the potential for the role of EFAs in prevention and management.

 Summary

 I look forward to more research on prevention and intervention with omega-3 fatty acids in mental health disorders. While three conditions were discussed in this article, there are other promising areas of research in the areas of aggressive behavior, personality disorders and attention deficit disorder. Psychiatric disorders, behavioral problems and neurodegenerative disorders are some of our society’s most prevalent and serious challenges. Dietary changes in decreasing saturated fats and increasing seeds and fish along with supplementation, particularly fish oil, hold great promise for improving our brain function and the diseases affected by health EFA metabolism and the brain.

Lastly, in the search for high quality fish oils, I recommend looking for products that perform and supply third party testing on peroxides, total oxidation, PCBs, heavy metals and dioxins.

Sources

1 Kessler R, Soukup J, Davis R, et al. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psychiatry 2001;158:289-294.

2 Smit E, Muskiet F, Boersma E. The possible role of essential fatty acids in the pathophysiology of malnutrition: a review. Prostaglandins Leukot. Essent. Fat. Acids 2004;71(4):241-250.

3 Hibbeln J. Fish consumption and major depression. Lancet 1998;351, April 18: 1213

4 Tanskanen A, Hibbeln J, Hintikka J, et al. Fish consumption and depression and suicidality in a general population. Archives of General Psychiatry 2001;58:512-513.

5 Hirayama T. Lifes Style and Mortality. A Large Census-Based Cohort Study in Japan. Basel: Karger 1990

6 Adams P, Lawson S, Sanigorski A, Sinclair A. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 1996;31:157-161.

7 McNamara R, Jandacek R, Rider T, et al. Selective deficits in erythrocyte docosahexaenoic acid composition in adult patients with bipolar disorder and major depressive disorder. J Affective Disorders 2010;126:303-311.

8 Weidner G, Connor S, Hollis J, Connor W. Improvements in hostility and depression in relation to dietary change and cholesterol lowering. Ann Intern Med 1992;117:820-823.

9 Booth-Kewley, Friedman. Psychological predictors of heart disease: a quantitative review. Psychol Bull 1987; 101(3):343-62.

10 Salem N, Ward G. The effects of ethanol on polyunsaturated fatty acid composition. In: Alling C, Diamond I, Leslie S, Sun G, Wood W, eds. Alcohol, cell membranes, and signal transduction in brain. New York: Plenum Press, 1993:33-46.

11 Poudel-Tandukar K, Nanri A, Iwasaki M, et al. Long chain n-3 fatty acids intake, fish consumption and suicide in a cohort of Japanese men and women- The Japan Public Health Center-based prospective study. J Affective Disorders 2011;129:282-288.

12 Williams A, Katz D, Ali A, et al. Do essential fatty acids have a role in the treatment of depression. J Affective Disorders 2006;93:117-123.

13 Stoll A, Severus W, Freeman M, et al. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Archives of General Psychiatry 1999;56:407-412.

14 Maes M, Christophe A, Delanghe J, et al. Lowered omega3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res 1999;85:275-291.

15 Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated faty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disorders 1998;48(2-3):149-1555.

16 Peete M, Murphy B, Shay J, Horrobin D. Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Bio. Psychiatry 1998;43(5):315-319.

17 Horrocks L, Yeo Y. Health benefits of docosahexaenoic acid (DHA). Pharmacol Res 1999;22(5-6):474-480.

18 Bruinsma K, Taren D. Dieting, essential fatty acid intake, and depression. Nutr Rev 2000;58(4):98-108.

19 Marangell L, Martinez J, Zboyan H, et al. A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry 2003;160 (5):996-998.

20 Su K, Huang S, Chiu C, Shen W. Omega-3 fatty acids in major depressive disorder-a preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 2003;13:267-271.

21 Peet M, Horrobin D. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry 2002;59 (10):913-319.

22 Freeman M, Hibbeln J, Silver M, et al. Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: preliminary open trial. Menopause 2011 18(3):279-284.

23 Stoll A, Severus E, Freeman M, et al. Omega-3 fatty acids in bipolar disorder; a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry 1999;56:407-412.

24 Joy C, Mumby-Croft R, J L. Polyunsaturated fatty acid (fish or evening primrose oil) for schizophrenia. Cochrane Database Syst Rev 2000;2:CD001257

25 Peet M, Laugharne J, Mellor J. Double-blind trial of fatty acid supplementation in the treatment of schizophrenia. International Congress on Schizophrenia Research, Colorado Springs, CO, April.

26 Peet M, Brind J, Ramchand < et al. Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia. Schizophrenia Research 2001;49:243-251.
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Caffeine, Detoxification, and the Healing Crisis

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Days after quitting caffeine, I started coughing up and eliminating nasty amounts of toxic looking phlegm from my sinus and lungs. (sorry for the descriptors.) I had been suffering from sneezing, clear drippy nose and “allergy” or “cold” symptoms for a couple of months previous to this. So, while I was disappointed to be getting sick over the holidays, it felt like I was finally getting “something out” of my system that had been brewing for a long time.

I have searched many databases for evidence based articles linking caffeine and sinus and have only found articles related to caffeine and heart disease. Apparently there is no evidence based link. However, in searching Dr. Google for other peoples opinions on caffeine and sinus health, there is a relationship between the two. Caffeine diminishes adrenal health by deleting epinephrine and affecting cortisol levels. This in turn affects the immune system and inflammatory levels, which can lead to increased candida levels causing chronic sinusitis.

The body wants to be in homeostasis. This means, the body seeks balance. In its natural state, without drugs, the human body will naturally produce secretions to eliminate microbes and return to its state of best health. This is one of the basic tenets of Naturopathic Medicine. This can produce what is known as a healing crisis. Fevers, vomiting, diarrhea, vaginal discharge, phlegm – secretions of various kinds are produced to aid the body in returning to its natural state. It can feel pretty awful to be in a healing crisis, but if you are able to trust that the body is actually working towards a state of improved health rather than spiraling towards destruction, it can bring about an awesome recovery. (This is also often what modern medicine is appropriate,  when medications or other medical interventions are appropriate interventions. The differential between the safe healing crisis and the situation needing medical intervention is the job of a ND.)

I haven’t felt too awful with this current “sinus and bronchial infection.” Although I have had copious elimination of some nasty stuff, my energy, appetite and general mood have been pretty good. I have been able to lay low, watch TV, do castor oil packs for my lungs, make soups, drink Cold Care and Throat Coat teas, and take anti-fungal and lung herbs to support the elimination. Overall although I am sick in a classical sense, I feel a renewal taking place. And, I have finally been able to kick the caffeine and headaches while avoiding the fatigue by resting so much! I will need to continue to work on my adrenal health and decrease sugar intake as candida has been flagged as a potential long term issue by this detox experience.

Everyone will have a different experience, and a different potential for a healing crisis. Age, stress levels, number of years on caffeine, gender, diet and nutrition levels all play into the effect caffeine has on the body, and the resulting effect its elimination can inspire.

Exerpt from http://www.health4youonline.com/article_sherridan_stock_conquering_candida.htm#Hypoadrenia

Hypoadrenia 

Several years ago we noted a correlation between healthy adrenal glands and the absence of candidiasis, and formed the opinion that healthy adrenal glands help protect against candidiasis. We now realize that the other side of the coin is perhaps more important: Candida commonly impairs adrenal functioning, sometimes severely so.

Having made this latter observation, we wondered about the possible mechanism.  Initially we supposed that the Candida infection constituted an adrenal stressor, like any other infection.  We then saw a lady in whom candidiasis was a major cause of hypoadrenia, and noted that the amino acids that supported her adrenal glands best were taurine, cysteine, and glycine – all antioxidants.  Following up this clue we then ascertained that Candida and its toxins appeared to be exerting a direct cytotoxic effect on the adrenal glands via free-radical activity.

Another mechanism suggested by our testing is that of Candida-induced autoimmune damage to the adrenal glands.  Several studies do, in fact, implicate Candida as a major cause of autoimmunity since it can reduce suppressor T-cell activity.(3)  Further, it is possible that because of a similarity between the protein sequence of the cell walls of Candida and that of human cells, antibodies directed at Candida may cross-react with human cells.(5)  We also wonder whether the presence of Candida and its toxins within a tissue causes the body to regard that tissue as non-self and therefore to initiate autoimmune attack.

Additionally, Candida toxins interfere with acetyl coenzyme A activity,(3) which could inhibit the synthesis of adrenal steroids, and further, it is believed that Candida possesses receptor sites that can bind adrenal steroids thus competing with host cells, producing apparent adrenal insufficiency.(3)

Exerpt: CONQUERING CANDIDA by Sherridan L. Stock BSc(Hons) CBiol FBiol FZS FRES

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Treatment Protocol: Weaning Off Coffee

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Treatment strategy adapted in part from Naturopathic Doctors News and Review article Managing Caffeine Withdrawal in the Patient Undergoing Detoxification (V. 7 Issue 12 p. 8-9) by Dr. Peirson ND and from Dr. Braverman’s Dopamine Deficiency Protocol. For more information on caffeine addiction see: http://thewrightdoctor.com/2011/12/26/coffee-addiction/

Daily Supplements and Lifestyle Changes:

  • 200-400 mg Magnesium Citrate – I like Trace Minerals Research liquid mineral formulas. It allows for a personal tailoring of dosage. Too much magnesium can have a laxative effect (which can be helpful if constipation is a side effect of caffeine withdrawal.) Take daily in juice.
  • 100mg B Complex  – I like Orti B by Seroyal, Thorne B5 Complex or Cortico B5B6 by Metagenics. 1 daily with food.
  • Buy several organic green teas, decaf coffee beans, a black tea and a decaf black tea. Start to mix the caffeinated and decaffeinated beans in your morning brews, and order “half-caf” when out.  Eventually leave the coffee behind and just have decaf or green teas.
  • Adrenal Assist by Vitanica – Vitamins, herbs and minerals for restoration of adrenal glands. Cross-check any medications with the herbs for possible interactions before starting this. 3 capsules daily, best in the morning for 3 – 6 months.
  • Coffee 6ch homeopathic remedy. 2 pellets as needed for headache associated with caffeine withdrawal.
  • High paced lifestyles need to be balanced with relaxation and restoration. Stress busting exercises such as deep breathing exercises, non-work related reading, chess, and non-aerobic exercises such as weight lifting are recommended 3 times per week.
  • Eliminating the kick of caffeine will result in cravings for sugar. Instead of sweets, turn to high protein foods rich in phenylalanine and tyrosine to restore dopamine levels depleted by chronic caffeine use. Round out high protein meals with plenty of fruits and vegetables. Phenylalanine is an essential amino acid found in the brain and blood that is converted to tyrosine and then to dopamine. Food sources of dopamine include:
Foods Amount Phenylalanine Tyrosine
Wild game 6-8 oz 2.6g 1.5g
Cottage cheese 1 cup 1.7g 1.7g
Chicken 6-8 oz 1.6 g 0.40
Duck 6-8 oz 1.6g 0.60
Turkey 6-8 oz 1.6g 0.70
Walnuts 6-8 oz 1.4 g 0
Wheat germ 1 cup 1.35g 1.00
Ricotta 1 cup 1.35g 1.50
Granola 1 cup 0.65 0.40
Rolled Oats 1 cup 0.50 0.35
Plain nonfat yogurt 1 cup 0.40 0.40
Whole milk 1 cup 0.40 0.40
Egg 1 0.35 0.25
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Coffee Addiction

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I am a coffee lover – dark, black, strong, sometimes sweet.   I am the girl who will get out of bed for a french press. I have known for some time though that I will need to break the addiction – for detoxification, for adrenal fatigue, for hormone health, for fertility. And, I have finally decided that its time to start weaning myself from the dream bean. I know my skin will improve in hydration and texture, that my energy levels will improve (after I get through the caffeine withdrawal) and that my body will thank me in the long run. Coffee is a strong, complex mix of chemicals, and eventually any constant chemical exposure must play its toll.

I don’t intend to become completely abstinent! I just want to break my daily reliance on the drug. I want to become someone who savors the delicate flavors of organic green tea on sunny mornings. I will know a gen mai from a jasmine or sencha, and my cells will bathe in the anti-cancer catechins from the green tea flavonoids. However, I am not there yet. This week I am weaning to “half-caf,” and then to decaf (french press.) I will still have occasional, even weekly hits of delicious (full strength) coffee. I am also using a black/green tea mix to break the coffee habit while also slowly weaning off caffeine.

In her NDNR (Naturopathic Doctors New and Review) article Managing Caffeine Withdrawal in the Patient Undergoing Detoxification (V. 7 Issue 12 p. 8-9) Dr. Erica Peirson ND recommends supplementing Magnesium Citrate, a B Vitamin Complex and Adrenal Botanicals while weaning off caffeine. She also explains how caffeine works as a CNS stimulant. “Blocking adenosine receptors in the brain is a primary way that caffeine acts as a stimulant given its structural similarity to adenosine, Adensoine is not a neurotransmitter but a neuromodulator. Adenosine receptors inhibit the release of neurotransmitters. The release of neurotransmitters is increased when adenosine receptors are blocked by caffeine, resulting in central nervous system stimulation.” She then goes on to explain that the headaches associated with caffeine withdrawal are in part from increased sensitivity of these same receptors leading to dilation of blood vessels and hypotension.

To take the biochemistry of caffeine one step further, the binding of caffeine to the adenosine receptors means instead of slowing down, the brain/nerve cells fire up. The pituitary notices this increased action and sends hormones to tell the adrenal glands to increase production of adrenaline, giving you a boost of fight or flight energy. At the same time, caffeine slows down resorption of dopamine which is our pleasure neurotransmitter. With extra dopamine, you not only feel alert, but you feel good!

All of this is great occasionally – but I know that years and years of this cycle cant possibly be good for me. I am dehydrated, magnesium deficient, and my adrenaline and dopamine levels are pushed beyond their natural limits of production. Stepping off the caffeine / coffee platform will give my body the opportunity to restore adrenal health, balance my brain chemistry, and a great side effect will be improved liver detoxification leading to improved skin texture and color.  Its not going to be all fun – I am sure I will be more tired than usual, need more rest, and I may even be a little grumpy as my dopamine deficiency gets exposed. At least its winter in Maine, and I can tuck in early!

http://science.howstuffworks.com/caffeine5.htm

Arousal effect of caffeine depends on adenosine A2A receptors in the shell of the nucleus accumbens. The Journal Of Neuroscience: The Official Journal Of The Society For Neuroscience [J Neurosci] 2011 Jul 6; Vol. 31 (27), pp. 10067-75.

http://scienceblog.com/community/older/2003/C/2003921.html

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On The Other Side of a Cold

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6 days later, I’m finally feeling human. Colds can be so rotten! I felt so awful on Tuesday and Wednesday – headache, runny nose, achy, tired, sinus pain, sneezing. UGH. Everyone gets colds, and after this round I want to share some ways to get through them easier, and how to help them not turn into the 6 week sickness, or bronchitis, or worse….

I grew up in a Yoga Ashram where getting sick was considered “cleansing” and an opportunity to throw off toxins and heal the body. I still think of sickness in this framework to some degree, and as such embrace having a cold in the following ways (once I am willing to accept I am, in fact, sick, which is another story.)

I like to view mini-sicknesses like colds, flues, and other bugs as opportunities for a mini-detox. As soon as I realize I am sick, all cow dairy, sugar, alcohol, corn, beef and gluten are eliminated. I also try to wean off caffeine by only having 1/2 cups of black tea as needed for caffeine headaches. This automatically gives my immune system a huge boost to fight off the offenders (see my food sensitivity blog post.) It also allows my liver, intestines and kidneys to do a little detox of their own, cleaning up old metabolites while other systems fight off the cold. This helps me heal faster, and makes me feel even better once the cold is done! I also often lose a couple of pounds while being sick.

What does this leave to eat? Lots of fruit, rice, steamed veggies, rice cakes and 100% fruit jam, gluten free toast, butter (even tho its cow I allow this), nut butters, eggs, organic chicken, goat milk kefir or yogurt if craved. I just made a butternut squash, ginger, chicken broth soup with kale, apples and lemon this sickness. I also found a coconut milk, agave sweetened vanilla ice cream when I was craving something cold for my throat. And lots and lots and lots of herbal tea. With raw honey, and lemon.

Botanical Medicine is *very* important for treating colds. Most colds start out as viruses and then develop into bacterial infections after the immune system has been worn down. Unlike drugs, herbs can be antiviral AND anti-bacterial at the same time. As soon as I start feeling sick, out comes the elderberry syrup that lives in my medicine cabinet. 2 tsp 2-3 times a day, AND once a day for my girlfriend so she doesnt get sick. Start taking lots of vitamins – everything you have. Take your C’s, B’s, multivitamin…. your immune system is weak and needs support. Olive leaf is a great anti-microbial to take at any stage of sickness. The trick with herbs is to take alot, early.  As in, 2 caps three times a day for the first week, rather than 1 cap a day for 3-6 weeks of sickness. Traditional Medicinals has some great teas with a good mix of acute care herbs. I drank Cold Care PM night and day, with lots of honey as well as lemon ginger tea and echinacea tea.

A side note on echinacea – this herb is anti strep as well as antibacterial and antiviral and antifungal. Its actually a great herb for colds and flues *when taken right away.* Echinacea seems to work better for some people than others as well. If you are going to use this botanical, start taking it as soon as you feel sick in high doses. Once you have been sick more than 5 days, it is no longer as effective *unless* you are fighting a strep infection.

If you can, go see an acupuncturist immediately. Acupuncture can do great things for helping a cold to not settle into your lungs, and move it through you faster. I’m certain it also helped this cold not become a sinus infection and just stay at the superficial level. I see Hadley Clarke of www.zenkaiacupuncture.com although http://www.jadeintegratedhealth.com also helped me when I had a serious case of bronchitis last year.Chinese herbs are also very effective when prescribed by an acupuncturist, however they are not meant for self-prescribing.

Finally, REST. Sometimes I think I get sick when my mind or body really needs down time. Call in sick, and lie in front of the TV, or in your bed all day. Pad around in track pants and socks and drink tea and moan on the couch. Facebook, nap, eat soup, but don’t do anything productive. The body *really* needs time to heal, and repair, and fight the good fight, and cant do that if you are also trying to teach or lead or answer phones or tend bar or save the world do all the other active things we all do in a day.


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Stress: Applied Physics

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Stress =  Force/ Area

Think literally for a minute about your body as a solid object governed by Newtonian Physics. The body as an object seeks constant equilibrium, and often finds it. How can we aid our body in maintaining the balance essential to feeling good?

The equation above gives all the answers, in proper Newtonian fashion. Stress equals a Force that needs to be balanced over an Area large enough to balance it. The Area becomes the places that we can spread out the Force of Stress and diffuse the pressure of modern life. What are the Areas in your life you use to diffuse stress? Look to meditation, time alone, exercise, family, intimacy, sex, reading, massage, acupuncture, counseling, baths, yoga, vacation, down time, friends, nature, and journaling as potential areas to consider for this kind of equation. Wine/ beer/cocktails, pot, white powder drugs, valium, ativan, television and eating are also common “areas” used to relieve stress ~ but these all have additive and addictive elements that create additional stress in a cyclic fashion.

Sometimes a Force in our life suddenly escalates – while the basic life Stress and Areas we balance it with stay the same. This force acts like a nailgun driving the nail of stress into your health. Therefore, it is imperative in times of high stress like a family illness, death, marital problems, a significant move or an exam period to reduce the force of other stresses and increase the area to contain them! During these periods of spiked pressure, improving nutrition is an important way to decrease oxidative stress and add another area of health to your equation. Simple changes like reducing sugar and coffee and increasing green vegetables and whole grains will make a big difference in the way your body reacts.

We all have stress – it’s a fundamental component of life. Even on a desert island with perfect weather, abundant food and no work, stress would present (eventually.) We are made to withstand stress, and even thrive in stressful environments. But when the Force of Stress cannot be spread over a large enough Area, or when Stress escalates in addition to basic Forces, equilibrium is lost and physical, mental and emotional  health problems ensue.

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Keeping the Pace – Part 2

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Maintaining Adrenal Health


Proper adrenal supplementation is as personalized as your causes of stress. The way the body adapts to stress can take many forms, and the best treatments will reflect your individual constellation of symptoms. However, everyone has some levels of adrenal fatigue just from the life we live, and daily generic supplementation will assist your body in maintaining adrenal health.  Healthy adrenal glands are like rich ripe plums, sitting atop our kidneys, playing key notes in our endocrine orchestra. Stress and exhaustion can cause them to become dried up and shriveled like prunes, which sequentially affects all the other players of our hormone system. Nourishing your adrenals and caring for them will help keep your entire hormone system playing smooth and true.

So, what products are best for you? The endocrine system includes a diverse set of very important glands including pituitary, thyroid, pancreas, adrenals and ovaries. This system often triangulates in function, and it is very rare to have a solo organ problem. Therefore, when choosing adrenal supplementation the rest of the endocrine system is also assessed in best practice treatment. Nourishment is multifactoral and includes vitamins to restore deficiencies caused by stress and botanical medicine to restore glandular function. This assessment is best done by a licensed professional who has had training in natural medications, contraindications, pharmaceutical interactions and adverse reactions.

Generally – an adrenal supplement taken daily will include Vitamin B5 and Vitamin C, both required for adrenal function. Rhodiola is a botanical that increases endurance and mental focus. In Russian army trials it proved to improve responses to stress – the typical dose is 150-300mg. Holy Basil is a lovely botanical that helps the body to regulate cortisol’s relationship to blood sugar; therefore,  it may be helpful for emotional binge eaters.  It has just come out a tea called Tulsi Tea. Relora is also a patented neutraceutical that has evidence based studies supporting its ability to re-regulate cortisol to normal diurnal patterns. It can also help reduce abdominal adiposity related to stress. My favorite general adrenal supplement for (US) long-term use is Vitanica’s Adrenal Assist – 3 capsules daily, which contains several of the above-mentioned products and more. In Canada, I like CanPrev’s Adrenal Thyroid Pro. Please note – if you are taking medications especially cardiac or blood pressure medications there is a potential for multiple interactions with these products, please seek advice from a Naturopathic Doctor or other professional trained in pharmaceutical-herbal interactions.

Adrenal Supplementation is a multi million-dollar industry as modern culture whips us into looking 15 years younger and doing the work of 3!  There are many approaches to restoring adrenal health, and new products available on a daily basis. One can be very scientific about adrenal disease, approach it from an energetic perspective, or start from somewhere in between.  Adrenal restoration is best done with a medical practitioner whether it’s a Naturopathic, Osteopathic or Allopathic Physician. Chiropractors are often trained in prescriptions for endocrine health, as are Nutritionists, Herbalists and Nurse Practitioners. Even some Pharmacists have jumped on the bandwagon. There is no Right answer or best practice that has been established, so finding someone with good credentials, experience and an approach to wellness you resonate with is the best place to start.

Depending on your state of health, laboratory testing may or may not be recommended. Salivary Hormone Testing of the hormone cortisol is a common place to start. This can be done as a single assessment or a 4-point panel reflecting an entire day. The 4-point is a more thorough and accurate assessment of daily cortisol activity. (Cortisol is pumped out by the adrenal gland in response to stress along with epinephrine and norepinephrine.) An entire endocrine panel including pituitary, thyroid and reproductive hormones can also be done for a good quality snapshot of the whole hormone system. Salivary testing is not required, but it is helpful to tailor an accurate treatment plan. However, a good practitioner will be able to read signs and symptoms of adrenal dysfunction from the initial interview, and will be able to do a differential diagnosis of whether or not there is thyroid involvement present. Therefore, laboratory testing is not always required. Bloodwork may also be suggested to assess whether the adrenal diseases Cushings and Addisons need to be ruled out.

Treatment of adrenal fatigue and endocrine dysfunction is a long slow process. Prescribed herbs and vitamins will need to be taken for a minimum of 3 months, and often over a 6-9 month period. This is especially true for women as the female reproductive hormones change weekly over a four-week period, so rebalancing can require several cycles for a noticeable response.

 

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Keeping the Pace – Part One

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Part One – Making Choices

 Keeping pace with life’s To Do list, career, academics, and family… its tough. Its hard on the body, its hard on the mind, and it can be hard on the waistline too. It’s worth it – for evolution, advancement, and a life well lived – but how can one minimize the toll of stress?

Adapting effectively to stress requires both a short term and long-term commitment to nourishing and sustaining hormonal response. The body responds to chronic stress by first an alarm phase, then sustained effort, then exhaustion. Making appropriate nutritional choices and choosing herbal adaptogens that match the endocrine condition relieve strain and sustain long-term health.

First and Foremost – What can you actually do when you are exhausted, and hungry, and cant stop? One answer: eat something green. A fresh arugula salad would be perfect; however a greens drink is very convenient. Spirulina and other microalgae are the red blood cell equivalents of the plant kingdom. They provide an instant nutrient-rich boost of antioxidants, alkalinizing and balancing your starved system and tiding over the hunger until you can take a break. Mix greens with juice for blood sugar support, or choose green protein-enhanced shakes or bars if needed. Odwalla has a yummy green pre-made green Superfood smoothie. There are several products available in one-serving envelopes that travel well. If you are on *any* medications, including Hypertension, Birth Control, Antidepressant and Anti-Anxiety medications, please choose a formula that ONLY has the microalgae, and/or wheat grasses, without herbal components.  The energy-supporting herbs used in many “energy greens” can have multiple medication interactions.

Protein is also an integral component of a high stress diet. The immune and hormonal systems require adequate protein for sustained cellular responses. This protein must be high quality: fast food meats or veggie burgers do not “count!” Good quality protein will create a smooth and better-sustained blood sugar response decreasing headaches, crabbiness, and dizziness while improving energy and balance. Include one serving of protein in most significant meals, and look for protein snacks on busy days.

Sugar, crackers, pastries, fruit or raw vegetables alone will burn quickly and leave you depleted. Lunchtime protein can include tahini on a cooked whole grain or steamed vegetables, avocado, hard-boiled eggs, nut butters and nut butter sauces, quinoa salads, and cheese in addition to fish or meat. Prepare ahead! Protein and fiber rich snacks like applesauce and cottage cheese, hard-boiled egg, toasted nuts and seeds with raisins, celery and nut butter can be pre-made and stored in little “to go” containers. It’s best to avoid consistent intake of processed proteins including whey and soy protein isolates as bars or shakes, but occasional use is well tolerated.

Therefore, the immediate moment, when you hit a wall look to greens and to protein for a boost. This will keep you from turning to sugar or fat to maintain your energy, keeping your waistline trim and nourishing your body rather than taxing it further.

If you cant get away from the piece of chocolate that seems like its the only thing that will save your day in that moment, choose a small piece of good quality chocolate! Research shows that small amounts of high quality chocolate actually have beneficial effects on our health. It is an antioxidant, and releases GABA neurotransmitter that is one of the “off” buttons in our brain. Commercial “industrial” chocolate, mochas, lattes, cookies, and other quick fixes have low nutritional value and provide high fat calories that lead to abdominal weight gain and create sugar addictions. Cacao Nibs are Nature’s superfood candy, and are a must for any true chocolate addict. Rich in magnesium, these replenish lost minerals lost through caffeine. Add Cacao Nibs to your trail mix with home-toasted walnuts, pumpkin seeds and organic raisins.

Long-term adrenal restoration in the form of individualized and endocrine-specific supplementation is also integral. Adrenal fatigue is a buzz term in today’s medicine, and will be the topic of Keeping the Pace  – Part Two!

Cocoa and chocolate in human health and disease. Katz DL, Doughty K, Ali A, Antioxidants & Redox Signaling [Antioxid Redox Signal], ISSN: 1557-7716, 2011 Nov 15; Vol. 15 (10), pp. 2779-811; PMID: 21470061; http://web.ebscohost.com.ezproxy.ccnm.edu/ehos/viewarticle?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bNNsa6zTrOk63nn5Kx95uXxjL6nrkewrq1KrqevOK%2bwsVC4qbE4zsOkjPDX7Ivf2fKB7eTnfLujsUm2p7NMsaakhN%2fk5VXj5KR84LPrhuac8nnls79mpNfsVbCntE6zqbdIpNztiuvX8lXk6%2bqE8tv2jAAA&hid=17

The impact of chocolate on cardiovascular health. Fernández-Murga L, Tarín JJ, García-Perez MA, Cano A, Maturitas [Maturitas], ISSN: 1873-4111, 2011 Aug; Vol. 69 (4), pp. 312-21; PMID: 21665390

 

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Nutrition to Strengthen Liver Yin

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     Modern culture is Yang obsessed. We go-go-go, we seek sun, we burn the candle at both ends, we exercise vigorously, and we love stimulants. It is a rare bird that has enough quiet, meditative alone time, in a dim or dark environment. This is the Yin state – nourishing, moistening, dark, and quiet – Yin builds what Yang wears down.

Every organ of the body has a Yin and a Yang aspect. Some organs (Spleen, Liver, Heart, and Lung for example) are naturally more Yin in Nature. Other organs (Stomach, Gall Bladder, Small Intestine and Large Intestine for example) are more Yang in nature. These “natures” were determined by the functions each organ enact as well as more energetic attributes. Supporting the natural state of each organ will optimize health, and promote healthy functioning.

      Much is said about detoxifying the Liver, and reducing its Yang (brought on by alcohol, drugs and stimulants) but what happens when you actually have deficient Liver Yin that needs to be nourished?  Stripping an already deficient organ will create further disharmony that will eventually manifest as pathology.

      A diagnosis of Liver Yin deficiency means that this aspect of the Liver organ network is compromised. The Liver not only detoxifies, it has many other (building) jobs including cholesterol metabolism, vitamin storage, bile production, and blood reservoir. Blood is a Yin substance (all fluids are yin) and many B12 and iron anemias can be diagnosed early on as a Liver Yin deficiency by a trained Acupuncturist. Thin brittle nails, anemia, sallow skin, easy bruising, hair loss, blurred vision, tinnitus, dizziness, infertility  and some tremors  are all associated with a Liver Yin deficiency diagnosis.

Nutrition is one of the best ways to support and recover Liver Yin. A diet that is nutrient rich and nourishing is essential, as is sitting down to relax while you eat and chewing thoroughly to savor flavors. The diet should also include plenty of fluids, especially in the form of soups. Meals consist of 40% easily digested complex carbohydrates like whole grains and starchy root vegetables. Another 40% of the diet is cooked vegetables. Proteins comprise 10-20% of the diet, with a focus on high quality organic or grass fed sources. Healthy fats fill the other remaining 5-10%.

Below is a list of recommended foods to nourish Liver Yin. Do not limit your nutritional intake to only these foods. Instead follow the guidelines above of the optimum ratios of carbohydrates, vegetables and proteins, and add the recommended foods from the list below within your meals. Where ever possible choose organically grown foods to avoid genetically modified ingredients.

Foods to Nourish Liver Yin Deficiency

 Zucchini, squash, potatoes, sweet potatoes, string beans, beets,

Mushrooms including wood ears & tremella,

Tomatoes, spinach, carrots, parsley,

Molasses

Apples, banana, mulberries, mango, coconut, peaches, lychee fruit, melons,

Grapes, raisins, cherries, plums

Olive oil, flaxseed oil, almond oil

Vegemite, kelp, spirulina, wheatgrass

 Oats, rice, millet, barley

Adzuki beans, black beans, mung beans

Organic cow, goat and sheep yogurt

Tempeh, tofu, miso

Nuts & seeds, black sesame seeds (great as a condiment!)

Eggs

Pork, chicken, Chinese black boned chicken, duck

Mackerel, sardines, oysters, mussels, clams

Cuttlefish, squid, perch, eel

Foods to Restrict or Avoid

Chilies, cinnamon, garlic, ginger, onions, shallots, leeks, basil, cloves, wasabi

Coffee, black tea

Vinegar, pickles

Lamb, shrimp, veal

Citrus fruits

Cigarettes, alcohol

Recreational stimulants

Activities that build whole-body Yin nourishment are also encouraged while working specifically on Liver Yin. Rest more. Read. Spend some quiet, alone contemplative time in a cool, dark room with a candle lit (taking a bath is a nice way to do this.) Exercises like Tai Chi and Yoga are more Yin building than Yang in nature. Drink warm water and lemon. Get extra sleep. Breathe.

References:

Clinical Handbook Of Internal Medicine, Vol. 2. MacLean & Lyttleton. University of Western Sydney: Australia. 2002.

Chinese Dietary Therapy. Liu, J. Churchill Livingston: Edinburgh. 1995.

The Healing Cuisine of China. Zhao & Ellis. Healing Arts Press: Vermont. 1998.

An interesting theoretical write up: http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/997986-liver-yin-deficiency-patterns-derived-patterns.html

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