Vanquishing Fat Improves Weight Loss

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 CoppackInternational 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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Foods to Enhance Detoxifcation

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

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

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

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

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

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

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

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

Brown Rice provides B vitamins and the antioxidant selenium.

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

Eggs supply B vitamins.

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

Spinach provides folate and other B vitamins.

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

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

Melons and peppers are good sources of vitamin C.

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

 

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

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

Cabbage like broccoli, contains natural sulfur compounds.

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

Brazil Nuts contain selenium, an antioxidant needed for detoxification.

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

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

Asparagus and Watermelon are rich, natural sources of glutathione.

Papaya and Avocado help the body to produce glutathione.

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

 

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5 Steps for Fertility Preservation Over 35

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

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

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

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

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

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Advanced Maternal Age

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

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

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

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

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

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

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

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

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

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

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

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

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

 

 

 

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The Lost Art

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

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

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

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

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

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

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

 

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Women need Testosterone

When I say Testosterone, what do you think?

Most people think: men, male. Some people think trans,*  transgender, or FTM. Very few people will think “the most abundant sex hormone across a women’s lifespan and an important sex hormone for all genders.”

All of the above is the correct answer.

Estrogen and Testosterone have been sequestered into gendered boxes, but both are equally important sex hormones for human health. Functional and biologically active androgenic receptors are located throughout the body in both sexes. Testosterone receptors are found in the breasts, heart, blood vessels, digestive tract, lung, brain, spinal cord, nerves, bladder, uterus, ovaries, skin, bone, bone marrow, muscles and fat cells of all women. This wide diversity of receptor locations illustrates the panorama of body systems that rely on adequate levels of testosterone for optimal female  function.

And yet, this important hormone is routinely ignored in women of all ages and especially those in their 30’s and 40’s who are exhibiting signs of testosterone deficiency including: dysphoric mood, muscle loss, cognitive decline, insomnia, breast pain, rheumatic and other pain, incontinence and sexual dysfunction.

Think you might be T deficient? Take our Eve test now! http://www.agemanagementcenter.com/eve-scale/

Around menopause, testosterone and other pro-androgens like DHEA, DHEA-S, and androstenedione become the primary hormones available as estrogen and progesterone levels decline. The ovaries stop becoming the major source of hormonal production, and the adrenal glands take over. As early as 1937, testosterone was used as a successful and important bioidentical hormone replacement option for menopausal women.  Seventy-seven years later, doctors still do not routinely address testosterone deficiency in this population, nor do they even test for it!

Symptoms are not enough to assess hormonal balance. Accurate bloodwork including Total Testosterone, Free Testosterone, Sex Hormone Binding Globulin, Estradiol, Total Estrogen, Progesterone and DHEA-S must be assessed to have a clear picture of hormone health for all genders.

Many endogenous hormones can be converted into other hormones, like Testosterone being aromatized to Estradiol and DHEA-S into Testosterone or Estrogen. Understanding these pathways and monitoring the blood levels over time is the best way to achieve optimized hormone status. No hormone should be ignored based on presenting gender or sex, as it is the delicate interplay of hormones that creates vibrant wellness.

For more information on women and testosterone make an appointment to consult with Dr. Wright now. To schedule bloodwork to assess your testosterone and other hormone levels, call Kristen at 207 774-1356. Free initial consults are available.  www.agemanagementcenter.com

References:

Transdermal testosterone therapy improves wellbeing, mood, and sexual function in premenopausal women. Goldstat, Rebecca MPH1; Briganti, Esther MD2; Tran, Jane MD1;
Wolfe, Rory PhD2; Davis, Susan R. MD, PhD1 Menopause. September 2003 – Volume 10 – Issue 5 – pp 390-398

Testosterone therapy in women: Myths and misconceptions Rebecca Glasera,b,∗, Constantine Dimitrakakisc, Maturitas 74 (2013) 230– 234

Current perspectives on testosterone therapy for women. Susan Davis MB, Bs, FRAC-P, PhD., Sonia Davidson MB, Bs, FRAC-P, PhD.  Menopausal Medicine. Volume 2 0 , No. 2 — Ma y 2 0 1 2

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Ideal Weight Program

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

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

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

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

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

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

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

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

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

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

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

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Counter-Response to the Multivitamin Controversy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The Longest Night of the Year

December is not always mistletoe and gingerbread. It can be one of the hardest times of the year for many people. People aren’t supposed to die on Christmas and relationships aren’t supposed to end around the holidays…. but they do. The myth of the happy family is only a reality for a portion of the population; and even those who do celebrate Christmas with family can have significant stress and sorrow around money, relationships, and more.

So, for those who are alone this month, or in the midst of tragedy or change or trauma, I wanted to offer some self-care advice. From a metaphysical perspective, no matter what your religion is, this time of year IS about the miracle of returning light. The first few weeks of the month bring ever increasing darkness. Light some lights in your own home, whether they are candles or Christmas lights, reflecting your own inner flame. No matter how dark the world appears, each of us has the light of our soul to guide us. Connect with yours.

broken_heart_remedy_compoundFor those with heartache, there are many botanicals that offer gentle physical and emotional support. Avena botanicals makes a Broken Heart herbal tincture and a lovely sweet Rose Petal Elixir. The elixir is in a glycerin base and is used to gently lift the spirits and open the heart. It tastes like a rose smells on a hot summer day! Many herbalists make their own rose petal elixirs at the summer solstice, in preparation for this dark time of year. Herbal medicines like these affect our body, mind and spirit. By using self-care medicines we are making a commitment to our Self to move through this time of change with as much gentle strength and internal fortitude as possible. http://www.avenabotanicals.com/rose-petal-elixir.html 

Many people have seasonal affective disorder (SAD) or just simply hate the cold. We have had a particularly cold pre-winter here in Maine, which makes getting out to enjoy our gorgeous local landscape more difficult. Prevention is key for SAD – once it takes hold it is harder to manage. Adequate levels of Vitamin D3 are especially important. I generally recommend 2,000-5,000 IU daily depending on your body weight and Vitamin D reserves. Have you had your blood levels of Vitamin D checked yet this fall? High quality fish oil is a good adjunct to Vitamin D, enhances its absorption and can help with mental health. Fish oil contains two chemical constituents – EPA and DHA. The EPA is the part that helps with depression. Aim for a minimum of 650 mg of EPA daily, taken with your D3.

Saint Johnswort is another classic treatment for SAD. This herb affects the metabolism of many medications. Therefore, I only suggest using St Johnswort if you are not on any other meds. Dosage must be 900 mg per day, taken *every day.* This herb acts like SSRI antidepressants in that it takes about 4 weeks to get the full effect, and it needs to be taken daily for best results. This herb has evidence of use back to 400AD by Hippocrates. It is an ancient and magical herb with an association to light. It is no mistake that it is useful for SAD! If you do take medications like birth control, daily pain medication or blood pressure medication but would like some mood support you can consider 5-HTP. This is a serotonin precursor that is naturally produced in the body, and is available in supplement form. It can be helpful for anxiety, depression, insomnia and “the blues.” It is quite safe in general, although it should not be taken along with antidepressant medications unless specifically advised by an Integrative Medicine Dr. Typical dosage for 5-HTP is to start with 50 mg twice a day, and increase to up 150 mg twice a day as needed.

Exercise and meditation are two other valuable tools for getting through hard times. Exercise releases endorphins which simply make us feel good! It can be a walk around the block or a cross-fit class or hot yoga. The type of exercise does not matter as much as the act of getting into your body and out of your head. Meditation offers ways to step outside the constant chatter of our ego. I recommend a guided meditation for beginners. I use this Buddhist body-focused beginner set by Reginald Ray, but there are many more available! http://www.soundstrue.com/shop/promotion/1047.pd

At the end of the day, we each need to get through our darkest times in the ways we know how. Alcohol, television and drugs are all effective in their own way, but they also exacerbate the feelings of isolation and despair. Connecting to your inner light source and fanning your fires of spirit and confidence and strength will help grant you the courage to move through these difficult times. Some of us need more help than others to connect to our strengths, and supplements like herbal remedies, vitamin D, fish oil, St Johnswort and 5HTp can be great support systems. I love the rose petal elixir for its sweet uplifting taste of summer in these harsh cold days of winter.

For personal support on transforming your own journey or connecting to your inner strengths, book an appointment with Dr. Wright. She is available for consults during the month of December including December 27, 2013.

Call 207-774-1356 now.

References:

The ABC Clinical Guide to Herbs. American Botanical Council, Thieme Publishing 2003. Currently out of print.

Encyclopedia of Natural Medicine. Michael Murray ND and Joseph Pizzorno ND. Prima Publishing, Rocklin, CA 1998

www.avenabotanicals.com

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Using Herbal Medicine in Pregnancy

pregnancy-tonic-tea-220x231There are always questions about which herbs are safe to use in pregnancy. There is considerable historical and clinical information on the use botanical medicine for enhancing fertility, treating common conditions of pregnancy, and supporting postpartum care and lactation. The modern push for evidence-based studies to confirm safety of use is hindered by the ethical issue of conducting clinical trials during pregnancy. Therefore, there are very few if any double blind placebo controlled studies to reference for this population. For this reason, most online and allopathic resources will list herbs as “not safe in pregnancy” even if they have been safely used for centuries as part of maternal medicine. Furthermore, the World Health Organization label requirements for botanical medicines includes information on the use during pregnancy and lactation. As there is insufficient evidence-based studies on botanicals in pregnancy, almost all products will say Not Safe in Pregnancy or Lactation. This is good in some ways, because it protects the fetus from harmful herbal constituents accidentally taken by an unsuspecting parent. On the other hand, it limits many people from accessing safe and effective supportive herbal therapies during this unique time of life.

As a general rule of thumb, almost all herbs are best avoided during the first 12 weeks of pregnancy unless specifically prescribed by an expert in this field. Ginger is one exception to this, as it has significant clinical evidence to reduce nausea of pregnancy. Still, even ginger can be too stimulating and is best taken in moderation. *Dosage for hyperemesis gravidum could be 5-10 drops of a ginger glycerite tincture as needed, up to 70 drops daily. Ginger tea or  chrystallized ginger can be used 2-4 times a day, and ginger candies up to 10 daily. Roobios is another herb that is a safe tea in early pregnancy. This is a traditional pregnancy medicine in Africa, and a very common tea base. Nettles are also very gentle and provide a mineral-rich tonic for the newly pregnant mom. Nettle is a lovely tea base to use throughout pregnancy and lactation for hydration and nourishment. As every person’s body is different, it is sometimes best to stick with what your body knew pre-pregnancy rather than trying new things in these sensitive weeks to avoid unexpected allergic reactions or other physical repercussions.

There are some herbs which must be completely avoided throughout pregnancy as these are known to be harmful in some way. For a complete list see:  http://thewrightdoctor.com/womens-health-2/herbs-not-safe-in-pregnancy/

Herbs with strong alkaloids (identified by a bitter taste) are to be avoided. These often have a strong action on the body, whether digestive or cardiac. There are many gentle herbs and nutritional supports which are safer digestive tonics for pregnancy. Laxative herbs exert their effects through muscular contractions and can stimulate uterine contractions as well. Most herbs with strong hormonal activity are to be avoided completely , as are all anti-parasitic formulas. Certain herbs that are to be avoided in pregnancy can be prescribed by experts in this field in the last few weeks of pregnancy to prepare the uterus for labour.  These are only to be used under the guidance of an experienced midwife or prescribing professional with obstetric training in botanical therapies.

There are many herbs which help pregnant women connect to their body and the environment in a grounding, tonifying way that are safe and effective. Some women will make their own creations from local plants, and others will buy them. When purchasing plant remedies, it is important to buy from reliable brands. Gaia, Apollo herbs, Herb Pharm, Vitanica, Wise Woman and Avena Botanicals are all ethical and responsible manufacturers of high quality herbals. If you are concerned about whether or not a product is safe for you, simply do not use it! Or, find a local Naturopathic Dr, Midwife, or Herbalist to guide you in your pregnancy care.

These are some herbs which are safe to take. * Alfalfa is very high in chlorophyll and rich in minerals and vitamins. This is a great greens powder in smoothies. Burdock can be used in small doses of 20 drops 1-2 times a day after the first trimester. Burdock supports women with blood sugar difficulties or constipation later in a pregnancy. Dandelion greens are a great tonic for women pregnant in the spring. They are robust in vitamins and strengthen the urinary system. Dandelion root can also be used in small amounts like burdock, for sour stomach, nausea and itchy skin. Oatstraw is a soothing tea or tincture which calms an overstimulated nervous system. This is a must have for pregnant moms with other small children! Up to four cups of Oatstraw tea daily is safe or use in tincture form 40-60 drops in water 2-3 times a day.

Rose hips are safe throughout pregnancy. These have abundant vitamin C to support collagen production in skin and help maintain vascular wall integrity.  They have a sour zip, and make a yummy tea with nettle and honey. Saint Johnswort herb is a safe and gentle mood support during pregnancy as well as a safe option to treat herpes outbreaks both topically and internally. It should not be used with other medications, but is a reliable ally for women during this time of life. Red raspberry leaf is very well known as a late pregnancy tonic. This silvery-green leaf strengthens the uterine muscle without stimulating contractions, preparing the body for the adventure of labour. It is rich in iron to support the increased blood volume in later pregnancy. It is best drank as a tea 1-3 cups per day for the third trimester. Finally, Valerian is a safe sleep support. It is best to use the smallest dose needed for therapeutic value, so start with 1 cup tea before bed or 10-30 drops of tincture and increase as needed.

Pregnancy is a time of life when so much is unknown, and so much can go wrong – there is so much responsibility for both parents and care providers. For this reason much of modern medicine has erred strongly on the side of caution when it comes to using herbal medicines in pregnancy. This caution is compounded by the high cost that many IVF assisted pregnancies carry. Every move becomes highly medicalized, and simple acts like a cup of herbal tea are forgotten as effective therapeutics. The bottom line when it comes to using herbs in pregnancy is: if it makes you nervous, dont do it. You cannot rely on the internet, on your OB,  or on labels to tell you what is safe to take during this time of life. However, there are some very reliable books on using herbs in pregnancy, and many Herbalists, Naturopathic Doctors and Midwives have expertise in this area. Enjoy!

http://apps.who.int/medicinedocs/en/d/Jh2945e/9.5.html

http://www.ahpa.org/default.aspx?tabid=70

*ABC Clinical Guide to Herbs. M. Blumenthal p. 174

*The Natural Pregnancy Book. Aviva Jill Romm

*Herbal Childbearing Year. Susun Weed p. 19, 51

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