As a psychiatrist, I am clearly familiar with the psychodynamic issues underlying eating disorders, and I see psychotherapy as a vital part of treatment. At the same time, I would like to share my experience with observing and treating some of the biochemical underpinnings, hastening recovery and helping to maintain it as well.

Many years ago, a psychologist who specializes in eating disorders began to send me her clients because she had heard that antidepressant medications worked for these patients. I had by then shifted to a more holistic approach, so I told her that before I prescribed antidepressants, I wanted to try some more natural methods. I had discovered that in many cases of eating disorder, there is an underlying biochemical issue – a combination of food sensitivity, blood sugar imbalance and nutrient deficiency. She agreed, her patients cooperated, and we had some excellent, medication-free results. This encouraged me to continue on this natural path as I have to this day. Here are some of my discoveries, as well as subsequent research by others in this growing field.

Food Sensitivity
We crave the foods that we are sensitive or “allergic” too. Not a typical allergy with hives or stomach aches, these sensitivities are intolerances, often inherited, and show up in any number of ways – for example, depression, inability to lose weight, eating disorders, tinnitus, unexplained aches and pains–many, many others. The very foods we crave will create the most symptoms and are the most damaging. In fact, food cravings are similar to an addiction to alcohol. As you withdraw from the foods you’re addicted to, you begin to have withdrawal symptoms and the craving begin. And if you happen to be addicted to wheat or baked goods, you can never get enough of them, so you binge on them, despite your best intentions to the contrary. People addicted to grains may drink excessive amounts of grain-based liquor or beer and can become alcoholics. They’re sensitive to and addicted to the alcohol, but it’s the grain-base that is causing the problem. They can even feel “drunk” after eating cereal or baked goods. Not so different from your regular carb-binger, except the target is alcohol instead of refined carbs.

Nutrients
It’s not just a matter of willpower. In order to break the addiction cycle, in addition to avoiding the undesirable foods, you have to supply the body with a good, supportive nutritional program of healthful food, vitamins, minerals, and amino acids. Then, the cravings will often simply go away! It’s quite remarkable; with a nutrient rich diet, and good vitamin and mineral formula, you can stop the cycle. In fact, once the diet and nutrients are in place, the cravings and addictions will often just fall away. Remember that nutritional supplements are not a substitute for healthy food, but a supplement to restore missing ingredients and balance biochemistry.

Magnesium is often deficient, and taking it can be very helpful. It’s great, too, for muscle tension, insomnia, and even, heart palpitations. The amino acid glutamine is also useful for reducing cravings. I’ve had former alcoholics (yes, former) say that the glutamine cut their cravings for good; they no longer were battling the desire to drink. They were done for good. Glutamine works similarly with bulimics and binge eaters.

Zinc: Some years ago, researcher Alex Schauss did a study on patients who were suffering from anorexia nervosa. By using a simple test called a zinc taste test, he found that they were zinc-deficient. He then gave them liquid zinc therapeutically, with very successful results. The test consists of the person taking some liquid zinc sulfate solution in their mouth, and if they describe it as having a bad or strong taste, they usually have sufficient levels of zinc. On the other hand, if they can’t taste the solution or if it tastes just like water, then they may have a cellular zinc deficiency, even if their blood levels look adequate. It’s a vicious cycle since zinc deficiency affects taste; so zinc-deficient anorexics don’t taste their food, so are less motivated to eat it. Zinc supplementation has continued to be used in nutritionally oriented settings, including my own practice.

Serotonin: Bulimia and binge-eating is often treated with the SSRI antidepressants such as Prozac, Zoloft and Lexapro They raise brain levels of serotonin, a neurotransmitter or chemical messenger in the brain that causes a feeling of well-being and relaxation, and reduces hunger. Rather than using medication, my preference is to prescribe the materials that make serotonin, the amino acids L-tryptophan or it’s relative, 5-HTP (5-hydroxytryptophane), and there is research to back it.

In her book, The Diet Cure, Julia Ross refers to a study where bulimics were deprived of tryptophan. In reaction, their serotonin levels dropped and they binged more violently, ingesting and purging an average of 900 calories more each day. In another study, adding extra tryptophan to the diet reduced bulimic binges and mood problems by raising serotonin levels. More recently, an Oxford researcher, Katherine Smith, reported that even years into recovery, bulimics can have a return of their cravings and mood problem after only a few hours of tryptophan depletion, concluding that, “Our findings support suggestions that chronic depletion of plasma tryptophan may be one of the mechanisms whereby persistent dieting can lead to the development of eating disorders in vulnerable individuals.”

The herb St. John’s Wort provides another way to raise serotonin levels. I have discussed this along with dosages of tryptophan and other nutrients in my book, Natural Highs.

Thiamine: As we have seen, nutrient deficiencies can aggravate anorexia, and it should be treated with nutrient rich diets. For example, restricting your diet will make you deficient in such vitamins as Vitamin B1 (thiamin). It’s found in foods that people with eating disorders rarely eat — including beans, whole grains, seeds, meats and vegetables. Common signs of thiamin deficiency are loss of appetite, weight loss, constipation, anxiety, chest pain and even sleep disturbance along with depression and irritation. Sound familiar?

Blood Sugar Swings
One mechanism underlying the craving and eating (or drinking) cycle is blood sugar imbalance: low blood sugar sets off the craving. The brain experiences this dip as life- threatening starvation, followed by a frantic search for whatever will raise blood sugar. Just picture our ancestors in the jungle, short on food, and having to hunt for their next meal–or die. We, on the other hand, just go to the refrigerator. The quickest fixes here are sugary foods or other refined carbs such as bread or pastries. And we don’t even burn any calories on our hunt.

Bottom Line: Treat Nutrient Deficiency with Nutrients
I will often order a blood test to see which amino acids are low, and by replacing them, the body (and brain) comes into balance. As a result, the food cravings will often be greatly relieved or even, come to a halt, as noted in the case of glutamine for acute cravings.

There are other natural treatments, as well, for cravings due to food sensitivities. Acupuncture and acupressure has been shown to help, especially some techniques such as NAET that can actually eliminate the food sensitivities themselves.

The point is, instead of simply taking an antidepressant, there are many other ways to approach what at first appears to be strictly a psychological problem. The combination of psychotherapy and a nutritional/biochemical approach is the most useful, and I have successfully treated many patients without resorting to medication at all. Not only does this approach work as well as medication, but in my experience, working with the body’s chemistry rather than introducing more chemicals in the form of medication, is often superior. It’s faster, has none of the side effects, and has many side benefits. I developed Brain Recovery AM & Pm formula to provide many of the nutrients mentioned here and more, to balance amino acids, serotonin, blood sugar, and mood.

In my Integrative and Functional Medicine practice, hardly a day goes by when I don’t see several patients suffering with a touch of corporatitis maximus (CM). While you won’t find CM defined on Wikipedia or easily searched on Google, you will find it lurking in the minds and bodies of stressed-out, over-extended, over-committed employees of corporations, everywhere.

So what exactly is CM? Well, to be honest, it’s a catchall phrase I use to describe the cornucopia of mind/body ailments that tend to arise when a patient’s life and how they’re living it is in direct conflict with who they are or wish to be. Over time, these conflicts begin to express themselves via a number of physical symptoms that diminish a patient’s quality of life to the point where they feel lousy most of the time, inadvertently setting the stage for larger health complications and even diseases down the road. Simply put, though CM starts in your head, before long it takes your body along with it. Prolonged periods of exhaustion and being perpetually out of sorts start to wear down our immune systems, eroding the body’s ability to heal itself and enabling the body to slip out of balance with frequent colds that go on far too long, allergy flare-ups, aches and pains, headaches, digestive problems, constipation, irritable bowel syndrome, sleeplessness and moodiness, testiness, depression and listlessness.

If all this sounds disturbingly familiar, then you may be in the wrong job. Realistically though, there are mortgages to pay and kids to educate, so for most of us simply “dropping out” is not an option. The question then becomes, then, “How do we combat corporatitis — short of moving to a hut in Tibet?” I suggest taking the integrative approach and battle the corporatitis beast on both the emotional and physical fronts. To do that, try a few of my corporatitis-busting tips to help restore balance, regain your health and start living again:

1. Step away from the water-cooler. In other words, be aware of office scuttlebutt and gossip, but don’t be an active participant. Gossip is rarely positive and mostly speculative, so why fill your head with scenarios that may never come to pass, or events you can’t control? If you’re going to keep your spirits up, don’t allow yourself to be pulled into the fray.
2. Allow obsessive thoughts, to a point. Set a time limit — or even an egg timer — on how long you will allow yourself to obsess over a work problem. Be it 10 minutes or 45, when time’s up, move on. Come back to the problem later in the day, but give your brain a rest now, so it can come up with a solution more organically later. Give your head a chance to go with the flow.
3. Just say no, graciously. Many of us have trouble saying “no” to co-workers, friends and relatives, so we say “yes,” and wind up taking on far more than we can reasonably handle. Next time, instead of saying “yes,” deliver the bad news with a positive spin, using phrases like, “That’s a great idea but…” or, “I would love to, but…” or, “That sounds wonderful but…” Follow the “but” with a polite reason why you can’t honor the request. It will make saying “no” a lot easier for you to say, and easier for them to hear.
4. Push back with finesse. Saying “no” to the boss is a bit more challenging, particularly if you plan to keep your job. One way to do it is to ask the boss to help you prioritize your current projects as new ones are assigned. Not only will this remind the boss of all you’re working on, but it will also make your boss accountable for clarifying and identifying priorities.
5. Keep moving. Incorporate exercise into your life every day, even if you have to break it into 15 minutes in the morning and another 15 minutes after work. Just move! Exercise will enhance mood, encourage weight loss, calm the mind, improve the function of just about every system in the body and help take the edge off some of those not-so-nice feelings you might have about your toxic boss. Not a lot of spare time to exercise? Then take a tip from one of my patients who recently installed an inexpensive exercise peddler under her desk at the office, and now pedals her way through her daily conference calls.
6. Then, put on the breaks. Just as important as exercise is relaxation. While it’s unlikely you’ll have the time to stretch out for a lunchtime power nap (a la “Mad Men’s” Don Draper), after work, take time to do a bit of restorative yoga, a short meditation or a few deep breathing exercises. Try self-massage, using your body weight on a foam roller or tennis ball rolled over pressure points and sore spots.
7. Give yourself a time-out with meditation. Take a few minutes off during the day to try one of the thousands of free guided meditations available online to help refresh your mind and spirit. How to find the time? Download a meditation and listen to it on the train to work or find a quiet spot to tune in during your lunch break. Meditation is a great way to re-center yourself, clear your mind and give yourself a bit of much needed “me time.”
8. Give yourself a Sabbath, and stick to it. Ideally, try to unplug from your electronic devices for one day a week. If that’s not possible, then at minimum, commit to not being accessible for brief periods of time. Unplug responsibly, though, by letting staff and/or bosses know when you’ll be unavailable.
9. Unstuff your life. Take steps to liberate yourself from the oppressiveness of keeping up with the Joneses and embrace the joys of a simpler life, a smaller house and the ease of owning (and owing) less. Not convinced stuff makes all that much of a difference? Watch a couple of episodes of “Hoarders” or “Enough Already” to get a sense of the tyranny of too much stuff.
10. Sleep it off. Corporatitis gains the upper hand when the quality of your sleep is poor or you don’t get enough. Take at least one hour to prepare yourself for sleep. In that transition time, do something relaxing, like taking a hot bath or some restorative yoga. My favorite chill-out pose is reclining belt pose. When it’s time to hit the hay, make sure your bedroom is cool, quiet and dark. Banish light with blackout curtains and cover lights from charging phones, flashing caller I.D. boxes, sleeping laptops or light-up alarm clocks with a bit of electrical tape. And if you can’t darken your room completely, get an eye mask.
11. Replace “dieting” with eating intelligently. Stop or cut down radically on sugar, processed foods, refined and junk foods. Slowly switch your diet over to predominately plant foods, ideally fresh and organic if possible. Although you should know how to read a food label, most of the food you eat should not have labels. Try eating a variety of different foods — the more colorful the better. Follow these basic principles as closely as you can to create a leaner, stronger, more resilient body that’s less prone to corporatitis-induced illness and weight fluctuations.
12. Supplement your health and happiness. Do this not with wine or Ambien, but with natural, health-supporting nutrients and supplements that encourage the body to return to a healthier, sustainable state of wellness. For optimal function, we all need to take various supplements depending on our age, diseases, stress level etc., so work with your health care practitioner to create a personalized supplement plan to help you achieve and maintain optimal health in a challenging world.
13. Connect with a community. Step outside of the office and connect with a community that’s not work-related. The idea is to broaden your circle of friends and acquaintances to literally open up your world, your heart and your perspective. Be it an informal book group or organized neighborhood committee, joining a community is a great way to step outside the daily office grind and connect with others.
14. Practice Ubuntu. We all tend to get caught up with our own “dramas,” which keeps us in our heads and takes up a lot of energy. When we stop focusing on ourselves and are sharing or being compassionate to others, we let go of a lot of unnecessary anxiety about our own dilemmas. In fact, we often actually receive more than we give.

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.

The Recommended Dietary Allowance or RDA (sometimes referred to as Recommended Daily Allowance) is defined as “the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (approximately 98 percent) healthy individuals”.

Most physicians (who practice Nutrition) and researchers consider the RDA an overly conservative and antiquated dietary standard. The RDA was designed by the federal government as a guideline for “practically all healthy persons,” but it’s easy to question whether Americans can be considered healthy-
In fact, the very concept of an RDA may be flawed. Forty years ago, Roger Williams, Ph.D., who discovered the B-vitamin pantothenic acid, developed the concept of “biochemical individuality.” Williams contended that people need the same nutrients-but that they are highly individualistic in the amounts they need. For one person, 100 milligrams daily of vitamin C might be sufficient for health; for another, 3,000 milligrams. In other words as we are all so different, so biochemically unique, our nutrient needs differ. As much as 10 fold for different people. And for optimal functioning, most people will need extra nutrients.

What’s a better way to assess a person’s nutritional needs?

Instead of minimum or recommended levels of nutrients, the late Nobel laureate Linus Pauling, Ph.D., emphasized the concept of optimal nutrition-that is, providing the body’s cells with levels of vitamins and minerals that help them function at their best. It is like putting premium gas instead of regular fuel into your body.

Determining your optimal intake requires a little experimentation as everyone is a little different. My experience has shown me that almost everyone in this day and age needs a good multi that has way more than the recommended RDA’s. For example, Pauling often recommended that people take anywhere from 100 to 300 times the RDA level of vitamin C for optimal health. Determining your optimal intake requires a little experimentation-everyone is a little different.

First, you need to set some clear objectives that you want to achieve with supplements. Second, you need to assess whether specific supplements help you feel better.

For example, if you’re in your 20s, eat well, and are in good health, your objective might be “dietary insurance.” You may not need much more than a multivitamin supplement and a little extra vitamin C.
On the other hand, if you’re in your 30s and face a lot of stress at home or at work, “stress management” might be an objective. In this case, you might do well taking a high-potency B-complex supplement. The B-complex has long been considered the anti-stress supplement.

My basic recommendations for supplements to sustain wellness are a good multivitamin with good amounts of the B vitamins, at least 2,000 IU of vit D, a good fish oil and a probiotic.

With the fanfare of a holiday parade, drug companies a few years ago unveiled two new Cox-2 inhibitor drugs-Celebrex and Vioxx-to treat arthritis, inflammation, premenstrual syndrome, and potentially even cancer. All the hoopla paid off. Since then, doctors have written more than seven million prescriptions for these “super aspirin” drugs, earning hundreds of million dollars for their makers.

Cox-2 is short for cyclooxygenase-2, one of the key enzymes that helps the body produce inflammatory hormone-like compounds called prostaglandins and cytokines. Cox-2 is essential-without it, we wouldn’t be able to fight infections or heal injuries. But when the body overproduces Cox-2, the result is chronic inflammation and pain.

The intensive marketing and advertising of Cox-2 inhibitors obscured why many people overproduce the enzyme. Too much Cox-2 appears to result from imbalances and deficiencies of certain nutrients. Rather than correct these underlying dietary problems, pharmaceutical Cox-2 inhibitors only mask the most visible symptoms. Relatively minor dietary changes, plus some vitamin and herbal supplements, correct the underlying problems.

Problems with Cox-2 Inhibitor Drugs

For years, people have used nonsteroidal antiinflammatory drugs (NSAIDS), such as ibuprofen, to treat the inflammation and pain associated with rheumatoid arthritis and osteoarthritis. NSAIDS ease inflammation by inhibiting the activity of both Cox-2 and Cox-1, the latter an enzyme that helps maintain homeostasis (biological equilibrium) protect the stomach lining. Because stomach ulcers occur in about 25 percent of NSAID users, pharmaceutical companies worked to develop NSAIDS that blocked only the activity of Cox-2. The idea was that a selective Cox-2 inhibitor would reduce inflammation but not irritate the stomach.

The motivation was profiting from a potentially huge market. An estimated 40 million Americans suffer from some form of arthritis. In a typical year, physicians write about 60 million prescriptions for NSAIDS-to say nothing of their over-the-counter sales. However, each year some half-million people develop complications from NSAIDS, with an estimated 80,000 people requiring hospitalization and 8,000 dying.

Though touted for their relative safety, Cox-2 inhibitors may be far more hazardous than originally believed. While gastrointestinal problems with Cox-2 inhibitors occur less frequently, they can be severe. Just four months after the FDA approved Celebrex, 10 deaths from the drug were reported. One study has even suggested that Cox-2 is important to the gut and healing ulcers, suggesting that pharmaceutical tampering with the enzyme may not be wise.

The Double-Edged Sword of Inflammation

Nutrients supply the most basic building blocks of the body’s powerful inflammatory compounds. The “parent” nutrient is linoleic acid, found in many foods but especially concentrated in vegetable oils (e.g., corn, soy, and safflower oils). The body converts linoleic acid to the omega-6 family of fatty acids, including arachidonic acid. Cox-2 plays a critical role in converting arachidonic acid to the hormone-like prostaglandin E2 (PGE2) and to the cytokines interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFa), all of which promote inflammation.

According to Robert F. Grimble, Ph.D., of the University of Southampton, England, once an infection or injury stimulates production of IL-1 and TNFa, these two proinflammatory compounds can further stimulate each other, as well as IL-6. In addition, IL-1 and TNF a trigger the production of free radicals, which encourage the production of more proinflammatory cytokines. The proinflammatory reaction essentially feeds on itself, setting the stage for chronic inflammation.

Ideally, the body balances these compounds with a group of antiinflammatory compounds that originate with alpha-linolenic acid, found in cold-water fish, leafy green vegetables, and flaxseed. The body converts alpha-linolenic acid to the omega-3 family of fatty acids, which include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Preformed EPA and DHA are also found in cold-water fish.

Much of the problem with inflammatory disorders actually stems from a lopsided imbalance in dietary intake of the omega-6 and omega-3 fatty acids-and the consequential cascade in proinflammatory activity. Artemis Simopolous, M.D., director of the Center for Genetics, Nutrition and Health in Washington, D.C., has shown that people historically consumed roughly equal amounts of the proinflammatory omega-6 fatty acids and the antiinflammatory omega-3 fatty acids.

However, over the past 30 years or so, Americans have replaced much of their dietary saturated fat (a bystander, so far as inflammation is concerned) with omega-6 fatty acids. Simopoulos estimates that people are now eating 20 times more omega-6s than omega-3s. From a biochemical standpoint, this sets the stage for powerful and chronic proinflammatory reactions.

Indeed, inflammation plays a role in many diseases, including arthritis, gingivitis and most of “-itis” diseases. Recent research has pointed to the role of inflammation in heart disease, stroke, and even Alzheimer’s disease. In addition, Bruce N. Ames, Ph.D., of the University of California, Berkeley, has estimated that chronic inflammation and infection cause about one-third of all cancers.

This relationship between diet, inflammation, and cancer was recently demonstrated by researchers at the American Health Foundation, Valhalla, New York. In animal experiments, they noted that corn oil (rich in omega-6) increased Cox-2 activity, whereas fish oil (rich in omega-3) blunted Cox-2 activity. The researchers also showed that the omega-6 fatty acids could promote the growth of colon cancer, whereas the omega-3 fatty acids prevented cancer.

In addition to a diet containing too many omega-6 fatty acids, a shortage of nutritional antioxidants, such as vitamin E, also contributes to chronic inflammation. The proinflammatory cytokines, IL-1 and TNFa, trigger the release of free radicals. A diet rich in antioxidants-found chiefly in vegetables and fruit-can help neutralize these free radicals. But relatively few people-9 to 34 percent, according to different researchers-eat the recommended five daily servings of vegetables and fruit. Between an excess omega-6 fatty acids and a lack of omega-3 fatty acids, and inadequate intake of antioxidants, the body’s proinflammatory reaction goes out of control, leading to chronic inflammation and pain.

Quenching the Fires of Inflammation

The simplest and most biochemically sound way of turning down the body’s proinflammatory prostaglandins and cytokines is by restoring a balance between pro- and antiinflammatory foods. From a dietary standpoint, this means switching from vegetable oils to extra-virgin olive oil (high in antiinflammatory omega-9 fatty acids). It also means avoiding most processed (boxed, canned, or frozen) foods, because their makers frequently add omega-6 fatty acids. By eating simple unprocessed foods-such as baked chicken, a salad, and steamed vegetables-it becomes easier to consume a more balanced ratio of omega-6 and omega-3 fatty acids.

However, if you’re like most people, you’ve been eating a diet high in omega-6 fatty acids and low in antioxidants for years. Simply restoring a balance is not enough to quickly offset accumulated damage, because the fatty acid composition of the body’s cells reflects their dietary ratios. It’s imperative to increase consumption of antiinflammatory fatty acids and antioxidants.

These are the supplements to emphasize:

• Omega-3 essential fatty acids

Found in fish oils, EPA and DHA are essential building blocks for the body’s antiinflammatory prostaglandins (e.g., prostaglandin E1) and for turning off Cox-2 and the body’s proinflammatory cytokines (IL-1, IL-6, and TNFa). In addition, omega-3 fatty acids block the activity of an enzyme that breaks down joint cartilage. Daily dosage: 3 or more grams.


• Vitamin E

Although Cox-2 and prostaglandin E2 levels rise with age, animal studies have shown that vitamin E supplements reverse the increase in Cox-2 and prostaglandin E2. Vitamin E also turns off nuclear factor-kB (NF-kB) and activator protein-1 (AP-1), compounds that turn on inflammatory genes. One recent study found that arthritics taking supplements of natural vitamin E (600 mg twice daily) for 12 weeks had their pain reduced by about half. Daily dosage: 400-800 IU.


• Polyphenols and Flavonoids

Researchers at Case Western Reserve University, Cleveland, recently reported that the antioxidant polyphenols in green tea had antiinflammatory properties by inhibiting Cox-2 and TNFa. Genistein inhibits prostaglandin E2 and Cox-2, and quercetin inhibits the activity of inflammation-promoting “adhesion” molecules. It’s likely that Pycnogenol, grape seed extract, and other flavonoids work through similar mechanisms. Daily dosage: 25-500 mg.


• Silymarin

A cell-culture study found that silymarin, the antioxidant extract of milk thistle, inhibited Cox-2 formation. This role of silymarin may partly explain why earlier cell-culture studies found it to inhibit the growth of prostate, breast, and skin cancers. Daily dosage: 100-200 mg.


• Rosemary

This common kitchen herb is rich in ursolic acid and many of its derivatives. In laboratory experiments, Swedish researchers found that the ursolic acid extract of rosemary was a potent inhibitor of Cox-2 activity. Daily dosage: 100 mg.


• Cat’s Claw

Known as una de gato and Uncaria tomentosa, this Peruvian herb has a long history as a remedy for inflammatory arthritis. Recent cell-culture and animal experiments at the Albany Medical College, New York, found that cat’s claw inhibited inflammation by blocking the activity of NF-kB. Daily dosage: Because products vary, follow label directions.

The take home message in all this is relatively simple: pharmaceutical drugs, while providing rapid relief of symptoms, do not correct the underlying cause of chronic inflammation. The cause is frequently a diet that’s either unbalanced or lacking in key nutrients. No drug can correct a nutritional deficiency or imbalance. Only nutrients can do that.

How do you treat Chronic Inflammation?

Avoid pro-inflammatory foods

Avoid sugar and refined foods, processed foods, trans fats, dairy, gluten grains and factory farmed meats, all of which are pro-inflammatory. Try the REMOVE or REVIVE diets – both of these eliminate the harmful foods you need to avoid.

Eat foods that cool inflammation

• Lots of spices – in particular, turmeric, ginger, rosemary and basil
• Lots of fruits and vegetables (preferably organic)
• Wild salmon, sardines, herring and anchovies
• Olive oil

Support your body’s own anti-inflammatory response with specific supplements

• Vitamin D3
• Fish oil
• Probiotics
• Green powdered drinks
• Turmeric
• Boswellia
• A good multivitamin

Balance your gut (gut imbalances are a common source of inflammation)

• Avoid food allergens
• Treat low-grade infections
• Take probiotics

Decrease toxicity (toxicity will cause inflammation)

• Eat organic foods as much as possible
• Decrease the amount of chemicals you put on your skin
• Decrease the amount of chemicals in your home
• Try the REMOVE or REVIVE diets – both of these eliminate the toxic ingredients you need to avoid

Exercise  

There is lots of research showing that physical activity suppresses inflammation.

Lose weight

This is because fat cells fuel inflammation.

Get plenty of rest and relaxation

Stress promotes inflammation and therefore decreasing stress will decrease inflammation.

Brush and floss your teeth

Periodontal disease causes inflammation and flossing prevents periodontal disease.

Try acupuncture

Apart from being able to calm down inflammation, acupuncture is a way to generally improve function.

In essence, my method is to remove what is harmful and add in that which is beneficial. This means removing as many pro-inflammatory foods and toxins as possible, eliminating foods that cause sensitivities or are common food allergens, while at the same time supporting your system with the appropriate nutrients and modalities for it to function more efficiently.

For about the last 30 or so years, doctors (dermatologists in particular) have repeatedly told us that sun exposure is bad for us and causes cancer. But is that true? In the last few years, numerous studies have shown that modest exposure to sunlight may actually be good for you, helping the body produce the vitamin D it needs for good health and disease prevention. The list of diseases associated with Vit D deficiency is huge and now there is tons of research documenting it. It is not only good for your bones, but for all the organ systems and it protects against most of the common cancers, including skin cancer. Though repeated sunburns–in children and very fair-skinned people–have been linked to melanoma, there is no credible scientific evidence that moderate sun exposure causes it. Since it’s difficult to get adequate amounts of vitamin D from food alone, sun is your best source. I’m not suggesting you go bake in the sun with your suntan oil or go to tanning salons. But getting some sun without getting sunburned makes healthy sense.

The key is balance. Too much sun exposure can cause melanoma and skin aging, while too little creates an inadequate production of vitamin D. The amount needed depends on the season, time of day, where you live, skin pigmentation and other factors. As a general rule, 20-30 minutes a day on your face and arms without sunscreen is adequate.
Please remember that even a mild sunscreen shuts down your body’s production of vitamin D.

We evolved in the sun; we were made to get some sun, not to live our lives indoors and slather on sunscreen every time we go outside. Talk about a free natural treatment! All you need is a little common sense when heading outdoors. That is, do it gradually and always avoid sunburn. If the sun is shining where you are today, get out and enjoy it, and “let the sun shine in!”

Special Note: Remember to take antioxidants when you sit in the sun, as these can help prevent skin cells from sun damage. If you are scared to go in the sun, please make sure you take adequate amounts of Vit D supplements, which is at least 2,000 units for most people.

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.

In this piece, Karen Sinclair gives you all the information you need to keep your skin in good shape through the winter season.

Atmosphere characteristics: cold temperature, freezing wind; dryness produced by indoor heating.

Skin issues: roughness, dryness, tightness, irritation, itchiness, fine lines and wrinkles.

Remedy: shelter, gentle skin care, richer moisturization, antioxidant and EFAs rich diet.

External Measures:

• Always bathe/shower with warm water. Cold water causes further vasoconstriction. Hot water strips your skin’s natural oils more easily.

• Avoid taking long baths/showers. The natural oils of your skin, responsible of keeping the skin lubricious and regulating Trans Epidermal Water Loss, will be stripped.

• Purchase a shower filter. Unfiltered water contains high amounts of chemical compounds such as chlorine and fluoride which alkalize water. Alkaline water severely alters the skin’s pH causing more dryness.

• Bathe/shower with a mildly acidic gel. Soaps are usually very alkaline and will disturb the skin’s pH balance.

• Make sure you rinse soaps and gels thoroughly. Residue can irritate the skin and prevent active ingredients from penetrating.

• Tone after showering/bathing with a mildly acidic solution. An extremely important step as it will restore normal pH and hydrate the skin.

• Exfoliate frequently (2-3 times x week). It will help remove all surface cellular debris and keep your skin soft and smooth.

• Moisturize with a lightweight, ultra-nourishing, mildly acidic lotion. Oils and butters with a heavy molecular weight can’t readily penetrate the skin and will likely clog it. It is important to replace the natural oils that have been stripped after showering/bathing with a good moisturizer as these oils are responsible for holding much of the Vitamin C stored in our bodies. If Vitamin C is allowed to escape, you will be more susceptible to colds and other viruses. Apply moisturizer twice per day, emphasizing face and hands. Use fragrance-free moisturizers; fragrances can sensitize the skin.

• Sunscreen daily (SPF 15 minimum). Even though winter sun is less intense it can burn your skin; remember that snow reflects up to 85% of sun radiation. Reapply every 2 hours.

• Dry brush every day. This is an excellent way of massaging your skin. Dry brushing will not only remove all skin debris but it will also stimulate circulation and help flush toxins through the lymphatic system. Pay special attention to the rough areas: elbows, knees, feet, etc.

• Pamper yourself. Apply once or twice per week a living food facial using
• nourishing fresh ingredients, this will prevent surface build-up and provide deep moisturization.

• Do not forget your neglected areas. Apply to 2-3 layers of moisturizer on the rough areas. Use emollient lip balms liberally and exfoliate your lips at least once per week with a toothbrush soaked in the vegetable oil of your choice (preferably organic). Moisturize your hands whenever you wash them. Smear organic coconut oil on your hands and feet at night and cover them with and cover them with a pair of gloves/mittens and socks, respectively.

• Dress warmly. This will prevent further vasoconstriction and encourage healthy blood flow which, in turn, will keep our skin cells oxygenated.

• Exercise. It increases blood flow to every single organ of your body including the skin.

• Purchase a humidifier. Humidifiers help combat dryness caused by indoor heating.

Internal Measures:

• Drink at least 8 glasses of water per day. Water is the most important nutrient and it also helps transport other nutrients throughout our system.

• EAT more water. The water from fresh fruits and vegetables is more easily absorbed by our cells than drinking water and so are the nutrients they provide.

• Go easy on alcohol and caffeinated beverages. For every glass of alcohol/cup of coffee you drink, have an extra glass of water to avoid possible dehydration.

• Increase your intake of EFAs (Omega-3) rich foods such as: salmon, flax seeds, walnuts, chia seeds, hemp seeds, purslane, scallops, cauliflower, cabbage, cloves, mustard seeds, halibut, shrimp, cod, tuna, tofu, kale, Brussels sprouts, collard greens, spinach, romaine lettuce and winter squash. These foods will keep the skin moisturized from the inside out.

• Supplement if necessary. If the aforementioned foods do not meet your EFAs needs, then by all means take mercury-free fish supplements. For vegetarians/vegans, you can find several algae-derived Omega- 3/DHA supplements in the market.

Seasonal Fresh Ingredients That Keep Winter Blues at Bay (Internally & Externally):

Avocado, Bananas, Chestnuts, Clementines, Cranberries, Grapes, Grapefruits, Kiwi, Kumquat, Oranges, Passion Fruit, Pears, Persimmons, Pomegranates, Pummelo, Radishes, Rhubarb, Squash (Winter), Sweet Potatoes, Tangelo, Tangerine, Ugli Fruit

This general panic about the flu this year raises some important questions about how you can protect yourself and your children- Deciding on vaccination is a complex question. As you know I prefer to approach each child individually and yet public health policy is demanding that we make decisions without regard to personal situations. We are still gathering info on the swine flu- It is spreading very quickly which in NO WAY means it is more deadly than any other flu- its just that there are more numbers! This will naturally increase the numbers of very sick among the not-so-sick. The elderly seem to be at less risk due to ‘herd immunity’ from the 70′s swine flu epidemic. This naturally shifts our focus to children and pregnant women. We have now seen over 200 cases of h1n1 in our practice and so far and they all seem to be very mild, (3-4 days of fever). But it’s still THE FLU! And that must be taken seriously. Most of the information that is being put out on the media is based on hospitalized patients (the sickest cases) and is meant to scare you into following the CDC guidelines without question. Fear does not help make rational decisions. The flu is never something to be taken lightly. Every year 35,000 people die in the US from the flu. If there is any history of underlying respiratory, cardiac or immune disorder then one should consider getting the flu vaccine.

The H1N1 influenza is spreading very fast. Once we reach a critical mass of people exposed to this flu, we as a community will develop what’s called ‘herd immunity’ which means even if we don’t get it we develop some immune protection. This is a fascinating phenomenon that demonstrates the power of the human community. I hope, in light of how quickly it is spreading, that this will happen before the seasonal flu begins.

General Preventive Measures for Flu season

Adults

Maintain a healthy immune system. Many forms of supplements will fortify immunity so that an attack by viruses will be less successful. If you tend to get acute illnesses easily, then begin a program of immune strengthening. A good herbal and antioxidant immune enhancing supplement will help build the strength of your system. These formulas are usually built around the herb Astragalus, a potent herb for augmenting the body’s protective defenses and stabilizing the exterior against invasion by pathogens and physical stresses such as cold and wind. Other supplements have similar immune enhancing properties.

Vitamin D3 is essential for a prevention program. Adults need 5,000 IU when midday sun exposure is not possible, infants need 1,000 IU, and older children need 2,000 IU.

Mushrooms: Several species of mushrooms have significant immune stimulating effects. Each contains high percentages of polysaccharides, long chain sugar molecules that regulate immunity. They activate white blood cells and stimulate complements and antibodies. These mushrooms include reishi (ganoderma), maitake (grifola), shiitake (lentinus), polyporus, and tremella. Many preparations of mushroom combinations in tablet, powder, or liquid extract form are available at major health food stores.

Colostrum is an excellent source of immune system stimulants. Colostrum contains a host of factors that stimulate the immune system and help to prevent illness. Immunoglobulin IgA coats the intestinal lining preventing attack by pathogens. Lactoferrin locks onto iron releasing it to red blood cells and depriving bacteria of the iron they need for reproduction. Lysozyme destroys microorganisms on contact. Cytokines boost T-cell activity and stimulate production of your baby’s own protective immunoglobulins. Polysaccharides bind to bacteria and block their attachment to mucus membranes. Take two capsules twice a day through the winter months.

Vitamin C at 2-4 grams per day prevents inflammation and maintains the body’s vigilance against infection.

Vitamin A is essential to immune function and mucous membrane integrity.

Zinc has potent immune protective effects. Take 25 mg zinc per day, but if you continue zinc for an extended period of time you will also need to take copper to prevent a deficiency (10:1 ratio of copper to zinc). Get a supplement that contains both.

Immune supplements for adults

Mushrooms (reiki, mitake, shiitake)

Colostrum – 4 capsules

Vitamin C – 2-4 grams

Vitamin D – 5,000 IU

Zinc – 25 mg with copper 2 mg

Influenzinum is a specific preventive for the flu. You can begin taking Influenzinum (9C, 12C, or 30C) if you are exposed to the flu. Take one dose each week for four weeks at that time, or you can take it once a week for four doses during the flu season.

The flu, like other respiratory viruses is spread through droplet transmission from human to human. You can minimize your exposure by not shaking hands. Frequent hand washing will also prevent you from inadvertently inoculating viruses into your nose and eyes. Simply avoiding touching your nose, mouth, and eyes during flu season will also help reduce your exposure. Of course, as common courtesy everyone should cover their mouth when they cough or sneeze to prevent transmission of viruses.

Get plenty of sleep, eat well. Eat warm foods during the winter. Soups and stews are excellent sources of concentrated nutrients. Exercise regularly despite the cold weather. Eat plenty of fruits and vegetables for their vitamin and antioxidant content. Stay warm and avoid getting chilled.

Immune System Supplementation for Kids

Children can take a few simple, specific supplements to maintain a strong and vital immune system during the fall and winter months when colds and flus predominate.

Omega-3 fatty acid supplement in the form of fish oil capsules or liquid fish oil will establish healthy cell membranes that prevent inflammation and resist toxins and attack by pathogens.

Vitamin D is essential for kids as well as adults to maintain immune function.

Vitamin E will ensure that fatty acids are maintained at optimum efficiency once they are absorbed into cells. In addition, vitamin E has anti-inflammatory effects and increases resistance to infection. Use only natural vitamin E (d-alpha-tocopherol), not the synthetic form (dl-alpha-tocopherol). A mixed tocopherol form of vitamin E is best because children need the gamma as well as the alpha forms. An appropriate dose is 100 mg for children under two and 200 mg for children aged 2-12.

Vitamin A is needed for proper mucous membrane function. It is essential for the growth and repair of body tissues, and for efficient digestion of protein. Vitamin A promotes good eyesight, strong bones and teeth, and a vital immune system. White blood cells, T -lymphocytes, and every cell in the important mucosal barriers of the respiratory, digestive, and urinary tracts require vitamin A.  A diet containing significant amounts of fruit and fat will help ensure adequate vitamin A intake. Whole milk products, butter, and free range eggs will help maintain necessary levels of this important nutrient. Use organic sources. For those who may not be getting enough vitamin A, a supplement is essential.

The recommended daily amount (RDA) of vitamin A is 1,000-2,000 IU for children, depending on their age (1,000 at one year of age, 2,000 by age nine). Primitive diets probably maintained 10 times that amount. One egg contains 300 IU, one cup of whole milk or whole milk yogurt contains about 225-250 IU of vitamin A. One tablespoon of butter contains 350 IU of A. The amount of vitamin A may vary by the season and the feed of the animals.

Colostrum is great for children as well as adults.

Zinc stimulates immune function, prevents infections, and acts as a cofactor in many enzyme reactions, including the creation of antioxidants. Normal dosage is 10-20 mg. per day. If zinc supplementation is continued over a prolonged period of time, it should be given in conjunction with copper in a ratio of ten to one to prevent copper deficiency.

Vitamin C has anti-inflammatory effects, antioxidant activity, and antibiotic qualities. A daily supplement of vitamin C during the winter months will round out the immune system prevention program. Use 500 mg for children under 3 years old and 1,000 mg for older children.

The easiest way to give supplements to children is through powdered sources mixed in a blender with fruit, fruit juice, yogurt or milk (rice milk for younger children and children with milk sensitivities), and honey (for children over 12 months old). Capsules can be opened and dumped into the blender. Children can chew oil-based supplements in soft gels or you can stick a pin into them and squirt out the contents onto something they will eat.

Immune Supplements for Children-Daily Dosage

* (d-alpha-tocopherol or  mixed tocopherols)

Elderberry syrup and osscillococcinum are extremely helpful as soon as your child gets sick.

Homeopathics considerations during illness:

Osccillococcinum 3 X a day for 2-3 days

Belladonna early then Gelsemium

Bryonia if prefers not moving

Rhus Tox if prefers movement

Eupatorium with myalgia + tender eyeballs