Category Archives: Beauty Medicine

To Sleep or Not to Sleep

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I love falling asleep quickly and easily and waking up 9 hours later.

When this doesnt happen, the work of unpacking the complex architecture of sleep and our associated subconscious and unconscious patterning begins. This post will provide a brief overview of sleep-wake cycle circadian dysregulation as well as nutraceuticals and botanical medicines to help fall asleep. Botanicals to stay asleep or address eearly waking will be in the following sleep post. I will not discuss prescription medications for sleep. Some people with trauma, PTSD, significant depression and anxiety, and persistent insomnia and/or sleep apnea may need pharmaceutical medications for sleep and/or sleep studies to better understand what is happening. Psychiatry, therapy and counselling can also be helpful to do a deep dive into childhood and adult patterning related to sleep or preventing sleep including hypervigilance as well as cognitive behavioral therapy to work with thought patterns preventing sleep.

Everyone agrees that sleep is worse in periods of stress, and sometimes in periods of excitement too. Disturbed sleep is also part of major depressive order for many people with either inability to sleep or desire to sleep too much. And, anyone with a significant grief experience knows that early mornings can be very tough times for waking up and experiencing sorrow. For these reasons and more, treating insomnia is far from simple as sleep is deeply entwined with the conscious and subconscious mind.

There have been many studies on sleep and health outcomes. This 2020 study by Hackett et al states: “Poor sleep quality has been linked with negative health outcomes. Adults who report sleep problems are more likely to have hypertension, obesity and coronary heart disease (CHD) than their counterparts without sleep problems (Koyanagi et al., 2014). Meta-analytic evidence has detected a relationship between short sleep duration and incident hypertension (Itani et al., 2017). However, studies investigating the prospective link between poor sleep quality and hypertension have produced mixed results (St-Onge et al., 2016). Pooled evidence indicates that short sleep duration is a risk factor for obesity (Itani et al., 2017). While poor sleep quality has been linked with the development of the metabolic syndrome in middle-aged and older adults (Troxel et al., 2010).”

Our bodies hormonal clock may originate in the suprachiasmatic nucleus, but many organs have their own biological rhythms that are regulated independently. This concept has been proven in modern science but orginated in Chinese Medicine more than 5ooo years ago

There is a reason we go to sleep at night and wake up in the morning. This is called the circadian rhythm and provides a skeletal structure for many of our hormonal biorhythms. Cortisol and ACTH levels are pulsing throughout the day and night, roughly every 60 minutes. The pulse is generated from within the HPA axis in a dynamic feedback loop. There is a threshold for a negative setpoint that is predetermined by the suprachiasmatic nucleus where ACTH pulses, stimulates cortisol production into the vasculature, which diffuses into the IC space of the brain and stops ACTH production which then retriggers the negative threshold and restarts this ULTRADEIAN cycle. At night (or during sleep hours) the circadean set point is set at a lower free cortisol level in a diurnal pattern.

Living with chronic stress can alter this rhythm. Living with depression can alter this rhythm. Substance use can alter this rhythm. Grief can alter this rhythm. PTSD can alter this rhythm. Changing time zones can alter this rhythm. Shift work can alter this rhythm. Parenting will alter this rhythm. And kids need to develop this rhythm as part of learned sleep patterns coming out of infancy.

So, once ones sleep is dysregulated, what can be done? So-called sleep hygeine is the first step. This is a basic series of actions designed to minimize sleep interruption and maximize comfort and melatonin production. I often tell patients to treat themselves like a 5 years old with a bedtime routine. This creates patterning in the mind and body (those ultradeian clocks) that signals sleep time is coming.

Insomnia falls into to big categories – falling asleep and staying asleep. We will discuss these seperately as they require different medicine.

Falling asleep. What a gift it is to drift into effortless sleep. How many times have i lain awake, unable to relax enough to let that sleep veil drift across my consciousness? Falling asleep medicine is often in the form of sedatives in an acute setting. Melatonin + a sedative botanical is a good combination for short or long term difficulty falling asleep. As you can see from the image below, melatonin production has an inverse relationship to plasma levels of cortisol. If your circadian rhythm is dysregulated, melatonin supplementation can help recreate a new pattern (which is why it is used in changing time zones.) In our “more is more” culture people sometimes think taking higher doses of melatonin will work better. In actuality, this pineal gland hormone is naturally microdosed and 1mg is often the best dose. Combining melatonin with an app to provide guided relaxation meditations or sleep-inducing music like binaural beats can increase theta waves at the level of the brain simulating deep relaxation and promoting sleep. (I use the Insight Timer free app almost every night!)

The amino acid tryptophan is converted into 5HTP which is concerted into serotonin which is converted into melatonin. This is the biochemical reason why serotonin deficiency (depression) can lead to insomnia. Increasing foods rich in tryptophan, or taking either SSRI medications or 5HTP supplement can also increase endogenous melatonin production. Do not take 5HTP and prescription mood medications unless prescribed and followed by a health care provider.

My favorite sedative botanicals are valerian (valeriana officionale) and california poppy (Eschscholzia californica). Both are decidedly yucky tasting, with california poppy being super disgusting! However, it is one of the few things that consistently works for me so I choke down the earthy swampy tincture with a juice chaser.

The European union has a formal scientific herbal monograph compendium listing the scientific and traditional uses of 167+ commonly used botanicals. This was originally created to standardize information about commonly used herbal medicines for providers and consumers in an upgradeable format as new evidence develops. I personally prefer the Alt Med review for botanical monographs which is North American but not government regulated like the European compendium. In general herbal medications come in dry form used as teas, preserved in alcohol called tinctures or preserved in glycerine for children or people who cannot tolerate alcohol, capsules of prepared herbs or standardized extract capsules with prespecified amounts of active ingredients in each capsule. The strength of the medicine increases from raw herb/ tea –> glycerite –> tincture –> capsule –> standardized extract as the most potent form.

Valerian is a natural sedative. The active phytochemicals are bicyclic monterpenes, free amino acids, and valepotriates. Valerian is very safe and can be used in pediatrics and pregnancy. I do not reccomend it in late stage kidney disease. If anyone is taking multiple medications with severe illness, please only use any herbal medication under the advice of a naturopathic doctor, experienced herbalist or physician. This plant has stinky volatile oils that are also part of why it works. The herbal chemicals are sedating and calming, they can help both to initiate sleep and to maintain sleep. Start with the lowest possible doses as a tea or low dose tincture (10-30 drops) and increase as needed up to 3 capsules before bed. The primary side effect of valerian is morning grogginess from oversedation. This can be avoided by using lower doses and less potent forms. The smell of valerian could be a factor in ones decision of which to use with glycerite and tincture the least pungent forms.

valerian plant botanical monograph
Valerian (Valeriana officinalis) illustration. Digitally enhanced from our own book, Medical Botany (1836) by John Stephenson and James Morss Churchill.

California poppy is the other sedative plant that I frequently use for my own sleep. I use it in combination with melatonin for shift work and during times of significant stress where I really need something to “knock me out.” It tastes so terrible, but some days that is a small price to pay. I have only found this plant in tincture form. It can be added to a small amount of warm water to evaporate off the alcohol. This medicinal plant is listed in the European compendium as safe for use for adults only with over 30 years of safety. It is not to be used in pregnancy or breastfeeding or for pediatrics as it is in the poppy plant family. It does not have narcotic effects but it does have many chemical alkaloids to induce sedation. It is recommended to be used for up to 2 weeks and then stopping use for at least 2 weeks.

references

  1. Oster H, Challet E, Ott V, Arvat E, de Kloet ER, Dijk DJ, Lightman S, Vgontzas A, Van Cauter E. The Functional and Clinical Significance of the 24-Hour Rhythm of Circulating Glucocorticoids. Endocr Rev. 2017 Feb 1;38(1):3-45. doi: 10.1210/er.2015-1080. PMID: 27749086; PMCID: PMC5563520.
  2. Ruth A. Hackett, Zeynep Dal, Andrew Steptoe. The relationship between sleep problems and cortisol in people with type 2 diabetes, Psychoneuroendocrinology. Volume 117,2020,104688, ISSN 0306-4530, https://doi.org/10.1016/j.psyneuen.2020.104688.

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Well Hello

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Its been a long time since I have posted from the medical world of Dr Wright. I am now in Albuquerque New Mexico, Land of Enchantment and Liver Disease. So many dying ciswomen in their 30s suffering of liver failure here, and transwomen too. I have been pleased with the cultural competency for trans and non binary folk in this city so far!  My hospital’s respect for the transfolk and their pronouns I have seen come through the door at UNMH has been heartwarming. The work is never done, but the foundations are in place thanks to those who have done this work before me.

There are so many things I could write about  it feels overwhelming. Like

  • how does one deal with anxiety in a productive way that does not encourage substance use?
  • how much does good food really influence health
  • and
  • the value of death: vs life. what is a life well lived
  • what is a good death

As an internal medicine doctor I know part of my life is to facilitate death. This is the job of the warrior; and as a hospitalist  I tend to those as they fight in their own particular battlefield . I have been privileged to sit with Death, and she is a  mistress no one wants to see. And yet, often such a sweet gift.

I wish that hospital medicine could embrace healing meditations and buddhist lectures. Imagine folks watching these daily in their hospital beds instead of cooking shows and NCIS? These are a few of my faves:

https://www.youtube.com/watch?v=og4B2ZMP-uY

Anything by Pema Chodron as well: I look for ones longer than 45 minutes

I certainly haven’t mastered the art of effectively handling my own stress without turning to food, or alcohol, or any thing that distracts me from the what-feels-like intolerable levels of emotion building up inside. So, I have empathy for my patients that use this coping mechanism to get through their life. What is the difference that has me as a privileged white woman in my 40s still strong and healthy foundationally, vs their 30 year old bodies that are broken down by alcohol? Genetics is certainly a piece of it. The Navajo, Zuni and Pueblo folks here have what must be a genetic succeptibility to liver failure secondary to alcohol use disorder. They are too sick, too young, and too many of them to have it be environment alone.

I cant help but feel these women are carrying the trauma of generations of dominance, trauma and oppression and it is manifesting as this alcohol sickness – a genetic trait passed from white rapists to their progeny and concentrated in generation after generation. Tie that to poverty, a lack of fresh fruits and vegetables, and ongoing systemic depression and it makes complete sense that we have these women dying, daily, in our hospital.

It is a helpless feeling, this system oppression and individual illness. This is certainly a piece of the burnout of becoming a physician. We do our best to hold together the pieces of survival for each person, holding the hope, while also titrating the reality of recovery.

As a person very new to this state I have very little working knowledge of the cultural climate of health care here and even what resources are available. As a new resident and hospital based physician, I have basically no time to investigate and advocate for this community at the ground level. All I can do is hold the space for the sickest of the sick and even in that I don’t have time to be present for their stories or their traumas.

Dandelion and Milk thistle, turmeric are not native botanicals to this part of the country, so I doubt they are used in traditional medicines?  I wonder how much early liver protection with these herbs, as well as anger management, trauma based care, and other integrative therapies could be used to protect and heal the liver in the teens and twenties for these folks? My acupuncturist said New Mexico is the land of wind, and heat, both properties of the liver meridian. This would argue for an environmental component to the imbalance as well. Food, Water, Emotions, Genetics, Trauma, Environment, Substances – so many nuances to health and to disease. And I, as a doctor, am depressed with the minimal amount of time I have to explore these facets with each individual that may lend insight into prevention before these women end up in our hospital beds.

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Insomnia is the Worst!

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luxury-hotel-rooms-pamilla-cape-townI 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 –

  1. unable to fall asleep
  2. 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.

untitled     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.

images7OHBNK29Difficulty 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.

Umbrella_GraphicFinally, 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?

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Frequently Asked Questions: Hormone Tx

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Many people have questions about the safety and efficacy of hormone treatments. I provide individualized hormone treatment programs. Every patient undergoes our complete metabolic bloodwork panel; a physical exam including breast exam, and a full 90-minute initial intake to make sure that hormone treatment is safe and recommended for you.

Here are some common questions, asked in our free 30 minute screening consults.

Will I need to stay on hormone treatment forever?

Current evidence shows that estrogen and progesterone bioidentical replacement therapy is safe for up to 15 years. After 15 years the risk of hormonal cancers increases very slightly. I encourage our patients to follow their own instincts around the duration of bHRT. Many women reach a point where they want to try coming off the hormones, to see how they feel. (Many then come back on the hormones for the feelings of well being they provide!) There is no “right answer” for the duration of hormones treatment; instead, your ongoing health and feelings of wellness may be the most important indicator to measure this.

What is a Bioidentical hormone?

Bio –meaning, of the body and Identical meaning, exactly like = hormones that are exactly like those your body naturally produces.

Why use Bioidentical hormones?

Generic and brand name hormones made by pharmaceutical companies all have biochemical additions to the basic hormone structures like pharma-signatures that make the drug patented (and profitable.) Bioidentical hormones are made as liquids, creams, troches, rapid dissolve tablets, injections or suppositories by a compounding pharmacy laboratory like Apothecary by Design to make them exactly like the hormones your body would naturally be producing. Drug companies cannot make money off of this form of hormone because they are universal; therefore their use is discouraged by big pharma. We know that bioidentical hormones are the safest, most effective way to replace hormones in your body. We only use compounded, bioidentical estrogen, progesterone, and testosterone at Age Management Center.

Do hormones cause cancer?

The Women’s Health Initiative study in 2001 did show an increased risk of not only breast cancer, but also heart disease in women taking the medications in the study. What is KEY here is that the hormone medications used in the study were the horse-based estrogen Premarin and a synthetic version of progesterone called progestin, brand name Provera. The study was separated into just Premarin users and Premarin + Provera “Prem-Pro” users. The Provera Rx was clearly indicated as the causative factor for the increased risk of breast cancer in clinical data. In further studies on bioidentical progesterone it has been evidenced that 200 mg of bioidentical progesterone is actually protective against the development of breast cancer.

It was the synthetic pharmaceutical analogue Progestin that is linked to cancer development, not either bioidentical estrogen or progesterone. Having said that, if you already have an estrogen positive cancer growing in your body, additional hormone replacement therapy can feed the tumor growth. We encourage all of our patients to get screening mammograms yearly during menopausal hormone replacement therapy, and actively support anti-cancer nutrition and antioxidant supplementation as part of our treatment protocols.

What about heart disease in women and estrogen use?

One of the most surprising results of the Women’s Heath Initiative was the increased risk of cardiovascular health issues like blood clots resulting from plaque rupture in women using Premarin. Estrogen is in fact protective for the cardiovascular system as it increases elasticity in all systems including the blood vessels. More elastic, flexible arteries means healthier blood flow. However, when combined with risk factors for atherosclerosis (plaques in the arteries) like elevated cholesterol, high blood sugar, smoking and being overweight the benefits and the risks need to be weighed to assess what is best for each woman.

At Age Management Center our complete metabolic blood work panel and 90 minute initial consult is in part to ensure that your body is metabolically able to handle additional bioidentical estrogen, and that you are a good candidate for hormone treatment. Some women need to do additional metabolic and cardiovascular work to reduce risk factors before estrogen-based therapy is indicated. Oral estrogen (taken by mouth) was associated with more risk for plaque rupture than topical estrogen. We start all women on a topical mix of bioidentical estradiol and estriol plus additional progesterone to manage symptoms while navigating risk, ultimately improving metabolic and cardiovascular health for effective anti-aging.

I thought testosterone was only for men?

Want to know a secret? Testosterone is like magic for womens health. It is actually the most abundant hormone across our entire lifetime because our body continues to produce it after menopause (if all goes well.) Testosterone is extremely valuable for women’s health because it is the “vitality” hormone that leads to physical and mental strength, bone health, leadership qualities, sexual appetite, sexual satisfaction, mood stability and more. Testosterone levels naturally start to get lower around 40, but the adrenal glands take over testosterone production when periods stop completely. We see low testosterone in women of all ages; we use testosterone supplementation in most of our menopausal treatments, because it helps you feel great! This hormone has been part of menopausal treatments since 1937. There is not much excitement generated about it in traditional medicine because who wants strong, sexual, healthy, happy, active, passionate postmenopausal women? I do!

Will taking testosterone make me look manly? (Facial hair, lower voice etc)

My job is to replace and optimize hormones to their natural levels. When testosterone levels are optimized for your body, it is unlikely you will have complications like black facial hairs, voice lowering, acne, or other classic side effects. However, this of course depends on your genetics and sensitivity to hormones. We start with the lowest possible dose after our thorough initial exam, an adjust dosages based on your personal experience plus laboratory testing. If you happen to be someone who does have side effects like facial hair or pimples, these are immediately reversible by lowering your dose.

At Age Management Center I also provide transition support for transgender and transsexual individuals. These dosages of hormones are significantly higher than doses used for hormone replacement, and do have permanent and reversible side effects that are usually considered desirable by the people using them.

Do you accept insurance?

Age Management Center is a concierge medical practice. We offer the best of modern regenerative medicine, guided by cutting edge evidence based research, in a relaxed, comprehensive manner. Our hormone programs are simple. Once a month fees include all doctor visits, emails, and phone calls, as well as your administrative support and foundational hormones. We operate outside the insurance system so that we can offer the high touch personalized medicine that our patients have come to rely on. We do not bill insurance companies for our services; however we can give you an itemized “superbill” for your services that you can submit on your own for reimbursement. We invite you to come in for our free 30-minute consultation to learn more about our concierge medical programs and how these might work for you.

Can I use my insurance for the comprehensive metabolic bloodwork?

We prefer that our patients use our cash-based in house laboratory services as it allows for consistent lab results and lab values, speedy results, streamlined workflow and improved coordinated care. We thoroughly research the best prices for lab work, and pass those savings on to our patients. For example, our complete metabolic blood work is priced at $1800 through insurance billing. We offer it at $395, passing on our physician pricing to you. Many of our patients have tried to use their insurance to run the blood work, and with deductibles and co-pays have ended up paying at least $600-800 for the same work.

Furthermore, many insurance companies and PCP’s will not cover some of the hormonal blood work evaluations we consider crucial to accurately understanding your metabolic and hormonal health. By having all of your blood work arrive in time for your initial visit, we are better able to serve you in a timely and effective manner. Laboratory, physician and clinical services can all be claimed as health expenses on your taxes, and can be part of your deductible.th

Can I use my Health Savings Account or Flex Spending Account?

Yes. Age Management Center services are billable through HSA and FSA’s.

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Vanquishing Fat Improves Weight Loss

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12428062215_8a3fa42d45_zI dreampt I was lying on a comfortable table in a private office, with a machine sending warm Infra-Red rays into my abdomen, melting away my belly fat. I was dozing, and imagining the fat cells bursting and my body’s lymphatic system scooping them up and leaving me with a trimmer waistline as I  thought about my life for 45 minutes…. Oh Wait! That wasn’t a Dream! That is the Vanquish machine!

It must be the 21st century because medicine has finally found a way to literally melt off fat in targeted areas like the belly, hips and thighs. This revolutionary selective radiofrequency technology is non-invasive, safe and effective. Heat penetrates deeply into the body targeting adipose tissue (fat cells) while protecting other neighboring organs and skin layers with cooling air flow.

The Vanquish experience is relaxing, pain free and requires no medication or recovery time. It requires lying still for about 45 minutes. Best results are obtained when repeated twice per week for at least 3 weeks (six sessions). Clinical results are visible within 3-4 weeks after your last session – do not expect immediate results! Physiologically, your fat cells are melted and slowly die, spilling their contents into local tissue to be cleaned up by the lymphatic, immune and circulatory systems. This process takes a few weeks, which is why results are not immediate.

A little science on fat cell physiology. It is now recognized that a fat cell is not just a glob of fat. Adipose tissue is a metabolically active, highly functioning part of the endocrine (hormone) system.

When your energy in (food & alcohol) is greater than your energy out (activity, intellectual work and exercise) insulin directs the body to store fat. The capacity to store fat is seemingly endless,  as individual cells can grow quite large while chemically signalling neighboring undifferentiated cells to turn into new fat cells. Energy deficit (energy out greater than energy in) stimulates the adipose tissue to release free fatty acids and become smaller fat cells, or the cells can die through apoptosis.

Centrally located adipose tissue is used as a storage area for many fat soluble hormones and chemicals like estrogen, pesticides and THC. When fat cells spill their contents, these are also spilled. Adipose tissue also independently synthesizes chemicals like adipsin that activate the inflammatory cascade. (This is why heavier people can have more inflammatory disorders than thin people.) As the Vanquish machine melts away the fat cells, stimulating apoptosis (cell death) your body will have to clean up these excess chemicals and inflammatory mediators as well as the free fatty acids released. Fortunately, a healthy body is designed to effectively remove cellular debris like this through the lymphatic and circulatory systems.

Drinking extra water is essential during this process. We also recommend using herbal teas like the Traditional Medicinal Daily Detox Tea, nettle tea and organic green tea for free radical/antioxidant protection. Taking a good quality multivitamin provides minerals and B vitamins to support liver detoxification while daily exercise will also stimulate fat burning metabolism and support free fat elimination. Nutritionally, a meal plan focused on weight reduction principles will enhance the slimming effects of Vanquish. I suggest small amounts of whole fiber rich grains a few times a week, daily leafy greens and raw vegetables, low sugar fruits like apples and blueberries, lowered carbohydrate intake, no processed foods, and grass-fed meats, vegetarian proteins and fish.

Some individuals with compromised health or congested lympathic or liver systems may benefit from additional Integrative Medicine alongside Vanquish treatment plans to optimize results. Integrative Medicine combines the best of botanical medicine, clinical nutrition and evidence-based nutraceuticals with modern diagnostic, laboratory and pharmaceutical expertise. This style of medicine is patient-centered; no two patients will get exactly the same protocol with our highly individualized care. Targeted therapies could include reducing systemic inflammation, improving detoxification pathways, clearing lymphatic channels, or tailoring nutrition to promote fat elimination.

Dr. Wright will be offered a group metabolic detoxification program at Cosmetic Enhancement Center in January 2015 and again in March 2015. This 7 day detoxification program is the perfect complement to a Vanquish Fat treatment plan. Ask Dr. Wright or Dr. Atkins for more information about the Vanquish Fat treatment plan, Integrative Medicine, or our upcoming Metabolic Detoxification program.

References:

Integrative physiology of human adipose tissue. K N Frayn, F Karpe, B A Fielding,  I A Macdonald and S W Coppack.  International Journal of Obesity (2003) 27, 875–888.

Adipsin and an endogenous pathway of complement from adipose cells. Choy LN1, Rosen BS, Spiegelman BM.J Biol Chem. 1992 Jun 25;267(18):12736-41. http://www.jbc.org/content/267/18/12736.long  Accessed 24/10/2014

Adipose cell apoptosis: death in the energy depot. A Sorisky,  R Magun and AM Gagnon. Department of Medicine and Biochemistry, Microbiology and International Journal of Obesity (2000) 24, Suppl 4, S3±S7 http://www.nature.com/ijo/journal/v24/n4s/pdf/0801491a.pdf  Accessed 10/22/2014

 

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