Monthly Archives: December 2013

Stress Connection Self Assessment

Hope everyone made it through Christmas without too much stress and with lots of love, compassion, laughter and joy.

I was at the “adding food back in” phase of testing for food sensitivities….good timing.  We were invited to our neighbors for turkey and all the fixings…what to eat?  I decided on turkey, mashed potatoes, sweet potatoes and pumpkin pie (without the crust, of course)….the one thing I decided to add back in my diet was dairy which I did with yogurt ice cream and whipped cream…I know, not the best choices but I wanted to enjoy Christmas and be a gracious guest.   It was delicious!  …..but, no question that I have a problem with dairy…tried just plain yogurt yesterday and didn’t react as much….interesting, besides the usual symptoms of bloating, stomach pain, and gas, I had itchy eyes, which I never thought of as a symptom before…another would be moodiness or depression…need to really pay attention and record everything.  So after adding dairy back to my diet for two day I now need to stop using dairy and wait for all the symptoms to go away before starting the next food to add….which will be corn.  So back to the Stress Connection Self Assessment.

There are four self assessments; Past Stressors, Current Stressors, Self-Care and Adrenal Fatigue Symptoms.  Then looking at all your test results you look at what pattern you fit.  For the most part my symptoms, when put together showed up as pattern 2, which says “Your adrenal glands are shot, but you don’t have many stressors and you have been doing better taking care of yourself.  This pattern shows someone who has an empty bathtub with a drain that is closed. Why isn’t the bathtub filling with water?  Why aren’t your adrenal glands bouncing back?  If you started your self-care and stress management programs only within the past year, my guess is that it just hasn’t been long enough.  You should still focus on the treatment suggestions in the following section but pay extra attention to the herbs and supplements that can help your adrenal glands recover.  You might have other systems in your body that are not functioning properly, such as your detox system or gut.  Or you’re eating foods that are causing stress for your system and keeping your adrenal glands from recovering or making them sick.” 

Treatment Plan:  Manage stress using meditation, imagery, drawings, and journaling for self -awareness.  I’ve been using the body scan and yoga meditations from Jon Kabat-Zinn, www.mindfullivingprograms.com .  I decided to try something using imagery and found an app that I really enjoy that’s free called Sleep Lite by Belleruth Naparstek.  Many other imagery ideas at www.healthjourneys.com.  Also, I took a class at the senior center for Emotional Freedom Technique (EFT) which is a series of meridian pressure points on your face and chest that you tap with your fingers as you recite positive thoughts towards healing or whatever change you’re trying to bring about.  I’ve been doing one for sleeping, since that’s my most challenging area right now.  Here’s a site to get you started.  www.eft.mercola.com.

Soft Belly Breathing.  I do this every night before I go to bed or if I’m stressed about something…really works.  Basically, you breath deeply in through your nose (you can lay your hand on your stomach and feel it raising up) and think “soft” then exhale and feel your stomach go flat and think “belly”, continue for 5 minutes…it’s the simple things that really work…give it a try.  Check out the Center for Mind-Body medicine at www.cmbm.org for more ideas…also the book, Unstuck, by James Gordon.

Tips for Sleeping Better:

  • Make sure you’re finished eating a large meal 4 hours before bedtime.  Lighter dinner 3 hours before bedtime.
  • Limiting or eliminating alcohol completely is important for healing your adrenal glands.
  • One hour before bedtime turn off all electronics.
  • Develop a nightly routine such as a warm (not hot) bath or shower, soothing music, lighting a scented candle, and/or reading an uplifting book.
  • Go to bed at the same time every night, even on weekends.  Be sure your bed is comfortable.
  • Keep your bedroom cool, dark, and quiet and reserve the bed for sex and sleep only.
  • Try meditation, progressive relaxation, breathing awareness and guided imagery to help the body and mind prepare for sleep.
  • Try journaling 30 minutes before bed asking “What is on my mind”…she calls it downloading your thoughts.

If these things don’t help try:

  • Theanine, 100 mg at bedtime and another 100 mg in the middle of the night if you wake up and can’t fall back to sleep.
  •   Herbal blends with valerian and passionflower.
  • 5-HTP 100 mg at bedtime, which will help you stay asleep.

Eating Stress-Free

  • Eat breakfast, lunch, a snack, and dinner every day.  Going more than four hours without eating activates your stress system.
  • Have a majority of your calories before 3:00 p.m.

Exercise

  • Make a plan for moving your body and keeping it active.  At a minimum, two hours per week of something aerobic (mild difficulty talking while you are exercising)  You should feel warm and slightly out of breath.
  • If you have extreme fatigue, wait until the fatigue lessens and your energy is coming back before starting.
  • Get a personal trainer for several session or a physical therapist can also design a home program and may actually be covered by your insurance.

Foods that support your Adrenal

  • First eliminate all white flour and white sugar and stop drinking soft drinks and adding sugar to your tea and coffee.
  • Eat protein with all your meals and snacks (nuts, seeds, and legumes, free range organic chicken and grass-fed beef)
  • Eat plenty of tyrosine (almonds, dairy products, lima beans and pumpkin and sesame seeds)  If you have a problem with dairy leave that off.
  • Healthy fats from avocado, coconut, fish, nuts, or seeds with every meal.
  • B vitamins, especially B5 and B6 (cremini and shiitake mushrooms, calf’s liver, eggs, cauliflower, cucumbers, avocados, asparagus, broccoli, celery, turnip greens, tomatoes, sweet potatoes, collard greens,chard and bell peppers).  Vitamin B6 (summer and winter squash, bell peppers, turnip greens, shiitake and cremini mushrooms, spinach, cauliflower, mustard greens, cabbage, asparagus, broccoli, kale, collard greens, Brussels sprouts, green beans, leeks, tomatoes, garlic, tuna, cod, chard, calf’s liver, turkey and salmon.

Supplements

  • Eleuthero (Siberian ginseng) or Asian ginseng (100 – 200 mg)
  • Rhodiola (100 – 200 mg)
  • Ashwagandha 500 mg once a day
  • B vitamins (300 – 1,000 mg) per day
  • Licorice (no more than 500 mg per day)
  • DHEA (under guidance of a professional

Professional Help

  • Find a physician, naturopath, chiropractor, or osteopath trained in functional medicine at www.functionalmedicine.org  OR you can go to a functional medicine lab website, like Genova Diagnostics, www.gdx.net or Metametric labs, www.metametrix.com and find a practitioner who uses their services.  Practitioners trained in acupuncture, herbal medicine, homeopathy, and naturopathy areall able to treat adrenal fatigue.
  • Make sure they give the following tests:  Adrenal Saliva Test, Blood work to measure DHEA, testosterone levels…under the supervision of a doctor, women should increase testosterone by taking DHEA, fixing their adrenal glands and adding 1 – 2 tbsp. of ground flaxseeds to your daily diet.

Healing your gut next time…

Still trying to get the lab tests through my doctor…ANA, Anti-SSA, Anti-SSB, Anti-nuclear antibodies, anti-phospholipid antibodies, antibodies to double stranded DNA, Anti Smith (sm) antibodies.  These are basic tests that should not be a problem to get and they aren’t able to pull them up to order them, so they’re having the lab check into it and will get back to me…If I’m not successful here, there is a functional type doctor I can go to but will not be covered by my insurance.

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Understanding the Stress Connection

This is THE most important chapter in my opinion because you can have the best diet in the world, exercise regularly and be in great shape….but if you’re reacting to stress instead of RESPONDING to it, like me…then you will eventually have health problems of some kind.  I believe my reacting to stress started as a baby….I was just one of those sensitive babies that reacted to every sound, every new situation….compound that sensitivity with having a very turbulent family life…alcoholic and abusive Father …I was incredibly shy, zero self esteem, thought I was so ugly that no boy could stand to even look at me (so sad and silly, I know)…but hey, I’m an adult now, I appreciate the good things my Mother and Father gave me and forgive the rest and am ready to move on.  I’m 56 years old…I’d say it’s about time to live my life…don’t you?  Stop fretting about every little thought in my head and be present, right now, experience the things that bring me happiness, joy, laughter and good health.  So here we go….the highlights from Understanding the Stress Connection:

The autonomic nervous system that controls your body functions such as heart rate, temperature, blood pressure, breathing rate and digestion has an on and off switch that is supposed to balance each other.  The on switch is called the sympathetic nervous system and it fires up when you’re stressed (you’ve heard fight or flight response). The off switch is called the parasympathetic nervous system and it acts as the brakes, helping you relax and turn off the stress response.  It’s supposed to turn off the fight or flight response, helping to bring you back into balance so you don’t get stuck in overdrive.

There’s also a hormone response to stress which starts in the hypothalamus and pituitary gland…where your emotions, thoughts and feelings are translated into hormone signals. which stimulate all your endocrine organs, including the thyroid, adrenals and ovaries to make their own hormones.  Cortisol is the most potent and raises your blood sugar so you can have the fuel to fight or flee and is the main anti-inflammatory hormone in the body, suppressing your immune cells and preparing your body for a potential injury…having direct impact to your immune system.  One of the most common symptoms of chronically high cortisol levels is an expanding waistline.  Belly fat is sometimes called “brown fat” because it looks and behaves differently from the other fat in your body, creating a lot of inflammation.  Stress normally has a starting point and an ending point but sometimes the stress system gets stuck in the on position.  This is called chronic stress.  I love the example Susan Blum gives in her book, about a documentary on zebras and lions.  “When one of the lions started chasing one of the zebras it was clear that the zebra was in a fight-or-flight mode as it ran for its life.  Finally, when it evaded the lion, its body began to shake wildly.  But then an amazing thing happened:  this same zebra who had just been running for dear life began quietly grazing in the field like nothing had happened.  It had already forgotten about the near-death experience it had just had, and I’m sure that if we measured the stress hormone levels in that grazing zebra, they would have been back to normal.  The zebra had a way to turn off the stress response and was now moving on.  Wish I could do this…I’ve actually heard a similar story about ducks….that after they fight they shake and ruffle their feathers then go back to what they were doing.  Here’s a good thing to try…when you’re going through a stressful situation, just taking a few deep breaths, might work the same way…..hey, I just thought of the term “shake it off”…maybe that’s where that came from.

Stress is believed to be a contributing factor in an amazing 80 percent of all chronic conditions, including autoimmune disease, heart disease, stroke, diabetes, and cancer.

The Adrenal glands.  Conventional medicine has ignored them because our medical system is primarily focused on looking for disease and the main diseases of the adrenal glands are extreme situations…Cushing’s syndrome (high levels of cortisol, usually from a tumor) and Addison’s disease, an autoimmune condition that destroys the adrenal glands so they fail to make any hormones at all.

These are the hormones produced by the adrenal:  Aldosterone, regulates blood pressure.  DHEA, regulates blood sugar and lipids and helps support your bones.  In women they can also make testosterone and estrogen from DHEA, especially during menopause.  Cortisol, the most potent stress hormone is considered a primary hormone…needed for life.

The adrenals are happiest and healthiest when you’re sleeping a minimum of seven but preferably eight or more hours a night, eating balanced meals that contain adequate protein and veggies, limiting sugar and white flour, practicing some form of relaxation, exercising moderately (not too much and not too little), and minimizing your exposure to toxins.  The first thing that happens when your adrenal glands get weary is that your DHEA and testosterone levels fall.  Your adrenal glands are focusing all their efforts on making cortisol….which is needed to live, whereas low DHEA and Testosterone might make you sick, but you’ll live.  If you don’t do anything about it, next you may no longer produce sufficient cortisol and adrenaline.  Then your levels of these two crucial hormones begin to plummet, severe exhaustion sets in, often combined with inflammation in the joints or muscles that can cause pain, swelling, or stiffness, especially in the morning.

Okay….so do I have adrenal fatigue?  If you have a history of a lot of stress, not getting enough sleep or exercise, eating a diet high in sugar and bad fats, you don’t ever slow down and relax, and you have a high toxic overload (which can be mercury in your fish, pesticides in your food, or other exposure to environmental chemicals)…..your adrenal glands may be exhausted.  Well, I have a history of a lot of stress, even though I have very little stress now, I haven’t been able to sleep well for the last few years, I have trouble slowing down and relaxing (although I’m working on this, with breathing techniques, meditation, yoga)…For the last year I’ve had an extremely good diet and have always exercised regularly (sometimes too much…which I’ve toned that down quite a bit in the last year)

If you wake up tired, feel best during the middle of the day, crash and need a nap in the late afternoon, and then get a second wind at night, you have the classic pattern of tired adrenal glands.

Stress can directly suppress an immune moledule (called secretory IgA) that helps keep the good bacteria strong and growing and the bad bacteria and yeast out.

Meditation causes blood vessels to relax and dilate; as a result, more blood vessels relax and dilate.  Your body can actually learn to have a different kind of response to a situation so that you don’t turn on the damaging hormones and instead maintain a balanced inner world that will help you prevent and reverse any chronic illness you have.

Check out The Center for Mind-Body Medicine at www.cmbm.org for ideas.  One of her suggestions is the book that I was already reading and love, Full Catastrophe Living, Using the Wisdom and Your Body and Mind to Face Stress, Pain and Illness by Jon Kabat-Zinn, PhD (see website at www.mindfullivingprograms.com).  He also has some meditation and yoga CDs.  I bought this book a couple years ago but I guess I wasn’t quite ready to make any changes…my health has given me a new outlook and I’m loving every page and soaking it up.

Next week I’ll go over the chapter, Understanding the Stress Connection Workbook….a self assessment to find out how to put it all together and know how to proceed with a plan for you.

Using Food As Medicine Workbook

I started my food sensitivities diet on the 1st of December….this means  for 3 weeks no gluten, dairy, corn or soy.  Initially I thought it was eggs too, but she didn’t include that in this section.  After 3 weeks I’ll be adding back each, one at a time to see if I have any symptoms.  I was already eating gluten and dairy free for the last year so I didn’t think this would be too hard….UNTIL….. I was invited to a “Spicy Lady Party” by my neighbor.  Okay, I can’t lie, I went off the diet that day.  Everyone was assigned a spice and was asked to bring a dish with that spice.  It was fun and fabulous….games, jello shots and all the different dishes that people brought….spring rolls, crème briolette, green chile, goat cheese brie with rosemary….how could I vote on the best if I didn’t try a little of everything.  Well, the next 2 days I payed for it with stomach cramps and exhaustion….but I’m okay now.  Sometimes you have to be “bad”, have some fun…it’s all part of having balance in your life.

So here are the highlights of the 3 week diet:

No gluten (wheat, barley, kamut, rye and spelt)  You can eat quinoa, millet, buckwheat and rice.  Watch out for processed foods containing gluten…even vitamins.

No Dairy (made from cow, goat or sheep’s milk, such as yogurt, cheese, milk, kefir and butter)  Try coconut kefir…delicious!  Dairy alternatives include almond, rice, hemp and coconut milk.

No Corn…read the labels on processed food for cornstarch, corn syrup, corn syrup solids, corn flour and high-fructose corn syrup…anything with the word corn in it.

No Soy.  Read labels.  No soy protein, soy lecithin, or soy oil…check your vitamins, mine had soy and wheat germ.  Later when you find you can eat soy only choose non-GM soy foods such as tempeh, edamame and tofu.

If you don’t have celiac disease but you have another autoimmune disease and gluten sensitivity, you need to be 100 percent gluten free for now, until you have completely healed your gut and have recovered from your autoimmune disease.  After that remain 95 percent gluten free.

Try to eat organic but at least for the list of Dirty Dozen (www.ewg.org)

Eat at least one salad every day.

Stay away from white stuff….white rice, white flour products….

Eat low glycemic…sweeteners:  Agave syrup, Stevia   Drinks:  Filtered water, decaffeinated herbal teas, limit one caffeinated coffee or tea per day   Bread, grains and starches, gluten free bread, pasta, crackers….I use brown rice pasta and gluten free bread…I also found a gluten free pizza crust at Whole Foods that’s really great.   Snacks:  hummus, almond butter or guacamole, nuts, apples, pears, peaches, plums and all berries   Desserts:  coconut milk yogurt or ice creams…declicious!!  Unsweetened dark chocolate, carob.  I like to cook apple with cinnamon, sweet potatoes with ginger and pineapple, or dates with coconut.

If you want some recipe ideas Susan Blum has some on her site at www.blumcenterforhealth.com

Healthy Fat:  Fish oil supplements, grass fed beef, egg yolks (up to 4 a week), ghee (clarified butter), all cold pressed oils, olive oil, canola, flax, safflower, sesame, almond, sunflower, walnut, pumpkin, avocado, coconut oil and milk.

Vitamins and minerals:  Beta-carotene 5,000 – 15,000 IU of mixed carotenes each day, Vitamin C 2,000 mg per day, Vitamine E 200 – 400 IU, Selenium 200 mcg per day, Essential Fatty Acids EPA plus DHA 1,000 – 2,000 mg per day, GLA200 – 250 mg per day for general support, Vitamin D 4,000 – 5,000 IU to raise your level for 3 months then retest, then 2,000 IU for maintenance, Zinc 15 mg of zinc each day, EGCG Green tea 1 – 2 times/day.

 

Tests to ask for from your doctor:

25-OH Vitamin D

Insulin and hemoglobin AIC.  This will tell you if you have been eating too much sugar and if you are at risk for diabetes

Cardio CRP and LpPLA2.  These will tell you if you have one kind of inflammation specifically important for your heart.  Since we don’t have tests for every inflammatory molecule your body makes, these tests are a good place to start.

Next week….Understanding the Stress Connection.

Endocrinologist Appointment Results

After waiting almost 2 months for an appointment I finally went to my endocrinologist appointment on the 3rd.  He ordered many blood tests and a ultra sound of my thyroid.  My next appoint is not until January, but I went to my general doctor who had the results of the blood tests available to her.  She was kind of confused about them, didn’t have the time needed to figure it out….so, as usual it’s up to me to research and learn as much as I can.

There were recommendations by my endocrinologist that didn’t really make sense and I probably won’t follow.  He wants to decrease my Armour thyroid from 120 mg to 60mg.  I think this is too drastic and so did my doctor…so we’re going to try going down to 90mg.  My TSH was .08, which actually, even though it’s below the normal range, might still be okay for me (I just increased my Armour from 60 to 120 mg 3 months ago based on a doctor’s suggestion)  I can’t keep making these drastic changes.  He also noted that he wanted me to stop taking my bio identical hormones.  I don’t agree with this either.  My progesterone is in the normal range (but still on the low side) and estradiol is in the normal range (was extremely high 3 months ago before the bio identical hormones)…I’m staying on my hormones for now and will check the levels in another 3 months.

Other test that were out of range or seemed unusual to me:

Sex Hormone Binding Globulin      204  (range is 130 – 135) Time for me to learn about this….Could be raised due to thyroid hormone?

Testosterone Bioavailable and Testosterone Free were within range but low end

White blood count was 3.7 (range is 3.8 – 11.2)

FSH  158 (range is 20 – 138)

TSH was .08 (range is .34 – 5.60) although I see ranges much lower than this.  My TSH was 2.85 3 months ago, so that’s a big change.  I’ve so had it with doctors saying “everything’s fine, you’re in the normal range”, without giving any consideration to how YOU feel.

Using Food as Medicine

Some of the highlights for me from the introduction to using food as medicine:

You need to make sure you’re getting enough protein (a general formula is 1 gram for each kilogram of your body weight (so for me it was 47.5 grams of protein for 105 lbs)

Do you have a food sensitivity?  Best to rely on how you feel, fatigue, feeling puffy and stiff all over, difficulty concentrating, joint or muscle pain, and any kind of digestive symptoms, such as reflux, gas bloating after eating, diarrhea, or constipation.  Simplest way to see if you have a food sensitivity is to remove the particular food from your diet for 3 weeks and then reintroduce it, and see how your body reacts.  After completing the next section I started her elimination diet on the 1st of December for 3 weeks, eliminating gluten, corn, dairy and soy.  This won’t be difficult because I was already eating gluten and dairy free.  The only thing I’m really missing right now is tortilla chips…need to find a replacement rice chip (that doesn’t have corn added).  Susan includes recipes in each section that are excellent so far…..really loving the granola and rice bowl. 

Gluten.  The genetically modified wheat has been altered to have more gluten because it makes the plant heartier.  With all the processed foods we eat that contain gluten we end up getting highly concentrated amounts.

Celiac.  It’s possible to have no gut symptoms right now but have a reaction in another part of your body from eating gluten.  The first disease you might get is a different autoimmune condition (thyroid, rheumatoid arthritis or MS) before you get any symptoms of celiac.  Gluten sensitivity is determined when your lab tests are normal for celiac but your symptoms go away on a gluten-free diet.  Susan’s recommendation for people who already have an autoimmune diseases is to be gluten free as well.

Tests.  A positive AGA (anti-gliadin antibody test) could be the first sign of potential celiac disease….attacking other tissues in the body.  Hashimoto’s disease, Graves disease, MS and Rheumatoid Arthritis are most often associated with celiac.  The first tests you should ask for from your doctor are AGA and DGA (deamidated gliadin antibody).  Susan says that even though a majority of her autoimmune patients are not positive for this test, she still recommends that everyone with an autoimmune disease stop eating gluten.

Stay away from white flour and white sugar, saturated animal fat and trans fats,.  Eat instead, fish, flax, avocado, coconut, nuts, seeds, olive oil and clarified butter (Ghee).  Choose grass fed, organically raised cattle if you do eat red meat.  Omega 6 (GLA) found in evening primrose, black currant and borage oil supplements….wild salmon, sardines; nuts, such as almonds and walnuts; seeds like sunflower and pumpkin seeds and leafy greens such as kale and swiss chard.

Vitamin D.  Your 25-OH vitamin D levels are good if they’re above 50 – 75 nm/l…take up to 4,000 IU/day monitoring every 3 months. Vitamin A is necessary for the absorption of Vitamin D.

Selenium and zinc.  It’s believed that one of the ways that autoimmunity develops is that the thyroid cells get damaged and look abnormal; then the immune system sees them and attacks, causing more damage and inflammation.  Zinc deficiency impairs your immune system, but zinc supplementation can reverse it….you can get zinc from sesame tahini, pumpkin seeds, and dark chocolate as well as a multivitamin/multimineral supplement.

Green Tea.  Epigallacatechin gallate (EGCG) found in green tea has been shown to be beneficial in treating and preventing cancer, cardiovascular disease, weight loss, neurodegenerative diseases and more.

Next week I’ll share with you how my self-assessment went and how my treatment program started.

On a side note….today I went to an endocrinologist.  When I first began experiencing exhaustion and flu-like symptoms 12 years ago I was diagnosed with Hashimoto’s disease, fibromyalgia, chronic fatigue.  They told me because TSH measured very high one week then very low the next….going from hypo thyroiditis to hyper….after several years I was told by an endocrinologist that my thyroid gland was no longer there (she couldn’t feel it)  Well, she never did any tests to confirm it and I didn’t know any better to ask.  Today I had a ultrasound and was told by the technician that yes, I do have a thyroid!!!  My thyroid antibodies test is showing in the normal range (mine was 2.2, the range is 0 – 14.4).  So they are telling me I don’t have Hashimoto’s.  Wow!  Okay, now what…..they are retesting my levels (I’m taking 120 mg of Armour)…we’ll see.  The doctors I’ve been seeing either don’t know or don’t agree on what’s going on with me.  I really need a Functional Doctor, someone who can look at all areas and put it all together.  Unfortunately there aren’t any here on Maui and my insurance wouldn’t cover it anyway…..so, this is why I’m reading this book.  I’m going to get smart and do what I can on my own, then possibly find a functional doctor in Utah or Colorado if I need more help.  I’m ready to LIVE my life.