Who Uses Integrative Health Practices?

If you have been reading my blog for awhile you know that I firmly believe in integrative health practices.  Techniques and methods borrowed from ancient traditions, such as yoga, manual therapies like massage and manipulation, Ayurvedic and traditional Chinese medicine, acupuncture, nutritional supplementation, homeopathy, meditation and others have definitely earned their place in modern treatment plans.

Am I weird?  Are YOU weird if you believe the way I do?  Well you’ll be relieved to know that we are definitely in good company in our beliefs.

The National Institutes of Health’s National Center for Complementary and Integrative Health recently released a report of the National Health Interview Survey.  Briefly, every year the NIH conducts a survey of 35,000-40,000 homes asking questions about the occupants’ health (both adults and children).  Every 5 years the survey includes questions about complementary and alternative health topics.  The last survey including these topics was in 2012.

In the 2012 survey, NIH found that integrative health practices are on the rise!  Both adults and children are practicing yoga in larger numbers.  Meditation, massage and acupuncture use was stable over the last 10 years.  Chiropractic manipulation therapy was stable among adults, but more parents are choosing manipulation therapy for their children.

The use of natural supplements is changing as well.  Almost 20% of adults and about 5% of children use dietary supplements (defined as products other than a multivitamin).  Fish oil was the most popular product in both adults and children. Other commonly used products include probiotics, glucosamine, coenzyme Q10, garlic and ginseng.

Melatonin use is REALLY on the rise.  Melatonin is a hormone that plays a role in sleep.  The use of melatonin in adults more than doubled in the last 5 years, but the big increase occurred in children.  Melatonin use in kids increased 7-fold between 2007 and 2012.  I guess Americans, both adults and children, are having more trouble sleeping and are seeking a remedy that will give them restful sleep.

What does all this data mean?  1/3 of adults and over 10% of children reported using integrative health techniques in 2012.  The bottom line is we’re NOT weird.  We’re in good company and our numbers are growing!

If you’d like to read the survey results yourself, they can be found at this link.

QUESTION:  Do you use integrative health practices?  Which ones do you use?

 

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3 Ways To Beat Irritable Bowel Syndrome

Chronic stomachaches.  Constipation and/or diarrhea (and sometimes both, alternating).  Bloating and gas.  These are all symptoms of irritable bowel syndrome (IBS).

This is the most common abdominal complaint I see, after reflux symptoms.  Generally patients have been told to decrease their stress level and eat more fiber.  These are helpful, as low fiber intake and high stress levels are associated with IBS.  However, often these measures aren’t successful in completely resolving symptoms.

I wanted to review 3 very effective strategies for helping patients get their irritable bowel syndrome symptoms under control.  Note I don’t say “treating irritable bowel syndrome.”  That’s because the focus in managing irritable bowel syndrome is on patient self-management.  There’s no magic pill to fix it, it’s an ongoing process of self-care that leads to the best results.

1.  Probiotic therapy

One of the simplest and, in my experience, most effective strategies for improving IBS symptoms is a high-quality probiotic supplement.  Probiotic supplements have been proven effective at improving the pain and other symptoms of IBS.

A probiotic supplement contains large amounts of bacterial organisms which are beneficial to the GI system.  Since you have 10 bacteria on and in your body for every cell that is actually “you,” disruptions in those bacteria can cause illness.  Your intestinal bacteria help digest your food and provide vitamins and other beneficial substances as well as affecting your mood, your immune system, your skin and inflammation in your body.  This area of research is very active right now, so if I wrote this article next year the list would probably be much longer!  Stay tuned!

The first thing I recommend patients with irritable bowel syndrome symptoms do is add a probiotic supplement.  Often this by itself is enough to make patients feel better.  In choosing a probiotic supplement, you want one that’s enteric coated to protect the bacteria from stomach acid.  My family and I take Shaklee’s OptiFlora, of course 🙂

A word about prebiotic fiber.  The bacteria in your intestine depend on YOUR diet for their own food.  Your diet hugely influences what bacteria are dominant inside your intestine.  Healthy bacteria thrive on what is called prebiotic fiber.  This is found in plant foods like fruit, vegetables, beans and whole grain bread products.  If you eat predominantly processed foods, gradually changing your diet to include more plants and whole grains will benefit your little passengers which will improve your digestive health.

2.  Food allergen elimination diet

A food allergen elimination diet is useful for people with unexplained symptoms of all sorts.  A trial of a food allergy elimination diet is a reasonable thing to do if irritable bowel syndrome symptoms do not respond to probiotic supplements and improving the diet.

Food allergies are much more common in children and are severe hypersensitivity reactions that may cause hives, trouble breathing, swelling of the throat, shock, and even death.  Common allergens are cow’s milk, egg, soy, peanuts and tree nuts.

On the other hand, food intolerances may be linked to a whole range of symptoms from irritable bowel syndrome to migraine headaches to eczema to menstrual disorders.  Unfortunately blood and skin testing are not accurate when it comes to identifying food allergies and intolerances.

The most effective way to identify foods to which you may be allergic or intolerant is to do a comprehensive allergy elimination diet.  In general this should be done under a doctor’s supervision.  The one I recommend for my patients can be found at this link.  I have had a number of patients identify important food intolerances that they would never have identified otherwise.

Before you say you can’t be allergic to something because you haven’t changed your diet recently, you can develop a food allergy at any time in your life.  There’s only one way to know for sure.  If you have irritable bowel syndrome and your symptoms don’t respond to simple measures, an allergen elimination diet may be your next step.

3.  Eliminate FODMAPs from the diet

I can hear you now.  “What the heck is a FODMAP?!”

FODMAPs are “Fermentable Oligo-Di-Monosaccharides and Polyols.”  They are sugars found in food that seem to be involved in some cases of IBS.  If someone did not improve with probiotics and increasing prebiotic fiber, and did an elimination diet without improvement, the next step would be to try eliminating FODMAPs from the diet.

A low-FODMAP diet is very effective for IBS symptoms.  However, it’s not easy to stick to.  Here is a great handout from Stanford University with information about a low-FODMAPs diet plan:

Low-FODMAPs Diet from Stanford University

So, if you have been told you have irritable bowel syndrome, the first thing to do is to tidy up your diet.  Make sure you’re eating plenty of healthy plant fiber (fruits, veggies, beans and whole grain bread products).  Add a high-quality probiotic supplement.

If that is not successful, consider a comprehensive food allergen elimination diet.  Figuring out if you’re intolerant to gluten, dairy, egg, soy, peanut, or other foods goes a long way towards settling IBS symptoms.

If all else fails, eliminating short-chain sugars from the diet with a low-FODMAPs diet is very effective but difficult to maintain.

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Gallstones

You just had a great dinner at your favorite restaurant.  Maybe you’re out with your family, maybe with friends or even on a date 🙂  Then you suddenly feel some pain in your upper abdomen, right under the ribcage.  Quickly it worsens to the point that you can hardly breathe.  You feel sick to your stomach, you’re doubled up in pain wondering if you can make it to the bathroom in time.

The pain spreads through the upper abdomen and aches into the back of the right shoulder.  Somehow you make it home, wondering halfway there whether you should just detour to the nearest emergency room.  Curled up on the couch while your worried family hovers over you, you just wish it would go away.

Then suddenly, it does!  The pain goes from about 254 on the 10-point pain scale to GONE.  You sit up carefully, and everyone jumps and starts asking questions, but you feel completely normal.  Now everybody’s looking at you funny, like you made it up.  Pain can’t go from severe to gone in no time, can it?

Yep, it can.  This was my experience with gallstones.

I thought I was crazy.  When it happened a second time, I went to the doctor who confirmed it with an ultrasound.  I had gallstones.

I had my gallbladder out when I was 19 years old.  Other than having to be careful about fatty, greasy meals, I haven’t had any problems since then.  However not all my patients who have their gallbladders removed have such a good experience.

Gallstones are crystals of cholesterol that form from bile in the gallbladder.  They can grow pretty large (I’ve seen gallstones several centimeters across removed) but generally the little ones cause the most problems.  They get stuck in the neck of the gallbladder and block the duct that drains bile into the intestine.  They can also get stuck in the common bile duct (which drains from the liver into the intestine) and cause pancreatitis, which is on my top-5 list of things I NEVER want to have.

Generally when a person has gallstones with typical pain, doctors will recommend surgery to remove the gallbladder.  The question is, will surgery resolve the pain?

Most of the time, it does.  However, sometimes symptoms continue, and sometimes removing the gallbladder causes other symptoms.

Bile is a soapy substance that acts like Dawn dishwashing liquid.  It breaks up big fat droplets in partially-digested food to little fat droplets that are more readily absorbed.  The gallbladder stores bile, and when you eat a fatty meal the stomach signals the gallbladder to contract and send out extra bile.  After the gallbladder is removed, the digestive system doesn’t have any way to adjust to higher-than-usual fat in the diet.  This can lead to abdominal cramping, bloating and diarrhea if you eat too much fat after gallbladder surgery.

There isn’t any good way to be absolutely sure that the abdominal pain and other symptoms a patient is experiencing are actually caused by the gallstones.  We have plenty of patients that have gallstones found on ultrasound done for another reason, but they have no symptoms at all.

Suppose you have abdominal pain.  As you know, MANY problems cause abdominal pain.  Wouldn’t it be reasonable to try to make sure your pain can’t be relieved by other measures before heading to surgery?

I dove into my nutritional medicine textbook to see if there were any measures that Dr. Gaby can suggest.  He has several recommendations.

1.  Eliminate food allergies

I’m aware that I’m beginning to sound like a broken record.  It seems that EVERYTHING is related to food allergies!  Well, in this case, it makes sense.  Intake of allergenic foods causes inflammation in the GI system.

One study showed that people with untreated celiac disease had VERY delayed gallbladder emptying as compared to celiac disease patients who were well controlled on a gluten-free diet and normal control patients.  Another study showed that 100% of study subjects with gallbladder problems were able to completely resolve their symptoms through use of an elimination diet.  100%.  Every single one.

If you or someone you know is struggling with gallstones or persistent symptoms after gallbladder removal, a food allergy elimination diet is a great next step and may resolve the symptoms.

2. Clean up the diet and use smart supplementation

Formation of gallstones is correlated with a typical Western diet.  Refined sugars, partially-hydrogenated oils, saturated fats and cholesterol in the diet increase the risk of gallstones.

Vegetarians have a much lower risk of gallstones as compared to omnivores.  Vegetable protein and dietary fiber in particular seem to decrease the risk.

Substances that stimulate bile flow and lower the cholesterol content of bile, like caffeine, vitamin C, fish oil and moderate alcohol intake, decrease the risk of gallstones.

It is interesting to note that iron deficiency increases the risk of gallstones.  This may contribute to the increased risk of gallstones during and after pregnancy.

3.  Maintain a healthy weight

Obesity is associated with an increased risk of gallstones.  If you have a family history of gallstones that’s a great reason to get serious about getting to and staying at a healthy weight.

If you have gallstones, are you doomed to have gallbladder surgery?  Not necessarily.  You might very well be able to resolve your symptoms without surgery.  And that, after all, is the goal.

If we can make your gallstones stop bothering you, maybe you shouldn’t bother them!  Over time, if you take care of the risk factors that may have caused them to develop in the first place, they might just resolve themselves.

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The Biggest Lies In Healthcare

My friend, you’ve been told a lie.  Several lies, in fact.  I want to expose some of the biggest lies in healthcare and help you see the truth.

You’ve been misled by several authorities that should have been trustworthy.  Some of these lies have been told by accident, and some of them are deliberate.

This is by no means an exhaustive list.  If you know of a lie I don’t mention PLEASE comment at the bottom and expose the truth.  They are just the most persistent and harmful, hateful lies I can think of right now.

1.  Food additives are harmless

I could write a book about this one.  The food industry has exploded the number of chemicals added to our food to make it cheaper, look better, taste better, last longer.

The government (more on that later) and the food industry have a category for these food additives:  “Generally Recognized as Safe,” or GRAS.  According to whom?!  There is no requirement that companies demonstrate ANY scientific evidence of safety before rolling out a new food additive.

Some of these food additives have been clearly linked to increased risk of cancer, like trans fats or partially-hydrogenated vegetable oils.  Others are associated with behavior disturbances in children, like artificial flavors and colors.  Artificial sweeteners promote obesity, they don’t reduce it.

I don’t generally hold up Europe as an example of how things should be, but in this case I agree with their stance.  Nothing may be added to food without demonstrating its safety.  This is called the “Precautionary Principle,” where you assume something is harmful until it’s proven to be safe.  Kraft, Kellogg’s and many other food companies successfully market and sell their products in Europe without food additives.  Why do we buy the American versions here?!

Please read food labels.  Avoid partially hydrogenated vegetable oils like the plague.  Consider carefully before buying products with artificial sweeteners (sucralose, aspartame, acesulfame, saccharine), artificial colors (the color plus a number), or any chemical whose name you don’t recognize.

There ARE alternatives out there that don’t have these chemicals.  For example, I’ve been frustrated for a long time because it’s difficult to find baking mixes (like cakes, brownies, etc) that don’t have partially-hydrogenated oils.  Check them out at the grocery store next time you are there.  I finally found the Immaculate Baking Company!  My son and I made their brownies and they are delicious!  (Not an affiliate, just a fan, LOL!)

2.  The government will protect you

OK, now I’m going to offend some folks.  The government looks out for its own interests, not yours.  This is because the government is made up of PEOPLE who are flawed and self-interested, just like the rest of us.

Companies lobby congress and give our representatives gifts and contribute to their campaigns.  Legislators and other government workers have their own agendas.  They champion causes that will get them elected.

I don’t trust the government to protect anyone but themselves.  Individuals don’t have the money to influence the legislative process, not compared to corporations and lobbyists.  Our individual concerns get lost in the shuffle.

In fact, there was a recent article published by CNN (not usually my favorite source, but this one is good) about the increasing amounts of pesticides permitted in our food supply.  Companies like Monsanto are gradually persuading the government to relax regulations about how much pesticide can be allowed in our food.

The government works for us, and like any other employee, they need supervision.  We all need to keep an eye on our government and their behavior.

3.  Someone or something else is responsible for your health

This one is a rotten lie.  Unfortunately it’s one that most Americans completely swallow every day.

We want someone else to fix us.  The doctor “fixes” your recurrent sinus infections (while you continue to smoke).  The cardiologist “fixes” your heart disease with stents (while you continue to smoke and eat whatever you want to eat).  The bariatric surgeon “fixes” your obesity with gastric bypass (while you change your diet for a few months but then gradually go back to old habits).

There is a limit to what others can fix when it comes to your health.  However, there is NO limit to what YOU can fix when it comes to your health.

You can choose to treat food as a grand adventure, changing your favorite recipes to make them healthier and exploring new healthy recipes until you find ones you adore.  You can choose to try out many different forms of exercise until you find one or more that you love.  You can choose to learn the practices of mindfulness and gratitude until you can create your own happiness from within.

No doctor can “fix” you.  We are only coaches and cheerleaders.

I love it when patients want to learn how to be healthy.  When they embrace the food adventure and bring ME healthy recipes they’ve found or created, I’m tickled.  When they tell me they took a ballroom dancing class, I want to do a happy dance!  (Sometimes I really do it.  Ask Sarah and Shari, LOL!)

I want you to be in charge of your own health.  You can choose to eat healthy food without nasty chemical additives.  You can choose to keep a close eye on our government and their shenanigans.  You can be the architect of your own health, with the assistance and guidance of your doctor.

QUESTION:  Have you come across any other health care lies?

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