Cognitive Decline

The importance of detecting the underlying reason and building a preventative plan


To date, there is no current treatment that can prevent or cure cognitive impairment. 

Dr. Dale Bredesen’s research helps us understand this complex and devastating condition; better understanding of disease at the molecular level, and underlying pathophysiological mechanisms could provide potential insights to develop novel treatment strategies to manage the cognitive impairment.  

You won’t hear about Dr. Bredesen’s work in reversing the cognitive decline on the 06.00 o’clock news as mainstream medicine still expects one drug to fix a condition that can be characterized by 36 separate contributory causes.

Dr. Bredesen explains that determining whether you have Alzheimer’s disease or not, does not help you to avoid it or reverse it. However, determining why you have Alzheimer’s is key to develop novel treatment options and preventative plans.

Most people who already have Alzheimer’s disease or MCI (mild cognitive impairment, the harbinger of Alzheimer’s) or SCI (subjective cognitive impairment, which precedes MCI) could show between 10-25 contributors to their cognitive decline. ³

Types of cognitive decline

Let’s jump right into Dr. Dale Bredesen’s six types of Alzheimer’s disease: ³

  • Type 1 Alzheimer’s is inflammatory, or hot, and driven by ongoing inflammation. One of the major mediators of the inflammatory response is called NF-κB (nuclear factor kappa-light-chain enhancer of activated B cells), and NF-κB increases the production of molecules that produce amyloid, so this shows a direct link between inflammation and occurrence of Alzheimer’s. ³
  • Type 2 Alzheimer’s is atrophic, or cold, and driven by suboptimal levels of nutrients, hormones, or trophic factors (cell growth factors like nerve growth factor). your brain is not receiving enough of the right building blocks to maintain your brain’s five hundred trillion (500,000,000,000,000) synaptic connections so cognitive problems ensue. ³
  • Type 1.5 Alzheimer’s is glycotoxic, or sweet, and driven by high blood sugar or high fasting insulin. We call this type 1.5 because it has features of both type 1 and type 2: chronic inflammation (type 1) occurs because the glucose attaches to many of your proteins causing an inflammatory response. Reduced trophic support (type 2) occurs because your brain cells become less sensitive to insulin, which is a critical growth factor for them. ³
  • Type 3 Alzheimer’s disease is toxic, or vile, and driven by exposure to toxins such as mercury, toluene, or mycotoxins (yes, exposure to some mold can cause Alzheimer’s through toxins made by certain molds such as Stachybotrys and Penicillium). Since we are exposed to toxins, we all experience this risk to a greater or lesser degree, so the key is to minimize exposure, identify the toxins to which we are exposed, and increase excretion and detoxification of them. ³
  • Type 4 Alzheimer’s disease is vascular, or pale, and driven by cardiovascular disease. Indeed, vascular dysfunction is identified as one of the main causes of the occurrence and development of Alzheimer’s disease. ³
  • Type 5 Alzheimer’s disease is traumatic and driven by head trauma. A traffic accident, a fall, or even repeated minor head injuries during sports could be a cause to develop Alzheimer’s disease. ³

We are all exposed to everyday toxins, the processed foods – the effects of pesticides and fertilizers on natural wildlife and our water supply is well-documented. Americans demand cheap food, so our agricultural policy for the past 30 years has focused on providing large amounts of inexpensive calories; the high-carbohydrate and unhealthy fat content of the standard American diet, the leaky gut syndrome so many of us have, and the lipid abnormalities (“cholesterol,” although the good cholesterol itself is not the problem), most of us have a significant risk for Alzheimer’s disease or some level of cognitive impairment, and yet…

The great news is we can prevent or reverse the problem as soon as we understand the contributors and underlying causes. 

As Dr. Dale Bredesen laid out at The End of Alzheimer’s Program and his protocol, here’s how we do that:

  • First, we address insulin resistance.
  • Second, we get into ketosis.
  • Third, we optimize all nutrient, hormone, and trophic (growth factor) support.
  • Fourth, we resolve and prevent inflammation.
  • Early interventions focused on modifiable lifestyle factors can help prevent and reduce the risk of cognitive impairment during aging.

Exercise/Physical activity

Regular physical activity and exercise can develop a better memory. Regular exercise has long been known to improve and maintain key aspects of cognitive function i.e. attention, learning, and memory.

A structure in the brain known as the hippocampus is linked to learning and memory. The hippocampus is in the medial temporal lobe (MTL), a well-connected hub of brain activity that is particularly sensitive to the effects of exercise. Alzheimer’s disease is often described as a syndrome of disconnection in the brain. Now, a study of healthy older adults aims to assess the effects of exercise on nerve connections within the MTL. ⁴

Exercise is one of the strategies that has been shown to optimize both mitochondrial and cognitive function, potentially decelerating cognitive decline and attenuating neurodegeneration.

Recent meta-analyses and controlled trials have found that several different types of physical activity, including the following, may improve attention, executive function, and memory: ⁶

  • Both low to moderate and high-intensity exercise ⁷, ⁸
  • Short-term interval training and aerobic exercise ⁸
  • Social dancing ⁸
  • Multimodal physical exercise ⁷, ⁸,⁹
  • Mind-body exercises such as tai chi, yoga, and qigong ⁹

And Mind-Body Therapies and Exercises

A 2019 systematic review and meta-analysis of 49 studies covering 4,506 participants found that mind-body therapies can be effective in treating insomnia and improving sleep quality for both healthy individuals and patients. The tested therapies included:¹⁹

  • Meditation
  • Tai chi
  • Qigong
  • Yoga

A Mediterranean or Keto Diet

Both the Mediterranean diet and the keto diet claim cognitive brain health benefits. Let’s take the keto diet, for example. How does the ketogenic diet affect the brain?

The first study, whose results appear in the journal Scientific Reports, looked at the effects of a keto diet on neurovascular function, which includes sensory and motor functions, as well as circulation.

“The keto diet seemed to boost the clearance of beta-amyloid protein in the brain — the “building blocks” that, in Alzheimer’s, stick together, forming toxic plaques which interfere with neuronal signaling.” – Scientific Reports

Nutrition is a key modulator of cognitive health, but what are those specific nutrients and vitamins that support cognition and reduce neurodegeneration?

Multi-pronged lifestyle interventions offer promise for the prevention and delay of cognitive decline. For example, personalized dietary plans that include neuroprotective foods provide nutrients for optimal cognitive functioning and potentially reduce neuroinflammation, as well as improve brain plasticity. ¹⁴

You may ask, what are specific nutrients and vitamins that support cognition and reduce neurodegeneration?

  • Neuroprotective Nutrients such as Q10 (CoQ10), acetyl-L-carnitine (ALC), and resveratrol.
  • Nutrient-dense anti-inflammatory whole diet approaches. Epidemiological and observational studies, as well as clinical trials, continue to demonstrate that higher adherence to specific diets that prioritize plant, whole grain, and healthy fat intake, such as the Mediterranean, DASH (Dietary Approaches to Stop Hypertension), and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets, is associated with less cognitive decline and reduced risk of dementia such as Alzheimer’s disease.15-19 For example, a 2021 observational study used questionnaires to evaluate the effect of Mediterranean diet adherence on the cognitive abilities and psychological state of 2,092 men and women (65 years or older) from seven different Greek cities.16 Results from the study indicated that higher diet adherence was significantly associated with both better cognitive status and fewer depression symptoms.¹⁵
  • Plant-rich diets, keto diets were positively correlated with anti-inflammatory microbial species, and animal product–rich diets were associated with a pro-inflammatory microbial profile; however, no association was found between cognition and microbiota composition. ¹⁶ “Research continues to explore the associations between neuroinflammation and gut dysbiosis and what role any alterations in the gut microbiota may play in cognitive health and prevention of neurodegeneration.”¹⁷

Research does suggest that the longer the healthy eating pattern persists, the greater the impact on cognitive function.

Nutrition

Certain nutrients have been shown to protect against oxidative damage to mitochondria, including:

  • Omega-3 fatty acids
  • Antioxidants (including vitamin C and zinc)
  • Members of the vitamin B family (including vitamin B12 and folic acid)
  • Magnesium

Sleep and Cognitive Decline

Several studies have suggested that sleep and sleep-wake rhythm disturbances are associated with an increased risk of incident dementia and cognitive decline in the elderly, independent of multiple confounders. ¹⁸

Sleep disturbances have a significant impact on cognitive and physical functions in individuals with cognitive decline and may be associated with important psychological distress and depression.

As Dr. Elena Klimenko says, ‘when we try to encourage a good night’s sleep for our patients, perhaps we are doing them better than we thought’ Sleep is a physiological necessity and being deprived of it has many harmful health effects. How do functional medicine practitioners can help their patients get more rest and limit the maladaptive mitochondrial changes that occur during states of stress?

Mental Stimulation

Mental exercise is one simple, yet effective, strategy. Exercise also changes chemical signaling in the brain, even in the short term. If you want to improve memory, increase focus, and feel sharper check our favorite platform called luminosity; you will learn a lot about how your brain works depending on how much you sleep, how much exercise you get, and more.

Manage Stress and Anxiety

Stress triggers inflammation in body that can lead to cognitive decline; stress management is helpful to overcome cognitive decline.

Stress and anxiety management another way to cure the cognitive declining diseases as researchers showed that psychological stress is the primary risk factor for the development of cognitive decline and dementia. 20 The physical or psychological stress can activate the peripheral process and neuronal circuits that can lead to triggering of inflammation and ultimately cognitive decline.21 Daily basis stress has also been linked with stimulation of release of inflammatory cytokines that’s why both stress need to manage to overcome the brain disorders and cognitive decline.

Environmental Toxins and Cognitive Decline: 5 Steps to Reduce Your Risk

In today’s world, we are all exposed to some level of toxins. These appear in our food, water, air, as well as in everyday items found around the home.
Research has shown that low-dose toxic exposure over long periods of time can add up, eventually contributing to cognitive decline disease. According to researchers, the top environmental toxin categories associated with cognitive decline are heavy metals, mold & mycotoxins, plastics, as well as pesticides.

  • Mercury – Mercury sources include dental fillings, contaminated fish, and air polluted from the combustion of fossil fuels and coal.)
     
  • Aluminum – Aluminum is the most abundant metal found on Earth; it’s used in many different daily-use products, including, cosmetics/personal care products, over-the-counter and prescription products, food additives and fillers, cookware, food packaging, etc. Studies now show that aluminum impairs our central nervous system
  • Mold & Mycotoxins – Mold is a fungus that usually grow at humid and damp environment. The poisons produced by mold can stimulate the inflammatory responses in the body. The exposure of toxic mold has been linked to the memory loss, depression, anxiety, brain fog and insomnia. Detoxification from toxic mold can help to treat these conditions and can treat cognitive decline effectively. 
  • Pesticides (Most conventionally farmed foods are exposed to some level of pesticides. Pesticides are substances that are used to kill insects, rodents, and weeds that may affect crop yield during food production.
  • Plastics – Use of plastic utensils, food containers, wrappers, water bottles, linings of cans/containers, coffee pods, to name a few sources, can cause bio-accumulation (build up in our bodies) from the leaching of plastic particles into food and beverages. Plastics are known “endocrine disrupters”, contributing to hormonal imbalances. They have also been linked with health risk including neurological diseases, like Parkinson’s Disease and cognitive decline.

Reducing your risk:

  • Upgrade your diet. (Include more nutrient-dense foods to enhance detoxification. Foods like dark leafy greens, cruciferous veggies (including broccoli, kale, and cabbage), and sulforaphane-rich foods like garlic and onion contain high concentrations of nutrients that increase our detoxification capacity. Load up on fiber and mineral-dense foods, which help trap and eliminate toxins through your digestive system. Last but not least, add cilantro, turmeric, and green tea to ramp up detox pathways.)
  • Incorporate detoxification practices into your daily routine. (Epsom-salt baths, sauna, lymphatic massage, sweat-inducing workouts*, and dry brushing are some examples of practices that improve detoxification. Daily bowel movements are essential. If you don’t have consistent bowel movements, consider working with a nutritionist to help you improve motility and, in turn, enhance your body’s natural ability to eliminate toxins.)
  • Live plastic FREE life. (It may be overwhelming at first, but slowly start to switch to glass bottles, paperware, or eco-friendly and plastic-free packaging.
  • Check your home Switch your home cleaning supplies to more natural alternatives, test your water for contaminants,, and get your home tested for possible air pollutants including mold and other toxic materials).

Conclusion

Overall, this article represents the importance of understanding contributing factors and underlying causes of cognitive decline disorders i.e., Alzheimer’s disease. A better understanding of disease at the molecular and biological level could lead to the development of novel treatment strategies to manage cognitive diseases. Some cognitive decline disorder management strategies include regular exercise, physical activity, keto diet, regular sleep, and management of stress and anxiety. These cognitive decline disease management strategies have proven as successful to manage the disorders such as Alzheimer’s disorder. 

If you would like to get more information about cognitive decline preventative treatment or to schedule an integrative medicine consultation, please contact us.

Resources:

  1. The Impact of Age on Cognition
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906299/

2. Smoking, dementia and cognitive decline in the elderly, a systematic review  https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-8-36

3. https://www.apollohealthco.com/the-six-types-of-alzheimers-disease/

4. https://www.health.harvard.edu/blog/more-movement-better-memory-202105172457

5. Cellular and Molecular Neurobiologyhttps://link.springer.com/journal/10571/volumes-and-issues/36-2

6. Exercise, Mitochondrial Health, and Brain Fitness
https://www.ifm.org/news-insights/neuro-midlife-strategies-for-brain-health/

7. Moreau D, Chou E. The acute effect of high-intensity exercise on executive function: a meta-analysis. Perspect Psychol Sci. 2019;14(5):734-764. doi:10.1177/1745691619850568

8. Zaenker P, Favret F, Lonsdorfer E, Muff G, de Seze J, Isner-Horobeti ME. High-intensity interval training combined with resistance training improves physiological capacities, strength and quality of life in multiple sclerosis patients: a pilot study. Eur J Phys Rehabil Med. 2018;54(1):58-67. doi:10.23736/S1973-9087.17.04637-8

9. Bouaziz W, Schmitt E, Vogel T, et al. Effects of a short-term Interval Aerobic Training Programme with active Recovery bouts (IATP-R) on cognitive and mental health, functional performance and quality of life: a randomised controlled trial in sedentary seniors. Int J Clin Pract. 2019;73(1):e13219. doi:10.1111/ijcp.13219

10. Hsu CL, Best JR, Davis JC, et al. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2018;52(3):184-191. doi:10.1136/bjsports-2016-096846

11. Vaccaro MG, Izzo G, Ilacqua A, et al. Characterization of the effects of six-month dancing as an approach for successful aging. Int J Endocrinol. 2019;2019:2048391. doi:10.1155/2019/2048391

12. de Oliveira Silva F, Ferreira JV, Plácido J, et al. Three months of multimodal training contributes to mobility and executive function in elderly individuals with mild cognitive impairment, but not in those with Alzheimer’s disease: a randomized controlled trial. Maturitas. 2019;126:28-33. doi:10.1016/j.maturitas.2019.04.217

13. Zou L, Loprinzi PD, Yeung AS, Zeng N, Huang T. The beneficial effects of mind-body exercises for people with mild cognitive impairment: a systematic review with meta-analysis. Arch Phys Med Rehabil. 2019;100(8):1556-1573. doi:10.1016/j.apmr.2019.03.009

14. Poulose SM, Miller MG, Scott T, Shukitt-Hale B. Nutritional factors affecting adult neurogenesis and cognitive function. Adv Nutr. 2017;8(6):804-811. doi:10.3945/an.117.016261

15. Mantzorou M, Vadikolias K, Pavlidou E, et al. Mediterranean diet adherence is associated with better cognitive status and less depressive symptoms in a Greek elderly population. Aging Clin Exp Res. 2021;33(4):1033-1040. doi:10.1007/s40520-020-01608-x

16. an Soest APM, Hermes GDA, Berendsen AAM, et al. Associations between pro- and anti-inflammatory gastro-intestinal microbiota, diet, and cognitive functioning in Dutch healthy older adults: the NU-AGE study. Nutrients. 2020;12(11):3471. doi:10.3390/nu12113471

17. Yuan C, Fondell E, Bhushan A, et al. Long-term intake of vegetables and fruits and subjective cognitive function in US men. Neurology. 2019;92(1):e63-e75. doi:10.1212/WNL.000000000000668

18. Tranah GJ, Blackwell T, Stone KL, Ancoli-Israel S, Paudel ML, Ensrud KE, Cauley JA, Redline S, Hillier TA, Cummings SR, Yaffe K; SOF Research Group: Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women. Ann Neurol 2011;70:722-732.

19. Wang X, Li P, Pan C, Dai L, Wu Y, Deng Y. The effect of mind-body therapies on insomnia: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2019;2019:9359807. doi:1155/2019/9359807

20. Sussams R, Schlotz W, Clough Z, Amin J, Simpson S, Abbott A, Beardmore R, Sharples R, Raybould R, Brookes K, Morgan K. Psychological stress, cognitive decline and the development of dementia in amnestic mild cognitive impairment. Scientific reports. 2020 Feb 27;10(1):1-1.

movement is life

Movement as Medicine

We have heard it a bunch of times and from different sources “movement is life”. Without movement we grow old faster, losing viral functions and become more susceptible to various illnesses. I always say that if I can only make a pill out of movement, it would be the most effective medicine in the world, but unfortunately, there is no pill replacing our body’s moves.

I found that many of my patients find it motivating to understand the reason why it is so beneficial to move. Below we discuss many benefits of movement. Because just like food, exercise is the medicine!

Mental Health

First, movement has mental health benefits. Any exercise improves mood. During, and immediately after the exercise the brain releases endorphins. This creates a feeling or euphoric happiness. Exercise also stimulates the release of brain chemicals, neurotransmitters that regulate the mood: dopamine, norepinephrine and serotonin, and of course exercise reduces stress by regulating stress hormones such as adrenaline and cortisol. Have you tried to go for a long walk while feeling blue? If you did, you know how much better you feel once you get the blood flow going.

Sleep

Sleep is one of the five pillars in Functional Medicine. Without proper sleep, our bodies can not repair and rejuvenate. Movement improves the quality of our sleep. Cardio exercise earlier in the day raises the body’s internal temperature which guides the body to decrease the temperature later in the day for better sleep. Also, the burst of energy created earlier in the day signals the body to rejuvenate and repair at night.

Prevention

Movement reduces the risk for chronic disease. As we like to say in Functional Medicine, our genes load the gun, but our lifestyle pulls the trigger. By adhering to good lifestyle habits, we can control if and how our genes are expressed. Movement is one of those factors. Exercise reduces inflammation, the main cause of chronic illness. Exercise stimulates sweating, one of major detoxification pathways and getting rid of toxins that always contribute to aging and development of chronic disease. Exercise improves sugar metabolism, and in turn prevents diabetes and cardiovascular disease.

Brain Health

Another benefit of exercise is that it stimulates brain activity. We used to think that brain cells do not regenerate. However, now we know that during exercise brain releases BDNF (brain deprived neurotropic factor) which stimulates neurons regeneration and growth. Movement increases the size of the hypothalamus, the part of the brain responsible for learning and memory. And increased hearth rate promotes blood flow to the brain, therefore delivering more oxygen and nutrients.

Bone Health and Healthy Weight

Exercise is imperative to support bone health. Weight training increases bone density and hence prevents osteoporosis. Exercising stimulates our metabolism and as a result our body burns calories more willingly, and hence we lose weight more readily. During exercise we enhance our lean body mass (muscles) and get rid of fat tissue.

There are many forms of movements and they are not one size fits all. However, any movement will give you some degree of benefits. Finding what works for your body and schedule can be imperative to keeping exercise as part of your healthy lifestyle habits.

The bottom line is that it all starts with you and what you’re willing to do and sacrifice to get what you want or you think you deserve. Hopefully, this article has given you that nudge you’ve been needing.

If you would like to get more information about cardiovascular health and treatments from functional medicine perspectives, and how to add more movementi into your daily life schedule an integrative medicine consultation at our office, call 212-696-4325.

I’d love to talk to you and answer your questions.

Stay healthy and strong!

Elena Klimenko, MD

Women Cardiovascular Health

The Heart of a Woman: Cardiovascular Conditions Affecting the Neglected Gender


Why is Cardiovascular Health Not a Major Topic of Discussion When It Comes to Women’s Well-being?


Typically, heart diseases have always been a topic of discussion and concern in relation to male health, leading to a lack of awareness when it comes to women. Little attention is paid to the fact that cardiovascular conditions are a leading cause of morbidity and mortality in women, especially after menopause. Statistics reveal that heart conditions are the number one cause of death in women, with 1 in every 5 women in the US dying from heart disease, 1 which is 10 times greater than deaths caused by breast cancer.2


Factors Responsible for Relative Cardio-protection During Reproductive Years and Thus Neglection of this Age Group:

When looked into depth, the causes for the stereotypical mindset of cardiovascular conditions being men’s diseases, “the jogging heart” comes first. The concept of jogging heart can be understood by comparing the hormonal activity going on in a woman’s body to changes induced by physical exercise done by a male of the same age.5 It is based on the premise that during the second half of the menstrual cycle, a woman’s basal heart rate increases, offering benefits comparable to that of moderate exercise. Additionally, the natural protection offered by estrogen before menopause prevents heart-related complications, decreasing the risk significantly. Estrogen is known to positively affect numerous tissues in the body, including the heart and blood vessels. It increases HDL (the good cholesterol), decreases LDL (the bad cholesterol), and relaxes and dilates blood vessels, allowing for adequate blood flow to vital organs, including the heart. After menopause, however, the estrogen levels fall, significantly increasing the risk of a cardiovascular accident. Thus, after menopause, the risk of heart diseases in women becomes equal to that of men.2
The good news is that cardiovascular diseases and their complications are preventable, but the lack of awareness delays recognition of warning signs and subsequent actions, causing the development of heart diseases, that could otherwise have been avoided. Screening should be carried out for the prevention of heart diseases in the same manner as it is done for cervical cancer (Pap smear) and breast cancer (breast exams). Being conscious regarding your cardiac health substantially prevents complications in the long run and allows early detection and treatment of predisposing factors.


What are some reasons that you need to take a closer look at your heart health?

The overall mortality secondary to CVD may be decreasing in the US, but the situation is the opposite for women. The CVD mortality rate in women is rising.4 It has been noticed that even younger, childbearing age women are also having some sort of cardiac problems now. In addition to having traditional risk factors such as hypertension, diabetes mellitus, dyslipidemias, family history, physical inactivity, metabolic syndrome, and obesity, there are risk factors unique to the female gender.1


The unique risk factors in women are:6

  • Pregnancy-related disorders like pre-eclampsia, pregnancy-induced hypertension
  • Autoimmune disease
  • Hormonal disorders such as polycystic ovarian syndrome
  • Breast cancer treatment

Unique Risk Factors

The complex hormonal changes that occur in a female body throughout the reproductive years predispose them to a number of pathologies. While many times these are physiological changes, occasionally, they can turn pathological, leading to hormonal imbalance, collectively termed as hormonal disorders, which also affect the heart.5
Many of the risk factors are common for a widely prevalent hormonal disorder, polycystic ovarian syndrome (PCOS), and cardiac diseases. Having PCOS thus increases the risk of long-term cardiac complications. PCOS is frequently associated with obesity and dyslipidemias. According to studies, women with PCOS are twice as likely to suffer a cardiovascular event compared to healthy women. It also increases the risk of type 2 diabetes mellitus which again is a prominent risk factor for CVDs. Moreover, many women of reproductive age use hormonal contraceptive methods, combined oral contraceptive pills (COCPs – containing both estrogen and progesterone) being the most common. COCPs are known to increase the risk of developing hypertension, and thrombosis (blood clotting), thus predisposing to serious cardiac events.
Pregnancy-related hypertensive disorder, called pre-eclampsia, is also of particular interest here. It leads to generalized vasoconstriction (blood vessel constriction) and thus high blood pressure. Although it resolves after delivery, the subsequent risk of developing essential hypertension significantly increases. Pregnancy-related hypertension and weight gain double the risk for the development of ischemic heart disease and stroke. Pregnancy itself is a hypercoagulable state. This means the risk of developing a thromboembolic event increases during pregnancy. One of the common complications after delivery is the development of thrombosis which may gain entry to cardiac vessels leading to serious acute cardiac manifestations. The risk of the development of insulin insensitivity also significantly increases during pregnancy leading to the development of gestational diabetes mellitus (GDM). GDM increases the risk of a cardiac event to seven times.
Autoimmune disorders such as systemic lupus erythematosus (SLE) increase the risk of cardiac diseases to a staggering nine times. Clinical interventions for common disorders in reproductive women, breast cancer being a prime example, come with their own set of side effects. The risk of cardiovascular events is significantly increased with radiotherapy. It is therefore essential that such cases are managed by a multidisciplinary team.


Risk factors unique to certain age groups

Some of the risk factors for CVDs are specific to age

Prepuberty:

  • Early menarche
  • Being overweight
  • Acne
  • High blood sugar levels

Adolescence:

  • Irregular periods
  • Obesity
  • Acne
  • Hirsutism

Reproductive period:

  • Infertility
  • Gestational diabetes mellitus
  • Pre-eclampsia

Perimenopausal period:

  • Diabetes
  • Essential hypertension
  • Obesity
  • Stroke

Post-menopausal period:

  • Withdrawal of protective effect of estrogen
  • Numerous chronic health conditions

Atypical Presentation

For women, CVD may present with atypical symptoms like profound sudden fatigue, shortness of breath, a general feeling of being unwell, neck pain or sensation of constriction or strangling in the throat, sense of foreboding – impending doom (due to intuition), syncope, dizziness or vertigo, indigestion (often feeling that if they burp, they will feel better), nausea, and vomiting. Because of a lack of knowledge regarding the presentation of CVD in women, these symptoms are often ignored.6 The result is that the cardiac health starts to worsen until it reaches a morbid state and then presents with an acute clinical event like myocardial infarction (heart attack).

Every woman must know the following factors that can increase the risk of CVD and related complications:

  • Age 
  • Diabetes 
  • Smoking 
  • Physical inactivity 
  • Hypertension 
  • Dyslipidemia 
  • Metabolic syndrome 
  • Obesity

Gender disparities

Women going through an acute cardiac event are not managed in a similar way as men. Younger women, in particular, are less likely to be properly managed by the acute MI protocol, and prescribed guideline-directed medical therapy (GDMT). They also do not often receive adequate treatment in a timely fashion or suitable prophylactic therapy such as fibrinolytic therapy. Furthermore, cardiological interventions like angioplasty, cardiac catheterization, thrombolytic therapy, and bypass surgeries are not routinely seen being performed in women.6 The studies regarding heart health also recruit male participants more frequently.5 Which means we are not well-aware of any unique risk factors and manifestations of cardiac diseases in women. Although heart disease kills more women than men every year, the treatment of women’s heart disease was based—until recently—on medical research performed on men.

This disparity leads to increased mortality when the treatment is finally administered. Studies have shown that women treated by a male cardiologist are more likely to suffer mortality.6 Treatment given by female cardiologists has comparatively better outcomes.7 Usually, there is a similar outcome for both genders when treated by a female cardiologist. Female cardiologists, however, are very few in number which means women are more likely to die in ER if treatment is administered by a male cardiologist. Even though there are fewer men dying from heart diseases, there are more male cardiologists than female. There is a need to draw attention to this fact and encourage more women to pick cardiology as their field of specialization.

The Barbara Streisand Women’s Health Center is working to correct these gender inequalities and to educate women on how to recognize female-pattern heart disease symptoms. Additionally, The center provides convenient access to all of Cedars-Sinai’s diagnostic and treatment resources for heart disease and is designed to help women reduce their chances of heart disease through a preventive approach, including state-of-the-art screening and testing.


What are some daily actions women can start implementing to take a preventative approach and preserve the health of their hearts?

As mentioned earlier the risk can be reduced and heart diseases can be prevented in women. Just following some simple tips and sticking to them can help a lot. Even if you do not have any of the aforementioned risk factors, you still need to take the necessary precautions. 


  1. Dietary modifications:

Whatever you eat reflects on and from your body. The healthier food you consume, the better your body will perform. Add more vegetables, fruits, and a small amount of whole grains, and cut down on sugars and processed food in your diet. Avoid consuming empty calories, which are foods that only provide energy but have no nutritional value, fast food for example. The idea is to eliminate harmful and toxic substances (like pesticides and herbacides) from the diet and take nutritionally rich food items that serve as important metabolites. This not only improves cardiac health but also improves general well-being.


  1. Mind-body techniques:

Try yoga and meditation. They relieve stress, balance the autonomic nervous system and positively affect healthy functioning. The cardiovascular system is under the influence of the autonomic nervous system, which has two arms: parasympathetic and sympathetic nervous system. The parasympathetic system is activated in a relaxed state, while the sympathetic tone of the autonomic nervous system prepares the body for fight and flight response.

To understand this, consider an example. Imagine you are sitting peacefully in a garden, relaxing and all of a sudden, a lion comes in. Facing an unanticipated danger you will start to sweat profusely, your heart will beat much faster (palpitations), your eyes will open wide and your blood pressure will shoot up. All of this happens because the sympathetic system has become activated and caused these changes, also collectively referred to as ‘Fight, Flight and Fright’ response. 

The point of emphasizing the functioning of the sympathetic autonomic nervous system is that the majority of the heart and vessel disorders are associated with an increased sympathetic tone.8 The treatment, therefore, often comes in the form of sympathetic blockers.

Yoga and meditation have been proven to relieve stress and thus decrease sympathetic overactivity.9 The result is heart and vessel functions returning to normal.


  1. Move Your Body:

The most important of all risk factors is the presence of visceral fat, the fat that is accumulated around our internal organs such as the heart, liver, and intestines. It is highly inflammatory and contributes to the acceleration of atherosclerosis. Movement is the most important preventive and curative option for all types of CVDs. Inflamed cholesterol (fat)  in the body deposits in the arterial wall and blocks the lumen causing atherosclerosis. With time, the lumen becomes so narrow that the blood flow to the respective organ diminishes or even gets completely obliterated. When fat deposits in the vessels that supply blood to the heart, cardiac events like myocardial infarction and angina occur, which if severe, may lead to death.

If you would like to get more information about cardiovascular disease and treatments from functional medicine perspectives, schedule an integrative medicine consultation at our office, call 212-696-4325.

I’d love to talk to you and answer your questions.

Stay healthy and strong!

Elena Klimenko, MD 

References:

  1. https://www.cdc.gov/heartdisease/women.htm
  2. Alkabban FM, Ferguson T. Breast Cancer. [Updated 2020 Nov 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
  3. Eskes, T., & Haanen, C. (2007). Why do women live longer than men?. European journal of obstetrics, gynaecology, and reproductive biology, 133(2), 126–133. 
  4. Garcia, M., Mulvagh, S. L., Merz, C. N., Buring, J. E., & Manson, J. E. (2016). Cardiovascular Disease in Women: Clinical Perspectives. Circulation research, 118(8), 1273–1293. 
  5. Garcia, M., Mulvagh, S. L., Merz, C. N., Buring, J. E., & Manson, J. E. (2016). Cardiovascular Disease in Women: Clinical Perspectives. Circulation research, 118(8), 1273–1293. 
  6. Giardina E. G. (2000). Heart disease in women. International journal of fertility and women’s medicine, 45(6), 350–357.
  7. Nakayama, A., Morita, H., Fujiwara, T., & Komuro, I. (2019). Effect of Treatment by Female Cardiologists on Short-Term Readmission Rates of Patients Hospitalized With Cardiovascular Diseases. Circulation journal : official journal of the Japanese Circulation Society, 83(9), 1937–1943. 
  8. Remme W. J. (1998). The sympathetic nervous system and ischaemic heart disease. European heart journal, 19 Suppl F, F62–F71.

Streeter, C. C., Gerbarg, P. L., Saper, R. B., Ciraulo, D. A., & Brown, R. P. (2012). Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical hypotheses, 78(5), 571–579.

An Extensive Guide to Holistic Medicine

Beyond conventional medicine, you may have heard references being made to alternative medicine and lifestyles involving holistic practices. You may have also heard of integrative and functional medicine, and wondered if they were any different from holistic medicine. In fact, holistic medicine is actually involved in both integrative and functional medicine. That is why we have prepared this Guide to holistic medicine for you.

First, what is Holistic Medicine? Simply put, holistic medicine involves caring for not only a person’s physical health, but also mental, spiritual, and emotional health. The Complete Herbal Guide’s article on the history of holistic medicine traces it back to 5000 years ago in ancient China. The philosophy of Chinese medicine was based on their Taoist and Buddhist belief that man and nature are closely linked, and that the body and spirit must be balanced. Internal forces being out of balance causes a sickness. In the West, it was introduced by the ancient Greeks. In modern times, the principles of holistic medicine remain similar: to treat the patient by naturally fixing any imbalance in their lifestyle.

What happens when thyroxine level fluctuates?

Integrative medicine is — as the name implies — when a doctor/practitioner integrates two kinds of medical systems and practices them together. These systems are usually holistic medicine and conventional medicine, which treats a patient through drugs, radiation, or surgery. In integrative medicine, the doctor takes into account the patient’s physical, mental, and spiritual conditions before offering a solution. Treatment usually involves a mix of medications and changes in lifestyle.

Functional medicine is a more specific field. It is similar to integrative medicine but is more systematic and conventional in terms of finding the cause of the health problem. As with integrative healing, it prescribes medicines and suggests lifestyle changes. However, it utilizes laboratory testing to determine the physical root of the sickness rather than relying on anecdotal evidence from the patient.

The term “holistic medicine” might sound new, but it is actually more common than you think. My Domaine’s guide to holistic medicine explains some holistic healing practices. The most heard of would be acupuncture, which uses needles to stimulate certain points in the body to release energy. Another familiar practice is aromatherapy. This uses the sense of smell to calm the body. Meanwhile, chiropractic involves tweaking the spine to alleviate pain.

These practices might make it sound like holistic medicine will cost you. But keep in mind that holistic healing takes care of the person as a whole. This means that it is always applicable, not only when you’re sick. Here are some simple holistic practices you can do every day:

What happens when thyroxine level fluctuates?

Being stressed will affect other aspects of your life, so it’s important to control and possibly prevent it. HelpGuide presents tips to help manage stress. The first is to identify the sources of stress in your life. Knowing why you are stressed helps you figure out what you should do next to relieve that. Try to point out which sources of stress are controllable, such as extra work you could say no to. However, this also means learning to accept the stressors that you cannot change. Regardless of the source of stress, don’t bottle your emotions up. Instead, engage in healthy coping habits, such as writing in a journal or sharing your thoughts with friends.

What happens when thyroxine level fluctuates?

Moisturizers and cleansers can only do so much to help achieve healthy skin. It is important to remember that the skin health goes beyond what we can see externally. This means we should rethink the things we put on our skin, and ensure that everything is formulated for holistic wellness. PrettyMe’s review of AR Vitamin E Cream explains that creams made from natural ingredients and enriched with vitamin E can help treat a variety of conditions, such as melasma, cellulite, scars, and dark spots. Consider investing in creams and products that are only made from natural ingredients. However, also consider how other factors such as diet, stress, and hormones are impacting your skin.

What happens when thyroxine level fluctuates?

The stomach contains microbes and bacteria, and absorbs nutrients and removes waste. Our article on “Can Environmental Toxins Affects Our Gut Microbiome?” warns how an imbalanced stomach can lead to diseases that will lead to other complications. Practicing a holistic diet can help prevent health problems. Choose organic food, read food labels and check that they are not genetically-engineered. Drinking tea also helps by boosting the immune system and preventing some diseases. In fact, different teas will have different effects on the body. Healthline’s article on green tea benefits show that it is high in antioxidants, boosts brain function, and helps weight loss.

What happens when thyroxine level fluctuates?

Not having enough sleep will make you irritable. Not to mention your brain and body functions will suffer more, the more hours of sleep you miss. Sleep deprivation can lead to memory issues, heart disease, and mood disorders, among others. Dr. Michael John Badanek’s discussion on the importance of sleep talks about the effects of sleep, or lack thereof, and how this is connected with other activities. The article answers for functional medicine, but remember that holistic medicine is tied to it as well. Sleep detoxifies the body, consolidates memories, and heals the body as a whole. Having a good night’s sleep regularly will definitely help you stay healthy — not just physically, but mentally too.

What happens when thyroxine level fluctuates?

Your job might require you to be seated for hours on end, and you might want to do anything but lie down when you can finally catch a break. No matter your circumstances, it’s important to still exercise. Physical activity doesn’t have to mean going to the gym or doing any of the heavy exercises. It can be as simple as going for a walk or stretching for about half an hour every day. What’s more, research shows how physical activity affects mental health, explaining that exercise tells the brain to release serotonin and endorphins, which improves self-esteem and mood.

Holistic medicine is gaining traction, and with good reason. By taking care of ourselves holistically, we can prevent physical, mental, and emotional problems.

Written by Jannice Belle for drelenaklimenko.com

12 tips to stay healthy during holidays

12 Tips to Stay Healthy During Holidays

The year 2020 will go down as one marked by enormous changes and uncertainty, which is why this time around, the most thoughtful gifts to give are ones that provide something we could all benefit from: health and wellbeing.
Read on to learn how to protect your health and wellbeing, and how to survive the holiday hustles and bustles with a smile on your face, even though this year’s holidays will look different than we’re used to.

1. Eat an Anti-inflammatory Diet

The holidays are full of temptations and indulgences. Unfortunately, many of our holiday classics from mac ‘n cheese to holiday roasts, from sugary cookies to sweet pumpkin pie, from egg nog to New Year’s Eve cocktails, are often promoting inflammation and therefore weaken our immune system.  Eating heavy, sugary, and inflammatory foods for a month or longer can be incredibly hard on your body. These foods zap your energy, decrease immune defenses, and increase the risk of disease.

Instead, I recommend that you stick to anti-inflammatory foods during the holidays. Whole foods vegetables cooked or fresh, small amounts of seasonal fruit, warming herbs and spices, nuts and seeds, and fermented foods are your best friends. If you eat animal products, always choose organic, pasture-raised beef, free-range poultry and eggs, wild-caught fish, or wild game. There are so many healthy holiday recipes made with whole foods to enjoy nutrient-dense foods without missing out on anything. If you still want to reach for some of your old favorites, I recommend that you limit them for the actual days of the holidays instead of eating them the entire month. If you are focusing on a nutrient-dense diet, you will notice how much better you feel!

2. Take Probiotics

Since your gut is connected to all parts of your body, its health is incredibly important. Inflammatory foods and stress may both compromise your gut integrity, causing increased intestinal permeability or leaky gut. If your gut flora and gut health are out of balance, your entire health can become compromised. Your risk of increased inflammation, fatigue, stress, pain, and disease increases.

A healthy gut, on the other hand, creates a strong base that supports your entire health and well-being. While eating an anti-inflammatory diet is essential for gut health, I also recommend that you eat plenty of probiotic-rich fermented foods, such as sauerkrauts, kimchi, and kefir (dairy and non-dairy), and take daily probiotic supplements to support your gut microbiome. In my practice I use a variety of different probiotics, so feel free to call us and inquire about our monthly special for probiotics.

3. Use Adaptogens

Burning the candle at both ends during the holidays can drain your adrenals. Too much stress, too little sleep, too much sugar, and junk food, or too many holiday alcoholic drinks may force your adrenals to overwork and may lead to adrenal fatigue, which leads to a sluggish immune system. 

To support your adrenal health and balanced stress response, I recommend adaptogenic herbs. Adaptogens have been used in Ayurvedic and Chinese medicine for centuries. They help your body to regulate cortisol, combat stress and improve fatigue. My favorite adaptogenic herbs are Ashwagandha, Rhodiola, Licorice and Ginseng.

4. Exercise

Exercise may be the last thing on your mind during the busy holiday season. However, it is crucial for your health and energy levels. Regular exercise can help to reduce stress, improve your mood, and boost your energy.

Ideally, you want to get some exercise for 20 to 30 minutes five times a week and stay generally active. Mix up your routine by including some cardiovascular exercise, such as swimming, running, or biking, strength- and resistance training, such as bodyweight exercises, weight lifting, or TRX, and low-impact exercises, such as yoga, pilates, and stretching. Stay active by getting a standing work desk (“sitting is a new smoking”), stretching throughout the day, going for a walk during lunch, playing with your kids, taking the stairs, or walking your dog.

5. Make Time for Yourself

If you are like most people, you try to please everyone during the holiday season and end up forgetting about yourself. It is certainly wonderful to have this opportunity to reconnect with family and friends and create beautiful memories together. But you also need some love – from yourself.

You deserve and need some quality “me-time”. Make “an appointment with yourself” time during the holiday season. Go for a nature walk. Take a hot, relaxing bath. Meditate. Breathe. Journal. Try some yoga. Curl up with your favorite book. Watch your favorite holiday movie. Even if it’s just a few minutes, try to make a little time for yourself each day. You deserve and need it. 

And don’t forget that sleep is so important for your immune system and overall health. During the holidays we all cut down on sleep, but it is one of the most important parameters in a healthy lifestyle. If you have a problem falling asleep or staying asleep try some simple homeopathic medicine like Quetude or Sedalia that you can obtain at our office. If that does not help, come see me for a consultation. We have many tools to investigate sleep issues by getting to the root cause of YOUR sleep problems.

6. Practice Gratitude

Anxiety and gratitude cannot exist at the same time. Having a gratitude practice is the perfect way to improve your mood, reduce stress, and increase your zest for life. Remember the ‘little things’ throughout the day. Keep a gratitude journal jotting down the things that you are grateful for each morning and evening. Tell your loved ones that you are grateful for them and why you appreciate them. Do “daily inventory” in your mind by the end of the day  and find 2-3 things you are grateful for and let this day go with appreciation.

7. Show Your Support While You Show Your Appreciation

One of my favorite things about the holidays is gift-giving.I am making a conscious effort to support as many small-owned businesses as possible and suggest curating a basket of some of your local favorites or industry-specific items.

This month we are giving thanks and support to our delicious friend, Stylish Spoon.

If you are looking for a healthier way to satisfy your sweet tooth, visit Stylish Spoon (stylishspoon.com/order). Stylish Spoon is a gluten-free, dairy-free, soy-free and refined sugar-free online bakery located in Harlem and they ship right to your door. Their signature baked OatMEAL Cups are a healthy and satisfying breakfast option. Pop them in your freezer to reheat and eat in the mornings or for dessert. Stylish Spoon is offering 15% off with code DRK15.

8. Be Present

When you spend too much time in the future, it increases anxiety and stress. Being in the present moment, on the other hand, can decrease anxiety and stress, and increase happiness. Spending only 15 to 30 seconds in the present being aware of your body can make a difference. Savoring positive experiences can stimulate and strengthen neural connections in your brain, increasing positive emotions. Meditation and breathwork are fantastic ways to spend some time focusing your awareness on the present moment. You can also set your timer a few times a day reminding you to stop and slow down and check-in with the moment for 30 seconds.

9. Keep It Simple

Even though this year’s holidays will look different than we’re used to, the holidays still can be an incredibly stressful time. If you have a large family, it can be quite a hassle. Try to keep it as simple as possible. Your family loves you no matter what, so by doing less, you are doing more. 

Try not to set unrealistic expectations for yourself. Don’t be a perfectionist. Ask for help if you need to. Ask everyone to bring/make a dish or dessert instead of doing everything by yourself. Make decorations a family event. Involve others in planning games and other holiday activities. Most importantly, know your limitations and say “no” when you have to.

10. Remember to Have Fun

During the holiday season, we tend to spend too much time running around and trying to make everything perfect. You have to take care of your holiday shopping, plan your holiday meals, and decorate your house. It can be a lot when you are a busy person.

But remember the time when you were a kid? The holidays were fun! All the decorations, lights, holiday cookies, movies, and music. It was magical. Be a kid again for a moment. Allow yourself to have a bit of fun. Dance to your favorite song. Sing along with the radio. Play some games with your family. Be silly. This is what the holidays are all about.

11. Ensure You Wear Your Face Mask

Ensure you wear your face masks when you travel. Here is a great site if you’re searching for a cloth mask to shop. But a simple disposable KN95 is still the best protection from increasing virus.

12. Be Smarter than the COVID-19. Take the Right Supplements and Minerals

Giving your body key supplements is also extremely important when you are supporting your immune system or battling Covid-19. I suggest the following:

  • Zinc: 30 to 50 mg per day (It can cause nausea, so take it with food.). If you can’t get your hands on the supplement, these food sources are rich in zinc: 
    • Oysters 
    • Ground beef
    • Alaskan king crab 
    • Cooked lobster 
    • Pumpkin seeds (raw)
       
  • Vitamin D: 5,000 IUs per day. (Ideally, you would have your level checked and keep the blood level between 50-80 ng/mL). 
  • N-Acetyl Cysteine (NAC): 600- 800 mg twice a day. It protects the lungs and supports the production of the master antioxidant glutathione in the body.
  • Glutathione. Have it handy and start using it only when you feel you are getting sick. Take 400mg 1-5 times per day (sicker you feel, more you need). It will help your immune system function optimally. 
  • Vitamin A: 5,000 IUS per day. 
  • Vitamin C: 500 mg every 1 to 2 hours with big glass of water until irregular bowel movement 
  • Herbs like Echinacea, Andrographis and Elderberry
  • Homeopathic Silver and Homeopathic Oscillococcinum

Take these supplements to support your immune system. If you are running low, you can order them from our office at 212-696-4325.

Final Thoughts

Remember, the holidays don’t have to be stressful. You can enjoy this season with your loved ones in happiness and health. If fatigue, chronic pain, health complaints, or health issues slow you down this holiday season, I recommend that you stay home and call your functional medicine doctor, like myself. 

As an experienced functional medicine doctor with an integrated expertise of both Western medicine and traditional Eastern practice, I can assess all the factors, including diet, lifestyle, stress, toxicity, allergies, sleep habits and medication that may affect your body in order to uncover the root cause of your health issues and prescribe a personalized and effective plan to improve your thyroid condition, repair your body and regain your health and well-being.

If you would like to get more information about autoimmune thyroid treatment or to schedule an integrative medicine consultation, please call my office at 212-696-4325.

Stay healthy and strong!

Dr. Elena Klimenko

References:

https://www.psychologytoday.com/us/blog/smart-habits-highly-successful-people/200912/7-tips-relieve-holiday-stress
https://greatergood.berkeley.edu/article/item/6_simple_practices_to_handle_holiday_stress
https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20047544
https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-st
https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/adaptogen
https://www.ncbi.nlm.nih.gov/pubmed/25857501 https://www.sciencedirect.com/science/article/pii/S0378874109005728 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628357/ http://www.brainlife.org/fulltext/2001/kelly_gs010600.pdf
http://www.herbs-for-menopause.com/ginseng/articles/siberian-ginseng.htm https://www.ncbi.nlm.nih.gov/pubmed/21793317
https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm https://greatergood.berkeley.edu/article/item/taking_in_the_good/

Stress Anxiety and Insomnia during the COVID-19

Webinar: Stress, Anxiety, and Insomnia during the COVID-19

Join Dr. Elena Klimenko, a functional and integrative medicine doctor, for a discussion on psychological issues during this current health crisis in our country and around the globe.

The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about the disease can be overwhelming and cause strong emotions in both adults and children.

Because of the big wave of questions regarding anxiety, stress control, and insomnia, we decided to guide you on how to manage your anxiety, stress, and insomnia during this unprecedented time.

Watch free webinar
“Stress, Anxiety, and Insomnia
during the COVID-19″
presented by Dr. Elena Klimenko, MD, IFMCP

 

LIVE MEDITATION
led by Erin Assenza
Integrative Nutrition Health Coach

https://youtu.be/8evTbq3eUkA

top 10 Gut-nourishing foods

Top 10 Gut-Nourishing Healthy Foods

The holidays are around the corner. This means that you will be tempted with all kinds of unhealthy treats and comfort foods that may lead to gut inflammation. The good news is that it is possible to eat delicious food while following a nutrient-dense, anti-inflammatory, and gut-protecting diet rich in gut-nourishing foods.

Your gut health matters. A healthy microbiome and well-functioning gut are absolutely essential for optimal digestion, absorption of nutrients, elimination of toxins, and your overall health. A compromised gut flora may lead to leaky gut syndrome, an underlying cause of many digestive issues and other health complaints, including chronic pain, fatigue, and autoimmune diseases.

Take control of your health and nourish your body with gut-friendly foods that promote well-being. Learn about the best gut-health foods and incorporate them into your diet today.

Top 10 Gut-Nourishing Foods

10 Gut-Nourishing Healthy Foods

Sauerkrauts

Sauerkrauts mean sour white cabbage in German. They are incredibly common in Germany, my motherland, Russia, and other parts of Eastern-Europe. They are fermented cabbage that serves as fantastic gut-health food. Sauerkrauts are not only rich in fiber but provide they are loaded with good bacteria. They help a healthy gut microbiome balance, promote smooth digestion, and help to prevent the leaky gut syndrome.

You can find sauerkrauts at your local health food stores, grocery stores, and farmer’s markets. You may even make it yourself. I recommend that you also try another powerful gut-friendly food, kimchi, a Korean version of sauerkrauts.

I like to get sauerkrauts in the local store, like Zabar or Fairway, sprinkle it with high-quality olive oil, shred some fresh carrots, chop some red onion and sprinkle with fennel. Takes 5 minutes to prepare and what a great salad to increase your intake of cruciferous vegetables! Bon Appetit!

Yogurt

Speaking of fermented foods, yogurt is another fantastic gut-nourishing food. It is made with fermented milk and is incredibly rich in probiotics. It helps to balance your gut flora, reduce digestive distress, and prevent leaky gut syndrome. If you like yogurt, I also recommend it’s close cousin, kefir, another gut-health food made with fermented milk with similar gut health benefits.

You may find yogurt and kefir at any grocery store. Make sure to buy organic and avoid added sugar and artificial ingredients. If you are intolerant to dairy or avoid dairy for other reasons, you may find dairy-free yogurt and kefir options made from coconut milk or nut milk. These dairy-free options are also fantastic gut-friendly foods. Trader Joy sells delicious cashew nuts kefir, it is delicious and what a great alternative to dairy!

Dandelion Greens

You may remember waving dandelion crowns as a kid. As an adult, you can use green leaves as a gut-health food that grows everywhere in the spring. Yes, the dandelions in your backyard are gut-nourishing free food. Dandelion greens may help to improve gastric motility relaxing the muscles between your stomach and small intestines. It is a powerful cholegogic (stimulates bile production and drainage). As a result, this ubiquitous plant will improve your digestion and prevent leaky gut syndrome. Dandelions may reduce inflammation balance your blood sugar, and lower blood pressure.

Dandelions are versatile and nutritious. You can eat their stems, roots, and flowers. They serve as a beautiful garnish on your salads and dishes and make gut-nourishing tea.

Recipe: Saute green leaves of dandelion in olive oil with onion and garlic. What a great garnish! Remember, more bitter is better for your digestion!

Asparagus

When you think of asparagus, the first thing that comes to mind is that they make your pee smell funny. While it’s true, asparagus is excellent gut-friendly food. Asparagus is a gut-nourishing food that may reduce inflammation, pain, and disease in your gut and body. It may improve nutrient absorption. Asparagus is a fantastic prebiotic food that helps to feed the good bacteria in your gut and prevent intestinal dysbiosis.

You may enjoy asparagus steamed, grilled, roasted, sauteed, and baked. It makes an excellent side dish and is fantastic in soups, salads, and baked vegetable dishes.

Jerusalem Artichokes

Don’t confuse Jerusalem artichokes with globe artichokes. Jerusalem artichokes are actually related to sunflowers. They are delicious tubers that are one of the best gut-nourishing foods. They are rich in fiber and promote the absorption of nutrients. They may help to keep your microbiome balanced and gut inflammation levels low. Jerusalem artichokes may also prevent diarrhea, constipation, and leaky gut syndrome.

You may find Jerusalem artichokes in the produce aisle and try them instead of potatoes next time. You may steam, boil, bake, or saute them, or even eat them raw (shredded) in a salad.

Onions

Onions are one of the best gut-nourishing foods. They are rich in prebiotics that supports your healthy digestion. They also contain flavonoids and antioxidants, including quercetin that fight free-radical damage. Besides boosting your gut health, they are beneficial for your immune system and heart health.

You may enjoy onions raw or cooked. They add a delicious flavor to most soups, salads, stir-fries, baked vegetables, and other main dishes.

Garlic

When talking about the best gut-nourishing foods, you cannot forget about garlic. As fantastic prebiotics, they have similar benefits as onions do. They are rich in manganese, selenium, vitamin C, and vitamin B-6. It has a significant antibacterial effect and also works against parasites and fungi, like candida. I use garlic in tablets (Garlic Forte by MediHerbs) as part of the gut flora restoration protocol. If you choose to do raw garlic, then one clove twice a day will give you close to a therapeutic dose.

Garlic is the most nourishing when eaten raw, however, you can enjoy its gut-health food properties when it’s cooked as well. If you choose to cook garlic, first crush or chop it and allow it to sit for 10 – 15 minutes to activate its beneficial gut-healthy enzymes before cooking. You may add garlic to your soups, salads, and favorite dishes.

Seaweed

Seaweed is also referred to as a sea vegetable. It is a form of algae that I recommend you to try as a gut-nourishing food. Seaweed is incredibly rich in antioxidants and fiber. It may help gut flora balance, promote gut health, and aid digestion. Seaweed is full of polysaccharides that help the production of short-chain fatty acids that protect and feeds your gut cell lining.

Add seaweed flakes to your salads and meals. Try nori snack as a crunchy treat. Be adventurous and enjoy a seaweed salad.

Pineapples

Pineapple is a delicious tropical fruit that is also powerful gut-nourishing food. They are rich in bromelain, an enzyme that helps your digestive system by breaking down protein from large food molecules into smaller, more digestible peptides. Bromelain in pineapples, if eaten on an empty stomach, also helps to reduce pain and inflammation, including gut inflammation. As a result, it may help to promote a healthy gut lining and prevent the leaky gut syndrome.

You can find pineapples at any grocery store or health food store. You can eat it as it is, or as part of a fruit salad, salad, vegetable stir-fry, or pineapple salsa. Make sure to eat it fresh and avoid canned pineapples that are full of added sugar.

Bone Broth

Bone broth is one of the best gut nourishing foods. It is a nutritious clear liquid made from brewed bones and connective tissue. It is a fantastic source of collagen, glutamine, and amino acids that may help to reduce gut inflammation, maintain a healthy gut lining and prevent the leaky gut syndrome. Besides being a delicious gut-friendly food, bone broth may also support your metabolism, joints, and immune system.

You can make your own bone broth from organic, free-range poultry, pasture-raised beef, and wild-caught fish bones. You may also find organic bone broth at your local health food stores. If you are a vegan or vegetarian, you may substitute bone broth for a vegetable broth. While vegetable broth doesn’t have collagen, it is still a gut nourishing food. However, bone broth is a high histamine food, so some people may not tolerate it well. If you are one of them please consult with your functional medicine practitioner and get tested.

Conclusion

If you are experiencing digestive troubles or suspect that the root cause of your health issues is your gut health, as a functional medicine practitioner, I am happy to help. Together, we can identify and address the root cause of your health complaints. With the help of a personalized treatment plan along with some gut-nourishing foods, I can help you to repair your body, and regain your health and well-being.

If you would like to get more information about my integrative and functional medicine services or to schedule a functional medicine consultation, please call my office at 212-696-4325.

In the meantime, share this article about Top 10 Gut-Nourishing Healthy Foods with your friends and family to help them regain their health with the power of gut-nourishing foods and holistic medicine.


References:

Autoimmune Thyroid Disease - Functional Medicine Approach

Functional Medicine Approach to Autoimmune Thyroid Disease

Autoimmune diseases affect nearly 24 million Americans, and thyroid diseases affect about 20 million. Many Americans are dealing with autoimmune thyroid disease. In fact, Hashimoto’s disease, an autoimmune thyroid condition, is one of the most common causes of hypothyroidism.

The scary part is that a high percentage of those with autoimmune thyroid disease are completely unaware of their condition. If you have autoimmune thyroid disease, you don’t want to leave it untreated. Read on to learn more about autoimmune thyroid disease and how functional medicine can help you to treat your condition naturally.

What Is Autoimmune Thyroid Disease?

Your thyroid is shaped just like a butterfly. It’s a small gland located at the base of your neck. It plays an important part in your endocrine system, which produces hormones that are responsible for your metabolism, temperature regulation, heart rate, breathing, and mood.

Autoimmune conditions occur when your immune system attacks your own body, in the case of autoimmune thyroid disease, your thyroid. The most common autoimmune thyroid disease is Hashimoto’s disease, a form of autoimmune hypothyroidism. You may also develop autoimmune hyperthyroidism, such as Graves’ disease.

Hashimoto’s Disease

Hashimoto’s Disease is an autoimmune condition characterized by an underactive thyroid.

Symptoms of Hashimoto’s disease include:

  • Fatigue
  • Muscle aches, stiffness, tenderness, or weakness
  • Joint pain and stiffness
  • Unexplained or unexpected weight gain
  • Constipation
  • Pale, dry skin
  • Hair loss
  • Brittle nails
  • Puffy face
  • Enlarged tongue
  • Increased sensitivity to cold
  • Memory issues
  • Depression
  • Prolonged menstrual bleeding

Early diagnosis and treatment of Hashimoto’s disease are crucial. Untreated Hashimoto’s disease may lead to a variety of health complications including goiters, heart problems, mental health issues, myxedema, and birth defects.

Graves’ Disease

Graves’ disease is an autoimmune condition characterized by an overactive thyroid.

Symptoms of Graves’ disease include:

  • Anxiety and irritability
  • Tremor
  • Fatigue 
  • Unexplained or unexpected weight loss, despite eating enough
  • Enlargement of the thyroid gland (goiter)
  • Heart sensitivity
  • Increase in perspiration
  • Warm or moist skin and increased body temperature 
  • Frequent bowel movement
  • Bulging eyes (Graves’ ophthalmopathy)
  • Thick, red skin on the top of the feet or shins (Graves’ dermopathy)
  • Rapid or irregular heartbeat
  • Thinning or brittle hair
  • Difficulty sleeping

It is important to diagnose and treat Graves’ disease early on. Untreated Graves’ disease may lead to a variety of health complications including heart problems; increased risk of heart disease, stroke, and congestive heart failure; eye problems; brittle bones; red and swollen skin and thyrotoxic shock.

Diagnosis of Autoimmune Thyroid Disease

Conventional, functional, and integrative doctors use similar tools for autoimmune thyroid disease diagnosis. You can expect a physical exam, a complete medical history and an analysis of your symptoms. Your doctor will also order some blood tests.

Many conventional doctors only check for your thyroid-stimulating hormone (TSH) level and inactive thyroid hormone (T4) level. However, in order to gain a full understanding of your thyroid health, most integrative medicine and functional medicine doctors find it important to get a complete panel. They check your TSH, free T4, free T3, and reverse T3 levels, as well as certain antibodies to understand the full picture.

What Conventional Doctors Don’t Understand About Autoimmune Thyroid Disease Treatment

Conventional doctors tend to look at your symptoms only, instead of looking at you from a holistic perspective, as a person affected by their diet, lifestyle, and environment. They miss digging deeper for the root cause of your issue and risk factors that may lead to autoimmune thyroid disease. The question of “WHY?” you developed autoimmune thyroid conditions most often remains unanswered.

Risk Factors of Thyroid Disease:

  • Stress: Cortisol, the stress hormone, may also interfere with thyroid hormone production leading to all kinds of imbalance in your body.
  • Leaky Gut: If you have increased intestinal permeability or “leaky gut syndrome”, your gut wall allows undigested food particles to escape into your bloodstream leading to chronic inflammation, a compromised immune system, and potential autoimmune disease.
  • Toxins: An exposure to harmful chemicals—in particular, the ones used in plastic may cause thyroid issues. Heavy metals is another big risk factor. 
  • Infections: Mononucleosis (Epstein-Barr virus), mumps and the flu virus have all been linked to thyroid problems. These viruses can stay dormant in your body for years then flare up when you are under great stress.
  • Food sensitivities and inflammatory foods: Inflammatory foods and foods that you are sensitive to may lead to further inflammation and disease in your body. Gluten sensitivity, for example, may lead to the overproduction of antibodies, which may end up attacking your own body, including your thyroid gland.
  • Autoimmune conditions: If you already have another autoimmune condition, then you are 10 times more likely to develop another one, including autoimmune thyroid disease.

Understanding these risk factors is incredibly important when it comes to autoimmune thyroid treatment. Unlike functional medicine doctors and integrative medicine doctors, conventional practitioners don’t take dietary and lifestyle factors into account when it comes to autoimmune thyroid disease treatment.

The conventional treatment of autoimmune thyroid diseases, such as Hashimoto’s disease and Graves’ disease, usually involves surgery and/or medication. Thyroid medications with synthetic thyroid hormones are one of the top sellers that patients usually stay on for life.

The problem is that these drugs don’t address the root cause of the problem and may lead to side effects and other health problems in the long run. Functional medicine doctors, on the other hand, have a different approach. Your functional medicine doctor will spend time with you to listen and understand why you may have developed an autoimmune thyroid condition. Instead of simply relying on thyroid medication or surgery, they look for the root cause of your autoimmune thyroid disease and offer natural treatment.

Functional Medicine Approach to Autoimmune Thyroid Disease

You will be happy to learn that you may be able to treat autoimmune thyroid disease naturally by following a functional medicine approach. This means addressing the root cause of your issues and following some dietary and lifestyle strategies.

Experiencing a lot of stress, sleeping very little, and eating junk food seems to be the norm in today’s fast-paced world. The problem is that such a lifestyle leads to inflammation and health issues, including autoimmune thyroid disease.

The functional medicine approach to autoimmune thyroid treatment requires dietary changes, adopting some lifestyle strategies, and appropriate supplementation to support your body. Visiting a functional medicine doctor is the first step for identifying the root cause of your autoimmune thyroid disease. Your functional medicine doctor can create an autoimmune thyroid treatment protocol that’s right for you.

Functional Medicine Strategies for Improving Your Thyroid Function

Take a look at some of the main functional medicine strategies for improving your thyroid function.

Repair Your Gut

Support your gut with a fiber-rich and nutrient-dense diet. Eat plenty of probiotic-rich foods, and take probiotic supplements to support your gut flora. Visit a functional medicine doctor to identify problems that may be compromising your gut health.

Clean Up Your Diet

Remove inflammatory foods, such as refined sugar, refined vegetable oils, processed foods, unhealthy fats, gluten, conventional dairy, and any foods to which you may be sensitive. Instead, eat plenty of anti-inflammatory foods, such as greens, vegetables, fruits, healthy fats and clean protein.

Lower Toxicity

Our modern world is full of toxins that create inflammation and disease in your body. Minimize toxic exposure by using organic and natural cleaning and body products, reducing the use of plastics, avoiding smoking and second-hand smoke and spending time in nature.

Identify Infections

There may be infections lying dormant in your body ready to activate an autoimmune thyroid condition under stressful circumstances. It is important that you work with a functional medicine doctor to identify your hidden infections and develop a plan to fight them naturally.

Exercise Regularly

Regular exercise supports your immune system and overall well-being. Aim to exercise 20 to 30 minutes five times a week and to move your body regularly. Get up and stretch at work. Go for a walk during lunch. Play outdoors with your kids or pets.

Relieve Stress

Managing your stress levels is absolutely essential for a healthy immune system. Avoid stress as much as possible. Learn skills that help you to react to stressful situations more effectively. Engage in relaxing activities, including yoga, meditation, journaling, breathwork, and nature walks.

Sleep Plenty

Getting regular quality sleep is essential for your overall well-being. Make sure to sleep 7 to 9 hours a night. Support your sleep cycle by having a regular bedtime. Develop a relaxing night-time routine that works for you to calm your mind and ease your body before bed. Meditation, journaling, light stretching, and a calming cup of tea are great ideas.

Find a Functional Medicine Doctor for Autoimmune Thyroid Treatment

If you suspect or already know that you have autoimmune thyroid disease, it is important that you find a functional medicine practitioner to help you identify the root cause of your condition and prescribe a personalized autoimmune thyroid treatment.

I can help you to address the underlying causes of your autoimmune thyroid condition using a system-oriented approach, engaging both patient and practitioner in a therapeutic partnership. As an experienced functional medicine doctor with an integrated expertise of both Western medicine and traditional Eastern practice, I can assess all the factors, including diet, lifestyle, stress, toxicity, allergies, sleep habits and medication that may affect your immune system in order to uncover the root cause of your autoimmune thyroid disease and prescribe a personalized and effective plan to improve your thyroid condition, repair your body and regain your health and well-being.


If you would like to get more information about autoimmune thyroid treatment or to schedule a functional medicine consultation, please call my office at 212-696-4325.

Functional Medicine Doctor NYC

References:

https://www.aarda.org/news-information/statistics/
https://www.thyroid.org/hypothyroidism/
https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855
https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855
https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism
https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659
https://www.thyroid.org/thyroid-function-tests/
https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
https://www.endocrineweb.com/conditions/thyroid/how-stress-affects-your-thyroid
https://www.webmd.com/women/news/20100121/chemical-may-be-linked-to-thyroid-disease#1
https://www.ncbi.nlm.nih.gov/pubmed/24574735
https://www.ncbi.nlm.nih.gov/pubmed/26230132
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099387/
https://www.ncbi.nlm.nih.gov/pubmed/30213697
https://www.uclahealth.org/endocrine-center/subacute-thyroiditis
https://pubs.acs.org/doi/abs/10.1021/acschemneuro.5b00148
https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/diagnosis-treatment/drc-20373665
https://www.sciencedirect.com/science/article/abs/pii/0024320589901793

How to Get Better Night Sleep

How To Get Better Night Sleep (According To Functional Medicine)

JUST ONE MORE click along your episodic TV show on Netflix, that means one less hour of sleep, but that’s nothing a cup of coffee won’t fix tomorrow, right? Not quite. Over time, a deficit of deep sleep could mean way more than just a bit of daze—think weight gain, mood disorders, fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting fewer hours for even a couple of nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, the chronic sleep debt can even contribute to illness.

I want to get real with you about the importance of sleep and share

12 simple tips from functional medicine on

How to Get Better Night Sleep:

  1. Set the right temp. Make the room a comfortable temperature for sleep (not too hot or cold). In general, the suggested bedroom temperature should be between 60 and 67 degrees Fahrenheit for optimal sleep.
  2. Soak the day away. Take a hot bath at night for 20 minutes. You might want to add 2 cups of Epsom salt and 10 drops of lavender essential oil to the bathwater.
  3. Calm your system. Take a daily dose of Magnesium Lactate before bed, which relaxes the nervous system and muscles. Magnesium supports ion signaling across cell membranes; it supports the body’s natural ongoing activities of bone formation and resorption; it helps facilitate muscle contraction and body’s energy production, which is used by the central nervous, neuromuscular, and cardiovascular systems. Raise your hand if you feel you don’t need it tonight!
  4. Supplement thoughtfully. Other supplements and herbs to get sufficient shuteye include calcium, L-theanine (an amino acid from green tea), Kava Forte by MediHerb and Min–Tran.
  5. Ditch the coffee addiction. Avoid or minimize substances that affect sleep, like caffeine, sugar, and alcohol.
  6. Unplug. Avoid any stimulating activities for two hours before bed such as watching TV, using the Internet and answering emails.
  7. Set a bedtime (and a rise time). Go to bed (preferably before 10 or 11 p.m.) and wake up at the same time every day.
  8. Sweat it out. Exercise daily for 30 minutes (but not three hours before bed, which can affect sleep).
  9. Designate a role. Keep computers, TVs and work materials out of the room to strengthen the mental association between your bedroom and sleep.
  10. Cut the lights. Keep your bedroom very dark or use eyeshades.
  11. REST. Keep it quiet. Block out sound if you have a noisy environment by using earplugs.
  12. Daytime Napping. “No day is so bad it can’t be fixed with a nap.”—Carrie Snow.
12 Tips on how to get a better night sleep

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Health Benefits of Nap

If you need extra support with sleep issues, feel free to call our office at (212) 696-4325 and schedule a consultation. We provide a full-spectrum functional medicine evaluation by a Certified Functional Medicine practitioner.


References:

The Institute For Functional Medicine

Inflammatory Bowel Diseases (IBD)

Functional Medicine Approach to Inflammatory Bowel Diseases (IBD)

Inflammatory bowel diseases (IBD), which include Crohn’s disease and ulcerative colitis, affect as many as three million Americans, most of whom are diagnosed before age 35. These chronic, life-long conditions can be treated but not cured, so as a result IBD can significantly affect a patient’s quality of life and may have a high financial load. Up until now, traditional medicine has taken a linear view of treatment options by focusing only on addressing and commonly suppressing symptoms, ignoring the impact of the whole person; their mind, body or lifestyle, causing many patients continuing the struggle.

In contrast, the Functional Medicine approach to Inflammatory Bowel Diseases (IBD) is the most healing road to optimal health. It focuses on addressing the root cause of the imbalance that is generating the symptoms. To do this, functional medicine doctors rely on many tools and methods, including but not limited to: food plan and balanced nutrition, lifestyle modifications, acupuncture, homeopathy and mindfulness therapy.

Gas, bloating, constipation, diarrhea, urgency, and painful cramping—these are just some of the many difficult symptoms that come along with inflammatory bowel disease. Inflammation in the gastrointestinal tract can become debilitating if left untreated, but an integrated functional medical approach can help restore the natural balance to a patient’s digestive system. The digestive system is one of the most important and sensitive biological systems in the body, critical to overall health and well-being. Also, we now know that the immune system is very reactive to the environment, so when we look at Crohn’s and ulcerative colitis, there is a genetic component in some but the escalation of these diseases worldwide in the last twenty years is not genetically founded, so something about the environment (such as what we are exposed to or consume) plays a fundamental role.

Functional medicine’s approach is like building a house, starting by building a foundation which is a healthy lifestyle, a healthy environment, and a personalized food plan. We need to return to the roots and start to cultivate a healthy inner environment – a strong microbiome that supports the rest of the body. Treating inflammatory diseases of the bowel can be challenging: genes, food, gut microbes and disrupted immune function – all contribute. Functional medicine is really a paradigm shift, progressing from the medications that suppress symptoms or a reactive immune system to addressing the underlying cause of the problem.

Inflammatory Bowel Diseases IBD

In our functional medicine of Healthy Wealthy & Wise Medical PC along with Dr.Elena Klimenko, we address the underlying causes of IBD disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It’s really all about approaching these diseases by looking at the wholeness of the patients and identifying the root causes, which may vary for each patient.

There is so much we can do for patients with IBD, which can be done in parallel with conventional medicine. Healing takes time, but the functional medicine approach is the most certain road for optimal health. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century.


As an experienced functional medicine expert with an integrated combination of Western medicine and traditional Eastern practice, Dr. Elena Klimeko can assess the numerous factors of you that can affect your immune system – potential environmental toxins, lifestyle, stress, diet, medication, allergies, and sleep habits – to uncover the root cause of your IBD diseases. If you would like to get more information or to schedule a consultation, please call her office at 212-696-4325.


References:

https://www.crohnscolitisfoundation.org/sites/default/files/2019-02/Updated%20IBD%20Factbook.pdf