25 Surprising Facts About Rheumatoid Arthritis Everyone Should Know 

25 Facts About Rheumatoid Arthritis (RA) Everyone Should Know 

 

Rheumatoid arthritis is an illness that’s widely misunderstood. I believe this is partly due to the fact that many confuse it with osteoarthritis (OA). This mix-up leads people to believe rheumatoid arthritis is caused by aging.

Rheumatoid arthritis (RA) is in no way “normal” aging and shouldn’t ever occur at any point in a healthy person’s life!

Rheumatoid arthritis is an autoimmune disease – meaning the body’s immune system is attacking itself – in the case of RA the immune system attacks a person’s joints.

Almost 1.5 million Americans have rheumatoid arthritis and it’s on the rise. Unfortunately, modern medicine doesn’t have much to offer for reversal of this terrible condition. However, functional medicine and full body integrative and holistic approaches have resulted in full recoveries and promising outcomes.

I am a perfect example of this. I was diagnosed with Rheumatoid Arthritis (I was also given many other additional diagnoses – another blog on this later) more than a decade ago. When modern medicine had no answers for me other than prescribing toxic immunosuppressive drugs and steroids, I voluntarily chose not to use those. As a practicing Internal medicine doctor who had a special interest in Rheumatology, I knew all too well, the terrible side effects and long term health consequences of these drugs. I was determined to find other answers!

Against conventional wisdom, I decided to be my own guinea pig and looked for other safer but effective alternatives. I researched and studied the fields of nutrition, and Integrative, Holistic, and Functional Medicine. I trained and became board certified in these, using all that I learnt, first on myself. It was trial and error at that point for me but I eventually healed myself from this crippling disease and from all other diagnoses that conventional medicine had given to my wide range of chronic symptoms!

My health completely recovered, and I no longer carry the clinical or lab diagnosis of RA, nor do I suffer from the pain or the disabling fatigue which is characteristic of this disease. In fact, I feel more energetic and vibrant than I did even in my 20s. I now use the same healing modalities and step-wise approach that worked for me, on my patients to help them in their recovery process.

As with everything else in life, we are all individuals with unique and varied characteristics, so no one size of treatment can fit all. Everyone with RA will have different root cause(s). I help my patients and clients find their particular root causes and then use a very personalized treatment approach that is right for their body.

In an effort to clear the confusion and misunderstanding surrounding rheumatoid arthritis, I’ve compiled 25 facts about rheumatoid arthritis that everyone should know. RA is a condition that can strike any person at any age – and it’s best to know these important facts.

 

1.      Rheumatoid arthritis (RA) is very different from osteoarthritis (OA)

Rheumatoid arthritis (RA) is very different from osteoarthritis (OA)

RA is an autoimmune disease while osteoarthritis is caused by erosion of the cartilage and bones due to aging, overuse or obesity. Because these conditions are completely different, so are their treatments and it is important not to confuse the two.

 

2.      Rheumatoid arthritis is not ‘normal’ wear and tear of the joints

Rheumatoid arthritis is not ‘normal’ wear and tear of the joints

Rheumatoid arthritis occurs when the body’s immune system attacks its joints. This attack results in painful inflammation of the hands, feet, knees and other joints. RA can also impact other tissues in the body such as the heart, lungs, mouth, and eyes.

 

3.      Rheumatoid arthritis is more prevalent now than ever before

Rheumatoid arthritis is more prevalent now than ever before. Is it toxins?

Many articles on RA like to cite the fact that there’s very little evidence RA existed before the 1500’s, however that fact remains uncertain. What we do know, is RA is more prevalent now than ever before and it’s incidence is on the rise. This fact leads many to believe it is a disease caused primarily by environmental factors such as diet and toxins.

 

4.      Children can develop Rheumatoid Arthritis

 Children can develop Rheumatoid Arthritis

It’s possible for children to develop RA -known as Juvenile Rheumatoid Arthritis (JRA) – because it’s an autoimmune condition, not caused by aging. In fact, children as young as five years old can develop RA, which is a deeply troubling to witness.

 

5.     Rheumatoid Arthritis is usually worst in the hands and feet

Though RA can impact any joint and many tissues in the body, it’s most common in the hands and feet. RA attacks the synovial lining between the bones of a joint, causing it to become inflamed, and ultimately damaging the tissue. Over time, RA can cause deformity to the affected joint.

 

6.      Women are three times more likely to develop RA

 Women are three times more likely to develop RA

For reasons that are not fully understood, women are three times more likely to develop RA than men. It is thought that hormones may play a role. Also, the prevalence of RA among women is on the rise.

 

7.      Geography influences RA risk

 Geography influences RA risk

RA is more common in people who live further from the equator, which suggests that adequate sunshine could help reduce RA risk, which leads me to my next point…

 

8.      Vitamin D reduces risk of developing RA

Vitamin D reduces risk of developing RA

Sufficient vitamin D significantly reduces your risk of developing RA and sunshine is your best source of vitamin D. Vitamin D has been linked to a reduced risk for nearly all autoimmune disease, so it’s a good idea to daily get about 20 minutes of sunshine, before applying sunscreen (without burning of course). If you have the ability to test your vitamin D levels, please do so and take supplemental Vitamin D under supervision. In my practice I use different strengths of Vitamin D based on my patient’s levels.

 

9.      Exercise is usually recommended in RA

 Exercise is usually recommended in RA

Surprising to some, physical therapy has been shown to improve symptoms of RA. Decades ago, doctors believed exercise would put unnecessary stress on joints and recommended against it. This belief is not true and proper exercise with rheumatoid arthritis is now encouraged.

 

10. Diet is a vital part of treatment of Rheumatoid Arthritis

Diet is a vital part of treatment of Rheumatoid Arthritis

Anti-inflammatory diets low in gluten, sugar, processed and fried foods are an integral part of the functional medicine approach to RA. I would recommend working with a Functional medicine doctor and getting detailed food, nutritional and gut assessment so your individual causes for RA can be specifically dealt with.

 

11. Chronic inflammation is a major component of RA

Chronic inflammation is a major component of RA

Rheumatoid arthritis goes hand-in-hand with chronic inflammation. This means you can do yourself a world of good by incorporating anti-inflammatory practices in your life through diet, by reducing the burden of toxins in your body, and by targeted supplementation. The fire needs to be quenched!

 

12. Muscle atrophy is a concern in RA

 Muscle atrophy is a concern in RA

Due to the lack of appetite that accompanies RA, coupled with the misguided but common belief that exercise will make RA worse, many people in the past suffered from muscle atrophy. These issues led to the nickname “wasting disease” because those with RA were often rail-thin and “wasting away.” A typical complaint is difficulty opening jars. Adding a daily protein drink or two to your nutritional supplementation can most certainly help replenish muscle strength. . My favorite protein powders are ones which also help gentle detox of the liver and the body.

 

13. Loss of appetite is common in RA

Due to inflammation of the gut, many with RA experience a strong loss of appetite, which contributes to weakness and muscle atrophy. The best way to fight this is through healing the gut and reducing inflammation.

 

14. A genetic risk factor called a “shared epitope” in RA

 A genetic risk factor called a “shared epitope” in RA

A shared epitope (SE) is a genetic variant that increases the likelihood of developing RA when present, in fact some studies suggest that SE is the single most significant genetic risk factor for RA. Though there’s a genetic predisposition for RA, most believe risk is more associated with environmental factors. Remember, genes are loaded guns but environmental exposures hold the trigger!

 

15. Heart disease is a problem for RA patients

Heart disease is a problem for RA patients

Having RA significantly increases your risk for developing cardiovascular disease and having a heart attack. This is likely due to the characteristic systemic inflammation present in both conditions.

 

16. Diabetes risk is higher in RA patients

Diabetes risk is higher in RA patients

RA increases the risk of many illnesses, including diabetes, though this could also be caused by the conventional RA treatments, which quite often include intermittent or chronic steroid use. Steroids increase the risk for diabetes. Opting for a functional medicine approach to rheumatoid arthritis could reduce this risk.

 

17. Fibromyalgia risk is higher in RA patients

Fibromyalgia risk is higher in RA patients

There is an increased risk for developing fibromyalgia in patients with RA. Suffering from a combination of these two illnesses can lead to chronic pain, severe depression, fatigue, as well as memory and cognitive issues.

 

18. Lung disease is a common complication in RA patients

Lung disease is a common complication in RA patients

Interstitial lung disease, a serious lung disease can be a frequent complication of RA when the disease activity is not properly controlled, in fact after joints, lungs are the second most common organ to be affected by this disease. Serious respiratory conditions, infections and pneumonia can also occur due to conventional treatments which suppress the immune function; or due to lifestyle habits such as smoking. Any symptom of shortness of breath should be properly investigated.

 

19. Pregnancy can temporarily improve RA symptoms

Pregnancy can temporarily improve RA symptoms

Pregnancy often improves symptoms of many diseases, including RA. I believe this is because of the elevated anti-inflammatory elements present in the body during pregnancy, such as the DAO enzyme. However, after a person with RA gives birth, they could experience a flare-up and should plan with their doctor accordingly. Postpartum follow up of RA and for that matter any autoimmune condition is crucial.

 

20. Giving birth reduces risk for developing RA

 Giving birth reduces risk for developing RA

Though the reason behind this is not fully understood, research has shown that giving birth reduces a woman’s overall risk of developing RA compared with someone who has never given birth.

 

21. Smoking increases RA risk and worsens symptoms overall

 Smoking increases RA risk and worsens symptoms overall

Smoking cigarettes increases a person’s risk for developing RA. Additionally, smoking cigarettes is a serious trigger for a flare of RA and can worsen symptoms overall.

 

22. It’s unclear whether alcohol is bad or good for RA

It’s unclear whether alcohol is bad or good for RA

Studies have been published suggesting some alcohol is both good and bad for people affected by RA. It’s my recommendation that you consume as little as possible because alcohol makes it difficult for your body to work on ridding itself of toxins in your everyday life that could be contributing to your RA.

 

23. Pollution increases Rheumatoid Arthritis risk

Pollution increases Rheumatoid Arthritis risk

Pollution is known to cause inflammation in the body, so it’s no surprise that researchers found women who lived within a third of a mile of a major highway had higher prevalence of systemic inflammation and RA.

 

24. Psychological stress can have a role in RA

Psychological stress can have a role in RA

Stress is one of the factors that may not only cause and but also exacerbate the progression of chronic inflammatory diseases such as RA. Relapses are common under conditions of emotional stress. Treatments based on mindful awareness and acceptance therapies lead to reductions in daily pain-related sense of doom and disability, fatigue, as well as stress-related anxiety in RA patients. A holistic mind-body approach is paramount along with other Functional medicine treatments for RA.

 

25. Functional medicine solutions are promising in RA

Functional medicine solutions are promising in RA

Steroids and NSAIDs (some of the conventional treatments for RA) are not a good long term treatment plan. Not only do they not offer long term solutions, they are harmful to the gut and the immune system! They work against the very systems that need healing.

 

Instead try a functional medicine approach to RA treatment with your Functional Medicine doctor, which includes:

Rheumatoid arthritis is a debilitating disease but there are better solutions beyond prescriptions. Reach out to your functional medicine doctor if you or someone you love suffers from rheumatoid arthritis.

Please share this article to help dispel common myths surrounding rheumatoid arthritis.

Please also share how you manage your disease and help others learn from your experiences.

 

Resources:

 

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024678/

 

http://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/what-is-rheumatoid-arthritis.php

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119866/

 

https://www.niams.nih.gov/health_info/Juv_Arthritis/default.asp

 

https://www.rheumatoidarthritis.org/ra/

 

https://www.ncbi.nlm.nih.gov/pubmed/14730601

 

https://www.ncbi.nlm.nih.gov/pubmed/28808949

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766928/

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921962/

 

https://www.ncbi.nlm.nih.gov/pubmed/24736263

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890244/

 

https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284707/

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717131/

 

https://www.ncbi.nlm.nih.gov/pubmed/24850878

 

https://www.ncbi.nlm.nih.gov/pubmed/28638686

 

https://www.ncbi.nlm.nih.gov/pubmed/25365778

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526553/

 

 

October 3rd, 2017

Posted In: Blog Post, Functional Medicine, Functional Nutrition, Integrative Medicine, Rheumatoid Arthritis, Uncategorized

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Interesting fact: The earliest known written record that likely referred to diabetes was in 1500 B.C in the Egyptian Ebers papyrus. It referred to the symptoms of frequent urination.

Basically, diabetes is a disease in which the body experiences elevated levels of blood sugar (glucose) due to an inability to either produce or use insulin. Most of the food we eat is turned into glucose, which our body needs for energy. In response to the rise in blood glucose, the pancreas makes a hormone called insulin, to help move the glucose into our cells for an ongoing source of energy. When you have diabetes, the body either doesn’t make enough insulin (Type-1 DM) or can’t use its own insulin efficiently (Type-2 DM). This causes glucose to build up in the blood, creating a potentially dangerous situation.

Type-1 DM is a chronic auto-immune health condition in which the immune system ravages the insulin-producing cells of the pancreas, causing a loss of the hormone insulin and affecting the way glucose is metabolized. Because of the loss of insulin, the body cannot move glucose from the blood into the cells where it is needed. Instead, glucose levels run high in the blood causing system-wide damage. While Integrative holistic health approaches can support the body, there is no cure once the pancreas are completely damaged and life-long management REQUIRES insulin. As a functional medicine doctor I have see halting of the disease process and even reversal if on early testing of the patient, the anti-bodies specific for type 1 diabetes are picked up and appropriate measures instituted. For more information on this contact my office.

Type-2 DM develops from lifestyle choices. A highly preventable disease, it was once most common in middle-aged and older people. Today, it strikes an alarming number of young adults and children. It’s directly related to poor eating and exercise habits, which typically results in being overweight – a risk factor for Type-2 DM. In this type of diabetes, your body produces insulin but does not recognize and use it properly. If health is not restored through diet, lifestyle changes, and holistic approaches, Type-2 DM can progress to a state in which insulin is required.

insulin resistance & Pre-diabetes are  your warning signs, conditions, respectively in which your insulin levels are high but the body cannot utilize it appropriately and the blood glucose level is chronically above normal, but not yet high enough to be diagnosed as Type-2 DM. These stages is your chance to stop the onset of diabetes in its tracks by improving your lifestyle choices.

 

A few simple guidelines can help you manage diabetes, and even prevent Type-2 DM:

  • Eat fresh whole foods, drink plenty of water, increase dietary fiber and the amount of dark fruits and veggies in your daily diet. Avoid processed foods and added sugars. Eat what a plant makes, not what is made in a plant!
  • Exercise 30 minutes per day everyday.
  • Supplement with a good high quality  multivitamin/mineral, pure Omega-3 Essential Fatty Acids and B- complex vitamin with activated bioavailable forms of B vitamins.
  • Test your vitamin D levels and make sure they are optimal. Take supplementation if necessary to raise levels.
  • To get higher support for blood sugars try a supplement formulation specially created for that purpose and a meal replacement shake which has ingredients that support a healthy blood sugar and weight.
  • Try a safe and guided detoxification protocol a few times a year especially in the spring and the fall to give a “reboot” service to your body.
  • Consult with a registered dietitian with functional medicine training or a Health Coach to learn how to plan and prepare healthy meals.
  • Ask your Functional medicine doctor about food allergy and sensitivity testing; nutritional deficiency testing; and comprehensive gut function testing. Also check into your adrenal health as high cortisol levels can lead to or exaggerate your condition.
  • Make sure you’re not constipated. If so increase fiber in your diet, and if needed try safe supportive supplements. Daily bowel movement(s) is imperative to good health!
  • Take high quality multi-species probiotic supplements in the capsule or powder forms. These come in refrigerated or shelf stable forms. I love to use the latter during my travels!
  • Keep your skin healthy (hydration and whole foods). Use non-toxic personal care products
  • Use natural remedies such as herbal supplements, vitamins, detoxification, and dietary adjustments under the supervision of a Board certified Integrative Medicine (ABOIM) physician and Functional Medicine trained physician (IFMCP). Try a safe and guided detoxification protocol a few times a year.
  • Take medications or supplements as directed by your primary care doctor or endocrinologist.
  • Take particular care of your feet. Carefully monitor wounds, because many people with DM experience poor circulation and neuropathy. Vitamin C and zinc can help support would healing
  • Don’t forget to take care of your mind and spirit! Emotions, stress, lack of sleep all affect the metabolic functioning of the body. Practice mindfulness of some form daily!

If you’ve been diagnosed with Diabetes mellitus (DM), or even pre-diabetes and Insulin resistance, don’t take it lightly. Follow treatment plans and lifestyle recommendations strictly. Left untreated, diabetes can lead to many complications such as heart disease, blindness, kidney failure, and lower-extremity amputations. It’s the seventh leading cause of death in the United States.

References
  • Murray, M.T., “Diabetes Mellitus” in Pizzorno, Joseph E. (2013). Textbook of Natural Medicine. St. Louis, MO Elsevier. p. 898; 1340; (chapter 161), 1320-1348.
  • National Institutes of Health. Diabetes. https://www.niddk.nih.gov/health-information/diabetes/types
  • Joslin Diabetes Center. http://www.joslin.org/info/general_diabetes_facts_and_information.html
  • Centers for Disease Control. Rates of Diabetes Diagnosed. http://www.cdc.gov/diabetes/statistics/prev/national/figbyage.htm
  • Weston A Price Foundation: Treating Diabetes. http://www.westonaprice.org/modern-diseases/treating-diabetes-practical-advice-for-combatting-a-modern-epidemic/
Image attribution: AndreyPopov/bigstockphoto.com

 

The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.
© Praana Integrative Medicine & Holistic Health Center, LLC. All rights reserved

February 19th, 2017

Posted In: Blog Post, Functional Medicine, Integrative Medicine, Uncategorized

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Coming from an Indian heritage, lentils have been an important part of my daily meals all my life. I absolutely love them and really wanted to share their beneficial properties with all of you readers and foodies!

Around the world, people enjoy the health benefits of lentils, part of a group of proteins known as pulses, which also includes beans, peas, chickpeas. Naturally gluten-free, lentils are rich in dietary fiber, protein, calcium, potassium, zinc, and iron. They help support lower cholesterol levels and are a great addition to the diet especially for people diagnosed with blood glucose/ blood sugar disorders.

Prior to the use of pharmaceutical medicines, lentils were used to deal with diabetic conditions. When included with a meal, the high fiber content helps prevent blood glucose from rising rapidly after eating. Although calorie dense (230 cal/ one cup serving), lentils are low in fat and very filling – you won’t be hungry after a lentil meal! I can vouch for that one from extended personal experience!

You can find lentils in the bulk bin aisle or in prepackaged containers.

A few tips on purchasing and cooking:

When purchasing in bulk, try to buy organic and make sure there is no moisture in the bin or in the packaging. Look for whole, not cracked lentils. Store them in an airtight container in a cool, dark and dry place. They will keep up to a year. When buying canned lentils, watch for added salt or other preservatives. though I don’t recommend canned food AT ALL, just for your information, unlike other canned veggies, lentils do not lose much of their nutritional potency.

Lentils are easy to prepare (I do like to pre-soak them but if in a hurry, can cook without presoaking unlike other dry beans). Wash and strain lentils under cool water before cooking. You can boil lentils (I like to use my pressure cooker as a matter of habit, but you can use an Instant Pot as well if you have one) and store in the fridge for later use in casseroles, soups, rice or pasta dishes, salads, spreads/hummus, or soups. Cooked lentils stay fresh in the fridge in a covered container for about three days.

Write in the comments if you liked these tips and how you use lentils and share some of your favorite recipes if you can so all of us can benefit.

I look forward to hearing from you!

 

References:
  • Future of Food: Pulses & Nutrition. Accessed on 6 Sep 2016: http://pulses.org/future-of-food/pulses-nutrition
  • Video: NutritionFact.org. “Diabetics Should Take Their Pulses” http://nutritionfacts.org/video/diabetics-should-take-their-pulses/
  • Helmstadter, A. “Antidiabetic drugs used in Europe prior to the discovery of insulin.” Pharmazie (2007) 62(9):717 – 720. http://www.ncbi.nlm.nih.gov/pubmed/17944329
  • MedicalNewsToday.com. Accessed 6 Sep 2016: http://www.medicalnewstoday.com/articles/297638.php
  • World’s Healthiest Foods: Lentils. Accessed 6 Sep 2016: http://www.whfoods.com/genpage.php?tname=foodspice&dbid=52
  • Singhal, P., Kaushik, G., Mathur,P. “Antidiabetic potential of commonly consumed legumes: A review.” Crit Rev Food Sci Nutr (2014) 54(5):655 – 672. Accessed 6 Sep 2016: http://www.ncbi.nlm.nih.gov/pubmed/24261538
  • Thompson, S.V., Winham, D.M., Hutchins, A.M. “Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: A cross-over study.” Nutr J (2012) 11:23. Accessed 6 Sep 2016: http://www.ncbi.nlm.nih.gov/pubmed/22494488
  • MindBodyGreen.com. “7 Health Benefits of Lentils” Accessed 6 Sep 2016: http://www.mindbodygreen.com/0-5488/7-Health-Benefits-of-Lentils.html
Image attribution: rtsubin/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.
© Praana Integrative Medicine & Holistic Health Center, LLC. All rights reserved

February 19th, 2017

Posted In: Blog Post, Food, Integrative Medicine, Recipes

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Hawthorn (Crataegus oxyacantha)

Hawthorn, also known as Maybush, is a thorny shrub found on hillsides and in sunlit woodsey areas throughout the world. Over centuries, all parts of the plant have been used to prepare foods, beverages, and medicines. In folk medicine, Hawthorn was used for the treatment of diarrhea, insomnia, and asthma. In China, it has been used to treat digestive problems, high cholesterol, poor circulation, and shortness of breath. During the early 1800s, doctors in North America used Hawthorn for heart conditions, circulatory, and respiratory disorders.

Hawthorn has a rich supply of flavonoids (antioxidants that protect cells from damage) and anti-inflammatory properties, which are important to heart health. It plays a role in helping dilate blood vessels, improves blood flow to the heart, and can lower blood pressure. In Europe, Hawthorn is regarded as a safe and effective treatment for early-stage heart disease. It is used to promote the health of the circulatory system and in patients with angina, high blood pressure, and congestive heart failure. In studies, patients with heart failure who took Hawthorn showed improvement in clinical symptoms and sense of wellbeing.

Hawthorn heart

Hawthorn is available as tea, capsule, tincture, and standardized extract found in prescription drugs, over-the-counter medication, standardized herbal medicine, or dietary supplements. Before taking Hawthorn, especially if you suspect or have a heart or lung condition, consult with a FUnctional medicine / Integrative holistic medical professional.

 

Resources
Hawthorn. Complementary and Alternative Medicine Guide. University of Maryland Medical Center Online. https://umm.edu/health/medical/altmed/herb/hawthorn
Johnson, Rebecca L. & Foster, Steven et al., National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. (National Geographic Society. (2010, 2014), 123-125.
Hawthorn Berry (Crateagus Oxycanthus): Health Benefits. http://www.herbwisdom.com/herb-hawthorn-berry.html
Mars, Bridgitte & Fiedler, Chrystle. Home Reference Guide to Holistic Health & Healing. (Beverly, MA: Fair Winds Press. 2015.), 189.
Dahmer, S., Scott, E. “Health Effects of Hawthorne,” Amer Family Phys. (Feb 15, 2010) 81:4, 465-468. Accessed: Dec. 09, 2015: http://www.aafp.org/afp/2010/0215/p465.html
Chang, W., Dao, J., and Shao, Z. “Hawthorn: Potential Roles in Cardiovascular Disease.” American Jnl. Chinese Medicine (January 2005) 33:01, pp. 1-10. DOI: 10.1142/S0192415X05002606. http://www.worldscientific.com/doi/abs/10.1142/S0192415X05002606?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
ie Wang, Xingjiang Xiong, and Bo Feng, “Effect of Crataegus Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 149363, 16 pages, 2013. doi:10.1155/2013/149363.
http://www.hindawi.com/journals/ecam/2013/149363/
Image attribution: morisfoto/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

 

February 7th, 2016

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February 7th, 2016

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Heart stethoscopeLong before the ancient Greek surgeon Galen carried out meticulous dissections of the heart, the Egyptians wrote about health and disease in relation to how the heart “speaks in vessels” with the rest of the body. Today, physicians may not associate the heart with the soul (or soul mates), but many credit early Egyptian medical knowledge of the heart as a precursor to modern cardiology.

 

The Heart: Powerful, but VulnerableHeart stethoscope

A key element of a healthy body is a healthy heart. The heart is the center of our cardiovascular system and beats an average of 100,000 times per day supplying oxygen rich blood to the whole body. Every day we make choices that have a profound affect on the health of this vital organ. Most heart disease (HD) is linked to inflammatory risk factors such as lack of exercise, obesity, smoking, stress, and poor eating habits.

One major condition that can develop with these risk factors is Hypertension, also known as high blood pressure. Often called the ‘silent killer’, Hypertension can cause significant damage throughout the cardiovascular and other body systems and ultimately results in over 80 million deaths each year.

The Silent Killer

Blood pressure is the amount of pressure exerted on the inside of blood vessels as the heart pumps the blood through the body. When there is resistance in the vessels, the pressure rises and hypertension results. The longer hypertension goes undetected and/or uncontrolled, the greater the damage to blood vessels and other organs. Hypertension can lead to heart attack, stroke, ruptured blood vessels, kidney disease or failure, and heart failure.

Warning signs for high blood pressure are rare but can include headaches, blurred vision, light-headedness, shortness of breath and nosebleeds. However, there are typically no warning signs or symptoms for hypertension, which is why it is called the silent killer.

Hypertension is diagnosed by looking at 2 numbers in your BP reading: Systolic pressure (the top number) is the pressure in your arteries when the heart beats (contracts). Diastolic pressure (bottom number) represents the pressure in your arteries between beats.

• Normal blood pressure is below 120/80
• Prehypertension is 120 – 139 systolic or 80 – 89 diastolic.
• Hypertension is 140/90 or higher

The Potassium Secret for a Healthy Heart
You’ve no doubt heard the best thing to do when you have hypertension is to reduce the amount of salt/sodium in your diet. Did you know the average adult needs 4,700 mg of potassium daily compared to only 200 mg of sodium. Unfortunately for most of us, our eating habits give us way too much sodium – 3,300 mg a day – and not nearly enough potassium. This imbalance can increase your risk of developing hypertension.

What’s truly important for your heart, and a more accurate strategy to prevent high blood pressure, is to balance the relationship between potassium and sodium (salt) in your daily diet. Proper sodium-potassium balance is necessary for nerve transmission, muscle contraction, fluid balance, and the optimal health of all the cells in your body. In regard to the heart, potassium is particularly important for regulating heart rhythm and maintaining blood pressure.

By reducing your sodium intake, you are often correcting the sodium-potassium imbalance without realizing it. To further support your heart health, eat more potassium-rich foods such as sweet potato, spinach, banana, peas, legumes, apricots, avocados, halibut and molasses.

More Healthy Heart Tips & Heart-Healthy Diet Do’s:

  • Eat a variety of fresh fruits and dark green veggies daily.
  • Use plant-based oils for cooking.
  • Eat mindfully, not on-the-run.
  • Reduce or eliminate packaged foods, sugar, and red meat.
  • Walk, No Need to Run: 30 minutes of daily, brisk walking lowers your risk for hypertension.
  • Be Calm: Learn to manage stress with healthy coping techniques, such as, deep breathing, yoga, meditation, gratitude journaling, and getting quality sleep.
  • Supplemental Support: Nutritional supplements shown to support heart health include Hawthorn, CoQ10, Essential Fatty Acids (Omega 3), Magnesium, Garlic and B-vitamins. Always speak with your Integrative/ Functional Medicine physician as to which forms of these supplements and what doses are optimal for you as all forms are not equal in efficacy or quality. Supplements you might have heard about—Natto-K (nattokinase), Guggul, or Niacin—should not be taken without the supervision of your health practitioner.

Because some blood pressure medications affect the potassium level in the body, be sure and discuss the best strategy for making this adjustment with your Functional Medicine Physician /Integrative Holistic Doctor.

Resources:
Murray, M. “Hypertension” as cited in Pizzorno, Joseph E. (2013). Textbook of Natural Medicine. St. Louis, MO Elsevier. (chapter 174), 1475-1485.
Johnson, R.L., S. Foster, Low Dog, T. and Kiefer, D. “Plants and the Heart” in National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. Washington, D.C.: National Geographic, 2012. 100-101.
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 1999-2013, through the Vital Statistics Cooperative Program. Accessed on December 11, 2015.: http://wonder.cdc.gov/ucd-icd10.html
Mayo Clinic. “High Blood Pressure- Hypertension.” Updated November 10, 2015. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580
National Heart, Lung & Blood Institute. “Risk Factors for High Blood Pressure.” Updated September 2015. http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/atrisk
Lelong, H., Galan, P. et al., “Relationship Between Nutrition and Blood Pressure: A Cross-Sectional Analysis from the NutriNet-Santé Study, a French Web-based Cohort Study” Am J Hypertens first published online September 3, 2014 doi:10.1093/ajh/hpu164. Accessed on Dec 21, 2015: http://ajh.oxfordjournals.org/content/early/2014/09/03/ajh.hpu164
Study above cited in Time magazine article, accessed on Dec 21, 2015: http://time.com/3313332/salt-and-blood-pressure/
Appel, L.J., Brands, M.W., et al., American Heart Association. “Scientific Statement: Dietary Approaches to Prevent and Treat Hypertension.” Updated January 2014. http://dx.doi.org/10.1161/01.HYP.0000202568.01167.B6
American Heart Association. “Learn more about heart disease and high blood pressure.” Accessed on December 11, 2015. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-Pressure-or-Hypertension_UCM_002020_SubHomePage.jsp
American Heart Association. “Walk, Don’t Run Your Way to a Healthy Heart.” Accessed on December 11, 2015.
http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/Walking/Walk-Dont-Run-Your-Way-to-a-Healthy-Heart_UCM_452926_Article.jsp#.Vop0pDYwcrg
Also see:
http://www.heart.org/HEARTORG/Conditions/Conditions_UCM_001087_SubHomePage.jsp
American Heart Association. “Walking Can Lower Risk of Heart Related Conditions” Accessed on December 11, 2015.
http://newsroom.heart.org/news/walking-can-lower-risk-of-heart-related-conditions-as-much-as-running
American Heart Association. “Potassium and high blood pressure.” Last Updated August 04, 2014. Accessed on December 11, 2015.
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Potassium-and-High-Blood-Pressure_UCM_303243_Article.jsp#.Vopz2DYwcrg
Harvard School of Public Health. “Shifting the Balance of Sodium and Potassium in Your Diet.” Accessed on December 11, 2015. http://www.hsph.harvard.edu/nutritionsource/sodium-potassium-balance/
Linus Pauling Institute: Micronutrient Information Center. “Sodium (Chloride).” Last Reviewed 2008. Accessed on December 11, 2015. http://lpi.oregonstate.edu/mic/minerals/sodium
Linus Pauling Institute: Micronutrient Information Center. “Potassium.” Last Reviewed 2010. Accessed on December 11, 2015. http://lpi.oregonstate.edu/mic/minerals/potassium
Image attribution:
lola1960/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

February 7th, 2016

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chronic-inflamation

Seems like everyone’s talking about inflammation these days! More and more studies are coming out linking chronic inflammation to a vast majority of chronic diseases, even cancer.
But, is all inflammation bad?

Not at all! Some inflammation is absolutely necessary for our survival. It helps us overcome any acute insult or injury to the body. For example, if you cut your finger, cells are recruited to the wounded area, and through a very complex mechanism, the body heals itself quite efficiently. That’s an example of inflammation working to heal you.

Similarly, if you contract a bacterial infection, the body quickly produces inflammatory chemicals known as cytokines, which help kill the foreign invaders. During this fight between the bugs and your immune system, you feel terrible, but only for a short time. Soon, you’re up and on your merry way again with little long-term botheration from the incident.
It’s only when this inflammation becomes chronic or long term—like a low-grade smoldering fire which does not die out—that it leads to major problems.
Normally, during a period of low-grade inflammation, the body tries to warn us that something is wrong. It does this by producing many nagging signs and symptoms, like:

  • Aching of joints and muscles
  • High blood pressure
  • Rising blood sugars
  • Headaches
  • Sleep issues
  • Allergies
  • Skin issues
  • Frequent abdominal pain and other gut issues
  • Mood swings
  • Difficulty with sleep
  • Low energy levels

If we do not heed these symptoms and allow the inflammation to persist unchecked, after years (yes, years!), the inflammation becomes evident in the form of a heart attack, stroke, Alzheimer’s disease, cancer, or an autoimmune disease like multiple sclerosis, ulcerative colitis or rheumatoid arthritis, which can no longer be ignored by us.
Some signs of chronic inflammation are:

  1. Chronic fatigue and low energy.
  2. Mood issues including anxiety, depression, and panic attacks.
  3. Memory problems, brain fog, or loss of focus.
  4. Difficulty falling asleep, waking up in the middle of the night, or unrestful sleep.
  5. Gut symptoms including acid reflux, IBS, constipation, diarrhea, blood or mucus in stools, intermittent abdominal pain, gas and bloating.
  6. Chronic muscle and joint pain, swelling, redness.
  7. Chronic allergies and asthma requiring frequent medications.
  8. Chronic skin issues like eczema, psoriasis, redness of face and cheeks, or hives.
  9. Frequent or daily headaches, tremors, easy loss of balance, tingling and pain along nerves in the extremities, dizziness.
  10. High blood pressure.
  11. Metabolic syndrome, abdominal obesity, or diabetes mellitus.
  12. Low bone density or osteoporosis.
  13. Heart disease, peripheral vascular disease.
  14. Diagnosis of cancer: Yes, taking action is possible even after being diagnosed with a cancer as you can still try to prevent future development of new cancers at other sites.

What should you do if you have any any signs of chronic inflammation? 
1. Find a functional medicine physician who is well versed in evaluating your symptoms. 
This person can help you eliminate the root cause of the chronic inflammation, rather than focusing on just suppressing symptoms.
2. Avoid all inflammatory foods. 
This includes refined sugars, sugar substitutes, juices and sodas, trans-fats, dairy products, non-organic eggs and meats from grain fed animals. I also suggested you eliminate any foods to which you may be sensitive/ allergic, all GMO foods, and foods with a high glycemic index.
3. Eat real foods. 
Incorporate large amounts of antioxidants, phytochemicals, and fiber-rich fruits and vegetables, nuts and seeds, small amounts of grass fed meats and wild small fish, healthy spices like turmeric, ginger, garlic, and herbs like cilantro, parsley, oregano and rosemary in your diet.
4. Stop eating microwavable lunches or dinners.
Don’t eat dead packaged and processed foods which have no life force!
5. Sip green tea on a regular basis. 
It cuts inflammation and calms the mind!
6. Try to avoid toxins as much as possible in your daily life. 
You’ll give your liver a much-needed break.
7. Incorporate a daily exercise regimen. 
Do yoga, tai chi or some other form of movement exercise. Move the body whenever you get a chance!
8. Meditate daily and breathe deeply. 
Who doesn’t love peace of mind? It’s also great for your nervous system.
9. Focus on optimal sleep. 
Your body restores and regenerates itself daily when you sleep!
10. Find time for rest and rejuvenation on a regular basis. 
Try to make time for mini-vacations and spending time in nature!
11. Get regular massages.
Better yet: learn the technique of self-massage and practice it daily!
12. Get your vitamin D levels checked and maintain optimal levels. 
Use supplements if needed. Vitamin D is not just a vitamin, it functions as a hormone messenger molecule in crucial body processes!
13. Maintain a positive mental attitude about life and people! 
Remember, just like your gut affects the brain, the brain in turn affects the gut, where the majority of our neurotransmitters are made.
Cutting down your risk of inflammation will most certainly reduce your chances of developing chronic diseases, so I urge you to take corrective action, one baby step at a time.

This blog was first published on MindBodyGreen

The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

 

November 1st, 2015

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heart-disease
Most people have their blood pressure, heart rate, lipid profile, fasting blood sugar, and even vitamin D levels measured during their yearly physical. Your physician may do an EKG or a stress test. All of these tests may be “normal,” but there are other significant risk factors for metabolic issues that contribute to cardiovascular disease, that may be completely missed unless more testing is done.
Below is a list of some easily run lab tests and calculations which give insight into risk for insulin resistance, metabolic syndrome, inflammation and risk for future coronary heart disease. In my opinion, these tests should most certainly be a part of any patient’s assessment for metabolic disorders and development of heart disease:

1. Triglyceride to HDL ratio

This is a simple measure of insulin resistance, risk for diabetes mellitus type 2 and cardiovascular disease. A ratio less than 3.0 is considered normal, and more than or equal to 3.0 is suggestive of insulin resistance. An elevated ratio should prompt counseling the patient about therapeutic lifestyle change with close follow-up of metabolic markers for prevention of development of diabetes, hypertension and coronary artery disease.

2. Fasting insulin levels (and, if possible, two-hour postprandial insulin levels)

Usually at the yearly physical your physician will measure fasting blood sugar, and may even measure hemoglobin A1c levels, which are markers for pre-diabetes and diabetes. In my opinion, abnormalities in these are late developments. Insulin is a hormone produced by cells in the pancreas; it’s responsible for regulating blood sugar levels and for promoting uptake of glucose into the cells for use as energy or for storage as fat. Measuring insulin levels two hours after a glucose load may be the first indication of metabolic problems in your handling of sugar (or carbs).
Sometimes a two-hour insulin measurement may be difficult, so in my practice I measure fasting insulin levels, which are the second measure to go up. These two can be early markers of insulin resistance, much before fasting blood sugar starts going up. Excessive insulin levels lead to increased serum triglyceride levels, decreased serum HDL (good cholesterol) levels, increase in levels of the small dense LDL (the plaque-promoting form of bad cholesterol) particles. Insulin resistance is a risk factor for hyperlipidemia, diabetes, hypertension, all of which contribute to atherosclerosis and plaque formation, which in turn is a risk factor for heart disease development. I encourage my patients to work toward a fasting insulin level of at least less than 6 microunits per mL (ideal is 4). Obviously diet is the key for reducing Insulin levels, but for patients who need additional short or long term support, I use a supplement known as Blood Sugar Support which have all the key factors to support blood sugar and insulin levels. It has helped many of my patients.

3. High-sensitivity C-reactive protein (hsCRP)

CRP is produced in the liver in response to nonspecific inflammation in the body. The high-sensitivity CRP is an assay which detects low levels of CRP specific to inflammation in the blood stream i.e., vascular inflammation, which could be the cause for development and progression of heart disease. Standard lipid tests do not test for inflammation, and this marker can be easily tested through your local labs. Even if your lipid profile is normal and you do not have other cardiovascular disease risk factors like hypertension or obesity or diabetes, if this marker is elevated, it is cause for concern. If somebody has already had a cardiac event like a heart attack or stroke, and this marker stays chronically elevated, it could be predictive of a high risk for future repeat heart attack or stroke. The therapeutic goal for hs-CRP is less than 0.7 mg/L, preferably as near to 0 as possible. I like to repeat this a few times to be sure it is actually staying high.
A word of caution with hs-CRP: though a marker of inflammation, it can also be a marker for infection and acute injury, so if you’ve had any recent surgery or procedure; have a respiratory, gum or other infection; or have the flu, please wait until your symptoms are resolved before testing, as this marker will be elevated due to that acute event.

4. Red blood cell magnesium levels

Red blood cell magnesium levels are the best way to assess magnesium status. Clinical signs of magnesium deficiency could be fatigue, weakness, muscle cramps, seizures, numbness and tingling in the extremities, mood and sleep issues, irregular heartbeats and also spasms in the arteries which feed the heart, contributing to heart attacks. Magnesium supplementation may reduce the risk of coronary heart disease, so try to keep levels at the high end of the lab range, though I monitor clinically more often. The form of magnesium I use is a very highly absorbable chelate.

5. Homocysteine levels

Homocysteine is a toxic amino acid and elevated levels can be a risk factor for development of cardiovascular disease and stroke. Elevated homocysteine levels damage LDL cholesterol, causing its oxidation. Oxidized LDL leads to plaque formation in the coronary arteries. Homocysteine is produced as an intermediate in the metabolism of amino acids methionine and cysteine. Activated forms of vitamin B12 and folate are needed for the conversion of homocysteine into methionine, so elevated homocysteine can be one of the indicators of deficiency in these important vitamins (remember that there are drugs like Methotrexate and acid blockers like Nexium which block the metabolism or absorption of these vitamins and may cause elevations in homocysteine levels). Serum homocysteine is great screening test for patients who are at a risk for cardiovascular disease and stroke, especially when there is a family history but no other known risk factors. Strive to keep levels around 8 micromoles/L. If elevated Homocysteine levels are due to a genetic variation in key enzymes of the methylation pathway then supplementation will usually be required long-term with frequent (every 3 months) monitoring of levels.

6. Ferritin levels

Ferritin is an iron-containing protein produced in the liver, and signifies the stored form of iron. Ferritin can also be a marker of inflammation. Moderate elevation of ferritin may lead to a 2-3 times increased risk for development of diabetes. Though the normal range in your lab for ferritin can be from 12-150 ng/mL in women and 12-300 ng/mL in males, studies have shown high ferritin levels increase cardiovascular risk. Lowering the iron stores to near optimal level of between 70-80ng/mL will improve outcomes in cardiovascular disease including reduced risk for heart attacks, strokes and also improve life expectancy. As a side note, I don’t think that ferritin levels less than 50ng/mL are in any way normal (even though your lab may show it in the normal range) and reasons for low iron stores must be looked into.

7. Testosterone levels (in males only — no correlation with heart disease has been found in women)

In males, testosterone deficiency has been associated with a high risk for cardiovascular disease. In elderly males, lower free testosterone level has been shown to be associated with a high prevalence of cardiovascular disease. If your total and free testosterone levels are low, work within integrative or a functional medicine physician to find out why that is the case. Replacing testosterone may not be the only answer. Certain natural supplements like Zinc, Magnesium, L-carnitine, B vitamins especially B6 can help support Testosterone levels naturally.
Males should try to keep testosterone levels between 350-600ng/dl. Remember, more is not always better with testosterone therapy if you need it, and always seek out a physician well versed in male hormonal replacement therapies, or someone who can help guide you to support your body’s hormone production naturally!

8. Testing for chronic infections

Many pathogenic bugs have been shown to have a significant correlation with development of coronary heart disease as well as acute coronary syndromes (heart attacks). Some of these are herpes simplex virus, cytomegalovirus, and H. pylori. Ask your physician to test for antibodies to these bugs through your local laboratories. Since most of your immune system is in the gut, taking a multistrain good quality probiotic can be a great first step.
Print out and take this list to your physician to help them better evaluate your risk for heart disease, or find a functional medicine physician who is well versed in managing and counseling patients with metabolic disorders!
Dr. Manisha Ghei first wrote this article for  Mind Body Green
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

September 20th, 2015

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