Flu season is headed our way and in a few weeks many will suffer, but you don’t have to be one of them if you start boosting immunity now. Here are 10 simple ways to prep your body so it’s strong enough to repel viral invaders all winter long:

1) Do your D’s.
Adequate levels of Vitamin D are essential for our immune systems to function the way it is designed to. Unfortunately, there are no significant dietary sources of Vitamin D – most of our intake comes from exposure to sunlight. To optimize your vitamin D levels, you’ll need to take a Vitamin D3 supplement daily. This is the most important step you can take to prevent the flu!! To find out how much vitamin D you’ll need, get your 25 hydroxy Vitamin D level checked by your doctor. If that’s not an option, you can self-test your level with ZRT labs. For optimal health, you’ll want your level to be between 50 and 70ng/ml. It may require several months of taking 5,000 to 10,000 IU of Vit D3 daily (especially during winter) under a doctor’s supervision to achieve this – but it will be well worth the effort. Monitor your 25 hydroxy vitamin D status every 3 months until you are in the desired 50 and 70ng/ml range, then cut back to a maintenance dose of at least 2,000 IU a day.

2) Do take a probiotic daily. 
A strong immune system relies heavily on having a healthy, well-functioning gut – and probiotics help keep your gut engine humming.  A recent study confirmed that probiotics could help fight off colds. Look for a probiotic with 10-20 billion organisms and take one every day.

3) Do stock up on antiviral herbal supplements.
Immunity –boosting antiviral herbs contain thousands of medicinal compounds that attack viruses with a full spectrum of synergistic substances – and without creating resistant viral strains. Four great antivirals are andrographis, olive leaf extract, grapefruit seed extract and elderberry extract. Use one or several in combination as a prophylactic measure, particularly if you spend time in high-traffic areas such as airports, offices, theaters, etc.

4) Don’t eat crap. 
In other words, avoid sugar and processed foods. Sugar is a poison which, among other things, dramatically decreases immune function – so lay off the stuff. And processed foods? Virtually all of the nutrients get processed right out of them so they do nothing to strengthen immunity. Talk about empty calories!

5) Do get your greens.
Colorful salads and dark greens are loaded with flu-fighting phytonutrients, so pile your plate high.

6) Do garlic.
Not only does garlic repel vampires, it also has anti-viral properties and is a known immunity booster. My advice? Dig in!

7) Don’t skimp on sleep.One key to a strong immune system? Sleep! Get plenty of it to allow the body to restore and repair itself while you rest. Shoot for at least 7 hours a night and try taking a 20-minute catnap if you’re falling short.

8 ) Do break a sweat.
Adequate exercise helps keep your immune system healthy and robust, so keep moving throughout the winter.

9) Do chill out.
Reduce stress, particularly during flu season. Do breathing exercises, yoga or simply things you enjoy, to help boost immunity, relieve tension and enhance physical and mental resilience.

10) Don’t wash with antibacterial soap.
Instead, wash hands frequently with good, old-fashioned hot water and chemical-free soap. Skip the antibacterials as they are loaded with toxins and increase the risk of creating resistant bacteria. They also over-dry and crack the skin, making transmission of viruses that much easier.

Best wishes for a flu-free winter!

Ah, January has arrived, and with it, the height of cold season. While there’s no “cure” for the common cold, there are ways to reduce the chances of catching one, and increase your body’s ability to fight back if you do.

 My winter battle plan includes a full arsenal of cold-fighters, starting with prevention, and finishing with a few key vitamins and supplements to help send colds packing. Here’s how I do it:

Avoid Sugar and Processed foods

Sugar decreases immune function.

Sleep. A lot.

Sleep: It’s free, it’s easy and it’s a key building block of total health, so make an effort to get some zzzz for 7- 8 hours. Think you can’t squeeze another hour out of your busy day? Well, consider the time lost when a cold takes hold, and then commit to going to bed just 15 – to – 30 minutes earlier every night. The more time you allow your body to repair itself with restorative sleep, the stronger your body will be.

Clean up your act.

Think about where your hands go in the course of a day: subway poles, escalator handrails, ATM’s, office phones, computer keyboards, restroom doorknobs, copy machines, communal coffee pot at the office, etc. – all fantastic sources of germs. To keep them at bay:
 

• Around town, hold bus and subway poles with gloved hands, or use a bit of coat sleeve as an impromptu mitten.
• At the office, wash hands with hot water and soap frequently, and wipe down your phone, desk and keyboard daily.
• In-between washes, remove surface grime with portable packs of hand-wipes. Look for natural wipes with little or no alcohol. I like Herban Essentials lemon-scented towelettes, not only because they smell like summer, but they’re also naturally antibacterial and antiseptic.
  Avoid antibacterial soap because of the risk of creating resistant bacteria.

Water your nose.

With heaters cranked up in the winter, nasal passages get dried out and crack, making the nose an easy entry point for germs. Clean out your sinuses and keep nasal passages moist with a neti pot (sea salt and water) or Saltaire available from Duane Reade or simple saline mist treatment, every day.

 Another tip? To add moisture without the hassle of a humidifier, try putting a pan of water on the radiator before bed, leave the bathroom door open when showering, or consider skipping the dry cycle on the dishwasher, open it to air-dry and release steam into the kitchen.

Know your alphabet.

A is for Andrographis, one of my favorite ways to stimulate the immune system. This is my preferred herb for preventing and treating colds. For prevention take 2-3 grams a day and for treatment of acute colds use up to 6-9 grams a day.

B is for Bacteria, that is good bacteria or probiotics. Take a probiotic daily (look for one with 10-20 billion organisms). A strong immune system relies heavily on having a strong foundation in the gut.

C is for Vitamin C, the classic immunity booster that can often help to fend off more serious infections. But you need high doses. So if you are willing, take at least 2 grams 3-4 times a day.

D is for Vitamin D, the best immune system regulator that can help arm your body to fight colds. Probably the most important thing you can do to prevent colds is to optimize your Vitamin D level. Most people need at least 2,000 units a day in the winter and usually more, but please have your blood level measured and take the appropriate dose.
 
E is for Echinacea. Although recent studies have suggested that it is not as effective as originally thought, it can sometimes be helpful.

“For every dollar we spend on prescription drugs, we spend a dollar to fix a complication. Understanding how nutritional supplements affect these drugs could make them safer and more effective.”

– Mehmet Oz, M.D., Professor of Surgery at Columbia University
 and author of bestsellers “YOU: The Owner’s Manual” and “YOU: On A Diet”

A little known but potentially life-saving fact is that common medications deplete vital nutrients essential to your health. Here’s a practical guide to avoid drug-induced nutrient depletion, and even replace your medications with natural supplements.

We have been called a pill-popping society, and statistics bear this out. Nearly 50 percent of American adults take at least one prescription drug, and 20 percent take three or more. In a survey, more than half of those over 65 and 30 percent of people 45 to 65 used at least three prescription drugs in a one-month period. With our increasing reliance on medications comes nutrient depletion, a problem we can’t ignore. Every medication, including over-the-counter drugs, will drain the body of specific nutrients. On top of this, most Americans are already suffering from nutrient depletion. In fact, many of the conditions we see in everyday practice may actually be related to this deficiency.

The good news is that with the right supplements, you can avoid depletion side effects, and even better, you may be able to control and prevent chronic diseases, such as diabetes, cardiovascular disease and osteoporosis.

A Common Scenario

I have seen case after case of patients who have experienced nutrient loss from taking prescribed medications. Too often, neither the patients nor their doctors were aware that the cause of symptoms was the medications themselves.

For example, a 57-year-old retired schoolteacher, Kathy, was being treated by her internist with three medications: the thiazide diuretic, Diuril, for high blood pressure; Fosamax for osteoporosis; and the beta-blocker, Tenormin, for heart palpitations.

She was referred to me, an integrative psychiatrist, because she suffered from fatigue, anxiety, depression and insomnia. I couldn’t find an obvious psychological explanation for these symptoms, except perhaps for the stress of her physical illnesses.

The likeliest cause of her symptoms was the drugs themselves. So, rather than adding an antidepressant, an anti-anxiety pill or sleeping agent, I checked the known nutrient depletions associated with these medications. Lab results confirmed that Kathy was deficient in three essential minerals: magnesium, potassium and zinc.

Any one of her three medications could deplete potassium and magnesium, causing arrhythmias, hypertension, fatigue and depression. The diuretic also could be depleting zinc. Her internist agreed that he would continue to oversee her medications while I supervised her nutritional regimen.

Daily doses of magnesium, zinc and potassium, in addition to a high-potency multivitamin, resolved Kathy’s “psychiatric” symptoms. Once her mineral levels were restored, her energy and mood were back to normal. She was not only spared the burden of an additional medication, but was able to lower the doses of the three she was taking.

I see cases similar to Kathy’s more frequently than I’d like. Physicians will often tell these patients that their symptoms are “part of the illness” or “just signs that they’re getting older.” They then prescribe an additional drug or two for the side effects, further compounding the problem.

To understand the role of medications in nutrient depletion, we must first understand the variety of nutrient-depleting mechanisms in pharmacy.

Many drugs, such as the stimulants Ritalin (methylphenidate) and Adderall, are prescribed for attention deficit disorder. These can reduce appetite. This, in turn, decreases the intake of beneficial nutrients. Some antidepressants also tend to have this appetite-reducing effect.

On the flip side, a drug can reduce nutritional status by increasing the desire for unhealthy foods, such as refined carbohydrates. Many of the neuroleptics (antipsychotic drugs) and some antidepressants cause insulin resistance or metabolic syndrome, with resulting blood sugar swings. Patients then crave simple carbohydrates, such as sugar, bread and pasta. Steroid drugs, including those given by an inhaler, can create similar issues as well.

Certain medications reduce the absorption of nutrients. In passing through the gastrointestinal tract, drugs often bind to specific nutrients before they’re absorbed into the bloodstream. The antibiotic, tetracycline, for example, can block absorption by binding with minerals such as calcium, magnesium, iron and zinc in the GI tract.

Weight loss drugs and cholesterol lowering medicines similarly bind to fats, preventing them from being absorbed. Drugs that treat acid reflux or heartburn raise the pH environment of the upper GI tract, which reduces absorption of needed vitamins and minerals. This is especially problematic among the elderly, who often are already low in stomach acid.

Nutrients are essential to the metabolic activities of every cell in the body. They’re used up in the process and need to be replaced by new nutrients in food or supplements. Some drugs deplete nutrients by speeding up this metabolic rate. These drugs include antibiotics (including penicillin and gentamicin) and steroids, such as prednisone and the gout medication, colchicine.

Other drugs block the nutrients’ effects or production at the cellular level. In addition to the intended effect on enzymes or receptors, medications can influence enzymes or receptors that help process essential nutrients. For example, widely prescribed statin drugs block the activity of HMG-CoA, an enzyme that’s required to manufacture cholesterol in the body. This action also depletes the body of coenzyme Q10, which requires HMG-CoA for its production. This has a serious negative impact on muscle and heart health.

Drugs also can increase the loss of nutrients through the urinary system. Any drug that does this can drain the body’s levels of water-soluble nutrients, including B vitamins and minerals, such as magnesium and potassium. The major offenders are medications to treat hypertension, particularly the diuretics that reduce blood pressure by increasing the volume of water flushed out of the body.

Drug-induced nutrient depletion is far more common than we think. In evaluating patients’ symptoms, doctors must assess whether symptoms are due to the illness, to side effects of the drugs or to drug-induced nutrient depletion. Considering the inadequate nutrition of most people, we must remember that the illness itself may be due, in part, to nutrient deficiency. To cover all bases, it is easiest to provide baseline coverage: a daily high potency multivitamin mineral formula, CoQ10 (200 mg), omega-3 fatty acids (2 grams) and additional vitamin D and probiotics, especially if you’ve taken antibiotics.

The bottom line: As physicians, we must look more deeply and determine underlying causes to determine whether drugs are harming patients, and what we can do to reverse these effects. As a consumer, be aware of these drug-nutrient depletions, and do what you can to avoid taking medications whenever you can, using natural products instead.

1. Centers for Disease Control and Statistics. Health United States 2006. Accessed via www.cdc.gov/nchs/data/hus/hus06.pdf#093.

I will also continue this theme in subsequent blogs, discussing various categories of medications, their nutrient depletions, and natural, healthier substitutes.

A more complete article can be found at Total Health Magazine, p. 40 ff.

For more information, see my book, Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition available at my website, www.cassmd.com.

I have heard a lot about enzymes and digestion–how are they related?

The digestive process is dependent on the presence of enzymes, which allows our bodies to absorb the food we eat and use it for fuel. Enzymes are present in the digestive juices, where they help break down food into simpler components the body can use for energy.

Which enzymes aid in the digestion process?

The three main enzymes involved in digestion are amylase, protease and lipase–though there are many more enzymes involved in digestion. Digestion actually begins in the mouth where the amylase in saliva starts to break down starches and carbohydrates.

Protein digestion begins in the stomach where the acidic environment activates the protease enzymes to begin breaking down protein. Most proteins are ultimately broken down into amino acids, the building blocks of life.

Fat digestion accelerates in the second part of the small intestine with the help of the lipase enzymes, which break down fat into essential fatty acids. The lipase enzymes help in the absorption of the fat-soluble vitamins: A, D, E and K.

Other enzymes, such as sucrase, lactase and maltase, play the crucial role of breaking down simple sugars that are essential for energy production.

Is it true that bacteria are good for your digestive health?

Some bacteria are very important for your health– these beneficial bacteria are known as probiotics. Two important probiotics are Lactobacillus and Bifidobacterium. The health benefits of both of these probiotic bacteria are well studied and supplements are available which can help increase the presence of these beneficial bacteria in your intestines.

How often should I take probiotics?

The key with probiotics is to ensure that they get to the intestines where they can help support a healthy digestive tract. Often, probiotics do not survive the acidic environment in the stomach, so it is important to find a supplement that offers a patented delivery system designed specifically to deliver the bacteria to the intestine. Since probiotics do not permanently colonize in our bodies, it is important to regularly replenish the probiotics with food or supplements.

I know that fiber is important–what exactly does it do?

Fiber helps promote and maintain regularity and in addition is important for immune systems as well as cardiovascular health. Unfortunately, most Americans get only about half of the fiber they need each day. If you are one of those who fall short, consider supplementing your diet with additional fiber. You don’t need to suffer through the gritty fiber drink mixes that your grandmother used to use. There are more and more fiber powders that are palatable these days or if necessary, look for chewable tablets that provide supplemental fiber and taste a lot better.

Digestive problems are probably the commonest problems I see in my practice. In addition, many of the patients who presented to me with other symptoms, from fatigue to allergies to arthritis, often the primary issue is faulty digestion. Most of these patients didn’t even realize that they had a faulty digestive system. They had become used to having mild indigestion or bloating or gas and thought it was a normal part of aging.

I believe that digestion is one of the most important functions for health. A well functioning digestive system will energize you, help your immune system and generally prevent all sorts of diseases. It will make you feel more vital.

So in almost all of my patients I always look to see if the digestive system is working well. It makes sense, because if you’re not digesting and or absorbing the food you eat, your nutritional needs will not be met.

I see many patients who are taking hundreds of dollars worth of supplements, which probably aren’t being absorbed properly because of a poorly functioning digestive system.

In Chinese medicine as well, the digestive function or the spleen function or earth element is at the center. When this is off balance, the whole system becomes imbalanced.

Here are 10 simple tips to help with digestion:

1. Chew your food well.
2. Sit down and relax while you eat. Eating in a rush and under stress is not healthy and may lead to digestive problems.
3. Make eating a mindful experience
4. Eat natural, whole, unrefined, unprocessed, high quality foods.
5. Eat when you’re hungry and stop when you are 80% full.
6. Eat organic and preferably local foods whenever possible.
7. Try resting your digestive system for at least 10 hours at night. eg if you eat breakfast a 7:00 am, try not to eat anything after 9:00 PM.
8. Try doing an Elimination diet for 1-2 weeks from time to time, where you eliminate all refined sugar, processed foods, alcohol, gluten and dairy. Notice how your digestion usually improves.
9. If possible have something bitter before your meal, it stimulates your body’s own digestive juices and therefore helps digestion. Eg arugula or dandelion root.
10. Try taking a good probiotic formula

The questions surrounding supplements continue to grow and though knowledge and understanding have also grown, pharmaceutical companies continue to hamper this quest by spending more and more money on their own studies and funding lobbyists that try to hamper our pursuit of a more natural approach to health. There is no doubt that the drugs we have developed are saving lives but they could save many more lives if they were part of an integrative lifestyle combining a healthy balance of diet, exercise, necessary supplements, and when these fail, pharmaceutical medications.

In integrative medicine we speak about the “core” nutrients. These are the vitamins and minerals that we all require. I generally start people on a multivitamin and mineral complex first. There are many out there so selecting an appropriate combination is not that difficult. Some of the new age-targeted formulas combine most of a person’s needs into one formula for ease of use. So a women’s formula for women over forty will include more calcium, magnesium and trace minerals than a formula designed for younger women. This simplifies what a person needs and often taking fewer products increases compliance. The next core nutrient necessary is a good healthy source of essential fatty acids, also known as EFA’s. EFA’s are essential because we cannot make them. We need to ingest them so that our bodies can then use them as raw materials for other things we do make. These include cholesterol (much needed), hormones, prostaglandins (messengers that help us control all sorts of processes in the body, including inflammation). There are so many problems with the environment and this includes our water. Eating fish that is not contaminated has become a problem and there is nothing in the literature that leads me to believe that things will change any time soon. Keeping your “ toxic burden “ low is the only thing we can control in trying to prevent cancer and other autoimmune diseases that seem to be growing in numbers in spite of all the new “ scientific advances”. In order to get the omega 3’s that you can get from one or two capsules of oil a day, you would probably need to eat 4 to 6 servings of fish a week, and thereby risk exposure to elevated levels of mercury, arsenic, cadmium, and lead. If you ate farm raised fish, than you increase your risk of exposure to dioxins ( carcinogens ) and PCB’s ( also carcinogens ). The amount of fish oil a person should take also varies according to need.

The next core nutrient is a probiotic. This is what many people commonly refer to as “acidophilus” but in reality is a whole family of beneficial bacteria that is comprised of many different “friendly” bacteria that thrive throughout the gastrointestinal tract, starting in the mouth and ending in the rectum. For women without any serious or chronic gut issues, eating a good organic yogurt containing live cultures of friendly bacteria, on a regular basis, is adequate.

For women, the big question today is about calcium. While we have all become conscious of our need for calcium many people are unaware of the need for magnesium, adequate amounts of vitamin D and the need for other trace minerals that aid in absorption. The amount of minerals that are needed varies from person to person. Women after the age of forty should begin to get bone density studies done to assess their need for minerals. The average woman needs 1000mg of calcium a day, 400 to 800mg of magnesium a day, and at least 2000 units of vitamin D3 but we are finding more cases of severe deficiency and under medical guidance we use as much as 10,000 units a day. If the bone density test, also called a Dexa scan, shows osteopenia or the beginnings of osteoporosis than I increase the calcium to 1200 to 1500mgs a day and increase the magnesium accordingly. I often request that patients have their vitamin D levels measured because many people supplementing with calcium and magnesium are still showing signs of progression of their bone density issues. In our search for answers why, the question of the right amount of D has come to be a new insight into possible failures of other therapies. In osteopenia and osteoarthritis, weight resistance exercise is essential for stopping progression.

There are a million supplements on the market and I encourage all women to try and get as much of their nutrition from food and then target the remaining imbalances with the supplements that are necessary. I encourage all my patients to eat as organically as possible. We need to reduce our exposure to chemicals. As long term studies are limited, I assume that all chemicals are bad and try to reduce them every where possible. Animal protein like chicken, fish, beef, and pork, as well as all dairy carry a heavy burden of toxins with them. First they contain the herbicides and pesticides from the foods they are grown on, and second they are usually given hormones and antibiotics to maximize the yield. All of these are passed to us when we eat these things. I implore all people to buy as much of their foods organically but animal derived products especially. With ovarian and breast cancer on the rise, you have to question the “estrogen dominant “ nature of society due mostly from the consumption of xeno estrogens and phyto estrogens from the food supply. With vegetables and fruits I take an aggressive approach to washing them before I consume them.