energy-depends-on-hormones-atp-levels-unsplash

Barriers to Our Internal Drive – What Keeps Us from Manifesting Our Potential

Fatigue, exhaustion, and tiredness are the terms that are often used interchangeably. However, it is important to understand these terminologies and what each one actually means, as the root cause is different for each. Fatigue is a state of feeling drained constantly, without doing anything or meeting anyone. The difference between being tired and fatigued is, tiredness goes away with adequate sleep and rest; while, fatigue always remains there and is often a symptom of something wrong within the body. Exhaustion is usually a result of the accumulation of psychological stress, just as physical stress causes tiredness.

Your energy levels, and subsequently, the feelings of enthusiasm, determination, and will power, depend on how smoothly the body and its organs function. The brain constantly monitors and controls the functions of the body organs via nerves and hormones. Hormonal imbalances influence the energy level of an individual, which correspond to the concentration of Adenosine triphosphate (ATP).1

The energy required to do something comes in the form of ATP, generated by various metabolic processes, under the influence of hormones. In simple words, as long as the body generates an adequate number of ATPs, the person feels enthusiastic and remains active. But once the supply of ATP is halted, the energy levels decrease. Here is a brief discussion on how different hormones affect metabolic activities and alter an individual’s energy level, subsequently leading to decreased motivation and will power.

Thyroid Hormones:

The thyroid gland is the most important gland involved in controlling the basal metabolic rate (BMR) of the body. It is a butterfly-shaped structure located at the base of the neck, stimulated by the thyroid-stimulating hormone (TSH), released from the pituitary gland. It secretes thyroxine hormone (T4), which performs the following functions:

  • Thyroxine acts on almost all cells of the body, increases their metabolic activities, and generates lots of ATPs, which translates to ample energy supply.
  • It acts on the heart to increase both the heart rate and the contractility; subsequently, cardiac output increases. As the cardiac output rises, more blood is available to supply oxygen to different body organs and enhance their functioning.
  • The major effect of thyroxine is on growth. It is essential for bone development, brain health, and muscle control.
  • It modulates the hepatic function, which in turn facilitates other systemic endocrine effects.

What happens when thyroxine level fluctuates?

As mentioned earlier, the thyroid hormone affects pretty much all bodily organs, so its imbalance results in alteration of the body’s functioning as a whole. During the stressed state, the thyroid-stimulating hormone (TSH) level falls, which results in a low level of thyroxine. This subsequently leads to slowing down of metabolic processes, and ultimately, decreased energy levels. 2 Other features of fluctuating levels of thyroid hormone are:

Hypothyroidism (Decreased thyroid hormones):

  • Fatigue
  • Cold intolerance
  • Weight gain despite the loss of appetite
  • Cold peripheries
  • Constipation
  • Depression
  • Muscle cramping

Hyperthyroidism (Increased thyroid hormones):

  • Hyperactivity
  • Heat intolerance
  • Fatigue
  • Loss of weight despite increased appetite
  • Diarrhea
  • Anxiety, nervousness
  • Muscle weakness

Fatigue is a common symptom of both hyper and hypothyroidism. The explanation is straightforward for hypothyroidism, that is – the metabolism is slowed down, and the body cannot produce enough energy. In hyperthyroidism, on the other hand, the body’s hyperactive state drains all energy, making the person feel tired.3

Adrenal Gland Secretions

Adrenal glands are two triangular structures located on the top of each kidney, therefore, also known as suprarenal glands. They are composed of an outer part – the adrenal cortex – and an inner part – the adrenal medulla. Each of these parts secretes different hormones under the influence of adrenocorticotropic hormone (ACTH) released from the pituitary gland.

The hormones of the adrenal cortex are:

  • Mineralocorticoids
  • Glucocorticoids
  • Sex steroid hormones

The adrenal medulla produces catecholamines that are:

  • Adrenaline
  • Noradrenaline
  • Dopamine

Mineralocorticoids are responsible for maintaining the salt and water balance in the body, thus regulating the blood pressure. Sex steroid hormones are discussed later. Following is a detailed discussion of glucocorticoids and catecholamines and how they affect the energy levels of the body.

Glucocorticoids

The most important of these is cortisol. It is also known as the stress hormone of the body. 4 It performs the following functions:

  • It stimulates glucose production by utilizing the body’s energy stores. The increasing levels of glucose in the blood mean lots of energy.  
  • It modulates the immune system to produce anti-inflammatory effects. Cortisol supplies the body with the reparative substances that allow prompt recovery.
  • In the stressed state, it activates the sympathetic nervous system, which prepares the body for fight and flight response.4

Some medical diseases result in excessive stimulation of the adrenal glands. Cushing’s syndrome is one such condition in which excessive glucocorticoid secretion causes extreme fatigue and weight gain. Other associated symptoms are:

  • Thinning and bruising of the skin
  • Diabetes
  • High blood pressure
  • Muscle weakness 
  • Bone pain secondary to osteoporosis
  • Excessive facial hair
  • Menstrual disturbances in women

Addison’s disease is a condition in which there is adrenal insufficiency. The hormonal disturbance drops the blood pressure and results in fatigue.5

Other symptoms are:

  • Weight loss
  • Anorexia
  • Nausea
  • Vomiting
  • Abdominal pain
  • Salt craving
  • Low blood sugar
  • Increased pigmentation in a chronic case

Catecholamines

The two major arms of the autonomic system of the body, maintaining the organs’ functioning, are sympathetic and parasympathetic nervous systems. The effects of both fluctuate with the physiologic state of the body and then balance each other, so that the organs function smoothly and healthily. Overactivation of any of these diverts the autonomic system towards that side. 

The catecholamines’ release activates the sympathetic nervous system.  In a stressful state, the autonomic nervous system effects are predominantly contributed by catecholamines, which is the normal, physiologic response of the body. The following changes occur in the body to prepare it for the fight and flight response:

  • Increased heart rate
  • Increased blood pressure
  • Decreased digestive glands secretion
  • Dry mouth
  • Sweating

Overstimulation of the sympathetic arm of the autonomic nervous system leads to the aforementioned changes occurring permanently in the body. Chronic excessive sympathetic activity results in fatigue.6

What happens when adrenal secretion fluctuates?

During the stressed state, the blood supply to the vital organs (heart, lungs, brain, and kidney) and adrenal glands increases. This is how our body responds to the stress. 4 It is done to increase the concentration of stress hormones, that are, cortisol and adrenaline. These hormones increase the survival chances and help cope with stress by reserving the energy. Under the influence of these, the basal metabolic rate (BMR) decreases, the glucose and oxygen are supplied limitedly to the peripheries to curb all activities redundant for healing, and the reparative activity increases. The long-term elevation of stress hormones and resultant unnecessary suppression of the metabolism causes chronic fatigue. Similarly, an extremely low level of cortisol possibly drops blood glucose levels and results in tiredness. 

On the contrary, the decreased levels of stress hormones in the body also have negative consequences, leading to stress intolerance.

Sex hormones:

Several hormones are produced in the body that control the reproductive system. The major sex hormone in a female is estrogen and in a male is testosterone. Both hormones are present in male and female body and both are very important. DHEA is the precursor of both sex hormone produced by adrenal glands. In the gonads, the DHEA converts to the respective sex hormone.

Estrogen:

In the female body, it is produced by ovaries and performs the following functions:

  • It is responsible for developing the secondary sexual characteristics and the internal reproductive organs
  • It preserves bone density by preventing bone loss
  • It increases muscle strength
  • The balanced level of estrogen keeps the body energetic 
  • Estrogen raises fat stores in the body
  • It enhances cognition and memory

At menopause, the level of estrogen falls in the blood. This results in fatigue, weight gain, bone loss, sexual dysfunction, mood changes, increased cardio-vascular risk and memory issues.

Testosterone:

In the male body, it is produced by testes and has the following functions:

  • It is responsible for developing the secondary sexual characteristics and the internal reproductive organs
  • It increases the muscles mass and strength
  • Collagen production also increases under the influence of testosterone
  • The cardiac output increases so large amounts of blood are available to be supplied to the organs
  • It builds up the bone mass and maintains it
  • The endurance and power both boost up, and the person feel active
  • It enhances cognition and memory
  • It is responsible for a “drive”

What happens when sex hormones fluctuate?

Imbalanced levels of sex hormones primarily affect libido and mood. 7 The declining sex drive further contributes to negative energy in the body. Mood swings, such as anxiety and depression, low energy, aggression, and weight changes, are some other features of hormonal imbalance. 8,9,10 The sex hormones contribute to other metabolic activities too. Their imbalance, therefore, disturbs the functioning of the organs and results in chronic fatigue. 

Many of my clients come complaining of fatigue or exhaustion or just inability to “get things done”. As you can see, there are so many things to consider and investigate. In my practice after the initial 60 min interview with the new client, I usually order some conventional tests as well as some test to investigate the common hormonal imbalances: sex hormones (estrogen, progesteron, testosterone, as well as cortisol), detailed thyroid test (8-12 markers).

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:

  1. Sánchez López de Nava A, Raja A. Physiology, Metabolism. [Updated 2020 Sep 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546690/
  2. Kaltsas, G., Vgontzas, A., & Chrousos, G. (2010). Fatigue, endocrinopathies, and metabolic disorders. PM & R : the journal of injury, function, and rehabilitation, 2(5), 393–398.
  3. Fischer, S., Markert, C., Strahler, J., Doerr, J. M., Skoluda, N., Kappert, M., & Nater, U. M. (2018). Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes – Role of Early Life Adversity. Frontiers in physiology, 9, 564.
  4. Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057–1072. 
  5. Giebels, V., Repping-Wuts, H., Bleijenberg, G., Kroese, J. M., Stikkelbroeck, N., & Hermus, A. (2014). Severe fatigue in patients with adrenal insufficiency: physical, psychosocial, and endocrine determinants. Journal of endocrinological investigation, 37(3), 293–301.
  6. Tanaka, M., Mizuno, K., Yamaguti, K., Kuratsune, H., Fujii, A., Baba, H., Matsuda, K., Nishimae, A., Takesaka, T., & Watanabe, Y. (2011). Autonomic nervous alterations associated with daily level of fatigue. Behavioral and brain functions : BBF, 7, 46.
  7. AlAwlaqi, A., Amor, H., & Hammadeh, M. E. (2017). Role of hormones in hypoactive sexual desire disorder and current treatment. Journal of the Turkish German Gynecological Association, 18(4), 210–218. 
  8. Zhang, H., & Sairam, M. R. (2014). Sex hormone imbalances and adipose tissue dysfunction impacting on metabolic syndrome; a paradigm for the discovery of novel adipokines. Hormone molecular biology and clinical investigation, 17(2), 89–97.
  9. Gambineri, A., & Pelusi, C. (2019). Sex hormones, obesity and type 2 diabetes: is there a link?. Endocrine connections, 8(1), R1–R9.
  10. Barth, C., Villringer, A., & Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in neuroscience, 9, 37.
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/

fasting mimicking support your health

The Power of the Pause: How the Fasting Mimicking Diet Can Heal the Body and Mind

Are you feeling overwhelmed and burned out?

Maybe you’re suffering from a lack of motivation or constant, low-level anxiety?

You’re certainly not alone:
Our fast paced lifestyles, combined with the stresses and strains of balancing a family life with a successful career can quickly become overwhelming.

Add in a global pandemic and the threat of financial instability, and well, you probably get the picture!

Pause for Thought…

When everything seems to be up against us, and motivation and productivity begin to tank, it’s tempting to try and push through the problem and work even harder.

But you know what? That’s a huge mistake.

In situations of stress, lethargy and procrastination, it’s absolutely vital to take a pause and reassess the root causes of your mental and physical overwhelm.

In this article, we’re going to look at how fasting, and specifically the “Fasting Mimicking Diet”, can form the cornerstone of successful life realignment or reset.

Fasting? But My Issues are Purely Stress Related!

Fasting has risen greatly in popularity over the last five or so years, and with very good reason: studies have repeatedly shown that not only does fasting promote weight loss, it’s also associated with boosts in general mood and wellbeing, with many of the physical benefits of fasting being closely tied to improved mental health and brain function.  Back in Russia, some hospitals treated most difficult cases of depression and bipolar disorders with water fasting up to 30 days, and those patients would reach the complete remission.   It is still done in some cases, but under physician supervision in the hospital setting.

Here are just a few of the positive health outcomes you can expect from a well-designed fasting program:

A Reduction in Elevated Blood Sugar and Lower Cholesterol

Repeated studies have shown that fasting can reduce “bad” cholesterol and promote more healthy insulin production, stabilizing elevated blood sugar levels.

Lowered cholesterol and insulin will reduce your likelihood of developing heart disease and diabetes respectively.  And, once your blood sugar is under control and stable, it will reduce mood swings, irritability and food cravings.  All of it can be accomplished once you successfully adjust to a lifestyle of periodic fasting.

A Reduction in Inflammation

Several studies on both animal and human subjects have shown a reduction in overall inflammation, once the body is allowed a rest from the demanding task of food digestion and processing, allowing the stomach and intestinal lining time to heal and repair.

We also see from the studies that fasting will change the gut microbiome (microorganisms populating the gut).  The science is still in its infancy, but having the wrong types (and ratios) of gut bacteria can be a key reason behind symptoms of lethargy, listlessness and anxiety.

The Slowing of Mental Decline and Improvements in Cognition

Autophagy is a complex process in which old and damaged cells are recycled to produce new, healthy ones. During the process of fasting or significant reduction of caloric intake, the process of autophagy kicks in around the third day.

Animal studies have repeatedly shown that fasting can improve lifespan and cognitive ability, and often drastically so. As a bonus, the process of autophagy can also help to ward off cancers and the growth of malicious tumors.

Overall, the evidence is mounting that far from being stressful, a well implemented fasting regime can do wonders for your health, both mental and physical.

Sounds Great! But What Do You Mean By the “Fasting Mimicking Diet”?

“The Fasting Mimicking Diet”, created by Valter Longo, PhD aims to give all of the positive benefits of a long fast, without severe calorie deprivation of a full-blown starvation diet.

So How Does It Work?

The “5 Days Fasting Mimicking Diet” called ProLonis designed by company L-Nutra. The company’s plan is based around specially formulated kits that feature pre-packaged meals and instructions. Here’s how the diet is structured:

  • During the five-day period, participants consume only the meals contained within the kit.
  • The first day of meals and snacks provides around 1,090 calories, with 10% protein, 56% fat and 34% carbohydrate.
  • From the second day onwards, the kit provides just 725 calories, with 9% protein, 44% fat and 47% carbohydrate.

The specially formulated meals cause your body to slowly deplete it’s stores of glycogen (stored sugar), and eventually burn energy from non-carbohydrate sources (your own body fat reserves).

This staggered calorie restriction triggers the body’s physiological fasting response, boosting cell regeneration, decreasing inflammation, and promoting  fat loss, without the dangers of eliminating food and nutrients entirely.

For optimal results, the Fasting Mimicking Diet should be undertaken at least once every 4-6 months, and shouldn’t be thought of as a one-time cleanse.

What Will I Be Eating?

If you decide to undertake a Fasting Mimicking Diet, you’ll need to order a ProLon meal kit from our office. The kit makes sticking to this protocol extremely easy, as you won’t need to worry about getting meal timings wrong or selecting the wrong types of food.

The ProLon kit is spread over five individual boxes, one for each day of the fast, and includes an easy to understand chart to help you make sense of the meal timings and order.

The kits are vegetarian, as well as being lactose and gluten free, but allergy sufferers should note that the meals do contain both nuts and soy.

There’s a broad list of foods to keep you on track, with nut bars, soup blends and vegetable chips all thrown into the mix. In addition, you’ll also get a range of herbal teas, as well as a comprehensive stack of vegetable supplements and specially formulated drinks.

Should You Try the Fasting Mimicking Diet?

Right away, it should be mentioned that breastfeeding or pregnant women should avoid lowering calories. That means a fasting protocol is not appropriate if you’re in either of those positions.

Likewise, if you already suffer from a serious medical condition such as diabetes or have a history of disordered eating, you shouldn’t undertake any kind of dietary intervention without consulting your doctor first.

Other than that, if you’re felling stuck in a rut and looking to improve your mood, energy levels and overall health, why not give it a shot? The benefits of a healthy fast are hard to ignore!

Watch: How can fasting support your health:

Call our functional medical office for a more explanations or simply click on the recording of the educational webinar that further discusses the science and process of fasting mimicking diet. 212-696-4325

Watch: The Power of the Pause in Business and Life:

Environmental Toxins and Gut Microbiome

Can Environmental Toxins, Like Glyphosate, Affect Our Gut Microbiome?

Glyphosate, a weedkiller also known as Roundup, has made many headlines in the past year.
It was named a “probable human carcinogen” in 2015 by the WHO’s International Agency for Research on Cancer. And shockingly, levels found in the human bloodstream have increased by more than 1,000% in the last two decades.

Now, more recent research is pointing to the negative effects that glyphosate has on our gut microbiome.

So, what is glyphosate exactly?

Glyphosate is the active ingredient in Monsanto’s weedkiller, Roundup. It is used to kill weeds that interfere with agricultural crops like soy, canola, corn, and wheat.

What is the gut microbiome?

The gut microbiome may be one of the most complex biological systems on Earth. It contains trillions of microbes and bacteria and is the entire system of organs that is in charge of digestion, removing waste from your body, and taking in energy and nutrients.

Research suggests that when the gut microbiome is in balance, it may prevent and treat many common diseases.

And alternatively, when the gut is out of balance it can be linked to dozens of chronic diseases, potentially being the origin point of dis-ease. The gut has a direct effect on our body’s inflammation, immune system, brain health, hormonal balance, and even skin. Studies show that obesity, asthma, rheumatoid arthritis, and depression all have been linked to an imbalance of the gut microbiome (and this is an incomplete list!).

Environmental toxins like Glyphosate can affect our Gut Microbiome
Image: Getty Images

How do environmental toxins impact our gut health?

Pesticides and other toxic chemicals, like glyphosate, can make their way from our food, into our mouths and into our gut. Anything we put in our mouths will impact the health of our gut, negatively or positively. For example, an organic vegetable may provide the necessary nutrients and fiber, called prebiotics, to help our gut microbes thrive. But, lace that vegetable with a toxin like glyphosate, and this healthy produce is no longer a source of just nutrients and fiber – it’s now also a vehicle for a harmful toxin.

In a 2018 study, rats were exposed to what was considered “safe” doses of glyphosate in their drinking water, over a 13-week period. The study “provided initial evidence that exposures to glyphosate, at doses considered safe, are capable of modifying the gut microbiota and warrant future studies on potential health effects of Glyphosate-based herbicides.”

Glyphosate and Leaky Gut

Glyphosate and other pesticides are also thought to increase intestinal permeability, commonly known as “leaky gut”, by irritating the gut lining. Leaky gut develops when the intestinal lining is damaged, allowing for undigested food and toxins to leak into your bloodstream, causing an immune reaction.

What symptoms should I look out for to know if my gut is imbalanced?

If there is one thing you should know, it’s that it is possible to feel well 100% of the time! As stated earlier, a lot of chronic dis-ease begins in the gut! If you have any of these symptoms, it might be attributed to an imbalance in the gut:

  • Chronic diarrhea, constipation or bloating
  • Nutritional deficiencies
  • Fatigue
  • Headaches
  • Moodiness, anxiety, depression
  • Difficulty concentrating
  • Skin problems like acne, rash, eczema
  • Joint pain

Tips to avoid environmental toxin exposure

While you might not be able to eliminate exposure of pesticides and glyphosate 100% of the time, there are steps you can take to minimize your exposure risk:

  1. Read your labels and choose foods that aren’t genetically engineered. Genetically modified crops are typically sprayed heavily with pesticides and glyphosate. So, choosing foods that aren’t genetically engineered is a simple way to avoid unnecessary exposure to this chemical. You can find labels on foods that let you know if they are genetically engineered or not. Labels to look for could be, “Partially produced with genetic engineering”. Alternatively, the label “No genetically engineered ingredients” suggests that there are no GMOs in the product. Not every single brand uses these labels, so it’s hard to tell 100% of the time, but you can start to remove extra known sources of these foods by simply reading the label.
  2. Buy organic when you can. Pesticides are never sprayed on organic crops. So you can try to buy as much organic food as possible. The good news is that you don’t have to buy 100% organic all the time. The Environmental Working Group, a non-profit organization that specializes in research and advocacy in the areas of agricultural subsidies, toxic chemicals & pollutants and corporate accountability, releases their “Dirty Dozen” and “Clean Fifteen” Food lists every year.
    Fruits and Vegetables that have the highest amount of harmful pesticides are on the “Dirty Dozen” list . Foods that have the lowest amount of harmful pesticides are on the “Clean Fifteen” list. Focus your attention on buying organic from the Dirty Dozen list to lower your exposure to pesticides and glyphosate. And you can buy conventional fruits and vegetables from the Clean Fifteen list without worrying about toxic exposure. Keep this list handy for reference.
    Additionally, many carbohydrate-type crops are most likely sprayed with glyphosate like wheat, oats, soybeans, corn and rye. Most recently it was discovered that some hummus (chickpea) brands contain high levels of glyphosate. Knowing which crops might be contaminated and can help you choose which to buy organic as well.
    A study done by Environmental Health News showed that levels of glyphosate fell by more than 70 percent in both children and adults, with reductions seen after just three days after switching to an all organic diet.
  3. Support Community Supported Agriculture (CSA) and Organic Food Co-Ops. CSA’s in New York are a great way to obtain high-quality organic foods from ethical farmers. If you are in New York, I like Local Roots, but you can find a full list of CSAs here. An added bonus of buying organic produce from your local farmer, you are working to maintain a healthy environment, a vibrant community, and a strong and sustainable local economy for you and your kids to thrive in.

Being Realistic

It might be completely impossible to avoid toxic chemicals like glyphosate 100% of the time, so making small changes and buying organic when you can to minimize your risk can be very helpful. If you are exposed to glyphosate and other pesticides, make sure to keep your microbiome in the best shape possible by eating a variety of organic fruits and vegetables, reducing processed foods and seed oils, and taking high-quality probiotics.

Next step

If you need help to stabilize and reverse chronic medical conditions including a variety of illnesses related to gut health, look for a certified functional medicine practitioner here. Or simply call our practice at 212-696-HEAL. In our practice, we test for glyphosates and recommend treatment protocols to detoxify you from glyphosate and toxicants alike. We also prescribe treatments to stabilize and enrich healthy beneficial microbes in your gut with nutrition and food like supplements. Feel free to call our office to schedule a consultation with Elena Klimenko, MD IFMCP at 212 696 4325.

ChronoBiology - Understanding Chronotype Circadian Rhythms

Understanding Chronotype May Address Underlying Causes of Chronic Conditions

When you think about how to achieve optimal health, it’s most likely you think about what nutrients to eat and what foods you might avoid, how many hours of sleep to get each night, how much water to drink and how much exercise you should try to achieve in a week. All extremely important lifestyle factors to consider in our quest for a healthy body.

However, there is an emerging field of functional medicine research that specifically addresses, not the what or how much, but the when – the timing of when to sleep, when to eat and when to exercise, to name a few – on the impact of human disease to help inform and improve medical treatment.

Chronobiology

Chronobiology is a study of biologic rhythms that follow a daily or ~24 hour cycle. Most of us are familiar with the circadian rhythm, our internal biological clock, responsible for sleeping at night and being awake during the day. These biological rhythms influence our sleep-wake cycles, eating habits and digestion, body temperature, and other metabolic processes.

Studies suggest that disruptions in the circadian-system (like watching a movie late at night, working late) have been linked to sleep disorders, seasonal affective disorder and various chronic health conditions like cardiovascular disease, neurodegenerative disorders, obesity, diabetes, and mood disorders.

Researchers are taking a closer look at other rhythms of the human body as it impacts health outcomes: timing of eating and meal schedules, when to exercise, and even when we should be taking our medications.

For example, “results from a 2019 study regarding eating times and mood disorders indicated that of the 1,304 study participants, those who reported skipped or delayed breakfasts were more likely to experience a mood disorder compared to those with a regular schedule of eating breakfast, lunch, and dinner.”

And “Human and animal-based studies suggest circadian rhythms influence cardiovascular function and diseases, and may also offer an avenue for disease prevention and treatment. In 2019, a study of over 19,000 patients with hypertension found that those who took their medication at bedtime rather than upon awakening had better ambulatory blood pressure and lower risk of developing cardiovascular disease (CVD).”

Impacts of Chronobiology on Health and Disease
Source

Considering the developing research of medical chronobiology and circadian rhythms, offer additional root cause reasons and tools to glean insights into achieving individualized optimal health and wellness. Understanding your own personal chronotype may help address the underlying causes of chronic conditions and assist in the optimization of treatments and lifestyle interventions. Considering the developing research of medical chronobiology and circadian rhythms, offer additional root cause reasons and tools to gleam insights into achieving individualized optimal health and wellness. Understanding your own personal chronotype may help address underlying causes of chronic conditions and assist in the optimization of treatments and lifestyle interventions.

Credits:

Erin D’Elia Assenza, Health Coach at Healthy, Wealthy & Wise Medical Practice

 

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

Immune Support for Lungs Health webinar

Webinar “Immune Support for Your Lungs Health”

Join Dr. Elena Klimenko, a functional medicine doctor, for a discussion on respiratory health, diving deep into the details of respiratory infections, especially in the time of COVID-19.

Learn the ways our respiratory system is affected (i.e. seasonal allergies, home pollutants, diet, environment, etc.), along with what we can do to support our respiratory health overall.

Watch free webinar

“Immune Support for Your Lungs Health”
By Dr. Klimenko

Password: Wellness2020

“Immune Support for Your Lungs Health” webinar

We should not forget about the important role our lungs play in our overall health. And like the rest of our body, our lungs need special regular care and attention. Lungs can have a build-up of toxins and tar caused by smoking, environmental pollution, allergens, dust, etc.

As we know, when we breath, we feed oxygen to every organ in our body on a cellular level. Lack of oxygen can lead to many health issues, including respiratory illnesses and even heart diseases, to mention just a few.

But our regular, everyday breathing is not enough to keep our body full of oxygen. During most of our daily activities, our lungs are functioning only at 50 percent of their full capacity. Therefore, we have to challenge our lungs with more intense activities. So, we need to “push them” to their limits by practicing special breathing exercises to help your lungs cleanse themselves and to avoid the above-mentioned problems.

Yoga has many breathing techniques that you can explore. Basically, any deep breathing or diaphragmatic breathing exercises will be helpful if they are done in a proper manner. We will write a separate article about this topic in future.

There is also special lung association that offers useful information about breathing techniques for people with lung and breathing problems. Check out their Better Breathers Clubs throughout the United States of America. You can visit the American Lung Association website or call them at (800) LUNG-USA to find out more information.

If you want to get more information about the Immune support and respiratory health or to schedule an integrative medicine consultation, please call our office at 212-696-4325.

Stay healthy and strong!

boost your immune system to fight coronavirus

4 Tips To Boost Your Immunity So You Can Reduce The Chances Of Getting The Coronavirus Infection

Don’t Panic! Our very own Dr. Elena Klimenko did a Facebook Live video at the Well, answering questions about the Novel Coronavirus and how to reduce the chances of getting the infection.

You can watch the full video here:

The Coronavirus is a family of viruses that most Americans have been exposed to in the past.

However, this Novel Coronavirus, Covid-19, is more virulent than what we are used to and spreads pretty quickly. Symptoms of Covid-19 are fever, body aches, runny nose and in worse cases, an upper respiratory infection.

Generally, only cases that go deeper into the respiratory tract will be seen by professionals.

To keep yourself from getting to that point, you must boost your immunity, keep your immune barriers strong and take the following necessary steps for general prevention.

By taking the necessary steps listed below, the likelihood of getting the virus (or any virus for that matter!) is low:

  1. Wash Your Hands. For at least 20 seconds at a time, several times a day, especially after touching anything that might have been exposed (doorknobs, shopping carts, subway poles, etc). Make sure to get under your fingernails as well.
  2. Wash out your nasal orifices. You can also use a normal saline nasal spray to flush mucus membranes 2-3 times/day to reduce exposure to the virus.
  3. Get good sleep! To keep your immune system strong, you must prioritize 7-8 hours of uninterrupted deep sleep.
  4. Take these supplements to support your immune system.
    If you are running low, you can order them from our office at 212-696-4325.

a. Vitamin D – Your Vitamin D levels should be between 50-80.
b. Vitamin A
c. Herbs like Echinacea, Andrographis and Elderberry
d. Homeopathic Silver and Homeopathic Oscillococcinum

If you are feeling sick, we recommend you stay at home to help stop the spread of any virus.
If you must leave your house for any reason, using a surgical mask can prevent you from spreading germs and keep your community safe.

Hydrogen Sulfide SIBO Small intestinal overgrowth

Hydrogen Sulfide SIBO

Small intestinal overgrowth (SIBO) is a common gut health issue characterized by bacterial overgrowth in the small intestine. It is normally diagnosed through a breath test identifying hydrogen or methane produced by the overgrown bacteria. The problem is that this breath test is unable to detect a less talked about form of small intestinal overgrowth, hydrogen sulfide SIBO.

The good news is that working with a functional medicine practitioner, you can find out if your symptoms are due to hydrogen sulfide SIBO and if so, treat it naturally through a low-sulfate diet.

In this article, you will learn what SIBO and hydrogen SIBO are. You will learn how they are different, what are their symptoms, and how to diagnose them. I will explain why a low-sulfur diet is the best solution for hydrogen sulfide SIBO and how to follow a low-sulfur food plan.

You will also understand how working with a functional medicine doctor, like myself, can help you overcome hydrogen sulfide SIBO.

What Is SIBO

Small intestinal bacterial overgrowth (SIBO) is a gut health condition that affects the small intestine. It happens when certain bacteria, normally grown in other areas of your gut, start growing in your small intestine leading to overgrowth.

Symptoms of SIBO

If you have SIBO, there are a variety of symptoms you may experience. These SIBO symptoms may include:

  • Stomach pain
  • Indigestion
  • Gas
  • Bloating
  • Diarrhea
  • Constipation
  • Cramps
  • Feeling of fullness and quick satiety
  • Weight loss

What Is Hydrogen Sulfide SIBO

If your doctor is suspecting SIBO after going through your symptoms, health history and performing a physical exam, she or he will use a breath test that can detect hydrogen and methane in your breath. Since excess bacteria in your small intestine can lead to the release of these gases, this certainly makes sense and helps to identify most forms of SIBO. However, it doesn’t take hydrogen sulfide SIBO into account.

Hydrogen sulfide is a third form of gas that is commonly present among patients with SIBO. The problem is that hydrogen sulfide cannot be measured with a SIBO breath test. Hydrogen sulfide is produced by a very specific type of bacteria that can overgrow in your small intestine.

The interesting thing about hydrogen sulfide is that in small amounts, it can be beneficial and anti-inflammatory. However, when it occurs in high amounts due to a bacteria overgrowth in your small intestine, it becomes very problematic. High amounts of it in your large intestine can also result in health problems. Therefore to handle this overgrowth and to resolve your symptoms, we have to bring the healthy balance back to your small intestine, your whole gut, and body.

Diagnosing Hydrogen Sulfide SIBO

Since SIBO breath tests are not looking for hydrogen sulfide, you may wonder how can you know if you have hydrogen sulfide SIBO. That’s a great question. Let’s see how functional medicine doctors, such as myself, can help to diagnose hydrogen sulfide SIBO.

As you’ve already learned, breath tests only look for hydrogen and methane, not hydrogen sulfide, and can only diagnose traditional SIBO, not hydrogen sulfide SIBO. One study has found that people with traditional SIBO also have a higher risk of hydrogen sulfide SIBO.

However, another study has found that people who test negative for the SIBO breath test have a higher likelihood of having hydrogen sulfide SIBO. This is why it is important that you are working with a doctor who is familiar with hydrogen sulfide SIBO and is willing to dig deep to find the root causes of your symptoms and gut health issues. Working with a functional medicine doctor, like myself, is a great option.

First, your doctor will go through your symptoms. Symptoms of hydrogen sulfide SIBO may be different than the symptoms of SIBO. Sulfur-like, rotten egg smelly gas or belching are generally a good indication that you are dealing with hydrogen sulfide SIBO. You may also be more likely to experience diarrhea and nausea. You may also have other symptoms as well, such as rashes and pain. Once your doctor understands your symptoms, they can run some more complex GI tests other than the breath test to look for bacteria overgrowth and other gut imbalances. Lastly, if going on a low-sulfur food plan helps to relieve your symptoms, it is a good indication that hydrogen sulfide SIBO was the culprit behind them.

Low-Sulfur Food Plan for Hydrogen Sulfide SIBO

Traditionally, people with SIBO are often recommended to follow the low-FODMAP diet.

However, research has found that low-FODMAP is actually not beneficial for hydrogen sulfide overproduction. If you have hydrogen sulfide SIBO, a low-sulfur diet is a much better idea.

When you eat sulfur-containing food, they go through a process to naturally occurring sulfate in your body. While in a small amount, sulfate is good for you, too much becomes a problem. If you are dealing with hydrogen sulfide SIBO, following a low sulfur food plan can help your body regain its balance and get rid of your symptoms.

What to Eat and What Not to Eat on a Low Sulfur Food Plan

Vegetables to avoid:

  • Arugula
  • Asparagus
  • Bok choy
  • Brussels sprouts
  • Broccoli
  • Cauliflower
  • Cabbage
  • Daikon radish
  • Collard greens
  • Garlic
  • Kale
  • Horseradish
  • Onion
  • Leek
  • Radish
  • Peas
  • Scallion
  • Swiss chard
  • Sauerkaut
  • Spinach
  • Split peas
  • Turnip
  • Soybeans
  • Watercress

Fruits to avoid:

  • Dried fruits
  • Dried coconut
  • Grapes
  • Papaya
  • Pineapple

Dairy and dairy alternatives to avoid:

  • Cow, sheep, and goat milk
  • All cheese
  • Cottage cheese
  • Yogurt
  • Whey
  • Eggs
  • Coconut milk from a carton
  • Soy products
  • Animal protein to avoid:
  • Red meat
  • Fish
  • Poultry white meat

Legumes to avoid:

  • All legumes, including beans, lentils, bean sprouts, soy, etc.

Herbs to avoid:

  • Chives
  • Curry
  • Ginger
  • Horseradish
  • Turmeric

Other things to avoid:

  • Amaranth
  • Buckwheat
  • Lemon and lime juice
  • Frozen potatoes and french fries
  • Peanuts
  • Quinoa
  • Tamarind
  • Vinegar
  • Wine
  • Tamarind
  • Wheat germ

Supplements to avoid:

  • ALA
  • Bromelain and papain
  • Chlorella
  • NAC
  • MSM
  • Milk thistle
  • Turmeric
  • DMSO
  • Dairy source acidophilus
  • Cysteine

Vegetables allowed:

  • All squash
  • Artichokes
  • Avocado
  • Beets
  • Bell pepper
  • Carrot
  • Celery
  • Cucumber
  • Corn
  • Eggplant
  • Lettuce
  • Mushrooms
  • Olives
  • Potatoes
  • Pumpkin
  • Tomato
  • Water chestnut

Fruits allowed (up to ½ cup a day):

  • Bananas
  • Berries
  • Cantaloupes
  • Dates
  • Figs
  • Grapefruit
  • Melons
  • Kiwi
  • Lemon
  • Lime
  • Mango
  • Pear
  • Pomegranate

Herbs allowed:

  • Anise
  • Bay leaves
  • Basil
  • Caraway
  • Cilantro
  • Cinnamon
  • Cumin
  • Dill
  • Lemongrass
  • Lavender
  • Nutmeg
  • Oregano
  • Parsley
  • Pepper
  • Thyme
  • Rosemary
  • Thyme

Other foods allowed:

  • Almond, rice, and hemp milk
  • Nuts, including almonds, cashews, and macadamia
  • Seeds, including pumpkin seeds, sesame seeds
  • Gluten-free bread
  • Beet, corn, or parsnip chips
  • Basmati and jasmine vinegar

Final Thoughts

Hydrogen sulfide is the third most common gas in those with SIBO, yet, there is less research on it making diagnosis and treatment more difficult. If you have hydrogen sulfide SIBO, I recommend that you try a low-sulfur food plan, and notice a reduction in symptoms within a couple of weeks.

If you suspect that you have SIBO or hydrogen sulfide SIBO, I recommend that you contact a functional medicine doctor, like myself, for diagnosis and treatment. I can help you to address the underlying causes of your hydrogen sulfide and other types of SIBO, as well as other gut health issues using a system-oriented approach and engaging both patient and practitioner in a therapeutic partnership. As an experienced functional medicine doctor with 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 gut health. Then I will prescribe a personalized and effective plan to improve your gut health condition, repair your body, and regain your health and well-being.

If you would like to get more information about hydrogen sulfide SIBO and gut health treatment or to schedule a functional medicine consultation, please call my office at 212-696-4325.

Sources:

https://www.ncbi.nlm.nih.gov/pubmed/15747080

https://www.ncbi.nlm.nih.gov/pubmed/9448181

https://www.ncbi.nlm.nih.gov/pubmed/19709217

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023273/

https://onlinelibrary.wiley.com/doi/pdf/10.1016/S0378-1097%2803%2900748-1

https://www.fasebj.org/doi/abs/10.1096/fasebj.29.1_supplement.598.10

https://www.ncbi.nlm.nih.gov/pubmed/23898195

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023273/https://www.ncbi.nlm.nih.gov/pubmed/23898195

Testing of Lyme Disease and photo of Tick

Testing of Lyme Disease and Problems with It

Lyme disease is an infectious disease spread by ticks. It is a growing problem with hundreds of thousands being diagnosed each year. However, Lyme disease is possibly the most misunderstood and controversial health issue. Many people go misdiagnosed and silently suffer from chronic and serious symptoms of chronic Lyme disease without receiving proper treatment. Unfortunately, current testing for Lyme disease is highly unreliable, and many doctors are not versed enough in Lyme disease to provide an accurate diagnosis and treatment.
In this article, you will learn what Lyme disease is, the difference between acute and chronic Lyme disease, and their symptoms. You will learn about current testing methods for Lyme and the problems with these tests. You will learn what tests may further help accurate diagnosis, and why you need a Lyme-literate health practitioner for proper diagnosis and successful treatment.

What Is Lyme Disease?

Lyme disease is an infectious disease. It is caused by the Borrelia burgdorferi bacteria found in ticks.
Lyme is more common in wooded areas or in nature. It is transmitted to the human body by the bite of an infected black-legged or deer tick. Based on the old standards, in order to transmit the disease, the tick usually has to stay in the body for 24 to 48 hours or longer. However, the new studies show that even 15 min from tick attachment it may transmit the variety of microbes into the victim.

Acute vs Chronic Lyme Disease

Acute Lyme disease refers to a short-term or recent infection, whereas chronic Lyme refers to a long-term infection with ongoing health problems. After getting infected with Borrelia burgdorferi, you may develop symptoms of acute Lyme disease. When caught early, within the first few days to weeks, acute Lyme disease is usually treated with a course of 1-2 antibiotics.
However, chronic Lyme disease is increasingly prevalent as well. Some people, unfortunately, are simply resistant to treatment. In other cases, Borrelia burgdorferi simply lingers in the body even after adequate treatment. While in other situations, acute Lyme disease symptoms may be too mild to take seriously, and the infection becomes chronic. In other cases, acute Lyme gets misdiagnosed and confused with the summer flu or another short-term illness and patients never get adequate treatment. Unfortunately, when the bacteria has fully integrated itself into your system, it leads to chronic health issues, and it is much harder to identify and shift.

symptoms from lyme disease include rash

Symptoms of Acute Lyme Disease:

  • Flat, circular rash with a bull’s eye
  • Joint pain, including neck and back pain
  • Fatigue
  • Muscle pains
  • Headaches
  • Sleep issues
  • Fever
  • Swollen lymph nodes
  • Concentration problems

Not all people with acute Lyme have a bull’s eye rash, actually, those who do are minority. Many people miss the tick bite altogether. Not all people with acute Lyme disease experience severe symptoms. Some may not visit the doctor. In some cases it may be confused with the flu or due to inaccurate Lyme testing, may get tested for autoimmune or other health conditions instead of Lymes. In some cases, symptoms may be written up as symptoms of stress, fatigue, or psychosomatic symptoms.

Symptoms of Chronic Lyme Disease:

  • Fatigue
  • Pain
  • Migrating and intermittent joints and muscle pains
  • Migrating pains or swelling in elbows, knees, and shoulders
  • Sleep troubles
  • Memory and concentration problems
  • Speech problems
  • Neurological issues — migrating numbness, tingling or burning pains
  • Fibromyalgia-like pain
  • Other chronic health issues

Chronic Lyme disease is often confused with fibromyalgia, autoimmune conditions, mental health issues, and psychosomatic illness. Without proper diagnosis and treatment, people with chronic Lyme disease may get worse over time and never recover.

Lyme Disease from Ticks

Conventional Testing for Lyme Disease

Conventional testing for acute Lyme disease usually starts with a health story. Your doctor will look for tick bites and rashes. They will perform a physical exam looking for symptoms of Lyme disease.
If your doctor believes that you have Lyme disease, they may order the following “standard-of-care” tests:

  • Enzyme-linked immunosorbent assay (ELISA) may be ordered to detect antibodies against B. burgdorferi.
  • Western blot may be used to confirm a positive ELISA test result. It is only used if your ELISA test is positive and checks for the presence of antibodies specific to B. burgdorferi proteins.
  • Polymerase chain reaction (PCR) may be used to evaluate people with Lyme arthritis or nervous system symptoms. This test is not routinely used as it has a very low sensitivity.

If a patient tests positive for both ELISA and Western blot tests the conventional diagnosis of Lyme disease can be established.

Problems with Testing for Lyme Disease

The problem is that Lyme disease is critically misunderstood by many people in the medical profession. Most doctors are not very well-versed in Lyme disease. Testing is not reliable. Many medical professionals are simply not educated about chronic Lyme disease to recognize and treat it. Conventional doctors often have a difficult time diagnosing, understanding, or treating something that they cannot see or isolate. Hence, Lyme disease diagnosis and treatment may be one of the most controversial and difficult issues in medicine. There are a lot of grey areas, a lot of misunderstandings, and unreliable testing, so going to a Lyme-literate practitioner is critical.

Lyme Testing Is Not Designed to Detect the Lyme-Causing Bacteria

It is important to know that there are many types of Borrelia, not just B. burgdorferi, that also cause Lyme-like illnesses. Despite of the variety of bacterias, the conventional tests only look for one species of Borrelia, B. burgdorferi. There are actually 16 known strains of Borrelia. Another example of Lyme-related infection, for example, is caused by B. mayonii. If it is not that you are infected with B. burgdorferi, conventional testing may not pick up on your Lyme diagnosis and may be misdiagnosed and left without treatment.

Inaccurate Results and False Negative Due to Lower Test Sensitivity

Most non-Lyme literate doctors and labs stick to the two-step test for Lyme that is recommended by the CDC and approved by the FDA. These tests include the ELISA followed by a Western blot test. Both tests are only designed to detect B. burgdorferi and no other Lyme-related bacteria or co-infection.

One of the problems with testing for Lyme disease is that the ELISA tests are not always accurate. False negatives may occur. For example, if you get tested too soon after getting bitten and infected, it’s possible that your body hasn’t developed enough antibodies for the test to detect the bacteria. If your ELISA test is negative, many labs will not move onto the Western blot. Many doctors don’t retest, even if your symptoms persist and are in correspondence with the symptoms of Lyme disease. Research has shown that the two-step testing of ELISA and Western blot may miss up to 60 percent of Lyme cases.

The ELISA and Western blot are also not accurate when it comes to chronic Lyme disease, and are more helpful when it comes to acute Lyme disease.

False-Negatives May Also Occur

While false negatives may occur, false positives also commonly occur. After getting infected with B. burgdorferi, your immune system may not show a positive response with positive IgM (young antibodies), however, neither convert or mount an immune response with IgG (old antibodies). One study, for example, has found that over 50 percent of test participants showed false positive for Lyme disease. This may happen because of early antibiotic use or because the B. burgdorferi destroys the specific part of your lymph nodes that are responsible for IgG antibodies.

Some patients simply will not ‘convert’ to a classic immune response that most conventional healthcare professionals and testing are looking for. If you are working with a health practitioner who is not Lyme-literate, they may have a false-positive interpretation as positive for Lyme disease, when you don’t have Lyme disease.

Indirect vs Direct Testing: More False-Negatives

The two-step testing process used by most doctors is indirect diagnostic methods that do not look for or detect the bacteria that are causing the infection but measuring your body’s immune system response when the bacteria is present. There are several problems with this method:

  • Timing: During the early stages of the disease, your body may not have created enough antibodies yet to show up on the ELISA test. Most doctors don’t retest even if symptoms persist.
  • Immune suppression: Tick bites are tricky. The saliva of Lyme-causing ticks has an immune-suppressing component that may prevent or delay your body’s immune response, hence, your body won’t respond to the two-step test.
  • Antibiotics: Taking antibiotics around the time of the infection may also prevent your body from making enough antibodies to show up on your test.
  • Modified form of Borrelia: In some cases, the bacteria will turn into a cyst and prevent the production of antibodies.
  • Weakened immune system: If you have a weak or compromised immune system due to an illness, co-infection, or poor diet, false negatives may occur.
  • Seronegative patients: Some patients’ bodies simply do not produce antibodies at all.

More Reliable Diagnosis

In order to get the right diagnosis and the right treatment, you need to find a Lyme-literate functional or integrative medicine practitioner who understands Lyme disease.

Direct Testing

Direct testing methods are better than indirect testing. They don’t simply rely on your body’s response to bacteria. Instead, they are looking for specific disease-causing bacteria. This can help to determine if you have Lyme, what exact bacteria is causing it and what co-infections you may have.

More Lab Testing

Lab testing only provides a glimpse of what’s going on in your body. There is certainly more needed than simple Lyme blood testing. Other blood tests, besides the standard Lyme tests, may help to evaluate the state of your health and get a better understanding of what is going on in your body. It is crucial that you find a Lyme-literate functional doctor who listens to your symptoms and is able to make an accurate Lyme diagnosis based on your symptoms, health history, and other tests.

Some further blood tests that may help accurate diagnosis include:

  • Complete blood count (CBC): white blood cells count (WBC), differential (diff), hemoglobin (HB)
  • Blood chemistries: electrolytes, liver function, kidney function
  • Glucose metabolism: fasting blood glucose, fasting insulin hemoglobin A1c (HbA1c)
  • Minerals: magnesium and calcium
  • Thyroid function: complete thyroid
  • Lipid panel
  • Autoimmune testing rheumatoid factor, ANA titer
  • C-reactive protein (CRP)
  • Vitamins: vitamin D and B12
  • Iron: ferritin
  • Urinalysis: pH, WBCs, nitrites, protein, bilirubin
  • Mold and mycotoxins
  • Food sensitivities
  • Omega-3/omega-6 ratio
  • Cytokine testing (Th1/Th2)
  • Adrenal hormone testing
  • Reproductive hormone testing: estrogen, progesterone, testosterone
  • Testing for toxins
  • Comprehensive stool analysis: yeast, parasites, viruses, and bacteria
  • Microbes testing
  • Genetic testing, like methylation ( MTHFR gene mutation)
  • Testing for neurological, cardiac, and GI symptoms
  • Testing for Lyme co-infections

Find a Lyme-Literate Integrative or Functional Health Practitioner

If you know or suspect that you have a Lyme disease (acute or chronic), it is important that you find a Lyme-literate functional medicine practitioner to help you received the right diagnosis, identify the root cause of your condition, and prescribe a personalized treatment.

As a Lyme-literate functional and integrative doctor, I can help you to receive the right diagnosis, address the underlying causes of all your health issues, and get the right treatment 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 accurately diagnose Lyme disease and/or other health issues or co-infections and provide a personalized and effective plan to improve other organs function like the thyroid condition, repair your body and regain your health and well-being.

If you would like to get more information about Lyme disease and other tick-borne illnesses or to schedule a functional medicine consultation, please call my office at 212-696-4325.

References:

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  10. Coulter P et al Two-Year Evaluation of Borrelia burgdorferi Culture and Supplemental Tests for Definitive Diagnosis of Lyme Disease Journal of Clinical Microbiology Oct 2005 Vol 43, No. 10 5080- 5084
  11. Craft J, Fischer DK, Shimamoto GT, Steere AC. (1986) Antigens of Borrella burgdorferi Recognized during Lyme Disease appearance of a new Immunoglobulin M response and expansion of the immunoglobulin G response late in the illness. J. Clin.Invest.1978, 934-39
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  15. Seriburi V, Ndukwe N, Chang Z, Cox ME, Wormser GP (2012) High frequency of false positive IgM immunoblots for Borrelia burgdorferi in clinical practice. Clin. Microbiol. Infect 18, 1236-1240.
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  27. https://danielcameronmd.com/lyme-diagnosis-tests/
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