Northern Virginia Holistic Primary Care

As Kirsten Karchmer aptly has made the analogy, your period serves as a barometer of your health, and can serve much like the canary in the coal mine. An erratic period, heavy bleeding, scant bleeding or loss of the cycle, PMS symptoms, cramps, and even PMDD can be your body’s signals that your health has gone off course. The first step is to recognize that these symptoms are not normal and you shouldn't assume that you are supposed to just tolerate it. Second, you can use these symptoms as a gauge of how your body is responding as you take steps to improve your underlying health.

*Because approximately 99% of magnesium in our body is intracellular, the common blood test used to check levels can be misleadingly normal even when one is very deficient.

*Soil contamination and erosion leading to mineral deficiencies in our food source, modern processing of refined foods, and water treatments have depleted our source of magnesium from the diet.

*Long term suboptimal intake of magnesium has been associated with the pathogenesis of many chronic diseases

*If deficiencies, the body will pull magnesium from bones, predisposing to osteoporosis & fractures

*Deficiency is also associated with:
high blood pressure, diabetes, migraines, metabolic syndrome & obesity, heart disease, osteoporosis, asthma, colon cancer, chronic inflammation, exacerbating states of stress, anxiety, painful menstruation, muscle cramps, and arrhythmias

*Because it is excreted in the urine, anyone with kidney disease must use caution with appropriate intake.

This information is for educational purposes only and should not be used for individual medical diagnosis or treatment.

REFERENCES: see comments

*MELANOPSIN, a retinal cell protein in your eye (different than rod and cone cells and only discovered in 2002), uses light to affect your circadian clock.

*When melanopsin is stimulated by light, it wires a message to the brain to reset your internal clock to the light it is perceiving - telling your brain it is daytime and to pump out time specific hormones like cortisol and turn off melatonin production.

*Melanopsin is triggered by blue light (all of your digital screens) and minimally stimulated by red light… hence the decision to offer red lights on phones in the evening.

*Melanopsin's effects on regions of the brain give insight to:
-People with migraines who are more sensitive to screen light
-People who don't go outdoors in daylight and feel low energy, depression, or brain fog
-Those with insomnia and anxiety

*Your circadian clock is set to optimize hormone production and biological functions at finely tuned timings. Most of us today have put the system into haywire. The more you are "functioning" at an off schedule, the more likely it is having a chronic negative effect on your health. Circadian disruption has been associated with gastrointestinal diseases, obesity, diabetes, cancer, and cardiovascular disease.

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REFERENCES:
S. Panda et al., Melanopsin (Opn4) Requirement for Normal Light-Induced Circadian Phase Shifting," Science 298, no.5601(2002):2213-16.
S. Panda. The Circadian Code: Lose Weight, Supercharge Your Energy, and Transform Your Health from Morning to Midnight. New York, Rodale Books, 2018.
N.F. Ruby etc al., "Role of Melanopsin in Circadian Responses to Light," Science 298, no. 5601 (2002):2211-13.
S. Sookoian etc al., "Effects of Rotating Shift Work on Biomarkers of Metabolic Syndrome and Inflammation," Journal of Internal Medicine 261, no.3(2007):285-92.

Answer:
B) Gastric ulcers, as a group, are usually associated with reduced acid production.

*Gastric ulcers (Type I-IV) are classified by location within the stomach. Generally, the closer the ulcer is towards the esophagus, the more likely it will be associated with low acid production.
*Gastric ulcers are also associated with Helicobacter pylori (H. pylori) infection, which thrives in a slightly less acidic environment.
*Because gastric ulcers can be malignant, they should be biopsied and healing confirmed.
*There is still a role of a PPI (acid blocker) for pain management and the acute healing of an ulcer, but it is not justified for long term use in MOST cases.

This information is for educational purposes only and should not be used for individual medical diagnosis or treatment.

References:

Sachs, G., Scott, D.R. & Wen, Y. Gastric Infection by Helicobacter pylori . Curr Gastroenterol Rep 13, 540 (2011). https://doi.org/10.1007/s11894-011-0226-4

Schubert ML, Peura DA. Control of gastric acid secretion in health and disease. Gastroenterology. 2008 Jun;134(7):1842-60. doi: 10.1053/j.gastro.2008.05.021. Epub 2008 May 12. PMID: 18474247.

If you missed our last Webinar, please join us:
Topic: What are my Cardiovascular Risks?
Speakers: Rachel Shelton, FNP & Dr. Salma Haque Date: Tuesday March 16, 2021 @ 7:00 pm Registration Required Heart Disease is preventable. The best time to address it is before you develop symptoms. If you already have heart disease, your greatest risk factors can be reversed. We will discuss the most important modifiable risk factors and how to test for them. Link: http://www.fallschurchva.gov/CivicAlerts.aspx?AID=1086

One of the greatest culprits for premature aging is: 

Advanced Glycation End-product (aka AGE)

*AGEs are produced as a by-product of high blood sugar and lead to inflammation and clotting. They age and damage every organ they cross, and can lead to:
Blindness, dementia, nerve diseases, heart attacks, strokes, diabetes, kidney failure, and cancer

*Every P*P checks an important marker of AGE:
Hemoglobin A1c (HgA1c)
This measures AGE of hemoglobin in your red blood cells (and will be a rough estimate of what is going on elsewhere in your body).  Since your red blood cell lives usually for 60-90 days, it will tell you the level of sugar overload your body is managing over the past 2-3 months. 

An elevated HgbA1c is a warning of early aging to all of your organs.

*Key point: Don't only look at reference ranges.  Diabetes occurs at 6.5%, prediabetes at 5.7%, but illness to your body starts at lower levels, and we recommend most patients keep it well below these ranges.

Even better, get an insulin level checked with it.  This is a way of looking for illness one stage earlier.

 (This is for educational purposes and should not be used for personal medical diagnosis or personal treatment recommendations)

Wheat and other gluten containing grains have a unique* ability to break apart your intestinal lining, leaking small particles into the bloodstream. Unless this is a tightly controlled and limited process, it can lead to a slew of autoimmune disorders, inflammatory reactions, and neurological diseases (gluten polypeptides cross the blood brain barrier as well). This process does not only occur in people who have Celiac Disease.

•50% of people with illnesses related to gluten sensitivity do not have abdominal symptoms.

•Why are so many people reacting now when we have been eating wheat for over 10,000 years without the epidemics we are seeing today?
There's an answer on this, but for
another post.

*cholera and amebic dysentery do this as well

https://doi.org/10.1016/j.cgh.2012.08.012
https://doi.org/10.1053/j.gastro.2009.03.059
https://doi.org/10.1016/S0140-6736(17)31796-8

Framingham study from Boston University

-789 men and 1,105 women free of stroke or dementia followed for 16-18 years with cognitive testing every for to six years

- Results showed a linear correlation with total cholesterol levels and cognitive scores. Participants with total cholesterol less than 200 scored the lowest, and those with the highest cholesterol performed better.

- Multiple studies have shown that cholesterol not only has a protective effect on the brain, but is essential for optimal neurological function.

Elias PK, Elias MF, D'Agostino RB, Sullivan LM, Wolf PA. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med. 2005 Jan-Feb;67(1):24-30. doi: 10.1097/01.psy.0000151745.67285.c2. PMID: 15673620.

◼️What happens when your body meets a stressful situation?

Among a finely orchestrated system, your adrenals pump out cortisol ( a steroid hormone) which acutely reduces inflammation...suppressing your immune system from reacting too strongly to an insult

◼️Stress resolves/body equilibriates:

Cortisol goes back down, immune system goes back to normal function

◼️What if you stay in a chronic state of stress?

Your body continues to pump out cortisol (the adrenals will hence be unable to focus on their usually balanced production of other hormones including testosterone and estrogen)... irregular periods, infertility, exacerbated PMS and menopause symptoms

Cortisol will initially suppress your immune system...more infections, poor gut health, mood disorders

To keep your energy high, cortisol will also keep your blood sugar high and make you insulin resistant

Add to that weight gain & impaired cognitive function

◼️Over time...
Your adrenals start to fatigue, & your stress hormones are no longer sufficient. This leads to:
▪️Inflammation/pain in the body
▪️Fatigue out of proportion
▪️Immune system unregulated/ risk for
autoimmune conditions/ new food
intolerances/allergies
▪️Hormone imbalance
The list goes on...
Keep in mind these symptoms can be
from many other causes as well, and are
not alone diagnostic.

◼️Don't get overwhelmed by the constellation of symptoms; address root causes.

◼️There are certain stressors you just remove... i.e. following the blogger who makes you feel inadequate
Other stressors... You learn not only to cope with them but how to grow through them, moving yourself into a more peaceful state.
Either way, you need to address these stressors in your life.
Couple this with:
1. Taking the time to care for yourself
2. Eating to support adrenal function

This IS the truth. Let yourself believe it.

Northern Virginia Holistic Primary Care updated their phone number.

This simple breathing technique not only calms your mental and physical state, returning your body into a parasympathetic mode, but also is quite effective in calming the mind into a sleep state.

Dr. Andrew Weil's 4-7-8 Breath:

1. Exhale your current breath fully through your mouth with a whoosh sound
2. Place the tip of your tongue on the central ridge of the roof of your mouth just behind your front teeth
3. Close your mouth. Over 4 seconds: inhale slowly through your nose
4. Over 7 seconds: hold your breath
5. Over 8 seconds: exhale completely thorough your mouth (keep your tip of tongue in place making a whoosh sound)

Do these steps 4 times (4 cycles). That's all.
You can do it any time in the day, but limit it it to 4 cycles at one time. It's a useful "de-stresser" when you are going through your to do list.

For more information including watching Dr. Weil perform the breathing technique see below:
https://www.drweil.com/videos-features/videos/breathing-exercises-4-7-8-breath/

While exercise was as effective in treating depression as taking antidepressant medication, to take it one step further, there are well designed studies that have found exercise to be superior to medicine in maintaining the therapeutic benefit and stopping depression recurrence.

Exercise will actually create new neural pathways in the brain with growth particularly in areas that have been found to be shrunken in depressed patients.

Why, then, don't more doctors prescribe exercise as a treatment? One of the more obvious answers is that implementing an exercise plan and confirming compliance to the regular exercise is a much greater time commitment than prescribing a drug.

We believe this is a time commitment worth investing in.

Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE. Exercise for depression. Cochrane Database Syst Rev. 2013 Sep 12;(9):CD004366. doi: 10.1002/14651858.CD004366.pub6. PMID: 24026850.

Rakel, D, Schneider, Wissik, T. Integrative Medicine: Depression. Philadelphia: Elsevier,2018.

Both answers are correct. It depends on whether you are quoting the relative risk reduction (A) or the absolute risk reduction(B).

This matters because many drug advertisements and even illustrious studies quote the relative risk reduction as the effects will look much more impressive and dramatic. My ICU attending years ago would lose his temper when we would review studies that quoted only relative risk reductions since it was misleading to the greater public and even the medical community.

If you are trying to decide whether you want to take drug X, you will want to know the absolute risk reduction when weighing the benefit-risk ratio. Usually Rachel and I do not find this is the number being quoted.

What if you could handle pressures by controlling your body's physical responses to stress?

There are many ways to do this but one of the most effective and well studied ways is biofeedback.
Biofeedback training, done with a qualified professional over several visits, uses instruments to measure the body's responses and gives you continuous data as you learn to control different muscle tensions, body temperature, your heart rate, and breathing patterns. It works to give you not only an awareness of your body's reaction to stress, but also how to manipulate these reactions. In essence your mind is trained to convert over your body's stress reactions to calm states. Once learned, these techniques can be easily applied in any real life situation.

Another incredibly effective way is by learning the skills of progressive muscle relaxation.

These techniques have been found beneficial particularly with chronic pain, anxiety, and other stress related illnesses.

Answer: B)10 min nap had immediate improvements that were maintained for 155 minutes in: sleep latency, sleepiness, fatigue, and brain function

The others had delayed effects or the benefits didn't last as long.

https://doi.org/10.1093/sleep/29.6.831

care &ocanal

Breathing with your diaphragm: With inhalation your abdomen/stomach should push down or out. Imagine your lungs are expanding like a balloon. All sides should go outward. With exhalation, it's a deflation of the balloon, and your abdomen will pull inward/upward.

If your abdomen pulls in with inhalation, you are breathing AGAINST your diaphragm.

While this is important for general health, it has relevance during this COVID pandemic as well. COVID frequently causes pathology in the lower bases of the lungs. One of the goals of treatment is to get the bottom of lungs aerated and expanded better. Breathing correctly is free, doesn't take extra time, and has numerous benefits for health.