Too little stomach acid often causes heartburn, not too much

Are you one of the 20 percent of Americans with acid reflux and heartburn? You’re probably chalking the problem up to too much stomach acid, but in many cases it’s the opposite causing the problems – too little stomach acid is the culprit behind those fiery episodes that feel like they’re burning a hole in your chest.

How can that be possible?

The environment of the stomach is highly acidic so that it can quickly break down meats and other foods, protect you from poisoning and infection from bacteria, fungi, and other toxins, and help you better absorb minerals. Good stomach acidity also helps ensure smooth function of the rest of the digestive tract and can help relieve not only heartburn but also indigestion, belching, gas, constipation, bloating, yeast overgrowth, food allergies, and other symptoms related to compromised digestion.

Why is stomach acid low?

Various factors can cause insufficient stomach acid. Stress, bacterial infection, poor diet, and nutritional deficiencies can hinder the stomach’s production of hydrochloric acid (HCl), or stomach acid. The most common cause of low stomach acid is infection from H. pylori, a bacteria also linked with stomach ulcers.

Pernicious anemia, hypothyroidism, a deficiency of zinc, B12, magnesium, or chloride can also contribute to the problem. Long-time vegetarians or vegans may be deficient in zinc and B12, as these are found in meats, and may need the support of HCl supplementation when adding meat back into their diet.

How low stomach acid causes heartburn

The stomach contents must be very acidic to trigger the release of food from the stomach into the small intestine. When stomach acid is too low it fails to trigger this release because the contents are not the right acidity to safely enter the small intestine.

As a result, the trapped food shoots back up into the esophagus. Although stomach acid is too low, it is still too acidic for the delicate tissue of the esophagus. This causes that fiery burning and pain of heartburn and acid reflux.

Why antacids and acid blockers can make the problem worse

Antacids or acid blockers bring temporary relief but may cause long-term problems with your overall digestive function. Proper acidity of the stomach triggers the pancreas to secrete digestive enzymes and the gallbladder to secrete bile. Enzymes and bile help ensure proper nutrient absorption, fat emulsification, protection against infections and parasites, and proper functioning of the large intestine.

Chronically low stomach acid hinders the function of these organs, often leading to larger problems throughout the digestive tract.

Correcting low stomach acid

If stomach acid is too low the most important thing to do is address the root cause, whether it is nutritional deficiency, hypothyroidism, or an H. pylori infection. You can also boost stomach acid by taking an HCl supplement. Just be aware that if you have gastric lesions or an autoimmune reaction to the tissue in your stomach, an HCl supplement could make you feel worse.

Ask my office for advice on whether you need supplemental HCl and how to use it safely and for the best results if you have heartburn or acid reflux. We can also help you get to the root cause of your digestive issues.

Nutritional support for getting and staying sober

Headed for the donut tray at the AA meeting? It’s not uncommon for people recovering from alcoholism or other addictions to report a ravenous sweet tooth. Alcohol is essentially fermented sugar and is frequently mixed with something sweet, so the alcoholic goes into recovery with a raging sugar addiction already established. Also, addiction in general spikes blood sugar; going cold turkey can cause drops in blood sugar and symptoms of hypoglycemia. This in turn causes sugar cravings that, in the brain of an alcoholic, feels like a craving for alcohol.

Stable blood sugar vital for sobriety

Fortunately, you can manipulate your brain chemistry to outsmart these cravings and help ease the transition. The key is to keep your blood sugar stable.

When blood sugar drops too low symptoms may include:

• loss of appetite or nausea
• irritability
• feeling spacy and lightheaded
• shaky, jittery, tremulous
• agitated and nervous
• depressed
• easily upset
• poor memory, forgetfulness
• poor decision making
• blurred vision
• feeling like you’re going to black out when you stand up
• sugar cravings

These symptoms happen because the brain is deprived of energy. It’s important to eat before these symptoms occur because low blood sugar triggers a cascade of consequences that can feed your addiction.

To keep your blood sugar stable do the following:

Eat small amounts of food frequently. Make sure these small meals are based around protein, fat, and plant fiber – not high-carb foods that will cause blood sugar to spike and plummet. Some people may need to nibble on something every hour, others can go every two to three hours. Protein for breakfast is paramount, and you may need to eat a little before bed to avoid waking at 3 or 4 a.m. Monitor your moods and energy and see what works best for you.

Avoid sugars, sodas, and high-carb foods. Sugars, desserts, sodas, coffee drinks, fruit juice, white rice, pasta, bread, pastries, etc. will crater your blood sugar, feed the addiction, and make your journey harder than it needs to be. It’s true that high-carb foods provide comfort, but only while sticking a knife in your back. Also, as far as the brain is concerned, they are just another drug.

Avoid food intolerances. Many people today are sensitive to gluten, dairy, eggs, certain grains, soy, or other foods. Eating foods to which you are sensitive creates surges of inflammation and blood sugar that feed cravings. A comprehensive food sensitivity panel or the elimination diet can help you figure out which foods may be sabotaging your chances at success.

Repair leaky gut. Alcohol damages the lining of the small intestine creating leaky gut -- large particles of undigested foods, bacteria, and other pathogens escape through the damaged gut wall into the bloodstream. However, essential nutrients, which are smaller, cannot pass through mucous built up around inflamed gut tissue. Kicking alcohol and stabilizing blood sugar will go a long way to repairing leaky gut, but you can speed the journey with certain nutritional compounds. Repairing leaky gut will lower inflammation, enhance nutrient absorption, and boost your overall energy and well being.

Don’t become a coffee junkie. Coffee spikes blood sugar and will keep you on the roller coaster of emotional and energetic highs and lows. Restrict your consumption.

Support brain chemistry while getting sober

Addictions of any kind skew the balance of brain chemicals called neurotransmitters. While the right diet will help balance brain chemistry, you may need specific support to foster sobriety. You can do this by taking supplements called amino acids. Certain herbs, vitamins, and minerals also help. B vitamins are especially important.

When working with neurotransmitter support, it’s important to get qualified guidance so you don’t accidentally make yourself feel worse.

Neurotransmitters to be aware of when dealing with addiction include:

Dopamine. Dopamine is the “pleasure” neurotransmitter associated with addiction. Supporting dopamine may help curb the cravings. Nutrients that boost dopamine include mucuna pruriens, D, L-phenylalanine, N-acetyl L-tyrosine, and blueberry extract.

Serotonin. Serotonin helps prevent depressive moods and is supported by St. John’s Wort, SAMe, 5-HTP, and L-tryptophan.

GABA. GABA is a calming neurotransmitter that soothes anxiety and nervousness. Ingredients that promote GABA include L-taurine, valerian root, passion flower extract, L-theanine, and glycine.

A well-rounded approach to sobriety

These are just a few ideas to support addiction recovery. Of course, family history, childhood experiences, subconscious belief systems, and other factors are important, too. However, by understanding how addiction works on the body and the brain, you can boost your chances of success with the right support. The sooner you feel great the sooner you can make peace with lifelong sobriety. Ask my office for advice.

Defend yourself with antioxidants and glutathione

You’ve probably seen antioxidant labels on foods and supplements, but what does it mean exactly and what is the best antioxidant to choose? Antioxidant means it prevents oxidation, a process that happens to all cells in nature, including those in the human body. Oxidation happens when oxygen interacts with cells and it’s what makes an apple turn brown, metal rust, or food go rotten. In the body oxidation is a normal part of cell turnover. However, a small minority of oxidized cells become problematic “free radicals” that set off a chain reaction of damage, causing cells to mutate and behave abnormally. Free radicals reach us through pesticides, air pollution, cigarette smoke, excess alcohol, sunburn, junk foods, etc.

The defense? Antioxidants. And our most powerful antioxidant is one the body makes called glutathione. To stay a step ahead of modern civilization we need to avoid free radicals as much as possible, eat an antioxidant-rich diet, and make sure our body is sufficient in glutathione.

The best source of antioxidants in the diet are colorful fresh fruits and vegetables. Since different plants contain different types of antioxidants, it’s important to eat a wide variety. Many supplements are also geared toward shoring up your body’s antioxidant supply.

Glutathione: The master antioxidant

Glutathione is such a powerful antioxidant it is called the master antioxidant. Glutathione protects cells from free radicals, is important for detoxification, and supports immune health. Many people with autoimmune conditions find plenty of glutathione is necessary to prevent or dampen autoimmune flares.

• Low glutathione raises your risk for:
• Autoimmune disease and autoimmune flares
• Chemical sensitivities
• Heavy metal sensitivities
• Inflammatory disorders
• Intestinal permeability (leaky gut)
• Other immune issues

Stress lowers glutathione levels

When we are healthy, when life is mellow, and when we eat a whole foods organic diet and avoid the use of toxic products, our bodies make sufficient glutathione. However, chronic stress depletes glutathione levels. This stress can come from toxins, poor diet, lack of sleep, smoking, excess sugar, and other stressors. Glutathione levels also decrease naturally as a result of aging.

Straight glutathione is not effective taken orally. Good deliveries of glutathione include a liposomal cream, nebulizer, suppository, or IV drip. However, S-acetyl glutathione is a newer form of glutathione that can be quite effective in helping to manage autoimmune disease when taken orally.

Glutathione recycling raises glutathione inside the cells

You can also raise glutathione levels inside the cells by taking certain precursor nutrients. This will help protect the cells’ mitochondria, which produce energy. Recycling glutathione means taking glutathione that has already been used and rebuilding it so it’s ready for action again. Good glutathione recycling will help you better manage an autoimmune disease and leaky gut.

The compounds that have been shown to support glutathione recycling include:

• N-acetyl-cysteine
• Alpha-lipoic acid
• L-glutamine
• Selenium
• Cordyceps
• Gotu kola
• Milk thistle

Boosting your antioxidant status and glutathione levels can play a profound role in managing autoimmune disease, inflammation, chemical sensitivities, food sensitivities, etc.

To learn more about how to increase your antioxidant and glutathione support, contact my office for advice.

Natural pain relief for grief and heartbreak

When someone breaks your heart, a loved one dies, or tragedy of another nature hits you, people often report the grief feels like a physical pain. That’s because your brain reacts to heartbreak or grief the way it would to an injury. Knowing this can help us put some natural pain-relieving strategies to work when grief is threatening to pull us under. I can’t promise a way out -- it seems the most enduring medicine for emotional pain is still the passage of time and the support of others, but some functional medicine approaches might make each day a smidgeon more bearable.

Broken heart syndrome can damage the heart

Some cases of heartbreak and grief are so extreme they actually damage the heart. This is called broken heart syndrome (the more technical term is stress cardiomyopathy) and can also be caused by extreme fear, anxiety, or surprise.

Broken heart syndrome causes the adrenal glands to send a surge of stress hormones to the heart, which essentially paralyzes it and shuts it down. This is different than a heart attack, which is caused by a blockage. Most people recover with no damage, however, in severe cases it can cause heart failure. (Broken heart syndrome most often occurs in women over 55 and researchers suspect low estrogen, on which the heart is dependent for good function, is a factor.)

Natural pain relief strategies for emotional pain and heartbreak

Because physical and emotional pain are processed by the same area of the brain, pain relief remedies might offer relief. In one study, subjects who experienced social rejection and who received acetaminophen every day for three weeks reported fewer hurt feelings than the group who received the placebo. Brain scans also showed less activation in the parts of the brain that processed pain. Of course, taking pain relievers long term, whether over-the-counter or pharmaceutical, is not a safe or healthy option. It also won’t address important emotional issues that need to be acknowledged and expressed.

However, there are a few natural options you can explore to soften the blow of emotional pain on the physical body:

Reduce inflammation: Grief, heartbreak, loss, etc. all raise stress hormones and can trigger inflammation. Try and avoid the tendency to fall back on comfort foods that are also inflammatory –- sugars, processed foods, sodas, desserts, and junk food. Not only are they inflammatory but they also will cause your blood sugar to plummet, which will only intensify your grief or heartache. Even if you don’t feel like eating, keep blood sugar stable and inflammation low with plenty of vegetables and enough high quality protein and fat to prevent those plunges into despair.

Natural pain and stress relief: Natural compounds that can act on pain and inflammation are therapeutic doses of emulsified resveratrol and curcumin, plenty of vitamin D, and a good quality fish oil and other essential fatty acids. White willow bark is an herb that has long been used for pain relief. Herbal adrenal adaptogens can also help buffer your body from the effects of stress.

Be extra gentle on your body: Remember, as far as your body is concerned, you are wounded. This means you need to heal and recover. Now is not a good time to work extra hours, drink too much, over exercise, or engage in other forms of avoidance activities that will only prolong your suffering while abusing your body. As the ancient poet Rumi said, “The only cure for pain is the pain.” In other words, you must work your way through your grief while taking care of yourself in order to emerge intact.

In functional medicine we don’t just work with physical problems. If grief or heartache has you suffering, contact my office for guidance on how we can support your body and mind through your grieving process.

Why getting high on life is good for your immune system

We all like things that make us high on life — that feel-good rush after exercising, a good belly laugh, playful activities with friends, meditation, a good massage, or a loved one’s touch. These are examples of things that release endorphins, the body’s chemicals that give us a natural high. But endorphins do more that make us feel good; endorphins are necessary for proper immune function. In fact, some studies suggest people with chronic illness suffer from low endorphins. If you have an autoimmune disease, chronic pain, or chronic illness, boosting your endorphins could help you better manage your health.

We are an endorphin-deprived society, what with our emphasis on being busy. Not only does this result in less happiness, but it also predisposes the immune system to malfunction so that one is more apt to develop chronic pain or illness.

Most immune cells have receptors for endorphins and need endorphins to function properly. Studies suggest low endorphins play a role in autoimmunity, when the immune system erroneously attacks and destroys tissue in the body, such as the thyroid gland (Hashimoto’s hypothyroidism), the pancreas (Type 1 diabetes), or the nervous system (multiple sclerosis).

Although many factors are linked with autoimmunity, including environmental toxins and poor diet, endorphins are not to be overlooked. Some research shows people with chronic illness have low endorphins. Low endorphin production is caused by alcohol fetal exposure, alcoholism, drug abuse, anxiety, depression, and chronic psychological stress, factors that can tip the immune system out of balance.

One way to help manage your autoimmune condition, chronic illness, or chronic pain is to work to boost the production of endorphins. Here are some endorphin-boosting tips:

• Strenuous exercise (the intensity varies from person to person; be careful not to over exercise as that will cause inflammation)
• Acupuncture or massage therapy
• Sex
• Meditation
• Laughter
• Healthy socialization
• Play
• Low-dose naltrexone therapy (this is a therapy using low doses of the opiate-blocking drug naltrexone to stimulate the body’s own production of endorphins)

Managing autoimmunity and chronic illness is a multi-faceted approach

Endorphins are but one factor to consider when managing autoimmune disease or another chronic condition. Other things to consider include gluten sensitivity, food intolerances, chemical intolerances, quality of diet, leaky gut, inflammation, nutritional status, brain health, and more.

For more information about managing your autoimmune or chronic condition, contact my office.

8 Healthy Habits to Better Manage Adrenal Fatigue

Do you always feel tired in the afternoon, wake up groggy, or feel flattened by exercise? You might suffer from a common condition called adrenal fatigue, in which the body can’t respond properly to life’s stresses. Some other signs and symptoms of adrenal fatigue include:

• Overwhelming fatigue
• Insomnia, especially between 2 and 4 a.m.
• The afternoon ‘blahs’
• Cravings for salt, sugar or stimulants, especially in the afternoon
• Lightheadedness upon standing
• Chronic low blood pressure
• Irritability and jitters when hungry

Thankfully, certain lifestyle habits are highly effective in helping restore your energy and healthy adrenal function.

8 lifestyle habits to manage adrenal fatigue

Below are eight lifestyle habits that can go a long way in supporting adrenal health.

1. Sleep. Regular, plentiful sleep is one of the best supporters of adrenal health. Even if you experience midnight insomnia or trouble falling asleep, it’s possible to create better sleep by sticking to these good habits:

• Go to bed at the same time every night, no later than 10 p.m.
• Try to get 9–11 hours of sleep every night; do it on weekends if it’s not possible on weekdays.
• Avoid computer, TV, and phone screens for the hour before bed; this allows the brain waves to shift gears in preparation for sleep. (If that’s impossible wear orange glasses that block the blue lights these screens emits. Blue light suppresses sleep hormones and can cause insomnia and a disrupted sleep cycle.)
• Eat a small snack just before bed that is strong in protein and healthy fat and low in carbs.
• Avoid sugar, stimulants, and high-carb foods before bed.

2. Relaxation Exercises. Think relaxation exercises are ineffective? Think again! Create at least ten minutes of quiet, stress-relieving activity for yourself every day, such as lying with your feet up, meditating, or breathing slowly. In addition, when you feel tired, respect the message your body is trying to send, and lay down for a few minutes.

3. Avoid junk food and excess sugar. Whether donuts or fruit, junk foods and excess sugar put the adrenal glands in overdrive, effectively sending them into energetic bankruptcy.

4. Avoid caffeine and other stimulants. Yes, that means coffee. Stimulants are one of your adrenals’ worst enemies! Like sugars, they drive the adrenals to work too hard, driving you into deeper exhaustion.

5. Gentle exercise only. With adrenal fatigue, prolonged, rigorous exercise will only drive you deeper into exhaustion. Try gentle exercise such as walking, yoga, or swimming. No matter what, avoid prolonged aerobic exercise. Caution: If you are exhausted after your workout, you overdid it.

6. Eat a breakfast strong in protein and fat, with no sugar or stimulants. Adrenal function, blood sugar, and energy levels are closely related. Eating a breakfast strong in protein and fat while avoiding sugars and stimulants allows the adrenals to get a strong start and remain steadier throughout the day. This can help you avoid the afternoon blahs and sleep better, too!

7. Take the stress out. Take a close look at what causes you stress, whether complaining friends, nagging bosses, or a crazy schedule. What stressors can you eliminate or minimize? Reducing stress is a huge factor in adrenal healing.

8. Avoid sugars and stimulants when you’re tired. When you hit the afternoon blahs, the first thing you might think of is a frothy cappuccino. However, that only serves to further bankrupt your adrenals. Instead, nourish your body with protein, healthy fats, and minimal carbs to support healthy blood sugar and brain function, which is what you really need to kick the blahs. Be prepared by having a healthy snack ready to go for the afternoon.

The bigger picture

Adrenal fatigue typically happens secondary to another issue, such as anemia, poor diet, hormone imbalance, autoimmune disease, inflammation, or micronutrient deficiencies. It’s important to determine the cause of your adrenal fatigue and include these lifestyle habits as part of your adrenal treatment plan –- with them, you will move much faster toward optimum health and energy.

Pain meds linked to hearing loss; get to the root cause instead

When the body hurts, people reach for over-the-counter (OTC) painkillers to ease their suffering; they are the most frequently used medications in the United States. Although they offer easy-access pain relief, they have been linked to hearing loss and you may want to be careful about using them on a regular basis.

A Harvard-affiliated study published in the American Journal of Epidemiology suggests that frequent use of the painkillers ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) may contribute to hearing loss. The study tracked more than 60,000 women during 14 years and found a 13 percent increased risk of hearing loss in those who took pain relievers two to three days per week, while the risk increased to up to 24 percent in those using it six to seven days per week. The findings are similar to another study that found aspirin to be a risk factor for hearing loss in men.

Why do these medications affect hearing loss? Researchers say ibuprofen can reduce blood flow to the cochlea, the auditory portion of the inner ear, which could result in cellular damage and cell death. Also, acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage.

Does this mean you should avoid OTC painkillers such as Advil and Tylenol? Although they can offer effective pain relief for many people, the study’s author says their use should be limited as much as possible and that people should instead explore alternatives.

Rooting out the Problem

If your chronic pain compels you to take painkillers on a regular basis, consider bypassing the conventional band aid approach of simply treating symptoms and look for the root cause of the problem.

Conventional pain management relies on pharmacological applications such as nonsteroidal anti-inflammatory drugs (NSAIDS), narcotics, and antidepressant pain modifiers, yet these approaches can build dependencies –- and potential hearing loss. While they relieve symptoms, they are a temporary fix for a chronic problem.

Alternatively, functional medicine addresses the root cause of pain, taking into account genetic, medical, environmental, and lifestyle factors that contribute to chronic pain and the inflammation associated with it. This offers a sustainable solution by getting to the root of the problem.

A Personal Plan That’s an Alternative to Chronic Pain

Depending on your unique needs, your pain management plan may involve the following changes, all of which can have a profound effect on chronic pain and inflammation:

• Herbal and nutritional compounds
• Therapeutic body work
• Meditation
• Breathing techniques
• Dietary changes
• Exercise adjustments
• Strategies to improve sleep quality
• Stress management

The Takeaway: Take the Pain Away!

While OTC pain meds offer instant relief, they ignore the root of the problem, pose unnecessary risks, and only offer temporary relief. However, a pain management program that addresses the underlying cause of pain can offer a long-lasting, healthy, and sustainable way to free yourself from pain.

Nobody likes to live with chronic pain, whether it’s a mild headache or debilitating back aches. I am trained to look at the contributing factors behind your pain and to create a personalized pain management. Don’t wait another day to get to the root of the problem!

Gut bacteria linked to autism

The digestive tract is home to more than 100 trillion microorganisms. That’s ten times the number of cells in the human body! Although humans can survive without these tiny guests, they perform a host of useful functions, such as fermenting unused food, preventing growth of harmful bacteria, producing vitamins, and training the immune system. But did you know the bacteria in your gut can affect your brain, too? In fact, recent research on the gut has found some interesting links between the gut microbiome -- the complex and unique microbiological community within the gut –- and autistic behavior in children.

As parents well know, children with autism have a high rate of problems with gastrointestinal (GI) disorders. The resulting discomfort can worsen behaviors and interfere with their ability to participate in, and benefit from, activities of daily life, education, and therapeutic activities.

On a related note, it has been known for some time that children with autism tend to have abnormal and less diverse communities of gut bacteria than children without autism. Recent research on children with autism has revealed these interesting facts:

• Their intestinal cells show abnormalities in how they break down and transport carbohydrates, which can affect the amount and type of nutrients these cells provide to intestinal bacteria. This in turn may alter the makeup of the intestine’s normal community of digestive bacteria -- with ill result.
• Their intestines are home to abnormal amounts of certain digestive bacteria that contribute to digestive problems, intestinal inflammation, and more severe autism symptoms.
• There are lower levels of three important gut bacteria; Prevotella, Coprococcus, and Veillonellaceae.

Theory has it that the community of bacteria in the gut affects the immune system, which then sends messages to the brain. This may explain why parents of children with autism report that special diets and probiotics (nutritional supplements containing “good” bacteria) improve their children’s digestion as well as their behavior.

The Gut-to-Brain Connection

The most recent research on the connection between the gut and autism explores how the gut microbiome affects the autistic brain. Researchers at Arizona State University found that concentrations of metabolites (byproducts) from seven specific bacteria are more prevalent in autistic children’s fecal samples. According to study author Dae-Wook Kang, "Most of the seven metabolites could play a role in the brain … We suspect that gut microbes may … affect gut-to-brain communication and/or alter brain function."

Of the seven metabolites that were noticed, three warrant special note for their apparent relation to brain function, thereby behavior:

• Homovanillate was present at lower levels in children with autism; it is normally produced when dopamine (an important brain neurotransmitter involved in many aspects of mood and behavior) is broken down.
• N,N-dimethylglycine was found at lower levels; it has been used before to decrease autism symptoms.
• The ratio of glutamine to glutamate was higher: these are metabolized into GABA, a vital inhibitory neurotransmitter associated with relaxation. An imbalance between glutamate and GABA transmission has been associated with autistic-spectrum type behaviors such as hyper-excitation.

These connections offer insight into possible link between the gut biome and the behaviors seen in autistic children. Researchers say they would like to conduct a clinical study using fecal transplants from healthy donors to see if normalizing an individual’s community of gut bacteria would reduce autism symptoms.

Although the study was small, it adds to the growing body of research that tells us the gut is closely tied to the brain.

Does gluten sensitivity exist? Debunking the recent headlines

 

Recent health headlines proclaimed gluten sensitivity doesn’t exist, fueling a backlash against the gluten-free diet as a baseless fad. These stories point to a recent study questioning the relationship between non-celiac gluten sensitivity and digestive symptoms. Sadly, they mislead the public by glossing over major points of research and cherry-picking information to debunk gluten sensitivity.

The study looked at how people with gluten sensitivity reacted to varying levels of gluten. Significant to the study was the elimination of FODMAPS (Fermentable Oligo-, Di-, and Monosaccharides, and Polyols), carbohydrates in many common foods known to exacerbate irritable bowel syndrome (IBS) symptoms. Foods high in FODMAPS include garlic, onion, beans, many fruits, yogurt, and more. Researchers removed FODMAPS to rule them out as a source of digestive symptoms, clearing the slate to determine whether gluten was to blame.

Study’s view is too narrow

The study concluded gluten had no effect on patients with gluten sensitivity who were placed on a low FODMAP diet, causing journalists to declare gluten sensitivity doesn’t exist. However, the paper doesn’t actually suggest that. Instead, the authors give nod to other factors that may have affected their results, such as the possibility that FODMAPS and gluten might work together to cause gastrointestinal symptoms. They acknowledged the results were markedly different from a previous study, and point out the need for further exploration on the topic.

Gluten sensitivity does not cause digestive symptoms in most people -- affects other parts of the body

More importantly, the study did not look at symptoms outside of the digestive tract. Other research shows gluten causes digestive symptoms in only about one third of those with gluten sensitivity. In fact, gluten sensitivity destroys the brain and nervous tissue more than any other tissues in the body, and symptoms can be ambiguous for years and difficult to connect with gluten. Symptoms of a gluten sensitivity can also manifest in the skin, joints, bones and teeth; gluten has been associated with more than 55 diseases so far, most of them autoimmune.

While this recent study looks at digestive symptoms in response to gluten, it does not consider other symptoms commonly associated with gluten sensitivity, such as depression (research here), muscle pains, inflammation, neurological issues  and changes in mental function.

The study also does not consider other important facets of gluten sensitivity, such as gluten cross-reactivity seen with autoimmunity (when the immune system mistakenly attacks body tissue, such as the thyroid gland or the brain, because it so closely resembles the gluten protein), leaky gut, other foods that cross-react with gluten and cause gluten sensitivity symptoms (such as dairy), and more. These other factors need to be incorporated into a more comprehensive understanding of gluten.

So does gluten sensitivity exist?

Although there is no verified biomarker for non-celiac gluten sensitivity, researchers at the Center for Celiac Research and Treatment say they are close to determining one. Also, this recent study is but one of many in the field of gluten research and other research shows very clear evidence of gluten sensitivity.

Should you abandon your gluten-free diet?

While this new study asks valuable questions, does it mean non-celiacs who experience symptoms from gluten continue eating? Of course not! While this study raises new questions in relation to FODMAPS, millions of people with gluten sensitivity worldwide experience relief from their symptoms and progression of chronic disease on a gluten-free diet. Functional medicine practitioners have especially seen the beneficial effect of a gluten-free diet on myriad conditions.

The body always knows best. When we learn to listen to the body, the wisdom it shares leads us to make solid choices for greater health and wellness.

Coffee enemas for detox, liver support, and glutathione boost

When most people hear the term “coffee enema” they think, “Oh, gross!” But before you click the back button, consider the following; coffee enemas have been known to:

• greatly relieve chronic pain
• help boost energy levels
• relieve depression
• improve mental clarity and sluggishness
• ease die-off symptoms during cleanse regimens
• aid elimination of parasites and sludgy buildup from years of slow intestinal action 
• help improve digestion

Enemas have been a regular part of medical treatment around the world since at least 1500 BC. Coffee enemas are believed to have been created in the 1920s; in fact, they were listed as a standard of care in the Merck Manual until 1977, when they were removed due to lack of room. Coffee enemas are an integral part of the renowned Gerson cancer therapy, and the National Institutes of Health recently allocated $1.4 million for research on the use of coffee enemas and dietary therapy for treating pancreatic cancer.

Why Do Coffee Enemas?

The modern environment is hard on our bodies. We cope with environmental toxins in our air, water, food, and the many products we use each day. It’s simply impossible to avoid all toxins. The liver is one of the main organs in charge of detoxification, metabolizing many toxins and escorting them via bile to the gallbladder, where they are then sent to the colon for removal. The catch: bile is reused up to ten times. In the past when our environment was cleaner, this recycling system worked fine. Today, however, the toxic burden is so great that it may overwhelm this system, increasing the body’s toxic load and hence the risk for disease.

The Most Powerful Benefit of the Coffee Enema: Detoxification!

In addition to the long list of benefits above, coffee enemas are known to be a powerful tool for detoxification:

• Liver Detoxification: The caffeine in coffee dilates the liver’s bile ducts, facilitating elimination of toxins trapped in the liver.
• Blood Purification: The lower colon is designed to re-absorb liquids from waste. Here, two palmitic acids in coffee -- kahweol and cafestol palmitate -- are absorbed into the portal vein system, which leads directly to your liver. These palmitic acids boost one of the body’s most powerful detoxifier, the glutathione s-transferase (GST) enzyme system, by up to 700 percent! GST captures and metabolizes toxins and binds them with reduced glutathione (the body’s master antioxidant) in the liver and escorts them out of the body via the colon. All of your blood passes through the liver every three minutes. Because a coffee enema is typically held for 15 minutes, it facilitates the elimination of toxins, purifies the blood, and prevents the reabsorption and recycling of toxic bile. Who wouldn’t want that?
• Improves Tone and Motility of the Colon: It is believed the theophylline compound in coffee causes blood vessels in the colon to dilate, enhancing blood flow and improving muscle tone and motility. In addition, the enemas help neutralize common toxins in liver and intestinal tissue, supporting repair and regeneration and improving function.

I Don’t Drink Coffee … Will I Get A Coffee Buzz?

Only the palmitic acid and other valuable compounds are carried to the liver from a coffee enema. The coffee itself remains in the lower colon until it is eliminated. A coffee enema engages different metabolic pathways than drinking it. Most people who don’t tolerate coffee have no problem with coffee enemas, and, in fact, many say they produce a calm, clear mind. People who are very fragile or sensitive may want to start with a very diluted coffee solution in case the detox overstimulates their system.

Cautions and Tips

Potential risks can be averted with common sense and attention:

• No hot coffee: The rectum has no nerves after ¾ inch, so each time you prepare an enema, make sure to dip your entire hand into the water for a full 5 seconds to test the temperature. The water should be warm, not hot.
• Physical damage to the rectum: The tissues in the rectum are delicate. Use a rounded enema tip, move slowly, and use plenty of lubricant. Only insert the tip as far as your little finger’s length, or less.
• Consider minerals: When doing coffee enemas regularly, you are not recycling bile salts (minerals) as much as before. Increase mineral rich foods and consider mineral supplements.
• Choose organic coffee: Many countries still grow coffee using chemicals banned in the U.S.. Additionally, instant coffee can be contaminated with gluten. Use organic coffee only. Look for coffees that have higher levels of the beneficial active compounds.
• Use a non-toxic setup: Use a metal bucket or silicone bag and silicone tubing. The acidity of coffee can leach toxins from a rubber or plastic enema bag or tubing. Seeking Health offers non-toxic stainless steel and silicone enema kits.

Okay, So How Do I Do This?

Ask my office for detailed directions on how to perform a coffee enema. Some guidance will help make the experience less awkward and more successful. And who knows? You may find yourself becoming an advocate of this time-tested health remedy.

Hidden gluten in medications and home and body products

So you’re officially gluten-free. You have your kitchen and shopping lists dialed in and you know how to look for hidden gluten in packaged foods. Ready to go! But wait -- did you know that some body products and household items, as well as over-the-counter (OTC) and prescription medications contain hidden gluten? These items can be the source for ongoing immune activation for those with celiac disease and non-celiac gluten sensitivity. Additionally, many people with autoimmune conditions experience cross-reactions with corn, a filler used in many medications that the body can mistake for gluten.

Keeping Gluten Out Of Medications and Supplements

Most medications and many supplements contain fillers or excipients that perform several functions: they provide bulk, lubricate ingredients, or help the tablet disintegrate in the gut. Many of these ingredients are sourced from wheat, barley, or corn. Cross-contamination in the factory can also be an issue.

The FDA monitors active ingredients closely; excipients, however, are only required to be an FDA-approved substance. We assume brand name and generic drugs will be the same, but in fact, generic drug fillers may be different than the brand name version. This means you need to read the label to determine GF status. In addition, manufacturers change the inactive ingredients in products regularly, so a periodic check of ingredients is necessary on all products. Tip: keep an eye out for labeling changes that include “New and improved,” “New formulation,” “New product appearance,” or “New manufacturer.”

Apparently, some diabetes medications contain gluten; while a diabetic may not be sensitive to gluten in the same way as someone with celiac disease, gluten has been shown to cross-react with pancreatic islet cells (in the case of Type 1 diabetes). Some thyroid meds also have gluten or corn fillers, which cause immune cross-reactions for patients.

Below are some commonly used excipients and their sources:

• Pre-gelatinized starch (corn, wheat, potato, tapioca)
• Sodium starch glycolate (commonly potato, but has other starch sources) (Any product containing pre-gelatinized starch and sodium starch glycolate are to be avoided if not specifically labeled GF)
• Be on the lookout for any starches; they are primarily derived from corn, potato, and tapioca, however they have been known to contain starch from wheat
• Maltodextrin (corn, wheat, potato, rice)
• Dextri-maltose (barley malt)
• Dextrins (primarily corn and potato, but can come from wheat, rice, tapioca)
• Dextrans (sugar)
• Dextrose (corn starch)
• Dextrate (starch -- source not listed)
• Maltodextrin (corn, wheat, potato, rice)
• Sodium starch glycolate (commonly potato; can come from any starch source)

Useful Tips for Avoiding Hidden Gluten In Medications

1. Read those ingredient labels! Become familiar with gluten/corn-based fillers. Keep an eye out for key labeling terms that indicate the need for deeper inspection!

2. If uncertain, ask your pharmacist. Although drug experts, pharmacists may not know the source for an ingredient and may need to call the producer to ask.

3. Call the drug company yourself. Ask your pharmacist for the number or find it online.

4. Ask ahead about hospital medications; some inpatient meds for surgery, radiology and other procedures contain gluten. Explain the potential risks to your health and demand verification.

5. Remind your doctor that you will be checking into the GF status of your medications and ask for first- and second-choice medications. This can save you time and help avoid problematic gaps in medication.

6. When generic medication is available your insurance company may not approve brand name labels. If you need to go with the brand name for health reasons, call your insurance company and ask how to obtain approval for the more expensive medication.

7. If you require an unusual medication that does not offer a GF option, find a compounding pharmacy that will make a custom GF medication for you.

8. Remember to periodically re-confirm the GF status of your medications and supplements.

What About the Rest of the House?

Manufacturers often use gluten or wheat flour to aid the manufacturing process for non-food items, such as fillers, lubricants or absorbents, and gluten-based ingredients are common in certain body products. While gluten is not absorbed through the skin, it is possible to transfer traces from your hands or face to your mouth, where it can be swallowed and cause a reaction. Children are prone to putting fingers and items they touch in their mouths, so monitor them closely if they have a gluten sensitivity.

Below are some common body and household items that can have hidden gluten. Look for a GF label, and if you see an unfamiliar ingredient, don’t hesitate to call the company and ask about its source:

• Lip stick and lip balm
• Sunscreen
• Children's stickers
• Price tag stickers
• Stamps and envelopes
• Cough syrup
• Shampoo
• Toothpaste
• Lotions
• Soaps
• Mouthwash
• Cosmetics 
• Play dough
• Laundry detergent
• Pet food

As you can see, gluten can lurk in plenty of places past the dinner plate, potentially throwing a wrench in your gluten-free lifestyle. If you are gluten-free yet still experience gluten-related symptoms, it is worth checking the labels on all medications, supplements, and household and body products for ingredients that contain gluten. With good label-reading habits and an eye for hidden gluten, you can create a safe and healthy gluten-free environment for you and your family.

How to avoid hidden sources of gluten

Congratulations, you’ve gone gluten free to improve your health! Perhaps you have celiac disease, or non-celiac gluten sensitivity, both of which require avoidance of gluten for optimal health. You know to avoid wheat, barley, rye, triticale, einkorn, farro, kamut, spelt, farina, emmer, durum, and semolina, plus most oats because they are commonly cross-contaminated with gluten grains in the field or factory. That pretty much sums it up, right?

Well, not quite. Gluten can actually reside as a hidden component in many common food ingredients, which can make food shopping, restaurants, travel, and potlucks a risky business. In this article, we’ll offer some guidelines for successfully navigating this tricky terrain.

Navigating Food Labels

Manufacturers are not presently required to identify gluten as an ingredient on labels. Just because a product doesn’t list a gluten grain, doesn’t mean it’s gluten-free.

Your greatest tool in determining what is safe to eat is to read food labels, and become familiar with stealthy ingredients that may include gluten. Have you ever seen an ingredient that you can’t identify? If so, it’s best to avoid it. Here is a (non-exhaustive) list of some common ingredients that can contain gluten:

• Malt, and barley malt
• Food starch and modified starch
• Dextrin and maltodextrin -- sourced from corn or wheat
• HPP = Hydrolyzed Plant Protein
• HVP = Hydrolyzed Vegetable Protein
• TVP = Texturized Vegetable Protein
• “Natural flavor”
• “Spices”
• “Artificial flavor”
• Brewer’s yeast
• Gelatinized and pregelatinized starch
• Brown rice syrup

Pre-packaged foods can add a challenge as well. Below are some common foods that may have gluten in them. Look for a certified GF label if you aren’t sure; otherwise, pass it up.

• Soy sauce (a good replacement is coconut aminos, or wheat-free tamari -- 100% soy)
• Many salad dressings use gluten thickener
• Gravies, sauces, marinades
• Fish sauce (common in Thai restaurants)
• Canned and boxed soups
• Soup mix
• Bouillon
• Licorice candy
• Instant coffee
• Coffee substitutes
• Condiments
• Puddings and pie fillings
• Processed meats (gluten is used as a binder in cold cuts, hot dogs, sausages, and some specialty/reformed meats)
• Many reduced-fat and ready-made foods have binder starches sourced from wheat
• Ice cream –- look out for added gluten (cookie dough, anyone?) and beware of scoop cross - contamination where ice cream is served
• Mashed potatoes
• Imitation crab
• Some wasabi
• Vegan meat substitutes
• Chips (factory cross-contamination)
• Beer
• White sauce (made from a wheat flour roux)
• Worcestershire
• Communion wafer (ask your church about bringing your own GF version)
• All Chinese condiments contain wheat, including soy, oyster, hoisin, and bean sauces
• Some spice companies use glutenous fillers; use only pure, high-quality herbs and spices with no fillers

The Restaurant Dilemma

Restaurants can pose their own challenges. Here are some things to look out for:

• Fried food; those delectable fries may have been cooked in the same oil that fried the onion rings doused in wheat batter
• Vegetables may have been par-boiled in the pasta water
• At Asian restaurants, you may ask for GF but the busy chef may not be looking at the ingredients on the hoisin or fish sauce; ask for no sauce if uncertain.
• GF foods may be prepared on the same surfaces or with the same utensils that glutenous foods touch.

If you are uncertain at a restaurant, talk to the chef directly. If you aren’t happy with the answer, don’t eat there. Many restaurants are becoming aware of the need for truly GF foods, but it’s always good to make sure they are careful about food prep. Ask friends, and ask local online GF groups about recommended eateries.

Gluten Free Shopping: When In Doubt, Go Without!

When you are new to eating GF, restaurants and grocery shopping can be daunting, but the more you do it, the better you’ll get at determining what goes in your belly. If you aren’t sure, don’t eat it. Ask questions, read ingredient labels; just because those noodles say, “Rice” on the front, that doesn’t mean they don’t have a gluten grain added in. “Wheat-free” doesn’t necessarily mean gluten free. Lastly, always check product labels for warnings that state a food is produced in a factory that also makes gluten-based products; if it is, cross-contamination could be an issue.

The more you do it, the more natural it becomes, and soon you will be navigating your gluten-free life with ease.

Gluten cross-reactivity with non-gluten foods

Non-gluten grain options include: rice, corn, amaranth, millet, quinoa, sorghum, teff, and buckwheat (not actually in the wheat family). However, these grains can cross-react with gluten in some people. This means their body recognizes them as gluten and responds with a reaction. An elimination/provocation diet or food sensitivity test  can let you know which grains are safe to eat. Dairy is another food that commonly cross-reacts with gluten, as is coffee. If your gluten-free diet is not helping you feel better you may need to consider cross-reactive foods.

Diet soda, artificially-sweetened foods

Though it does not actually contain gluten, the artificial sweetener aspartame is recognized as a serious offender for many with gluten intolerance or celiac disease. Since aspartame often triggers similar allergic symptoms, including severe stomach pain and bloating, avoiding it can spare you the pain and suffering.

Manage diabetes with functional medicine

Anyone with diabetes knows it’s important to manage insulin levels. Functional medicine offers unique tools to manage insulin and blood sugar -- including diet, exercise, stress management, detoxification, and maximizing essential nutrients. To understand how all these tools apply, it’s helpful to know how insulin works.

Insulin and Blood Sugar: A Balancing Act

Insulin helps keep glucose (sugar) levels in the bloodstream within normal range. When you eat, carbohydrates are broken down into glucose, our primary energy source. When glucose enters the bloodstream, the pancreas responds by producing insulin, which enables glucose to enter the body’s tissues. Excess glucose is stored in the liver; when needed to sustain blood sugar between meals, the liver releases sugar and the pancreas responds with more insulin to help it enter cells. This balancing act keeps the amount of sugar in the bloodstream stable.

When the pancreas secretes little or no insulin (type I diabetes), when your body doesn’t produce enough insulin, or when your cells are resistant to insulin (insulin resistance, common in type II diabetes), sugar levels in the bloodstream can get too high. Chronic high blood sugar can lead to complications such as blindness, nerve damage, and kidney damage.

Managing Insulin with a Multi-Faceted Approach

Certain environmental and lifestyle factors increase the need for insulin, which is a problem when the body can’t produce enough.

Diet

What you eat directly affects your blood sugar and insulin levels.

• Not eating regularly, and eating larger meals causes drops and spikes in blood sugar and insulin, driving insulin resistance  If blood sugar is a problem, better to eat smaller, more frequent meals to keep blood sugar and insulin levels stable.
• Processed and fast foods drive inflammation, which causes insulin resistance and other disease processes. It also increases cortisol levels, which can increase blood sugar levels.
• Food sensitivities cause immune and inflammatory responses, which causes insulin resistance. Many people have food sensitivities they don’t know about.
• Pay attention to Glycemic Index and Glycemic Load. Glycemic index measures the insulin response your body has after eating a food. The higher the number, the more insulin your pancreas needs to secrete. Glycemic load is the amount of that food eaten.

Exercise

Fat cells have insulin receptors. Exercise burns calories and fat; fewer cells mean less need for insulin. And, when you exercise, your muscles need more energy to fire and insulin receptor sites become more receptive. Even a short walk can reduce blood sugar levels and insulin demands dramatically.

Stress

Up to 90 percent of doctor visits are related to chronic stress. Stress has big impact on insulin by:

• decreasing insulin receptor sensitivity, which means the body must make more insulin to have the same response to blood sugar.
• elevating cortisol, which can raise blood sugar levels.
• causing the liver to raise blood sugar (the body’s way of increasing energy to handle stressful situations). Raised blood sugar means more need for insulin.

Toxins

Toxins are found throughout our environment -- in body products, food, air, and water. The body gets overworked trying to deal with them, causing inflammation and increasing insulin resistance. Inflammation shuts down receptor sites, requiring the body to make more insulin.

Essential Nutrients

Essential nutrients are necessary for healthy bodily function. Key nutrients commonly lacking in patients with blood sugar issues are:

• Alpha-Lipoic Acid -- Alpha-lipoic acid is one of the main nutrients responsible for making sugar into energy. Anti-inflammatory and anti-oxidant, it helps reduce insulin resistance.
• Magnesium -- Diabetics tend to utilize magnesium faster than non-diabetics. Magnesium is responsible for making energy, helps muscles and nerves fire, and is responsible for over 300 processes in the body. Low magnesium can contribute to constipation, depression, and high blood pressure.
• Zinc -- Excess inflammation causes you to use more zinc than normal. Because diabetes is rooted in inflammation, a lot of diabetics are low in zinc. An important nutrient to the pancreas, it plays a role in almost 300 reactions in the body.
• B-Vitamins -- The b-vitamins play a role in almost every cellular process. Diabetic medications can deplete b-vitamins.
• Chromium -- Chromium helps make insulin receptor sites receptive to insulin, helping lower blood sugar levels.

A Multi-Faceted Approach is Key

For proper diabetes management, we must provide adequate exercise, proper nutrition, and manageable stress levels. As a functional health provider, I understand that you have unique needs and am prepared to help you develop a customized action plan to manage your blood sugar and insulin levels.

Grow "thin" gut bacteria by eating more veggies

We’ve all heard that a high-fiber diet is good for health because it keeps the digestive system moving. As it turns out, fiber also plays a more important role than we suspected. To understand why, we need to take a look at the gut microbiome -- the community of microorganisms that live in the digestive tract.

Trillions of bacteria live in the human gut –- they account for ten times more cells than in the human body -- and they play vital roles in our metabolism and health. It’s a mutually beneficial relationship; the bacteria happily feed on dietary fiber while they perform a variety of duties, including helping to make vitamins B and K, repressing growth of harmful microorganisms, and breaking down and fermenting dietary fiber. This breakdown of fiber results in a release of beneficial, anti-inflammatory short chain fatty acids that are a vital energy source for our bodies.

In recent research, the firmicutes and bacteroidetes classes of gut bacteria have received a lot of attention. Multiple studies show that obese people have a higher concentration of firmicutes than bacteroidetes, while in lean people the bacteroidetes predominate (to help keep it straight, think of fermicutes as “fat” and bacteroidetes as “bony”). Moreover, when the diet is high in fat, the obesity-friendly firmicutes increase (the exception being a ketogenic diet), yet a high-fiber diet helps bacteroidetes increase. In addition, researchers observed that overgrowth of firmicutes led to chronic systemic inflammation, which is known to contribute to common health problems such as metabolic syndrome, diabetes and heart disease. The message: Though they both have jobs to do, you want your bacteroidetes to be stronger than your firmicutes.

Feeding The Magnificent Microbes

One might wish to rid the body of the firmicutes microbes, yet this can actually open the pathway to overgrowth of candida albicans, or a yeast infection, which leads to problems of its own. Instead, supporting a healthy population of bacteroidetes is the key, and this is done by supplying ample prebiotics in the diet. Prebiotics are non-digestible carbohydrates –- in the form of dietary fiber –- that serve as food for the bacteria in your gut.

To keep a healthy balance of bacteria in the gut, an ample supply of fiber-rich plant foods is necessary. These foods should be part of a diet that includes plenty of good fats, vitamins and micronutrients, and avoids bad fats, excess refined sugars, processed/junk foods, and excess alcohol. Good forms of dietary fiber include: All vegetables but especially artichokes, peas, broccoli, and Brussels sprouts; fruits; and beans. Your mother was right, even if she didn’t know the whole truth: Veggies are good for you!

In addition to a diet strong in prebiotic fiber, you can help support a healthy gut environment by using supplemental probiotics: Live, "friendly” bacteria that bolster your gut's population of healthy microbes. For probiotics to work, there must be a sufficient number of live bacteria present in the product (read your labels!) to survive the acidic environment of the stomach, and reach the large intestine. Your dietary fiber (prebiotics) acts as food to nourish these friendly probiotic bacteria, and ensures their growth and colonization. This combination of pre- and probiotic support can be vital for insuring a healthy gut.

Fermented foods such as sauerkraut, kimchee, kombucha, and yogurt contain live microbes, and can also help boost the probiotic content of your digestive tract. One caution; not all fermented foods have live cultures, and it’s the live ones you want. Again, read your labels!

Medications, hygiene, age, health status, and stress can also influence your gut microbe balance. Eating a fiber-strong, gut-friendly diet and supplementing with probiotics and fermented foods is one of your best strategies for supporting gut health.

What causes a hangover

It’s no secret that drinking too much alcohol can cause a hangover. Have you ever wondered what goes on inside your body that could cause so much suffering? The facts are intriguing, and may even change how much you drink.

The formal term for hangover is veisalgia, from kveis, the Norwegian word for “uneasiness following debauchery,” and algia, the Greek word for pain. Generally, the more drinks consumed, the worse the hangover. Some common symptoms of hangover include:

• General malaise
• Headache
• Nausea
• Fatigue
• Dehydration
• Anxiety
• Difficulty Sleeping

While we don’t know why all the symptoms of hangover occur, scientists have uncovered some unique facts behind the physiology of the common symptoms.

Vasopressin Inhibition: Enter Dehydration

Alcohol consumption blocks the production of vasopressin, a hormone that promotes water absorption in the body. Without enough vasopressin, the body sends water directly to the kidneys for elimination. Ever notice how much you run to the restroom when you’re out for drinks? Studies have shown that drinking about 250ml of an alcoholic beverage causes the body to expel 800 to 1000ml of water; a four-to-one loss!

This diuretic effect helps create the fatigue and dry mouth. And that headache? During dehydration, the body’s organs compensate by stealing water from the brain, causing it to reduce in size and pull on the membranes connecting it to the skull. Ouch!

Frequent urination also depletes the body of magnesium and potassium, critical for proper muscle and nerve function, a lack of which can lead to headaches, fatigue and nausea.

Glycogen Breakdown

Alcohol breaks down the body’s store of glycogen, a key energy source, turning it into glucose that gets expelled in the urine. The resulting lack of glycogen is partly responsible for the weakness, fatigue, and lack of coordination you feel the next day.

The amount of alcohol consumed isn’t the only factor; what kind of alcohol you drink affects you, too. Alcohol contains congeners, toxic byproducts of fermentation. The greatest amounts are found in red wine and dark liquors such as bourbon, brandy, and whiskey, while less is found in clear liquors such as vodka and gin. White wine has the least. Combining different kinds of alcohol compounds the toxic effect. Finally, the carbonation in beer speeds up alcohol absorption; following beer with liquor puts extra strain on the liver to deal with the added toxins, hence the phrase, “Beer before liquor; never sicker.”

Glutathione: Your Hangover Prevention Ally

A product of alcohol that is more toxic than alcohol itself, acetaldehyde, is created when liver breaks down alcohol. The body attacks it with a powerful antioxidant called glutathione. When we drink in moderation, the levels of glutathione in the liver can keep up with the need for detoxification; we feel fine the next day. When we drink too much, the liver’s store of glutathione depletes quickly, allowing toxic acetaldehyde to build.

Glutathione is our body’s most powerful antioxidant; this enzyme is integral for regulating the immune system, and is on the front line of fighting destruction from oxidative stress in the body. You need it to function well. When glutathione is depleted, it sets the stage for destructive inflammatory processes; in fact, studies show a direct correlation between a breakdown in the glutathione system and autoimmune disease.

Glutamine Rebound

The fatigue, stomach irritation, and general malaise that hangovers deliver have been tracked to glutamine rebound. While you drink, alcohol inhibits glutamine, one of the body’s natural stimulants. When you stop drinking, the body responds by producing more than it needs. The increased glutamine stimulates the brain, preventing deep, refreshing levels of sleep, which results in fatigue the next day. Severe glutamine rebound may also be responsible for hangover tremors, anxiety, restlessness, and increased blood pressure.

Alcohol Contributes to Leaky Gut

Alcohol can contribute in a variety ways to leaky gut, a condition where the lining of the intestinal tract becomes over-permeable, allowing foreign particles into the bloodstream and promoting inflammation throughout the body.

For instance, alcohol reduces the body’s production of prostaglandins, substances that help control inflammation. Suppression of prostaglandins allows systemic inflammation to increase, which can trigger or contribute to leaky gut.

Heavy alcohol consumption also damages the lining of the gastrointestinal tract, reducing the body’s ability to extract nutrients from food. This can lead to micronutrient deficiencies that help drive various chronic disease states.

As you can see, excessive alcohol consumption has some pretty serious effects on the body; our casual cultural mindset about the consequences –- a hangover –- gloss over the ugly truth of what happens inside the body when we over-consume alcohol.

Ask my office for hangover prevention and remedy ideas from the world of functional medicine.

New study pegs sugar as main culprit in diabetes

For years, medicine has pegged obesity as the number one cause of diabetes. However, results of a recent large epidemiological study suggest it’s sugar that plays a pivotal role in diabetes. The study also illustrates that how many calories you eat isn't as important as what makes up those calories -- the study found calories from sugar is more damaging than calories from other foods.

Researchers looked at the correlation between sugar availability and diabetes in 175 countries during the last ten years and controlled for such factors as obesity, calories consumed, diet, economic development, activity level, urbanization, tobacco and alcohol use, and aging.

They found the more sugar a population ate the higher the incidence of diabetes, independent of obesity rates. According to Sanjay Basu, MD, PhD, the study’s lead author, “We’re not diminishing the importance of obesity at all, but these data suggest…additional factors contribute to diabetes risk besides obesity and total calorie intake, and that sugar appears to play a prominent role.” The study provides the first large-scale, population-based evidence for the idea that perhaps it’s not just calories, but the type of calories, that matter when looking at diabetes risk.

All calories are not created equal

One thing is clear from the study – although by definition all calories give off the same amount of energy when burned, sugar is uniquely damaging to the body.

The study showed an additional 150 calories from any food source caused a 0.1 percent increase in the population’s diabetes rate whereas an additional 150 calories of sugar caused it to raise a full 1 percent. That’s a ten-fold increase. To put it into perspective, a can of soda contains roughly 150 calories of sugar. Consider the average American consumes 22 teaspoons of added sugar a day, or about 350 calories’ worth, and it’s clear why diabetes is the fastest growing disease in history.

The study also showed the longer a population was exposed to excess sugar, the higher the diabetes rates were. The clincher: Diabetes rates dropped when sugar availability dropped, independent of changes in calorie intake, physical activity, or obesity rates.

Does sugar cause diabetes?

Does sugar cause diabetes? It’s too early to say definitively, but this study clearly shows a correlation and spotlights the need for more research. Dr. Basu suggested sugar affects the liver and pancreas in ways that need more exploration.

What can you do to prevent or manage diabetes?

While there are various forms of diabetes, Type II diabetes, which is caused by diet and lifestyle, accounts for 90 percent of all cases of diabetes.

What can you do to minimize your risk for diabetes? Reducing your sugar intake is a great place to start. In functional medicine we understand that every body is unique. We start with a careful evaluation of your health history, lifestyle, heredity, nutritional status, and environmental risk factors. We help you customize a program that includes diet, exercise, stress management, nutritional support, detoxification, gut health support, and dampening of inflammation -- all of which can dramatically affect your insulin and blood sugar levels and hence your risk of diabetes. This can reverse the path to diabetes and sometimes even the disease itself.

Ask my office for more information on support with blood sugar imbalances and diabetes.

How alkaline and acidic diets affect your health

You may have heard of the importance of an alkaline diet. It can help reduce acidity in the body and prevent bone demineralization, kidney stones, back pain, muscle wasting, hypertension, stroke, cancer, asthma and exercise-induced asthma. The foods you eat profoundly affect how acidic or alkaline you are, and thus your health.

Let’s begin with some chemistry… pH is a measure of how acidic or alkaline something is. On a scale of 0 to 14, a pH of 0 is totally acidic, 14 is totally alkaline, and 7 is neutral. Blood is slightly alkaline at between 7.35 and 7.45. The kidneys and respiratory system tightly control blood pH with little room for variation. Your stomach is very acidic at 3.5 or below. This acidity is necessary to break down food and protect you from harmful bacteria and other organisms. Your urine pH changes depending on what you eat.

The nutrients in food have either an acidic or alkaline effect on the blood. Fish, meat, cheese, eggs, legumes and grains are considered acid forming, while fruits, vegetables, and mineral soda waters are considered alkalinizing. All junk foods, sodas, and processed foods are considered acid forming, and should be avoided. Note that just because a food is acidic itself doesn't mean that it will be acid forming in the body and vice versa with more alkaline foods. For instance, although lemon and raw apple cider vinegar are acidic they are alkalinizing in the body.

Acid and alkaline imbalances

When the body’s pH gets out of balance, health issues can arise:

Acidosis (too acidic)

In acidosis, the enzyme systems of the body run on high speed, forcing the adrenal glands into overdrive. Symptoms include:

• Agitation
• Feeling fast and racy
• Being physically tired but mentally wired
• Cancer
• Candida

Alkalosis (too alkaline)

While acidosis is more talked about, one can become too alkaline. In alkalosis, the enzyme systems of the body run below par, reducing blood pressure and pulse, contributing to:

• Low thyroid activity
• Low stomach acid (digestive issues)
• Allergies
• Wheezing
• Diarrhea
• Fatigue
• Sluggishness and slowness
• Fertility issues

So, what’s for dinner when you want to reduce acidity?

There is little question that the mainstream western diet imposes a high acidic load on the body. You might think the fix would be to eliminate all acidic foods. Instead, increasing the ratio of alkaline foods to acidic foods is what makes the most sense. It's all about balance. An added benefit; this reduces the total number of calories consumed.

When you consider that many classically acid forming foods have important vitamins, fats, minerals, and other nutrients, it makes sense to find a reasonable place for them in the diet. Remember, the acidic foods you consume should be nutrient-dense, quality foods, not a binge in the chip aisle! Instead, focus on a plant-based diet that is made up primarily of vegetables, fruits in moderation, and enough protein and healthy fat to keep your blood sugar and energy levels stable.

Increased fruits and vegetables in an alkaline diet improve the sodium/potassium ratio, which can benefit bone health, reduce muscle wasting, as well as mitigate other chronic diseases such as hypertension, strokes and cancer. On the other hand, an overly acidic diet (such as too much meat and not enough veggies) can reduce bone density. In fact, in a recent study of 136 trials that examined the effects of dietary calcium (mainly from dairy) on fracture risk in osteoporosis, two-thirds of the trials showed that a high calcium intake does not reduce the number of fractures. Meanwhile, it was found that eating fruits and vegetables improved bone density in an amazing 85 percent of studies that looked at the effects of such foods.

A more alkaline diet can also increase growth hormone, which may improve cardiovascular health and memory and cognition.

Based on the alkaline/acidic nature of foods, scientists have created a way to rate foods called the Potential Renal Acid Load (PRAL) score. But take note: becoming too concerned with pH and doing constant measuring of urine pH (the most accessible form of testing) will likely cause more stress than good; it’s balancing the big picture that matters!

The acid-alkaline diet is about balance

Food isn't the only thing that affects pH in the body; stress also plays a big part. Stress causes us to breathe shallowly, creating a buildup of highly acidic carbon dioxide, which is acidifying. Therefore, it's important to utilize positive stress reduction methods to help manage your body’s acidic load.

Alkalinizing lifestyle tips

• Engage in regular, weight-bearing exercise.
• Eat a diet strong in alkalizing vegetables and fruits.
• Use positive stress management techniques such as yoga, meditation, laughter, qigong, and walking.
• Deep breathing reduces stress and increases the rate at which carbon dioxide is released from the body, reducing acidity.
• Go Organic: pesticides are acid-forming.
• Make the change gradually: If you think a quick switch will be stressful or set you up for failure bingeing, make the transition slowly over a matter of weeks.
• Adequate dietary Vitamin D levels may help with absorption of calcium, magnesium and phosphate, which can help with acid/alkaline balance. Most populations in northern climates are deficient in vitamin D, so getting tested may be a good idea for you.

Remember, the big picture is what matters; balancing diet, exercise, and lifestyle will provide you with the best tools for maintaining a healthy pH balance in your body.

Cholesterol often wrong target in heart disease risk

Everyone has heard that high cholesterol is bad for heart health. But as it turns out, the association between cholesterol and cardiovascular disease has been somewhat misrepresented. Doctors are starting to accept that cholesterol levels do not necessarily predict risk for heart disease as much as we thought. Consider the following:

• 75 percent of people who have heart attacks have normal cholesterol.
• Older patients with lower cholesterol have a higher risk of death than those with higher cholesterol.
• Countries with higher average cholesterol than Americans such as the Swiss or Spanish have less heart disease.
• Recent evidence shows that it is likely statins’ ability to lower inflammation that accounts for the benefits of statins, not their ability to lower cholesterol.

We need cholesterol!

Cholesterol is a fat-like substance found in every cell in the human body. The liver makes 75 percent of cholesterol. Cholesterol helps produce cell membranes, vitamin D, and vital hormones, and is needed for neurological function. Put bluntly, we would die without it.

The cholesterol players

When we measure cholesterol levels, we are actually measuring the lipoproteins LDL and HDL. We refer to them as cholesterol, but they are actually small packages of fat and protein that help move cholesterol throughout the body.

High-density lipoprotein -- HDL

This is considered “good” cholesterol. It helps keep cholesterol away from your arteries and removes excess arterial plaque.

Low-density lipoprotein -- LDL

This is considered “bad” cholesterol. It can build up in the arteries, forming plaque that narrows the arteries and makes them less flexible (atherosclerosis).

Also important are:

Triglycerides

Elevated levels of this dangerous fat have been linked to heart disease and diabetes. Levels rise from eating too many sugars and grains, smoking, being physically inactive, excessive drinking and being overweight.

Lipoprotein (a) or Lp(a)

Lp(a) is made up of an LDL part plus a protein (apoprotein a). Elevated Lp(a) levels are a very strong risk for heart disease.

When testing cholesterol, total cholesterol is not as important as:

• Levels of HDL “good” cholesterol versus LDL “bad” cholesterol
• Triglyceride levels
• The ratio of triglycerides to HDL
• The ratio of total cholesterol to HDL

In order for cholesterol to cause disease, it has to damage the arterial walls. There are small and large particles of LDL, HDL, and triglycerides. Large particles are practically harmless, while small, dense particles are the dangerous ones, lodging in the arterial walls, causing damage and inflammation. The resulting “scar” is called plaque. Repeated trauma causes a buildup of plaque and chronic inflammation while your risk of high blood pressure and heart attack increases.

The biggest culprits in high cholesterol? Sugar and bad fats!

Although we’ve been taught that a high-fat diet causes problems with cholesterol, the type of fat you eat is more important than the quantity. Trans fats, or hydrogenated and saturated fats, promote abnormal cholesterol, while omega-3 fats and monounsaturated fats actually improve the type of cholesterol in our bodies. Eat your good fats, your body needs them!

The surprise: the biggest source of abnormal cholesterol isn’t dietary fat, but sugar. Sugar (and refined carbs, including processed white foods), drives good cholesterol down and triglycerides up. It causes those small particles, encouraging dangerous plaque buildup, and can lead to heart disease and metabolic syndrome or “pre-diabetes.” Doctors are starting to admit that sugar, not dietary fat, is the bigger cause of most heart attacks.

So, the real concern isn't really the amount of total cholesterol you have, but the type of fats, sugar, and refined carbohydrates in your diet that lead to abnormal cholesterol production.

Inflammation promotes heart disease

Systemic inflammation plays a key role in heart disease and, in fact, most all chronic illnesses. Systemic inflammation can arise from poor diet, a sedentary lifestyle, stress, allergies, and more. Research at Harvard has shown that people with high levels of systemic inflammation (measured by a test called C-reactive protein, or CRP) had higher risk for heart disease than those with high cholesterol, while normal cholesterol was not protective to those with high CRP.

Clearly, multiple factors come together to determine your risk for heart disease, including diet, lifestyle, and environment. If you are concerned about your heart health, contact my office for a comprehensive evaluation to help reveal the factors that may increase your risk for heart disease.

ME/CFS: A new name for Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS), a condition of severe, chronic tiredness, is a well-known term in the medical world and affects between one and four million people in the United States. However, since it was coined in 1988, considerable controversy has arisen over the term CFS. Many patients, advocacy groups, and experts believe the name trivializes the condition and leads to a lack of respect for patients within the medical community; some doctors view the illness skeptically and as a psychosomatic condition, and patients find they receive improper –- or no –- treatment for the illness.

Globally, a number of accepted names for this illness of uncertain cause are used, including Myalgic Encephalopathy (myalgic means muscle aches or pains, encephalomyelitis means inflammation of the brain and spinal cord), Post-Viral Fatigue Syndrome, and Chronic Fatigue Immune Dysfunction Syndrome. In the United States, organizations and doctors recently started calling the illness ME/CFS, for Myalgic Encephalopathy/Chronic Fatigue Syndrome. This combined name reflects the standpoint that the illness is indeed physical as opposed to psychological.

In 2014, the US Department of Health and Human Services contracted the Institute of Medicine to review the evidence and create a clinical definition for ME/CFS, one that might also result in a newer name for the disease(s). Using both terms together in the new name is somewhat controversial since ME has an identifiable viral trigger, while CFS may not, and continues to be diagnosed solely by symptoms. Over time the research will reveal more; for now, patients are thankful that the new combined name reflects a medical basis for the illness.

What is ME/CFS?

ME/CFS affects four times as many women as men, occurs most often in people in their 40s and 50s, and does not draw lines around race. It is a debilitating chronic illness characterized by the following symptoms:

• Extreme Fatigue -- brought on by low levels of, or no exertion. “Post-Exertional Malaise” is a hallmark.
• Unrefreshing Sleep -- disrupted and unrefreshing sleep that increases symptoms of fatigue and pain.
• Cognitive Problems -- characterized by brain fog; difficulties with concentration, attention and memory.
• Pain -- muscle, joint, and all-body pain; headaches are common.

Many patients also experience visual disturbances, gastrointestinal issues, food and chemical allergies and sensitivities, irritability, chills and night sweats, depression and weight changes. A diagnosis is made after ruling out other illnesses that can cause similar symptoms, such as: fibromyalgia, thyroid problems, anemia, Lyme disease, lupus, MS, hepatitis, sleep disorders, and depression.

The Functional Medicine Approach To ME/CFS

Functional medicine uses an individualized, multi-dimensional approach toward working with the symptoms and possible causes of this debilitating illness. While no known cure for ME/CFS exists, addressing underlying health imbalances through diet and lifestyle changes and customized supplementation and other therapies can relieve symptoms, increase function, and allow the person to engage more fully in daily activities.

The functional medicine practitioner will look at possible underlying roots of an individual’s symptoms, such as:

• chronic inflammation
• immune system activation (is a food, infection, or environmental chemical or metal triggering the immune system?)
• impaired functioning in the hormone system
• neurological system dysfunction
• gut inflammation, leaky gut, bacterial infection or other gut dysfunction
• problems with detoxification and methylation
• mitochondrial dysfunction
• poor glutathione activity
• and more

By paying close attention to and working with these possible roots of ME/CFS, the practitioner can help the patient achieve a greater level of relief from debilitating symptoms, and create a lifestyle that supports ongoing health and well-being.