Low cholesterol caution: Why you need cholesterol

We frequently hear about the dangers of high cholesterol, but keeping cholesterol as low as many doctors recommend may be doing your body more harm than good.

Although conventional medicine has demonized cholesterol and many healthy foods as a consequence, too little cholesterol can be harmful in a variety of ways. Your body uses cholesterol to make cell membranes, hormones, vitamin D, bile acids (to help you digest fats), and it’s vital to good brain function.

Cholesterol prevents depression and memory loss

Cholesterol is abundant in brain and nervous tissue. It provides insulation around nerve cells that transmit electrical impulses, thus maintaining healthy communication in the brain. It also supports the activity of neurotransmitters, chemicals used for communication that greatly affect our mood, personality, and cognitive function. In fact, sufficient cholesterol is necessary to prevent depression and cholesterol-lowering medications have been linked with loss of memory and cognition.

The majority of your brain is made up of fat and the fats you eat help determine the chemical structure of your brain. Many of the foods people are told to avoid in order to lower cholesterol—eggs, fatty meats and fish, butter—also contain choline, a precursor to a brain chemical called acetylcholine. Acetylcholine is necessary for learning, memory, concentration, and focus. It’s important to eat healthy, natural fats and avoid processed vegetable oils. You also want to strictly avoid trans fats, or hydrogenated oils, which have been shown to damage the brain and raise your risk for heart disease.

Cholesterol needed for healthy hormones

Cholesterol is a primary building block for the reproductive hormones, such as estrogen, progesterone, testosterone, and adrenal hormones. When cholesterol is too low, hormone deficiencies may result. Sufficient cholesterol is also necessary to digest vitamins A, D, E, and K, which are found in fats and are important antioxidants.

Although cholesterol scares are over inflated, it is nevertheless important to pay attention to other lipid panel markers, such as the ratio of HDL to LDL, triglyceride levels, and small, dense LDL. It is important to note too that some people have a genetic tendency toward extremely high cholesterol. In those situations medical attention beyond diet may be necessary.

Inflammation is the real culprit in heart disease

Researchers are increasingly finding chronic inflammation, not healthy dietary fats, damages the walls of the arteries and raises the risk of heart disease. Cholesterol's job is to repair this damage by creating patches, or plaques—it is more the Band-Aid for arterial damage than the cause.

High blood sugar and insulin increase inflammation and heart disease risk

High blood sugar and insulin levels are a primary cause of chronic inflammation. Sweet and starchy foods such as desserts, pastries, cereal, white rice, sodas and sweet drinks, and any other foods that spike the blood sugar and subsequently insulin are the real threat to the arterial walls.

When it comes to looking at your risk of heart disease on a blood test, inflammatory markers such as C-reactive protein (CRP), a protein in the blood that rises in response to inflammation, are important to check. High triglycerides and abnormal blood sugar levels are other markers that can reflect whether your diet may be promoting inflammation.

To learn more about healthy cholesterol and a genuine heart-healthy diet, contact my office.

How to motivate yourself to exercise

Exercise is the golden bullet when it comes to lowering your risk of heart disease, bone loss, dementia, high blood pressure, diabetes, obesity, and a long list of other modern health maladies. Yet many Americans just can’t seem to make the time or find the motivation.

The problem, say researchers in a New York Times article who have studied the issue, is that exercise is a “should” instead of a “want.” For many people, exercising to prevent a possible health problem later in life is not a good enough reason to get out of the office chair or off the sofa. Being scared into exercising because of a current health condition, like obesity, heart disease or bone loss, may be more effective, but still fails many.

Give exercise an emotional hook

With most of the population struggling with overstuffed schedules, people will only fit in what they feel is absolutely necessary for that moment. Therefore, say research psychologists, we need an emotional hook to compel us to stay physically active. The solution is not to exercise for theoretical medical reasons or some long-off health goal, but because it makes your life better now. Instead of using media scare tactics or self-admonishment to make yourself exercise, find what’s enjoyable about it and use that.

For instance, one researcher suggests a busy working mom use a walk with her kids as a way to spend time with her children and teach them the importance of physical activity.

Another woman, struggling with obesity and diabetes, decided to use long walks to spend time away from her kids and fulfill a life-long dream of taking photos during her walks to use for paintings later.

Another woman in her 60s meets her daily goal of walking for an hour thanks to the company of a friend, so that her morning walks are also a time to socialize.

Reasons that will motivate you to exercise

A number of emotional benefits can help motivate you to exercise if health goals aren’t good enough carrots on a stick. Below are some reasons that may give you cause to get moving.

• Sleep better at night
• Relieve depression
• Relieve anxiety
• Relieve stress
• Boost energy and productivity
• Better able to cope with daily frustrations
• Endorphin rush, that natural high from physical exertion that lasts for hours
• Boost self-esteem; exercise makes you feel better about yourself and how you look
• Time to socialize if you exercise with one or more friends (adding the health bonus of socialization)
• Time with the family
• Time away from the family
• Time with a favorite pet
• Time doing something fun and playful (dance, skating, Frisbee, golf, hiking, etc.)

Making exercise fun improves motivation

When trying to meet your exercise “dementia-prevention” quota or weight loss goal, it’s easy to get trapped in a boring, noisy gym, staring at the television while on the treadmill, or going through a tired old weights routine. Although certainly better than not exercising at all, some people may find such routines too boring and eventually lose motivation to continue.

Find ways to turn your exercise into play time; scientists have found other species of intelligent animals, such as dolphins, chimps, and otters, play throughout their adult lives as a way to stay active and socially connected. Think back to when you were a child and what you found enjoyable. Perhaps you will have more fun taking your walks to an outdoor hiking area, swimming, doing Zumba, or even roller skating.

Although regular exercise is a powerful tool for health, its ability to simply enhance your current quality of life is undersold by the media. By dropping the health obligations and making exercise into something fun and enjoyable, you will look forward to doing it every day.

Diet for diabetes may be different than you thought—20 percent are “type 1.5”

Although insulin resistance and type 2 diabetes get pinned on diet and lifestyle choices, in some cases these disorders could be associated with an autoimmune reaction, which is the mechanism behind type 1 diabetes. If so, this changes the diet for diabetes to manage the autoimmune condition. It is estimated that 20 percent of people with type 2 diabetes also have an autoimmune reaction against the cells of their pancreas, prompting researchers to dub this “type 1.5 diabetes.” Type 1.5 diabetes may be even more prevalent than type 1 diabetes.
Insulin resistance (pre-diabetes) and diabetes are typically linked with a long-standing diet heavy in sweet, starchy foods and processed fats, as well as overeating and a lack of exercise. This is often referred to as “adult-onset diabetes,” although it’s becoming more common in younger people as their obesity rates rise. In these cases a diet for diabetes would involve managing blood sugar. Type 1 diabetes, referred to as “juvenile diabetes,” is an autoimmune disease in which the immune system attacks and destroys pancreatic beta cells, which produce insulin.
A person with type 1.5 diabetes may have aspects of both: diet and lifestyle affect pancreatic function, as does an autoimmune reaction which may or may not have been identified. In this case a diet for diabetes would address blood sugar and autoimmune management.

Are you a slender, healthy diabetic or pre-diabetic? Consider type 1.5

Some individuals are at a healthy body weight, exercise regularly, and eat a healthy diet yet can’t seem to control their consistently high blood sugar levels. With type 1.5 diabetes an autoimmune reaction destroys cells of the pancreas, but the pancreas still secretes insulin—autoimmune damage is not advanced enough to shut down insulin function. In type 1 diabetes, on the other hand, more than 90 percent of the insulin-producing cells have been destroyed. Because a person with type 1.5 diabetes has not sustained pancreatic damage to such a great degree he or she is often misdiagnosed.

Identifying type 1.5 diabetes

If a diet for diabetes that is lower in carbohydrates begins moving blood sugar toward a normal range, it may be that your insulin resistance or type 2 diabetes does not have an autoimmune component. However, if insulin resistance or type 2 diabetes are stubborn despite a diet for diabetes, or if you are slender and active, it’s worth screening for antibodies against pancreatic beta and islet cells. Additionally, some people have antibodies against the glutamic acid decarboxylase (GAD) enzyme, which is involved in the release of insulin from the pancreas. GAD is also found in areas of the brain, and an autoimmune reaction to GAD may be associated not only with a blood sugar disorder but also with such neurological symptoms as obsessive-compulsive disorder, dizziness, or problems with balance.

A diet for type 1.5 diabetes

Because type 1.5 diabetes is autoimmune, these individuals will want to go beyond a diet for diabetes that manages blood sugar to include managing the immune system. This means strictly avoiding immune-reactive foods, which for most people includes gluten and dairy. The GAD enzyme may cross-react with gluten so that eating gluten can stimulate an immune attack against GAD. Additional foods that trigger autoimmune reactions can be ferreted out by adhering to an autoimmune diet for a period of time. With type 1.5 diabetes, a diet for diabetes should be an autoimmune diet that also manages blood sugar.
Beyond a diet for diabetes, a number of nutritional compounds have been shown to regulate the immune system and dampen autoimmunity. Ask my office for advice on managing autoimmunity.

When your blood is drawn could affect TSH level and hypothyroidism diagnosis

If you check your thyroid levels in the afternoon with a blood draw, results may come back normal even though you’re hypothyroid, according to a new study. Checking your TSH in the morning can give you more accurate results.

Like other hormones in the body, thyroid-stimulating hormone (TSH) follows a daily rhythm and is not consistent throughout the day. Researchers in the study evaluated untreated patients with subclinical hypothyroidism along with patients taking a T4 hormone. They tested the participants’ TSH before 8 a.m. and again between 2 and 4 p.m.

In both groups TSH dropped substantially during the afternoon test, which would have led to hypothyroidism not being diagnosed in about 50 percent of the untreated participants.

Their TSH was 5.83 mU/L in the morning and 3.79 mIU/L in the afternoon. In the group being treated with thyroid medication TSH was 3.27 mIU/L in the morning and 2.18 mIU/L in the afternoon.

A 2004 study also showed that late morning, non-fasting TSH dropped 26 percent compared to early morning, fasting TSH.

Timing of TSH test adds new ammunition to thyroid range controversy

The researchers concluded that the timing of your blood draw plays an important role in how to decipher the results of your thyroid panel.

Unfortunately, even with an early morning blood draw, many hypothyroid patients still slip through the cracks because most doctors use ranges that are too wide.

It’s still very common for doctors to diagnose hypothyroidism using a TSH range of 0.5 to 5.0 mIU/L even though the American Association of Clinical Endocrinologists recommended years ago the range should be 0.3 to 3.0 mIU/L.

Functional medicine uses narrower ranges and more markers to identify hypothyroidism

In functional medicine we use an even narrower range of 1.8 to 3 mIU/L. We also know in functional medicine that looking at TSH alone can miss hypothyroidism.

For some, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that looks at a more complete thyroid picture, which can include total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Evaluating other thyroid markers gives insight into these imbalances.

Always screen for autoimmune Hashimoto’s hypothyroidism

In addition to these markers, anyone with hypothyroid symptoms should be screened for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland. Hashimoto’s accounts for about 90 percent of hypothyroid cases in the United States. You screen for Hashimoto’s by checking TPO and TGB antibodies.

Although thyroid medications may be necessary to maintain thyroid function, they do not address the immune system’s relentless attack against the thyroid gland. Not managing Hashimoto’s increases the risk of developing other autoimmune diseases. These can include pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes.

Ask my office how to properly evaluate your thyroid symptoms and lab markers for appropriate thyroid management.

 

Your antacid may be doing more harm than good

No one can be blamed for wanting relief, especially when acid reflux makes it feel like molten lava is shooting up through your esophagus. Antacids can bring quick relief, but their long-term use can also bring lasting problems. It’s better to identify and address the underlying causes of acid reflux than simply to squelch the symptoms.
Acid reflux occurs when the contents of the stomach backwash into the esophagus. These contents can include stomach acid, bile, food, or sour liquid. Although the lining of the stomach is designed to handle such an acidic environment, the more delicate tissue of the esophagus is not. As a result, symptoms include indigestion, a burning sensation in the chest (heartburn), and tasting regurgitated food or liquid in the back of your mouth.
Many factors can cause acid reflux, including overeating, obesity, or the types of foods you eat. Spicy foods, fried foods, coffee, chocolate, and citrus are frequently cited as triggering acid reflux. When the reflux becomes constant, it’s worth exploring some of the common underlying conditions.

Possible underlying causes of acid reflux

H. pylori overgrowth: An H. pylori infection occurs in the stomach and is the most common chronic bacterial infection, affecting more than 50 percent of the world’s population. An H. pylori infection may promote acid reflux by decreasing stomach acid. Although acid reflux is associated with too much acidity, the truth is in many cases too little stomach acid causes acid reflux, which I’ll explain in the next paragraph.
Too little stomach acid: Sufficient stomach acid is necessary to break down dietary proteins, ensure absorption of vital nutrients and minerals, and protect the digestive tract from harmful bacteria. It’s believed that low stomach acid, or hypochlorhydria, results in improperly digested food lingering too long in the stomach. Eventually it backwashes into the esophagus, and although the contents are not acidic enough for the stomach, they are too acidic for the delicate esophageal tissue. Factors that cause too little stomach acid include an H. pylori infection, a nutrient-poor diet, stress, and antacid medications.
Gluten: If you eat gluten, it could be a culprit in your acid reflux. One study found chronic acid reflux affected 30 percent of patients with celiac disease compared to less than 5 percent of those not diagnosed with the disease. Another study found almost 40 percent of children with celiac disease suffer from esophagitis, inflammation of the esophagus that causes heartburn.

Acid reflux usually just one of many digestive symptoms

Acid reflux is often just one of many digestive symptoms that can result from poor digestion, food intolerances, chronic stress, gut infections, and other factors. In fact, one study showed that participants with irritable bowel syndrome (IBS) were nearly twice as likely as non IBS participants to suffer from gastroesophageal reflux disease (GERD), a chronic, advanced form of acid reflux. Conversely, another study found a majority of participants with GERD also suffered from IBS.
Although antacids can bring temporarily relief, they may also worsen your acid reflux problem in the long run. Ultimately, antacids reduce stomach acid, hinder digestion, and inhibit nutrient absorption. In addition, antacids are shown to weaken bones and increase the risk of food poisoning.
For natural ways to relieve your acid reflux, please contact my office.

Your spouse: The biggest barrier to a gluten-free diet?

You swore to support each other in sickness and in health, yet when it comes to a gluten-free diet, you may have found your spouse to be your biggest barrier to success.

Spouses complain that eating gluten free is too expensive and too restrictive, they tell you that you’re making a big deal about nothing, or perhaps they simply cannot imagine life without those staples of Western civilization, bread and pasta. Whatever the reason, spouses are often one’s greatest saboteur when it comes to maintaining a gluten-free diet.

Gluten-eating spouse sabotaging your gluten-free diet?

Their transgressions can be maddening. They order pasta with garlic bread in front of your newly gluten-free children, who proceed to cry through the rest of the meal. They dip their knife into your gluten-free mayonnaise after having used it on their whole wheat bread. They don’t read labels, feed the kids something with gluten in it, and then go off to work while you’re left at home to deal with your children’s stomach aches or behavioral outbursts.

Does going gluten free unearth marital issues?

Sometimes a spouse’s stubbornness unearths dormant marital discord that may require attention. Or the new gluten-free dieter becomes assertive and demanding for the first time in the relationship, which can rattle spousal dynamics. But given that gluten is linked to 55 known diseases and many neurological issues, going gluten free is worth the fight.

How to win over your reluctant spouse to a gluten-free lifestyle

The first spouse to go gluten free is often the wife. This is because moms usually spend more time caring for and feeding the children, and are more apt to notice health issues and take dietary action.

Also, the hormonal upheavals of pregnancy and childbirth can be a health tipping point for many women, who must buckle down to manage an autoimmune disease, adrenal dysfunction, hypothyroidism, inflammation or other issue after the baby is born.

So how does one win over a reluctant spouse to support a gluten-free diet?

How others have gained support from their spouse for a gluten-free diet

Patience, persistence, education, and even the willingness to nag are the ticket, say those who’ve done it.

• “My husband had to see a lab test with positive transglutaminase antibodies [regarded as a celiac marker] and stool IgA antibodies to gluten [a marker for gluten intolerance] to be convinced our child needed to be gluten-free.”
• “I would nag and nag and nag. I would send video via cellphone of one of the kids losing it after eating gluten.”
• “Experiencing the severe sleep deprivation of a breastfeeding baby who was colicky and having that go away when I went gluten free.”
• “He saw how differently I acted and felt on a gluten-free diet, and saw positive changes in our son.”
• “He saw how sick I got when insensitive visitors who insisted on eating gluten contaminated my kitchen and my food.”
• “He saw I was literally unable to move, stand, use my hands, or do anything unassisted for six weeks.”
• “We called a mediator to write up a divorce agreement at the start of a GAPS diet [a stricter, grain-free diet many moms have discovered helps their children who have autism symptoms]. He told me he would leave if I didn’t go back to the way things were. I told him I could not and would not ever go back. Many rough times later, he is eating with us and on his own healing journey. We went from numb, angry, ramen-eating zombies to people who fell in love on a deeper level.”

Many spouses eventually embrace gluten-free diet

Given enough time on a gluten-free diet—even if it’s initially against their will—even the most stubborn of spouses may see the light. For instance, when the wife and kids are eating gluten free at home, the husband can get his gluten fixes only when eating out. During such a gradual weaning, some are amazed to find they also suffer from a gluten intolerance. One husband discovered gluten to be a trigger for his canker sores and migraines. The chronic back pain and depression of a spouse magically lifted on a gluten-free diet. Others find they are more energetic and clear-headed.

You, too, may find that your resistant spouse not only becomes more supportive but also embraces the diet as his or her own.

Could your IBS, constipation, or diarrhea really be SIBO?

Do you meet the criteria for irritable bowel syndrome (IBS) and can’t find relief? Do you look pregnant thanks to a bloated belly? Are chronic diarrhea or constipation your constant companions? If so, you may be a victim of stubborn gut bacteria, also known as small intestinal bacterial overgrowth (SIBO).

While a long list of symptoms accompany SIBO, its trademark symptoms are a chronically bloated, distended belly; gas, which can cause flatulence, belching, or both; and a tendency toward chronic diarrhea, constipation, or both.

SIBO symptoms

• Excess gas, flatulence, belching
• Abdominal bloating from gas
• Abdominal pain and cramping
• Constipation, diarrhea, or both
• Nausea or heartburn
• Irritable bowel syndrome
• Multiple food sensitivities
• Leaky gut
• Fatigue
• Malabsorption symptoms (anemia or fatty stools)
• Rosacea
• Neurologic and muscular diseases

How SIBO causes bloating, gas, constipation, and diarrhea

The entire gastrointestinal (GI) tract contains bacteria, both good and bad. The small intestine contains bacteria different from that of the large intestine. In the case of SIBO, the small intestine contains too much bacteria, and these bacteria more closely resemble the bacteria of the colon. These bacteria consume sugars and carbohydrates, producing large amounts of gas. Not only does this gas cause bloating, belching, and flatulence, it is also behind chronic cases of constipation and diarrhea (depending on the type of gas produced).

SIBO causes leaky gut

In addition to producing gas, the bacteria create byproducts that irritate and damage the lining of the GI tract. This damage causes intestinal permeability, or “leaky gut,” a condition in which the lining of the intestine becomes damaged and overly porous, allowing undigested foods, infectious bacteria, and other pathogens into the bloodstream. This creates inflammation in the GI tract and throughout the body. And because the bacteria digest foods normally meant for the intestine to absorb, nutrient deficiencies and malabsorption are common side effects with SIBO.

SIBO linked with restless leg syndrome and other neurological conditions

In addition to causing gastric complaints, SIBO is linked with neurological and cognitive symptoms. One of the best known is a condition called restless leg syndrome.

How to manage SIBO

Diagnosing SIBO involves a hydrogen breath test, which has the patient ingesting sugar solutions and giving breath samples over a period of several hours. Although experts debate its validity, clinicians report hydrogen breath test results often correspond with symptoms. Standard medical treatment of SIBO, which includes expensive antibiotics, has a good success rate, but patients can relapse if they do not take preventive measures after treatment. Anecdotal reports show success using herbal antibiotics, although there are no published studies. A medical fast using a nutrition drink for two to three weeks shows a good success rate, as it starves the bacteria. But because no eating is allowed during the fast, many find it too challenging a remedy.

The Specific Carbohydrate Diet and Gut and Psychology Diet, which are widely touted online, also aim to starve the bacteria by eliminating foods the bacteria need to survive: all grains, most legumes, all sugars and sweeteners excluding honey, and starchy vegetables. Both diets require strict adherence for a full year after the resolution of symptoms. In real terms, this could mean being on the diet for up to four years.

The good thing about these two diets is that they are virtually identical to diets used to manage autoimmune disease and chronic inflammation, and can thus address far more than SIBO.

For more information, visit www.siboinfo.com.