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Eastern Medicine & Natural Healing, Nutrition, Traditional Chinese Medicine

The Mind-Body Connection and Our Emotions

May 13, 2015
The Mind Body Connection and our Emotions

While Western medicine usually sees emotions as a secondary factor or an effect resulting from physical disease, Chinese Medicine views the emotions as an integral part of our internal organ’s interactions and oftentimes as the primary cause of disease. Emotions are not “good” or “bad”, but reflections of how we interact with life experiences as well as ourselves. It is important for us to express different emotions at appropriate times. For example, when a loved one passes away, one should feel grief and sadness. In fact, it is abnormal not to, and detrimental to our physical health if we ignore or suppress these emotions as they will manifest physically in our bodies. Our emotions also become the cause of disease if they are extreme and especially if they are prolonged over time. The inseparable connection between the mind and body shows that emotions are not only the cause of disease, but that they can also be caused by disease. For example, having prolonged fear and anxiety, the emotions associated with the Kidneys, can cause Kidney weakness. On the same token, weak or deficient Kidneys, which can happen after having too many children in a short period of time, may cause fear and anxiety.

Suppressing appropriate emotions or having prolonged emotions will cause emotional blockages in our meridians and may ultimately lead to physical disease. Each emotion is connected to a different organ system in our bodies. It is important to find out the underlying emotional component and treat the appropriate organ system and its corresponding meridian (I will discuss meridians and acupuncture points in more detail later). These emotions are then processed and released, so that we do not become “stuck” with the emotions, resulting in physical problems. This is the intricate connection between the mind and body. There are seven major emotions in Chinese medicine. Let’s take a look at each of these emotions.

Anger

Anger is the one emotion that will include several other related emotional states. It is probably the emotion that most of us deal with on a day to day basis from stress (road rage anyone?). It can also be expressed as:

  • resentment
  • repressed anger
  • irritability or annoyance
  • frustration, (internalized anger)
  • rage
  • indignation (anger or annoyance provoked by what is perceived as unfair treatment)
  • animosity
  • bitterness
  • impatience
  • violence or belligerence
  • arrogance
  • stubborness
  • aggression
  • impulsive or explosive personality

These emotional states will mainly affect the Liver and if they persist can cause Liver Qi or blood stagnation (review Qi and Blood pathology here and here). Anger can also cause Qi (energy) to rise in our body causing signs and symptoms to show up in our head and neck such as headaches, tinnitus, dizziness, a red face, red tongue, or thirst. Headaches are one of the most common symptoms caused by anger. Who hasn’t gotten a headache after being really angry?

Repressed anger and resentment, usually towards a family member, can also develop into depression. In this case, someone can appear subdued, depressed, and pale. The way to determine whether the depression is due to anger or sadness is to look at the tongue color. Depression due to anger will manifest a red or dark-red tongue and wiry pulse.

Anger can also affect the Stomach and Spleen (digestive system). The interaction between our Liver and Spleen/Stomach (digestive system) will become clear when we discuss The Five Element Theory. The take home lesson of this is not to get angry while you are eating, which can easily cause digestive problems.

Nutritional Guidelines to Treat and Heal the Liver

– When liver qi stagnates, the best thing to do is eat less (unless you are malnourished). It is also important to eliminate foods that further damage the liver, such as foods high in saturated fats (meat, cream, cheese, and eggs).
– Foods that get rid of liver qi stagnation are moderately pungent foods, herbs, and spices (review the Five Flavors here) : watercress, all members of the onion family (chives, garlic, leeks, scallions), mustard greens, turmeric, basil, bay leaf, cardamom, marjoram, fennel, dill, ginger, horseradish, rosemary, mint, and lemon.

Joy

Joy is only a cause of disease when we experience excessive excitement or continuous mental stimulation (no matter how pleasurable), which will affect the Heart and cause Heart Yin deficiency. For example, a migraine attack can be triggered by sudden excitement from good news. Have you ever been so happy and excited about something that caused a headache or your heart to flutter and skip a beat?

Nutritional Guidelines to Treat and Heal the Heart

In order to enrich the body’s yin, the Heart will usually rely on Kidney Yin for replenishment. Foods that strengthen Kidney Yin will also strengthen Heart Yin. These foods include parsley, wheat berry (sourdough bread), and sweet rice. Herbs that strengthen Kidney Yin include: rose hips, oyster shell (in supplement form), clam shell, schisandra fruit, raspberry and blackberry leaves.

Sadness

Sadness or grief directly weakens Lung Qi but also affects the Heart. Prolonged sadness and grief can lead to symptoms like breathlessness, fatigue, depression, or crying. This is most common after the death of a close family member. In cases of severe grief, this can lead to more devastating diseases. A poignant example is when Christopher Reeve’s wife, Dana Reeve was diagnosed with lung cancer at age 44, despite never smoking, less than a year after his death. Sadly, she also passed within 7 months of her diagnosis.

Foods that support Lung Qi

– Foods and herbs that strengthen lung qi include rice, sweet rice, oats, carrot, mustard greens, sweet potatos, yams, potatoes, ginger, garlic, molasses, barley malt, and herring.
– Cooling and mucus forming foods should be restricted (citrus fruits, milk and dairy products, spinach, chard, and seaweed).

Worry and Pensiveness

Anyone out there who thinks or studies too much? If so, your Spleen and Stomach, or digestive system will directly be affected causing symptoms of fatigue, loss of appetite, and loose stools. This is most commonly seen in those in school, graduate studies requiring excessive mental work, or those with demanding intellectual occupations. Spleen weakness and deficiency will cause accumulation of mucus and phlegm in our bodies and is further aggravated by a person who doesn’t eat on time, eats too fast, or discusses work while eating. Sound familiar?

Chronic worry will not only injure the digestive system, but also the Lungs. The most common causes of worry are financial, employment, and family problems. Weak Lung Qi will lead to anxiety, shortness of breath, and stiffness in the shoulders and neck. Instead of worrying about your problems, do something about it, since worrying will only make you sick and do nothing to resolve the situation.

Foods that strengthen Digestion/Spleen and Stomach Qi (previously discussed here)

– Foods that help Spleen Qi deficiency are sweet and/or pungent.
– This includes complex carbohydrates: rice (in the form of congee), oats, spelt, sweet rice
– Carbohydrate-rich vegetables: winter squash, carrot, rutabaga, parsnip, trurnip, garbanzo beans, black beans, peas, sweet potato, yam, and pumpkin
– Pungent veggies and spices: onion, leek, black pepper, ginger, cinnamon, fennel, garlic, nutmeg
– Severe deficiency will require small amounts of animal products in congee: mackerel, tuna, halibut, anchovy, beef, chicken, turkey, or lamb.

Fear

As I discussed above, fear and anxiety are the emotions associated with the Kidneys. An easy way to remember is when someone is scared, they pee in their pants. Good analogy? Fear drains Kidney Qi and makes it descend. It also drains our Essence (read more about Essence here). Fear in children causes descending Qi and nocturnal enuresis, usually from insecurity. In adults, fear and chronic anxiety will deplete the Kidney’s Yin, or cooling power, and cause heat in the face, night sweats, palpitations, dry mouth and throat.

Foods that Nourish Kidney Yin and Essence/Jing (previously discussed here)

In general, foods that nourish the Kidney will also nourish Jing. However, choosing the appropriate foods and herbs to strengthen our Kidneys largely depend on each individual’s constitution and condition.

Cooling Jing Foods – for those who tend to have heat signs and symptoms, yin deficiency, or excess

– chlorella, spirulina, black beans, seaweed, wheat grass, blue-green microalgae, almonds, and bone marrow soup

Warming Jing Foods – for those who tend to have cold signs or deficiency symptoms

– royal jelly, bee pollen, milk, clarified butter, placenta, dear antler, walnuts, animal products (chicken, liver, beef or lamb kidney) and warming seafood (especially mussels; also trout, salmon, anchovy)

Shock

Mental shock affects the Heart and Kidney. It will suddenly deplete Heart Qi leading to palpitations and insomnia. It also affects the Kidneys since our bodies must use Essence to replenish the sudden exhaustion of energy. This can cause night sweats, dry mouth, dizziness, and tinnitus.

What you need to know:

  • Chinese Medicine views the emotions as an integral part of our internal organ’s interactions. This is the mind body connection.
  • If emotions are suppressed or prolonged, physical disease may manifest in the associated organ. Weak organs can also cause the emotions to appear.
  • The seven major emotions are anger (liver), joy (heart), sadness (lungs), pensiveness and worry (stomach and spleen), fear (kidneys) and shock (heart and kidneys).

Which emotion do you think you are most affected by?

In health and wellness,
Dr. Elain

References:

The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford

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Eastern Medicine & Natural Healing, Health for the Body, Nutrition, Traditional Chinese Medicine

The Four Vital Substances Part 3 – Blood and Body Fluids

May 8, 2015
Swiss Chard Builds Blood and Stops Bleeding

I hope everyone had a great week! I’m finishing off my discussion on the four Vital Substances today with Blood and Body Fluids. I have been focusing a lot on theory the past couple of weeks and I promise I will be writing more on the practical application of these theories. It is important to have a basic understanding of the fundamentals, and if you forget, you can always refer back to these posts!

Blood

Blood in Chinese Medicine is slightly different from what we recognize in Western Medicine. Blood itself is a form of Qi, but a dense and material form. Qi and blood have an interconnected relationship. Blood is inseparable from Qi. Without Qi, blood is inert. That is, Qi moves blood. In Western medicine, this is equivalent to our cardiovascular system where blood moves through our arteries and veins. Qi is more yang relative to blood (it is more insubstantial) and blood is more yin relative to Qi (it is more dense). Its main function is to nourish the body and nourish Qi. It also has a moistening function, which Qi does not possess and ensures that our tissues stay hydrated. Finally our blood provides the material foundation for the Mind. It houses and anchors the Mind or Spirit.

Blood Pathology

There are three basic cases of Blood pathology:

1) Blood deficiency – Blood becomes deficient when not enough is made. This is usually caused by Spleen Qi deficiency (or weak digestion), since Spleen Qi is the catalyst of transforming Food Qi into Blood (review the foods that correct Spleen Qi deficiency here). It is also caused by inadequate intake of nutrients, inability to absorb those nutrients, and loss of blood through gastro-intestinal bleeding or heavy menstrual flow.

Signs of blood deficiency include pale lips, nailbeds, tongue, and complexion, thinness, spots in the field of vision, unusual hair loss, premature graying and thinning hair, dry hair, dry skin, and numbness in the arms or hands. Disorders of blood deficiency are anemia, nervousness, low back pain, headaches, painful periods, or amenorrhea (absence of periods).

  • Iron, folic acid, and vitamin B12 are the nutrients most often needed to reverse blood deficiency, where iron is the most common cause of anemia. Copper, B vitamins, and vitamin C aid in absorption of iron. Protein intake is also important.
  • Iron sources: dark leafy greens like spinach and swiss chard, legumes, nuts, and seeds.
  • Folic acid sources: dark leafy greens and sprouts, should be eaten either raw or lightly steamed.
  • Vitamin C sources: cabbage, bell peppers, broccoli, sprouts, parsley, and rose hip tea.
  • Cooling Vitamin C sources: Tomatoes, citrus fruits, and most other fruits are cooling sources of vitamin C. Use with caution by those with cold signs or deficiency symptoms.
  • Other Blood Builders: blackberries, grapes, protein (beef, lamb, mussel, pork liver), mulberry, raspberry, turnips, and watercress.

Note: Our hair is an indicator of blood quality and is considered an extension of blood in Chinese medicine. Healthy hair has a shine and thickness to it. Hair loss and premature graying is a sign of deficient blood as well as weak spleen and kidneys. (Hair is directly affected by the kidneys, which I will discuss later).

2) Bleeding – In Western medicine, bleeding is caused by weak blood vessels and poor clotting function while Chinese medicine views bleeding as the failure of the spleen to hold the blood in the vessels. (Remember from last week’s post on Qi – Spleen Qi holds blood in the vessels.) This makes sense as Spleen Qi extracts nutrients from our food to maintain the integrity of our blood and blood vessels.

Bleeding can be caused by heat in the Blood or deficiency of yin (our cooling power). Blood becomes hot when heat in our system invades deeply into the body, disrupting blood and increasing the potential to hemorrhage.  Signs of blood heat include scarlet tongue, skin rashes, fever, thirst, and fast pulse. Bleeding from heat is bright red. Chronic bleeding from heat in the blood is treated by increasing cooling foods and minimizing foods that may increase heat (meat, alcohol, tobacco, coffee, hot spices, and warming foods).

Cooling food remedies for bleeding from Heat in the Blood should be eaten raw or lightly cooked by simmering or steaming.

  • spinach and swiss chard have hemostatic properties (stops bleeding)
  • raspberry leaf can specifically treat excessive menstrual bleeding
  • eggplant for anal and urinary tract bleeding
  • persimmon for urinary bleeding and vomiting blood
  • celery and lettuce treat blood in the urine, but don’t have other hemostatic properties

Signs of deficient yin include a red tongue, night sweats, and fast thin pulse. This is treated with yin strengthening foods such as millet, mung bean, seaweed, tofu, barley, beets, persimmon, grapes, blackberry, raspberry, mulberry, banana, and watermelon.

Bleeding can also be caused by deficiency with cold signs or deficiency symptoms. Blood is pale or dark-colored. The blood and its vessels are malnourished and weak, allowing blood to leak out of the vessels. This needs to be treated with warming or neutral foods.

Neutral or warming food remedies for Deficiency Bleeding can be moderately cooked. (Note: Neutral rememdies, marked with * may be used for bleeding from Heat in the blood as well.

  • *olives treat hematemesis (coughing up of blood)
  • leeks and guava have hemostatic properites
  • cayenne pepper is a good first-aid remedy for internal or external bleeding from injuries. It can be directly applied to an external wound or taken internally as well. (Internal use: 1 teaspoon cayenne with 1 cup boiling water or 400-500mg capsules)
  • chestnut is helpful for vomiting blood, nosebleed, and blood in the stool

3) Stagnant Blood or Blood stasis – Stagnant blood is blood that coagulates or congeals and is caused by either tissue injury or insufficient Qi energy (usually Liver Qi) to push blood through the vessels (i.e. the blood doesn’t move). Signs of stagnant blood include stabbing pain that is fixed in location, frequent bleeding, bleeding dark purple clots (especially with menstruation), dark purple tongue with red spots, and an unnaturally dark complexion. Stagnant blood will also tend to develop clots and chronic stagnation develops tumors, cysts, nodules, and hard immobile lumps.

Gynecological problems are related to stagnant blood. Diseases caused by stagnant blood include amenorrhea (absence of menstruation), dysmenorrhea (painful menstruation), uterine hemmorhage, uterine tumors (fibroids and cancer), and ovarian cysts. , it will stagnate, which is mainly caused by Qi stagnation (mainly Liver), Heat, or Cold.

Foods and spices that disperse and move Stagnant Blood include:

  • warming foods – turmeric, chives, garlic, vinegar, basil, scallion, leek, ginger, chestnut, rosemary, cayenne, nutmeg, kohlrabi, sweet rice, spearmint, butter
  • cooling foods – eggplant, white pepper (eggplant especially relieves stagnant blood in the uterus)
  • neutral foods – aduki beans, peach seed

Body Fluids

Finally, the fourth Vital Substance is Body Fluids. Body Fluids originate from food and drink. Once they enter our bodies, they are separated into “clean or pure fluids” and “dirty or impure fluids.” The pure fluids are transported by the Spleen to the Lungs, through the skin and down to the kidneys. The impure fluids are taken to the Small Intestine where they are separated again into pure and impure parts (pure parts going to Bladder and impure parts going to the Large Intestine where some of the water is reabsorbed). The Bladder further separates into pure and impure (pure part going to the exterior of the body to form sweat and impure part downward to form urine).

There are two types of body fluids in Chinese Medicine:

Jin is Fluids in Chinese
Ye is Liquids in Chinese

Jin fluids are clear, light, thin-watery and circulate with our Defensive Qi and the Exterior (skin and muscles). These fluids move quickly and are controlled by our Lungs, which spread the fluids to the skin. Jin fluids hydrate, moisten, and partially nourish our skin and muscles. This is not part of our sweat, but is a part of our tears, saliva and mucus. Jin fluids are also a component of the fluid part of Blood. They thin the Blood to prevent stasis (stagnation) of Blood.

Ye liquids are heavier and denser. They move with our Nutritive Qi in the Interior, moving slowly (compared to Jin fluids. They are controlled by our Spleen and Kidneys and hydrate and moisten our joints, spine, brain, and bone marrow. Our sense organs (eyes, ears, nose, and mouth) are lubricated by Ye liquids.

The pathology associated with Body Fluids are either Deficiency in Body Fluids or Accumulation of Body Fluids (edema or excess phlegm) in the body. We will talk more about pathology of body fluids especially related to Qi in later posts.

The Take Home Messageeat enough dark leafy greens and fruits (at least 5-7 servings per day), which most people do not! Dark leafy greens build, tonify, strengthen our blood, and potentially stop bleeding. The fluids from fruits keep us hydrated and the Vitamin C from citrus fruits aid in iron absorption. Win-win!

Have a great weekend!

In health and wellness,
Dr Elain

References:

The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford

Contact Dr. Elain
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Eastern Medicine & Natural Healing, Health for the Body, Men's Health, Nutrition, Traditional Chinese Medicine, Women's Health

The Four Vital Substances Part 2 – Essence (Jing)

May 1, 2015
Walnuts nourish Essence and Jing

May is Mental Health Awareness month and couldn’t come at a better time since the Vital Substance I am talking about today is closely associated with our mental vitality. Earlier this week, I introduced the concept of Qi (energy) as one of the four Vital Substances in our bodies (read about it here). The next Vital Substance, Essence, also known as “Jing” in Chinese Medicine, is essential to life and one of the foundations of mental health.

Essence

Essence in Chinese is “Jing” (精). The Chinese character defines it as “something derived (or extracted) from a process of refinement of a larger crude substance.” For example, the essence of a perfume is extracted from raw materials such as flowers, grass, spices, fruit, or wood. Hence, Essence is a concentrated and precious substance. It is associated with our genetic potential and the aging process. The quantity of Essence we have dictates our lifespan and vitality.

1) Prenatal Essence or Original Jing – At conception, the combination of the mother and father’s refined Essence forms Prenatal Essence. This blended Essence develops an energy that is the basis of new human life.  Before birth, the fetus relies on the mother to protect and nourish its Prenatal Essence. After birth, Prenatal Essence becomes active and helps in transformation of food to energy.  A small amount of Prenatal Essence is constantly released which is used by our bodies to maintain function. Prenatal Essence determines our constitutional make-up, how long we live, and our individual vitality. This largely depends on the age and health of the parents at conception, and especially the age and health of the mother. This is also what makes each of us unique. Original Jing is fixed in quantity and quality, meaning once it’s used up, it cannot be replenished and we die.

2) Postnatal Essence or Postnatal Jing – Formed after birth, this Essence is extracted and refined by the Stomach and Spleen (the digestive system) from food and fluids. When Postnatal Essence is maintained at sufficient levels, our Prenatal Essence is used more slowly, which in turn slows the aging process. This is why people take Jing tonic herbs, to maintain Postnatal Jing levels.

3) The Essence (Jing) – This Essence, used for the entire body, is stored in our Kidneys and derived from both Prenatal and Postnatal Essence. It is also a hereditary energy that determines our constitutional make-up, but can be replenished through interaction with Postnatal Essence. It is the root of our vitality and a very concentrated energy. Strong Jing energy will lead to a long and healthful life, whereas loss of Jing will cause physical and mental deterioration, leading to a shortened life.

The difference between Essence and Qi:

– Essence comes from our parents, while Qi is formed after birth
– Essence is fluid-like, Qi is energy-like
– Essence is stored in the kidneys, Qi is everywhere
– Essence is difficult to replenish, while Qi can be restored daily
– Essence changes slowly and gradually, whereas Qi moves quickly

So is Essence more yin or yang relative to Qi?? If you’ve been following, the answer is easy. =)

Essence Functions

  • determines growth and development – Essence controls growth of bones, teeth, hair, brain development, sexual maturation, reproductive function and fertility, which are all part of the Kidney’s function in Chinese medicine. Deficiency results in stunted growth, poor bone growth, infertility, frequent miscarriages, mental retardation in children, loose teeth, and premature graying hair.
  • forms the foundation for Kidney Qi (Kidney energy) – Deficiency of Kidney Qi results in poor sexual function, impotence, weak knees, tinnitus (ringing in the ears), and deafness.
  • produces Marrow – This Marrow is not the same as the bone marrow recognized in Western Medicine but a broader term. Marrow not only produces bone marrow but also constitutes the brain and spinal cord, nourishing these areas. This means that Kidney Essence plays a crucial role in brain function and mental health. Weak Kidney Essence may lead to lack of concentration, poor memory, dizziness, and more serious mental problems if severely depleted.
  • determines constitutional strength and our resistance to exterior or external pathogenic factors. Our Defensive Qi draws from Kidney Essence. Weak Kidney Essence results in frequent colds, influenza, susceptibility to exterior pathogenic factors, chronic rhinitis, and allergies.

Factors that Deplete Essence (Jing)

  • chronic and acute stress, chronic pain and illness
  • excessive behavior such as overwork, excessive emotions (especially fear, anxiety and shock, emotions which weaken the Kidney), substance abuse, sexual excess (especially in men and old age)
  • excessive menstrual patterns (heavy periods) and too many pregnancies (more than one’s constitution can adequately support, which is different for everyone)

Foods that Nourish Jing

In general, foods that nourish the Kidney will also nourish Jing. However, choosing the appropriate foods and herbs to use as Jing tonics largely depend on each individual’s constitution and condition.

Cooling Jing Foods – for those who tend to have heat signs and symptoms, yin deficiency, or excess

– chlorella, spirulina, black beans, seaweed, wheat grass, blue-green microalgae, almonds, and bone marrow soup

Warming Jing Foods – for those who tend to have cold signs or deficiency symptoms

– royal jelly, bee pollen, milk, clarified butter, placenta, dear antler, walnuts, animal products (chicken, liver, beef or lamb kidney) and warming seafood (especially mussels; also trout, salmon, anchovy)

For children with severe Jing deficiency, there will be stunted growth, learning disabilities, mental retardation, skeletal weakness and deformities, and failure of the fontanel (skull bones) to close. Deer antler is specifically used for these conditions as well as tortoise shell in failure of fontanel closure.

Note: Did you notice that walnuts and salmon are included in this list? They are both high in Omega-3 fatty acids making them good for the brain which also means it strengthens Essence. See how everything is coming together?

The Three Treasures

A final note on Essence and mental health. Essence and Qi form the foundation of the Mind also known as Shen (神), which is the most immaterial substance in our bodies. Together they form the “Three Treasures” which are the three fundamental physical and psychic substances of human beings. The Chinese word “Jing Shen” 精神 collectively means spirit. The strength of our spirit and mental health ultimately depend on the strength of our Essence (Jing). Coming soon, I will discuss some major Jing tonics that help strengthen and stabilize our mind and spirits keeping us mentally sharp and strong!

In health and wellness,
Dr. Elain

References:

The Foundations of Chinese Medicine by Giovanni Maciocia
The Ancient Wisdom of the Chinese Tonic Herbs by Ron Teeguarden
Healing with Whole Foods by Paul Pitchford

Contact Dr. Elain
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Eastern Medicine & Natural Healing, Health for the Body, Herbs, Nutrition, Traditional Chinese Medicine

The Four Vital Substances Part 1 – Qi (Energy)

April 28, 2015
Qi and Energy one of the Vital Substances

In Chinese Medicine, our bodies contain four vital substances: Qi, Blood, Essence or (Jing), and Body Fluids. Our lives depend on these four vital substances to exist. I will focus on the first vital substance, Qi, and then talk about the other three in a subsequent post.

Qi

Qi, pronouced chee, can be translated as our “energy”, “life-force”, “vital force”, “moving power”, “material force”, or “matter”. It is a fundamental principle in Chinese medicine and the energetic force that circulates through our physical body enabling it to function. It is yang in nature (to review basic yin and yang principle, read here) and its functions are transforming, transporting, holding, raising, protecting, and warming (see in bold below regarding the functions of different forms of Qi).

Two aspects of Qi pertain to medicine.

1) Qi is an energy that can manifest simultaneously on a physical and energetic (or spiritual) level. The components of the Chinese character Qi (氣) define that it is both material and immaterial. The top part of the character means “vapor, steam, or gas” while the bottom part of the character means “uncooked rice” (i.e., a subtle substance such as steam can be produced from a more tangible substance such as uncooked rice) and hence why I featured an image of steamed rice! =)

2) Qi is also in a constant state of flux and can manifest itself in different forms. When it condenses, Qi can transform into a physical shape. In Chinese medicine there are different forms of human Qi, but it is important to remember that there is only one Qi energy that assumes these different forms of energy.

The different forms of Qi:

  • Original Qi – This is Essence (another vital substance), but in the form of Qi. It originates between our two kidneys from “Pre-Heaven Essence” and is continually replenished by “Post-Heaven Essence.” Original Qi is Essence that has transformed into Qi. We will discuss the significance of Essence in a subsequent post.
  • Food Qi – This is the first step in transformation of the food we eat into Qi (energy). Food first enters the stomach where it is processed and then transformed into “Food Qi” by the Qi of the Spleen. Spleen Qi then transports Food Qi to the lungs and heart. In the lungs it is combined with air to form Gathering Qi, and in the heart it is transformed into blood. (Spleen Qi holds the blood in the blood vessels, Kidney-Qi and Bladder-Qi hold urine, and Lung-Qi holds sweat. Spleen Qi also raises the organs by keeping them in our body cavities).
  • Gathering Qi – This Qi nourishes the heart and lungs, controlling respiration, blood, and blood vessels. It controls our speech and the strength of our voices. It sends blood circulation to our extremities. Hence, poor circulation to the extremities and a weak voice signify weak Gathering Qi.
  • True Qi – This is the last step of Qi transformation. Gathering Qi is turned into True Qi by Original Qi. True Qi originates in the lungs like Gathering Qi and is the energy that circulates all through our meridians (or channels) and nourishes all our organs. There are two different forms of True Qi – Nutritive Qi and Defensive Qi.
  • Nutritive Qi or Nourishing Qi nourishes and moistens our internal organs. It flows in our blood vessels and meridians. This Qi is extracted from food and water to regulate and moisten our internal organs. It is yin relative to Defensive Qi because it is nourishing and travels in the interior of our bodies.
  • Defensive Qi – We discussed this last week on my post on The Six External Pathogenic Factors. This Qi protects and defends. It is more yang than Nutritive Qi since it flows in the outer layers of the body, outside our channels. It warms and protects our bodies from exterior pathogenic factors such as Wind, Cold, Heat, and Damp. It warms, moistens and nourishes our skin and muscles, controls the opening and closing of our pores and regulates our body temperature through sweating. Our lungs control Defensive Qi. Those with weak lungs will have weak Defensive Qi, weak immunity and be more susceptible to colds.

Direction of Qi Movement

The Qi of our internal organs move in specific directions in order to function correctly. When Qi is flowing in the right direction, our organs work properly. When Qi moves in the wrong direction, we will see symptoms and even pathology in those specific organs.

Lungs – Our lungs inhale clear Qi (air) and exhale impure Qi (impurities). Lung Qi descends. It directs Qi downwards towards the kidney and bladder. When Lung Qi is rebellious and ascends, this can result in coughing.

Liver – The Liver controls the overall smooth flow of qi in all directions of our body. In general, Liver Qi ascends and counterbalances the descending action of Lung Qi.

Kidneys – Kidneys control transformation of Water. Impure fluids move down while clear Qi (air) moves up. The Lungs and Kidneys also balance each other as Kidney Qi ascends, while Lung Qi descends.

Spleen and Stomach – Spleen Qi ascends to the lungs and heart, while the Stomach sends impure Qi downwards. These two organs balance each other. When Spleen Qi rebels and descends, the resulting symptoms are diarrhea or in more severe cases organ prolapse. When Stomach Qi rebels and ascends, this can result in nausea, belching, or vomiting.

Heart-Kidneys – The Heart Qi, associated with the Fire Element, flows down to meet Kidney Qi, associated with the Water Element. Kidney-Water rises to meet Heart-Fire.

Qi Pathology

Qi pathology happens in four ways:

1) Qi deficient – Spleen, Lung, and Kidney Qi are especially susceptible to Qi deficiency.

Spleen Qi deficiency signs and symptoms: This is caused by poor diet or malnourishment, stress, worry, thinking too much, overeating or overeating sweets. Symptoms include loose stools, fatigue, generalized weakness, pale tongue with a thin white coating, and a weak pulse. Spleen Qi deficiency can cause food sensitivities, indigestion, diarrhea, dysentery, anemia, ulcers, and upper abdominal pain. In more severe cases of Spleen Qi deficiency, we will see prolapse of organs such as hemorrhoids and prolapsed uterus or bladder (see #2 below – Qi Sinking).

Foods that can correct Spleen Qi deficiency:

  • complex carbohydrates such as oats, spelt, and sweet rice, and foods that are sweet and/or pungent (see my post on The Five Flavors for review)
  • carbohydrate-rich vegetables: winter squash, carrots, parsnip, turnip, garbanzo beans, black beans, peas, sweet potatoes, yams, and pumpkin
  • pungent vegetables and spices: onions, leeks, black pepper, ginger, cinnamon, fennel, garlic, nutmeg
  • sweeteners or cooked fruits in small quantities: barley malt, molasses, cherries, and dates
  • with severe deficiency, small quantities of animal products prepared in soup or congee: mackerel, tuna, halibut, beef, beef liver or kidney, chicken, turkey, or lamb. No dairy products except for butter, as dairy products are phlegm producing and further weaken the spleen.

Lung Qi Deficiency Signs and Symptoms: This is usually a chronic problem resulting from chronic long-term lung disease, over-all lack of body Qi, and long-term grief or sorrow (the emotions associated with the lungs). Symptoms are weakness, fatigue, weak voice and limited speech, coughing, and shortness of breath. You may see spontaneous sweating with any kind of physical activity and poor immunity if Defensive Qi is weakened.

Foods that treat Lung Qi deficiency include foods that tonify and support Lung Qi as well as improve the absorption of Food Qi:

  • rice, sweet rice, oats, carrots, mustard greens, sweet potatoes, yams, potatoes, fresh ginger, garlic, molasses, rice syrup, barley malt, and herring; herbs like licorice root
  • foods should be cooked warm; avoid cooling foods or phlegm producing foods like citrus fruits, salt, milk, dairy products, spinach, chard, or seaweed.

Kidney Qi Deficiency Signs and Symptoms: When Kidney Qi is deficient, the kidneys do not have enough energy to control urine and semen. This is caused by either a congenital defect, too much sexual activity, sexual activity at an early age, or uncontrolled fear and anxiety (the emotions associated with the kidney). Typical symptoms are low back pain, weak knees, pale tongue, weak radial pulse, minor cold signs (aversion to cold weather, wanting to drink warm food and drinks, clear urine, watery stools, or thin watery mucus), frequent urination, incontinence, inability to urinate, dribbling urine, and other problems with urinary or seminal control (involuntary emission).

Foods and herbs for Kidney Qi deficiency:

  • parsley, wheat berry, sweet rice; herbs such as rose hips, oyster shell, clam shell, schisandra fruit, and raspberry

2) Qi sinking – Qi that is deficient can sink, resulting in prolapse of organs. As mentioned above, this is mostly from Spleen Qi deficiency, where a severe deficiency will cause prolapse of organs such as the uterus, bladder, and rectum. Since Spleen Qi sinking is a direct result of Spleen Qi deficiency, foods that treat Spleen Qi deficiency will also treat Spleen Qi sinking.

3) Qi stagnant – This happens when Qi does not move and becomes stagnant in your body. Liver Qi stagnates the most. (Liver syndromes which include Liver Qi stagnation require a post of its own which I will discuss soon).

4) Qi rebellious – This is when qi flows in the opposite or wrong direction (e.g. rebellious ascending Stomach Qi results in nausea, belching, and vomiting.)

Ok, here’s what you need to know about Qi:

  • Qi is one of the four Vital Substances in our body and essential to our body’s function. Qi is the substance that gives us life and we cannot live without it!
  • Qi manifests simultaneously on a physical and energetic level, and can manifest in many different forms.
  • Qi transforms, transports, holds, raises, warms, and protects.
  • The different forms of Qi are Original, Food, Gathering, True, Nutritive, and Defensive Qi.
  • Each form of organ Qi moves in a specific direction. When the organ Qi goes against its natural direction, this causes disharmony and disease in that organ.
  • Pathologic Qi is deficient, sinking, stagnant, and rebellious.

I presented a lot of information on Qi today because I would like you to have a solid and thorough understanding of what it is, and why it is essential for life! I will be talking about Qi frequently, so feel free to reference back to this post if you need a refresher. And please don’t hesitate to ask any questions for clarification!

In health and wellness,
Dr Elain

References:

The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford

Photo Credit: Pontus Edenburg www.edenburg.com

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The Six External Pathogenic Factors and Spring Wind

April 21, 2015
Spring Wind

I hope everyone is enjoying their Spring so far! I want to introduce another concept in Chinese medicine that we are all affected by. The six external pathogenic factors refer to environmental or climatic factors that may cause internal disease in our bodies. We are especially susceptible to these climatic changes if they are stronger than usual or if our body’s qi or immune system, is weak compared to the climatic change.

What are the six external pathogenic factors?

The six external causes of disease are:

  • Wind
  • Cold
  • Heat
  • Dampness
  • Dryness
  • Fire

Usually, weather should not have a pathological effect on the body, as our bodies are designed to withstand these changes in weather and protect against them. The exterior of the body, which includes the skin, muscles, nose, and mouth, function to defend the body from these pathogenic factors. The weather causes disease only when our bodies and Defensive Qi are relatively weak compared to the climatic factor. I say “relatively” weak since you don’t have to be extremely weak for the pathogenic factor to invade your body. These exterior factors can invade a relatively strong and healthy person if it is stronger than that person’s body energy at that point in time. Make sense?

A person’s basic constitutional make-up, which is different in everyone, will also determine which exterior pathogenic factor will affect them the most. Someone who is born with a hotter constitution (heat intolerant) will tend to be more affected by heat and dryness, while someone who is more cold intolerant will be more affected by wind and cold.

Each pathogenic factor is also associated with a season during which it is more prevalent. However, pathogenic factors can occur during any season.

  • Wind – Spring
  • Heat – Summer
  • Dryness – Autumn
  • Cold – Winter
  • Dampness – Late Summer
  • Fire – Summer

While these pathogenic factors invade the exterior first, the internal organs may also be affected if there is already weakness and disharmony in that organ system. Once it invades the body, they can easily change their nature. Wind-Cold can easily turn into Heat. Dampness can also generate Heat. Extreme Heat can turn into Wind.

The climatic factors will trigger certain clinical symptoms indicative of that climate. That is, the symptoms your body experiences mimics the pattern and behavior of the pathogenic factor. So not only is the pathogenic factor a “cause” of the disease, but the behavior of it becomes clinically relevant as “patterns of disharmony” in the body that need to be treated. I will give examples to make this easier to understand.

Spring External Wind

Since we are in the heart of spring, I will focus on Wind and its clinical manifestations of the body. Wind is yang in nature and tends to injure the blood and yin of our bodies. Wind can carry other pathogenic factors into the body (i.e., cold can enter the body as Wind-Cold and heat can enter the body as Wind-Heat). Like wind, the symptoms happen quickly and can change rapidly.

The behavior of wind include:

  • rapid onset
  • causes rapid changes in signs and symptoms
  • causes signs and symptoms to move from one area to another area of the body
  • can cause tremors, convulsions, as well as stiffness and paralysis (extreme cases: Parkinson’s and stroke)
  • affects the top part of the body (especially the head and neck)
  • attacks the lungs first
  • affects the skin
  • can cause itching

Wind-Cold Signs and Symptoms – aversion to cold or wind, shivering, sneezing and cough, runny nose with white-watery mucus, no fever or slight fever (seen more with Wind-Heat), severe occipital stiffness and aching, itchy throat, possible sweating (Wind-Cold with a stronger cold component will have no sweating as cold contracts pores, while Wind-Cold with a stronger wind component will have slight sweating, since the pores are open), no thirst. Tongue body color – no change with thin-white coating. Floating-tight pulse.

Wind-Heat Signs and Symptoms – aversion to cold, shivering, sneezing, cough, runny nose with yellow mucus, fever, occipital stiffness and aching, slight sweating, sore throat, swollen tonsils, thirst. Tongue body color – red on the tips or sides, thin-white coating. Floating-rapid pulse.

(Note: Chinese Medicine uses the tongue and pulse to diagnose diseases. Tongue diagnosis is based on the color, shape, coating, and moisture of the tongue while pulse diagnosis is more complex. These subjects will require their own posts!)

Do the signs and symptoms of Wind-Cold and Wind-Heat sound familiar? Yes, it’s the common cold or flu. When these symptoms are not promptly addressed or your body’s constitution and defenses are too weak to fight them, the symptoms can invade deeper into the body and cause more severe respiratory problems such as bronchitis, upper respiratory infections, and pneumonia. From a Western medicine perspective, the common cold is caused by viruses, not bacteria, which is why antibiotics don’t work on a cold.  We have viruses and bacteria in our bodies all the time. It is not until our defenses (“Defensive Qi” or immune system) are compromised that our bodies cannot handle them and we get sick.

Finally, the internal organ that is most affected by Wind in the body is your liver. According to the Five Element Theory, Wind is associated with the season of Spring, the Wood element, and the Liver (more about this later). Exterior Wind can aggravate an already weakened Liver disharmony in the body which can cause stiff neck and headaches. It can also “stir” Blood (since wind moves) stored in the Liver manifesting symptoms of skin rashes that will start suddenly and move all over the body (e.g. urticaria and hives).

Note: I have been talking about “external” wind, from climatic changes. Internal wind, can also cause disease. Some of the clinical manifestations may be similar to external wind, but it is mainly caused by Liver weakness and disharmony (i.e., Liver issues will cause internal wind in your body).

What are practical ways to prevent and treat the common cold?

Wind usually enters the back of the neck under the occiput, while cold enters the bottoms of the feet or the base of the neck. If you are already cold intolerant, it’s important to keep your feet warm on colder days and wear a scarf to protect your neck on windier days. We are most vulnerable to catching colds during season changes, especially winter into spring, or summer into fall. Poor nutrition, lack of sleep, too much alcohol, overwork, and increased stress will also make us more susceptible to getting sick.

When we get sick, supportive care is usually the best way to get through a cold. Increase your fluid intake (water is best) and get plenty of rest and sleep. Adding lemon, ginger, and honey to warm or room temp water can also help wind-cold symptoms, as lemon strengthens your liver, ginger can clear wind and is slightly warming, while honey is soothing to your throat. Try to stay away from cold or iced drinks which can increase phlegm and mucus in your body, aggravating symptoms. It is important to spit out any phlegm (whether you have cold or heat symptoms) since swallowing it back into your system will keep the pathogen in your body longer.

If you are more internally hot, a cold can quickly turn into Wind-Heat in your body. Feeling warm or flushed, fever, sore throat, and yellow mucus are early signs of Wind-Heat in your body. Focus on drinking fluids only (water, dilute juices, and herbal teas such as green or peppermint tea, which can clear heat symptoms – green tea and peppermint have a cooling thermal nature). Eat only if you are truly hungry as fasting for a day can clear heat from your body quickly.

If you are not sweating, it may be helpful to induce sweating to release the pathogen (in both wind-cold and wind-heat). In this case, drink a strong cup of ginger tea followed by a hot bath until your entire body is sweating. Once this happens, stay in for another 5 minutes, dry off completely, cloth yourself completely to avoid exposure to cold, and then take a long nap.

Food, herbs, and supplements for the common cold

For Wind-Cold:

Anti-wind herbs  – ginger, fennel, basil, anise, and valerian – can also use cinnamon, garlic, and onions (which all have detoxifying properties)
Wind-cold reducers: oats, pine nuts, shrimp

For Wind-Heat:

Anti-wind herbs – peppermint and peony root
Wind-heat reducers: celery, mulberry, strawberry

For both Wind-Cold and Wind-Heat:

Wind reducers with a neutral thermal nature – black soybeans, back sesame seed, fresh flax oil, herbs – sage and chamomile
Pears, especially Asian pears, are good for cough and help to moisten the lungs.

Foods to avoid:

Wind aggravators : eggs, crabmeat, and buckwheat

Phlegm producing foods: all dairy products, bananas, sugar, cold drinks, alcohol, rich and heavy foods (phlegm and mucus are perfect breeding grounds for virus and bacteria)

Supplements and Herbs

Vitamin C – A meta-analysis of 29 trials in a total of 11,306 participants found that supplementing with 200mg Vitamin C daily did not reduce the frequency of colds, but did reduce the severity and duration of colds.

Echinacea – Lab and animal studies suggest that echinacea contains substances that enhance our immune systems, relieve pain, reduce inflammation and may have anti-viral and anti-oxidant effects. One study found that of 95 people with early symptoms of cold and flu, those who drank several cups of echinacea tea every day for 5 days felt better sooner than those who drank tea without echinacea. Echinacea has been found to work well with Vitamin C.

Tinctures are the best way to take echinacea since they are better absorbed and easier on the stomach than taking capsules. Drink 1-3ml or (20-90 drops) of a 1:5 tincture, added to warm water or tea, 3-4 times a day.

Goldenseal – This is also used in conjunction with echinacea to treat colds, but because it is cooling, it should only be used with symptoms of wind-heat. The National Center for Complementary and Integrative Health (NCCIH) is currently funding studies on possible anti-bacterial mechanisms and cholesterol lowering effects of goldenseal.

Reishi – This medicinal mushroom has long been known for its immune boosting properties. It should be used more for long-term immune building and prevention rather than treatment of acute colds. (More on this soon.)

Your cold should generally resolve in 7-10 days and you shouldn’t need to take supplements and herbs for longer than this. If your symptoms don’t improve, go see your doctor!

What do you do when you catch a cold?

In health and wellness,
Dr. Elain

References:

The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford

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Magnificent Magnesium Deficiency Continued

April 17, 2015
Dark Chocolate for Magnesium Deficiency

Earlier this week, we discussed the intricate relationship between calcium and magnesium (read more about it here), and established the current dilemma we have with overemphasis on calcium consumption while minimizing the importance of magnesium. Because of this, an estimated 80% of Americans are deficient in magnesium. Not only is magnesium necessary for over 300 biochemical reactions in the body and responsible for a host of basic functions such as muscle contraction, nerve conduction, and our heartbeats, but studies have now shown that it may prevent heart disease, diabetes, stroke, and osteoporosis.

What are the risk factors for magnesium deficiency?

  • age – Our ability to absorb anything decreases with age. The elderly are also more likely to be on medications that may interfere with magnesium absorption.
  • over-exercising – Magnesium is lost in sweat.
  • menopause – Magnesium levels fluctuate with menstrual cycles and decrease even more after menopause. (Ever wonder why you crave chocolate before your period? It could be magnesium deficiency.)
  • diabetes – Diabetics have increased magnesium loss in their urine, especially if poorly controlled.
  • kidney disease – Those with unhealthy kidneys will also lose magnesium through their urine.
  • malabsorption or gut problems – Digestive problems such as Crohn’s disease or leaky gut syndrome will interfere with your ability to absorb magnesium.
  • use of certain medications – Diuretics, antibiotics, and certain cancer medications can result in magnesium deficiency as they interfere with its absorption.
  • eating processed foods with high sugar content and drinking soda – This depletes magnesium in our bodies, since magnesium is used to metabolize and detoxify these foods.
  • alcoholism – Alcoholics tend to have low magnesium levels.
  • exposure to heavy metals and environmental chemicals – Magnesium is depleted through detoxification of these exposures.

What does magnesium deficiency cause?

According to Dr. Carolyn Dean, a leading researcher in magnesium and author of the book, The Magnesium Miracle, magnesium deficiency has been found to trigger 22 medical problems including:

  • anxiety and panic attacks
  • asthma
  • blood clots
  • bowel diseases
  • cystitis
  • depression
  • detoxification
  • diabetes
  • fatigue
  • heart disease
  • hypertension
  • hypoglycemia
  • insomnia
  • kidney disease
  • liver disease
  • migraines
  • musculoskeletal conditions (e.g. cramps, fibromyalgia, chronic back pain)
  • nerve problems
  • obstetrics and gynecology (e.g. PMS, infertility, preeclampsia)
  • osteoporosis
  • Raynaud’s syndrome
  • tooth decay

Review: How do I know if I am magnesium deficient?

Early signs and symptoms of magnesium deficiency include fatigue, nausea, headaches, loss of appetite and weakness. Signs of chronic magnesium deficiency may lead to more serious symptoms of numbness and tingling, muscle contractions and cramps, seizures, coronary spasms, abnormal heart rhythms, and even personality changes. An easy way to find out if you are deficient is to get a magnesium RBC test. The “normal values” are between 4.2-6.8mg/dl, but you really want your levels to be 6mg/dl or higher. Once you find out your baseline, check every 3 months to make sure you are taking enough to maintain your levels. According to Dr Dean, unlike most medications, “as your body becomes saturated with magnesium, your body will need less, not more, to maintain these levels.”

How do I increase my magnesium levels?

The foods with highest concentrations of magnesium (per 100mg or 3.5 oz) include:

– seaweed: kelp (780mg), dried agar (770mg)
– dark leafy greens: kale (88mg), swiss chard (86mg), and baby spinach (87mg) (if it’s green, it’s got magnesium, as it plays a central role in the chlorophyll molecule)
– nuts and seeds: pumpkin seeds (534 mg), flaxseed (392mg), sunflower seeds (325mg), almonds (286 mg), Brazil nuts (376mg), and walnuts (201mg)
– fish: mackerel (97mg), halibut (83mg), and wild salmon (37mg)
– legumes: soybeans (86 mg), lima beans (188mg)
– avocado: 58 mg in one avocado (another great reason to eat one a day!)
– dried fruit: dried figs (68mg), dried apricots (62mg)
– cocoa and bitter chocolate: ounce for ounce, dark chocolate (with cocoa content over 80%) delivers the most magnesium (327 mg)

Review: Magnesium supplements

With the depletion of magnesium in our soil, we are probably only getting 200 mg of magnesium from our daily diet versus 500mg in the past. The Recommended Daily Allowance (RDA) of magnesium for young adults is 400mg for men and 310mg for women. In adults over 30, the RDA is 420mg for men and 320mg for women. It is important and necessary to supplement and perhaps even double this recommended allowance through food and supplements, especially if you have stress in your life (who doesn’t?), as stress uses up our magnesium stores even more.

Magnesium glycinate provides the highest level of magnesium absorption. Metagenics comes in 100mg tablets (take 2 twice a day for a total of 400mg/day) and OrthoMolecular Products offers 235mg in 2 tablets (also taken twice daily for a total of 470mg). It is probably best to start with the recommended dosage and adjust according to your levels.

The many benefits of magnesium

1) Magnesium protects the heart.

Studies have reported a a 34% lower risk of sudden cardiac death in women who took higher levels of magnesium. When a heart attack occurs, there can be increased damage to heart muscle when calcium rushes into the muscle. Blood clots can block blood vessels to the heart. Decreased circulation can cause blood vessels to constrict. New formed arrhythmia in the injured area can occur. Magnesium counteracts these events by dilating blood vessels, preventing spasm in the blood vessels and heart, opposing the action of calcium which increases spasm (remember, magnesium is the “calming” mineral with a relaxing action), dissolving blood clots, lessening the site of injury thereby preventing arrhythmia, and using its antioxidant activity against free radicals that may form at the injury site.

2) Magnesium may prevent diabetes.

Magnesium reduces insulin resistance. In a study with overweight subjects, the group taking 365 mg of magnesium daily for 6 months had lower fasting blood sugar levels and less insulin resistance than the control group. It seems that magnesium controls the activation of the enzyme tyrosine kinase, which is required for proper functioning of our insulin receptors.

3) Magnesium may prevent and treat symptoms of stroke.

A study found that for every 100mg increase in magnesium intake, risk of stroke was decreased by 8%. Intravenous magnesium has also been used for neuroprotection in patients with acute stroke.

4) Magnesium may prevent osteoporosis and hip fractures.

Magnesium is involved in bone formation and bone health. It regulates osteoblast activity (cells involved in bone formation) as well as osteoclast activity (cells involve in bone breakdown). It influences parathyroid hormone and vitamin D, which are both major regulators of bone homeostasis. Researchers also discovered that women with osteoporosis had lower serum levels of magnesium than women with osteopenia or women without osteoporosis or osteopenia. In Norway, a study found that those who drank water with magnesium had a lower risk of hip fracture in both men and women.

4) Magnesium has been used in colorectal cancer prevention.

Higher intakes of dietary magnesium was correlated with lower risk of colorectal cancer. The data from this study showed that for every 100mg increase in magnesium intake, the risk of colorectal cancer tumor decreased by 13% while colorectal cancer risk decreased by 12%.

5) Magnesium promotes weight loss.

Finally, we see a positive correlation between magnesium intake and weight loss. The more magnesium we have in our bodies, the more our bodies are able to regulate insulin and control our blood sugar levels, leading to prevention of diabetes and obesity.

Hopefully, I’ve give you plenty of incentive to check your magnesium levels and start supplementing as needed! Have a great weekend!

In health and wellness,
Dr. Elain

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The Yin and Yang of Calcium and Magnesium

April 14, 2015
Kelp and Fish - Calcium and Magnesium

You’re probably wondering why I used an image of kelp to talk about calcium and magnesium. Kelp actually contains one of the highest concentrations of both calcium and magnesium with 1,009 mg of calcium (more than 9 times the amount of found in milk!) and 780 mg of magnesium (the highest amount delivered in any food) in a 3.5 ounce serving. See? There is a method to my madness. Moving on, let’s talk about two important minerals we absolutely cannot live without and how they need to be balanced in order to function correctly. Let’s examine the yin and yang of calcium and magnesium.

What are their respective roles?

Calcium is the most abundant mineral in our bodies and makes up 2% of our body weight. We use 99% of our body calcium towards our bones, teeth, and maintaining our skeletal structure and function. The other 1% is utilized for:

  • cell signaling
  • blood clotting
  • nerve function
  • muscle contraction
  • enzyme activation
  • ion transport across cell membranes
  • sending and receiving neurotransmitters for cell communication
  • conducting electricity in our bodies crucial in maintaining a regular heartbeat, since it contains an electric charge

Magnesium, is the fourth most abundant mineral in our bodies that regulates over 300 biochemical reactions. As one of the most common enzyme cofactors, it is necessary for:

  • protein synthesis (a building block for RNA and DNA)
  • muscle and nerve function
  • blood glucose control
  • regulating blood pressure
  • energy production (generating ATP)
  • glycolysis
  • oxidative phosphorylation
  • aiding in digestion of proteins, carbohydrates, and fats
  • a precursor to neurotransmitters like serotonin
  • calcium and potassium transport across cell membranes vital in nerve conduction, a normal heart rhythm, and muscle contraction.

Magnesium is the yin to calcium’s yang

Since magnesium is the mineral that moves calcium across cell membranes, it is considered the gate keeper and controls when calcium should be moved out of the cell.

This is best summarized in Magnificent Magnesium, an article published in Weston A. Price Foundation’s quarterly magazine:

Magnesium works in concert with calcium to regulate electrical impulses in the cell—magnesium concentration inside healthy cells is ten thousand times greater than calcium, and there are crucial reasons for this safeguard. Cellular calcium channels allow that mineral to enter the cell only as long as needed to conduct an impulse; it is ushered out immediately by magnesium once its task is fulfilled. This vigilance is necessary to prevent calcium accumulation in the cell, which could cause dangerous hyper-excitability, calcification, cell dysfunction and even cell death. When excess calcium enters the cells because of insufficient magnesium, muscle contraction is sustained for too long, and we suffer, for example, twitches and tics in mild cases. When magnesium deficiency becomes chronic, we suffer the symptoms of heart disease such as angina pectoris, hypertension and arrhythmia, or the spasms and contractions characteristic of asthma, migraine headache or painful menstrual cramping.”

So if we are experiencing any type of cramping, whether it is muscle cramps or leg cramps, the mineral we should be looking to for a deficiency is not calcium, but in fact, magnesium. Magnesium is what is needed in order to move calcium out of the cell to relax our muscles. Calcium causes contraction while magnesium elicits relaxation. The article goes on to state that:

“Magnesium operates as a natural calcium channel blocker and is responsible for relaxation—counter to calcium’s contraction. Thus magnesium is pivotally important to the healthy functioning of our parasympathetic nervous system. It may be hard to believe, but our bodies were actually designed to operate for the most part in a calm, relaxed parasympathetic state, rather than in the heart-pounding, stress-and adrenaline-driven mode of sympathetic nervous system dominance that is nearly constant for many of us today, and which uses up great quantities of magnesium.”

Magnesium is a very important mineral in managing and dealing with stress as it is the calming mineral which opposes the excitable actions of calcium. The more stressed we are, the more our muscles tense up and contract. Hence, when we are stressed, we need more magnesium to relax our muscles. It counteracts calcium and acts as a necessary antagonist in order to maintain balance in a body function as basic as muscle contraction and as vital as our heartbeats.

What should our calcium magnesium ratios ideally be?

Calcium and magnesium need to be in balanced amounts in our body in order to carry out their roles. Researchers previously suggested that 2:1 is a healthy ratio. However, according to Dr Carolyn Dean, MD, one of the leading researchers in magnesium, this 2:1 ratio has led her to see statistics with a “700 times increase in osteoporosis in a 10-year period, even while taking calcium”! In fact, many supplements reflect this ratio where there is 1200-1500 mg of calcium versus a few hundred milligrams of magnesium. The frightening reality is that our ratios are probably closer to 4-5:1 with our high calcium and low magnesium diets along with extra calcium supplementation! A more appropriate ratio should be 1:1 and some have even postulated that a 1:2 ratio is warranted. This is because we have tipped the scales so heavily towards calcium with over-supplementing and calcium fortification of our foods.

More concerning, there have now been studies in the past several years showing that calcium supplementation may not only increase your risk of heart attack by up to 30%, but also does not slow the process of bone loss and may even increase your risk of prostate cancer! Bone is made up of at least a dozen minerals and supplementing with only calcium may actually increase your risk of osteoporosis. Other studies have shown that higher bone density in women may actually increase your risk for breast cancer by 2 fold, because bone density is a marker for life-time exposure to estrogen.  (I also do not recommend taking osteoporosis drugs such as bisphophonates, as there is enough evidence to prove that they do not decrease fracture risk nor strengthen bones, but cause other deleterious side effects including bone death, liver, kidney, and digestive problems. More on this later.)

How does calcium over-supplementation cause this? When we have too much calcium in our bodies, it gets deposited into areas where they shouldn’t be. Calcium deposits can cause kidney stones, gallstones, bone spurs, stiff joints, osteoarthritis, coronary artery disease, artherosclerosis, hypothyroidism, and obesity. It is the calcium deposits in blood vessels that actually cause hardening of your arteries (not cholesterol, which is a soft, malleable waxy substance), and may increase the risk of heart attack.

What’s worse, magnesium deficiency is widespread. It is one of the most depleted minerals in our soil. Now, more and more new plant hybrids are made to survive mineral depleted soil, so our foods are already grown with less minerals. Magnesium is further depleted and even lost during harvest, refrigeration, transport and storage. For some reason, calcium is much more resilient during these processes. Maybe because it is a more yang and robust mineral? (To review the basics of yin and yang, read here.)

In addition, processing foods continues to deplete magnesium. Magnesium in grain is lost in milling. Magnesium in nuts is lost in roasting. Magnesium is leached out into water when we cook greens. Then, eating processed foods with high sugar content, drinking alcohol, and soda also deplete the magnesium in our bodies since it is needed to metabolize and detoxify these foods. According to Dr. Natasha Campbell-McBride, “the body requires at least twenty-eight molecules of magnesium to metabolize a single molecule of glucose. Phosphates in carbonated drinks and processed meats (so-called “luncheon meats” and hot dogs) bind with magnesium to create the insoluble magnesium phosphate, which is unusable by the body.”

What is the solution to this huge calcium/magnesium imbalance?

The best way to get your calcium is through your diet. In fact, studies show that calcium from food sources are more effective than calcium from supplementation as our bodies absorb calcium from food sources more completely. Food sources highest in calcium include seaweed (hijiki, wakame, kelp, and kombu, which are available in most whole-food or Japanese markets), dark leafy greens (such as kale, spinach, and collard greens), nuts (such as almonds, hazelnuts, and brazil nuts), wild salmon, sardines and parsley. The calcium content in milk does not even come close to these foods. While calcium is necessary at all ages, certain stages require more calcium than others. Calcium requirements ramp up during increased periods of growth and should be supplemented during pregnancy and lactation. I supplemented 500mg calcium daily in addition to my pre-natal when I was pregnant and nursing, then decreased to 200mg daily, once my son started solids. (My multi-vitamin, has a 1:2 (10mg:20mg) ratio of calcium to magnesium.)

How do we know if we are magnesium deficient? Early signs and symptoms of magnesium deficiency include fatigue, nausea, headaches, loss of appetite and weakness. Signs of chronic magnesium deficiency may lead to more serious symptoms of numbness and tingling, muscle contractions and cramps (as I stated above), seizures, coronary spasms, abnormal heart rhythms, and even personality changes. An easy way to find out if you are deficient is to get a magnesium RBC test. The “normal values” are between 4.2-6.8mg/dl, but you really want your levels to be 6mg/dl or higher. Once you find out your baseline, check every 3 months to make sure you are taking enough to maintain your levels. According to Dr Dean, unlike most medications, “as your body becomes saturated with magnesium, your body will need less, not more, to maintain these levels.”

What form of magnesium supplement is the best and how much of it should I take?

The Recommended Daily Allowance (RDA) of magnesium for young adults is 400mg for men and 310mg for women. In adults over 30, the RDA is 420mg for men and 320mg for women. If you don’t get enough in your food, which probably applies to most people, then we need to supplement. There are many forms of magnesium in the supplement market because magnesium must be bound to another substance in order to be absorbed. One of the cheapest and most common forms, magnesium oxide, is not absorbed very well by our bodies (4% absorbed, with the remaining 96% going through your intestines). This is what is usually used as a stool softener and laxative, which is helpful if you have constipation.

Magnesium glycinate probably provides the highest level of magnesium absorption. Metagenics comes in 100mg tablets (take 2 twice a day for a total of 400mg/day) and OrthoMolecular Products offers 235mg in 2 tablets (also taken twice daily for a total of 470mg). It is probably best to start with the recommended dosage and adjust according to your levels. Other forms, which provide less absorption include magnesium chloride and magnesium lactate (12% absorption) and magnesium taurate, which is used for its calming effects. I will talk more about the additional health benefits of magnesium in later posts!

Here’s what you need to know:

  • calcium and magnesium have a yin and yang relationship — calcium is the active yang mineral, while magnesium is the calming yin mineral.
  • we need calcium and magnesium to be in constant balance in order to carry out our body functions.
  • most people over-supplement with calcium and tend to be deficient in magnesium.
  • you can get your magnesium levels checked with a magnesium RBC test to see if you are deficient.
  • the most highly absorbable magnesium supplement is magnesium glycinate.

Do you think you are magnesium deficient?

In health and wellness,
Dr Elain

References:

Healing with Whole Foods by Paul Pitchford

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10 Things To Do To Stay Heart Healthy and Prevent Heart Disease

April 9, 2015
Avocados to prevent heart disease

The follow-up post to our discussion on cholesterol and heart disease is here! To sum up what we last talked about, cholesterol and saturated fats are not the “bad guys” that they have been portrayed to be in the 80’s and 90’s. In fact, it plays a number of essential roles in our bodies. Low cholesterol levels would not only prevent our bodies from functioning properly, but we could potentially get very sick. Sadly, it has also been used as the scapegoat for heart disease, the leading cause of death in the world. Now, more and more research on people taking statins to lower their cholesterol has refuted this “lipid hypothesis” where dietary fat and cholesterol are the culprit of heart disease. There has already been a movement in Sweden (which started several years ago), where people were getting healthier (and more fit) by stopping their statins and eating high fat and low carbohydrate diets. It is time to relearn what we know about preventing heart disease! Here’s what you need to do to.

1) Eat a heart healthy diet. 

a) A heart healthy diet is high in healthful fats and low in processed carbohydrates and sugars. Healthful fats include:

  • monounsaturated fats like olives and olive oil, avocados, nuts and seeds (macadamia nuts, hazelnuts, pecans, almonds and almond butter, cashews and cashew butter, pistachios). Food fact: Adding one avocado per day to a moderate fat diet lowers LDL more than a moderate fat diet without the avocado.
  • polyunsaturated fats which include omega-3 and omega-6 fatty acids. Omega-3’s are turned into anti-inflammatory hormones in our bodies to decrease inflammation. Foods with high levels of omega-3’s include salmon, mackerel, herring, sardines, anchovies, flaxseed, chia seeds, butternut, and walnuts. Food fact: Eating four walnuts a day raises α-Linolenic acid, or ALA, and improves your lipid profile.

A note on omega-6 fatty acids: The essential omega-6 fatty acid that our bodies need in small amounts is linoleic acid, or LA, (not to be confused with α-Linolenic acid, or ALA, the omega-3 precursor of DHA and EPA). I know, I get confused with these terms too. Omega-6’s are turned into pro-inflammatory hormones in our bodies to increase inflammation when we catch a cold or sprain an ankle. This acute inflammatory process is basically turning our immune systems on to fix a problem. So inflammation is necessary! However, problems occur when our bodies are out of balance and our immune systems cannot shut off, resulting in chronic inflammation and autoimmune disease. Ideally, we should be eating an omega-6:omega-3 ratio range of 1:1 to 5:1, but the American diet’s ratio range is more like 20:1 or 50:1. This is because processed and deep-fried foods are rampant with omega-6 fatty acids so we will rarely be deficient in omega 6’s.

Food fact: Nuts, such as walnuts and pine nuts, also contain high concentrations of omega-6 fatty acids. Potato chips contain omega-6’s because they are fried in vegetable oil. You want to eat more of the nuts and less of the chips, because the omega-6 oils from the potato chips have been oxidized and damaged in the frying process, while nuts contain their own antioxidants that protect the oils from damage. Think of oxidation when you peel an apple and it starts to turn brown from being exposed to the air. Make sense?

b) The low-down on saturated fats:

  • Saturated fats or cholesterol laden foods such as egg yolks, fatty meats (including red meat), poultry (chicken with skin), full-fat dairy products (milk, yogurt, cheese), butter, coconuts, coconut oil, and palm oil are not bad for you. In fact, including them in your diet can decrease the risk of heart disease by lowering lipoprotein a, Lp(a), which correlates with a strong risk for heart disease.  Some research has even concluded that it may be to our advantage to include fats in as much as 50% of our diets. (Not ready for that yet? It’s ok, baby steps). It’s not a far-fetched notion since breast milk, the ideal diet for developing infants, has been found to average anywhere from 41-46% saturated fats, based on mothers from different cultures.
  • The saturated fats you do want to stay away from are those produced through hydrogenation of vegetable oils. If the label says “hydrogenated,” then steer clear.

Note on meat and dairy: you want to choose grass-fed beef that is not injected with added hormones or antibiotics rather than corn-fed beef. If you’re going to eat bacon (one of my favorites =) choose bacon that is nitrate free (uncured). And sorry for those of you who love Popeye’s chicken (my husband included), deep frying chicken in trans-fat oils will negate the effects of saturated fats. Also, eating too much dairy has been linked to allergies as well as increased dampness (phlegm and mucus) in your body. Dampness is one of the external pathogenic factors in Chinese medicine that I will discuss soon. If you are someone who tends to have more phlegm and mucus, or is more allergy prone, I would minimize dairy products in your diet.

c) Trans-fats are what you want to avoid:

  • Trans-fats found in partially hydrogenated vegetable oils, shortening, and margarine were previously used by companies in processed and fast foods (for deep frying and re-frying) because they were easy to use, inexpensive to produce, and had long shelf lives. A study published in 2009 found that “in 87,000 U.S. women followed over 26 years, trans-fat intake was linked to increased risk of sudden cardiac death among those who had underlying coronary heart disease. In this group, the women eating the most trans fats were three times more likely to die of cardiac arrest!” Yikes!

d) Increase the amount of organic or locally grown fresh vegetables. A great way to do this is visit your local farmer’s market at least once a week. A recent study done in 2014 showed that eating 5-7 servings of fruits and vegetables per day had a 36% lower risk of dying from any cause.

e) Eat organic foods as much as possible to avoid exposure to harmful agricultural chemicals such as glyphosphate.

f) Avoid genetically modified ingredients (GMO’s) that are detrimental to your health and have been linked to chronic inflammation, heart disease, cancer, and infertility.

g) Decrease sugar and eliminate processed foods. Diets high in sugar and processed foods increase insulin resistance and the risk of diabetes. This is a hard one for me too! I have trouble strictly adhering to this and have been known to eat the occasional Krispy Kreme donut or Egg McMuffin and hashbrowns for breakfast (it just brings back childhood memories for me =).

h) Avoid food or sugary and/or diet drinks loaded with artificial sweeteners such as Equal, Nutrasweet, Splenda, Sweet N Low, and high fructose corn syrup. Opt instead for the stuff nature intended – cane sugar, raw sugar, or raw honey. (Diet drinks have also been known to cause severe neurologic problems).

i) Try eating one third of your food raw and avoid cooking foods at hot temperatures to maintain nutritional integrity of the food for absorption (read more about how the different ways of cooking affect foods here).

j) Drink plenty of water. This article explains very well how to tell if you are not drinking enough water. Signs and symptoms include:

  • Fatigue and/or mood swings
  • Hunger even though you’ve recently eaten
  • Back or joint aches
  • Dull, dry skin and/or pronounced wrinkles
  • Infrequent urination; dark, concentrated urine, and/or constipation

2) Supplement yourself to bridge the nutritional gaps

  • Omega-3 lower triglyceride levels and raise HDL levels. Find a high quality fish, krill, or algae oil (for vegetarians) with high concentrations of DHA (at least 300mg) and EPA (read more on Omega-3’s here).
  • Vitamin D – A recent study in 2014 has shown that supplementing with only 400 I.U.’s of Vitamin D improves serum 25-hydroxyvitamin D levels in menopausal women which improved their lipid profiles (increased HDL, decreased LDL and triglycerides). Supplement with enough Vitamin D to get your levels between 40-60ng/ml (read more on Vitamin D here). See how everything is coming together?
  • Multi-vitamin mineral use has been found to reduce the risk of cardiovascular disease in women. In the study, women, but not men (sorry gentlemen), who took a multi-vitamin mineral supplement for at least three years had a 35% lower risk of dying from heart disease. (This doesn’t mean that men should not be taking one either.) Look for a whole food based multi-vitamin rather than synthetic, for obvious reasons. The brand I like to take is MegaFood. Whatever you choose, make sure your multi-vitamin does not contain sodium selenite or selenate, which have been found to be carcinogenic and genotoxic.
  • Magnesium is a mineral that is important because calcium depends on it to function correctly. In addition, magnesium deficiency may result in many cardiac symptoms such as angina, arrhythmia, and hypertension. I will talk more on how to determine whether you are magnesium deficient and what to do about it.
  • Herbs – Chinese herbs that have been found to improve lipid profiles include Reishi Mushroom and Gynostemma which I will also discuss in more detail later.

3) Exercise Regularly –  Exercising is beneficial for heart disease and diabetes because it can help normalize your blood sugar, insulin, and leptin levels. It releases endorphins, which gives you that high afterwards and is a great stress reliever. It also helps you sleep better, maintain a healthy weight if done correctly, and optimizes brain function.

If you are not used to exercising regularly or are overweight, the best exercise to start with is walking. It is recommended to take 10,000 steps per day, which can easily be tracked using a pedometer. Start slow and begin walking 5-10 min per day if you are out of shape. The key is to be consistent and listen to your body. Don’t push yourself beyond your limitations. As you build endurance you can increase length and intensity of training. Incorporate strength and resistance training with weights. Again, start with lighter weights and increase as you improve your strength. A study has shown that doing 1 set of repetitions (or reps – the number of times any muscle or group of muscles is used) is just as effective as doing 3 sets of reps. Building core strength to prevent back injuries and stretching are also important aspects to add to your fitness program.

Note: Studies show that endurance type exercise, such as marathon running, may damage your heart and increase your cardiac risk. This is because running long distances may increase inflammation and trigger a cardiac event. For those with documented heart disease or heart failure, it is imperative not to overdo it and add extra stress on the heart, as it is already decompensated and weakened.

4) Don’t Smoke – Smoking is all-in-all a bad habit for your health. It can lead to so many devastating diseases such as cancer, heart disease and stroke, which you won’t see until many packs per day later. If you smoke, try to quit and make sure that your diet is in good shape before you quit as health problems from poor diet may actually be worse than smoking.

5) Alcohol in Moderation – This means 1-2 drinks/day for men and 1 drink/day for women. There have been studies done on mice that show the antioxidants from polyphenols, called resveratrol, found in red wine may benefit the heart by protecting them from obesity and diabetes as well as lower LDL. But to get the same dose of resveratrol used in mice in these studies, a person would have to drink 1000 liters of wine every day. Ahem, this is not advisable. My thinking is if you don’t have alcoholic tendencies or liver disease, and a glass of wine a day makes you happy and helps you wind down, do it. (See #10 below)

6) Avoid Statins and also Diabetic Medications – I discussed this in my previous post. If you must take statins, make sure you add at least 100mg (if not 200-300mg) of CoQ-10 to your supplement regimen. Anyone over 40, take the ubiquinol (most reduced form) of Co-Q10 as your body’s ability to convert CoQ-10 to ubiquinol decreases with age. The ubiquinol form is also more bioavailable.

A recent study published in Lancet Diabetes and Endocrinology showed that patients who manage diabetes with drugs that lower glucose or blood sugar, may be at higher risk for heart failure. The study was also presented in March 2015 at the 64th Annual Scientific Session of the American College of Cardiology in San Diego, CA. What?! Looks like I will have to dedicate a different post to this subject.

7) Get enough sleep – I mentioned in the previous post that our brains make cholesterol when we sleep. Sleep is so important to recharge your brain and give your body the rest it needs to replenish itself. A recent study showed that poor sleep may lead to brain shrinkage and may even accelerate Alzheimer’s onset. Here is the most recent recommended sleep guide from the National Sleep Foundation:

Age GroupRecommended # of hours of sleep needed
Newborns (0-3 months)14-17 hours
Infants (4-11 months)12-15 hours
Toddlers (1-2 years)11-14 hours
Preschoolers (3-5)10-13 hours
School-age children (6-13)9-11 hours
Teenagers (14-17)8-10 hours
Young adults (18-25)7-9 hours
Adults (26-64)7-9 hours
Seniors (65 and older)7-8 hours

8) Manage your stress – There is not doubt that emotional stress affects you physically. I have not expounded too much on the mind-body connection yet, but there is a clear correlation between emotional stress and physical disease. This is actually one of the tenets of Chinese Medicine. We are spiritual souls connected to a physical body. Emotional stress from anger, frustration, depression, grief, worry, fear, and anxiety cause mind-body blockages, a disconnect between our spirit and our bodies which can lead to physical disease if not promptly addressed. So besides exercising to relieve stress, what else can you do? See #9

9) Get regular body tune-ups – If you take your car in for tune-ups and oil changes every few thousand miles, why would we think that our bodies don’t need the same maintenance? The tune-ups I get are the treatments that my father and I give to our patients on a regular basis. The treatment we do is a powerful form of acupuncture, which my father coined Neuro-BioEnergetics Treatment or NBE. In short, we combine the Chinese Medicine principle of acupuncture with Western anesthetic injections or trigger point injections. We inject acupuncture points with a diluted solution of anesthetic and clear these mind-body blockages that occur in your body from stress in your life, emotional or physical trauma, eating wrong, not exercising, not sleeping enough, drinking too much, smoking…the list goes on. I will expound on this more in future posts, but you can check out what we do on drtong.com

10) Do something every day that makes you happy or makes you laugh – Finally, to be heart healthy, you have to be happy. Why is this? The emotion associated with the heart in Chinese medicine is love, joy, and happiness. A blockage in these emotions, can also cause blockages in your physical heart. Whatever makes you happy, whether it is watching a comedy, taking a dance class, cooking, or reading a book, try to do it daily. There is something to be said about laughter being the best medicine.

What makes you happy?

In health and wellness,
Dr. Elain

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Cholesterol – Facts and Myths

April 6, 2015
High Cholesterol Foods

Cholesterol has gotten so much recent press that I feel it is a topic that needs to be addressed. Last month, a 6 year Finnish study of 9,000 men concluded that the cholesterol lowering medication, atorvastatin and simvastatin, increased the risk of Type 2 diabetes by up to 46% – the higher the dosage, the greater the risk. It appears that statins “increase a person’s insulin resistance” and also “impair the ability of the pancreas to secrete insulin.” And now, the Dietary Guidelines Advisory Committee (DGAC) is saying that “cholesterol is not considered a nutrient of concern for overconsumption.” So what is going on? Cholesterol lowering medication is causing a disease (diabetes) that can lead to a disease (heart disease) that it was originally trying to prevent? And we shouldn’t be concerned about having too much cholesterol in our diets? It seems that everything about cholesterol originally ingrained in our knowledge has done a complete 180. Let’s get the facts straight.

Cholesterol 101 – What is it and why do we need it?

  • Cholesterol is not a fat, but a steroid alcohol that is not water soluble. Around 75% of the cholesterol in our bodies is produced in the liver while the other 25% comes from food.
  • Cholesterol is essential for the production of all our cell membranes, bile acids (for digestion, fat metabolism, and elimination of cholesterol), sex hormones (such as testosterone, estrogen, progesterone), adrenal hormones (such as cortisol, DHEA, aldosterone), and Vitamin D (read more about Vitamin D here).
  • It maintains structure in our cells and blood vessels, and regulates protein pathways for cell signaling and communication between all our cells.
  • It is essential in our nervous systems, helping us with learning, memory, and cognitive function.

Our brains, which constitute only 2% of our body weight, contain 25% of the cholesterol in our bodies, and most of that 25% is made in our brains when we sleep. This is why babies sleep so much — while they sleep their brains are making more cholesterol to help them grow and develop. Infants and toddlers also need adequate amounts of cholesterol in their diets for proper brain development. For the elderly, it was found that those with high cholesterol in their brains had the best memory function, while those with low cholesterol had a higher risk for depression and even death! For all of us in between, it goes without saying that we also need cholesterol to function properly.

Ok, so now we have established that cholesterol is very important and ESSENTIAL to life.

If cholesterol is so good, why do statins even exist??

Let’s define the main components that make up cholesterol.

LDL – This is the “bad cholesterol” contributing to plaque build up in your arteries causing them to harden, also known as atherosclerosis. If a blood clot forms and blocks a narrowed artery, then a heart attack or stroke may result. However, what is not commonly known is that there is “good” LDL and “bad” LDL as well. According to Dr. Ron Rosedale, M.D.:

“LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation.”

HDL – This is the good cholesterol that carries LDL away from the arteries and back to the liver where it is processed and eliminated.

Triglycerides – This is fat that contributes to atherosclerosis. It is caused by being overweight or obese, lack of exercise, alcohol, smoking, and a diet high in carbohydrates (more than 60% of total calories). High triglycerides are actually a higher risk factor than LDL for developing diabetes and heart disease. (You’ll see why in a second).

VLDL – Very low density lipoproteins are considered bad cholesterols.

Lipoprotein (a) or Lp(a) are made up of LDL plus a protein (apoprotein a). High levels of Lp(a) also contribute to diabetes and heart disease.

Total cholesterol (TC) is the sum of all the above components.

So how do statins work?

Statins block the synthesis of cholesterol by inhibiting an enzyme in the liver called HMG-CoA reductase. This enzyme is what controls the production of cholesterol in the liver.

The problem is that HMG-CoA reductase also makes CoQ-10 in our bodies which is a major energy source for our hearts and responsible for energy production in all our cells. Therefore statins also decrease CoQ-10.

Statins increase insulin levels in our bodies. Chronically elevated insulin levels can cause inflammation and ironically, heart disease. Isn’t this the reason why people are prescribed statins — to decrease heart disease? Elevated insulin levels may also cause high blood pressure, heart attacks, thyroid issues, Parkinson’s disease, Alzheimer’s and even cancer.

Statins increase the risk of diabetes because it raises your blood sugar levels. How? Excess sugar that you eat from a meal is shunted to the liver where it should then be processed and stored into cholesterol and triglycerides. If the cholesterol production is blocked, then the sugar is kicked out of the liver and back into your blood stream, raising your blood sugar levels, which increases your risk of diabetes. This is exactly what the researchers in Finland discovered in their study.

How do I know if I’m at risk for heart disease?

If you visit your PCP or cardiologist, they will check your lipid profile to assess your risk for heart disease. The old school of thought is that your total cholesterol should be 200mg/dl or lower and under 150mg/dl if you already have heart disease. Your HDL should be over 40mg/dl, your LDL should be under 100mg/dl or under 70mg/dl for high risk patients, and your triglycerides should be under 150mg/dl. (Note: The lipid panel should be done fasting.)

Better and more accurate indicators of your risk for heart disease is using the following criteria according to Dr. Joseph Mercola:

1) HDL/Total Cholesterol Ratio : Divide your HDL by your Total Cholesterol and multiply by 100. This should ideally be 24% or higher. If your ratio is 10% or lower, then you are at significant risk.

2) Triglyceride/HDL Ratio: Divide your triglycerides by your HDL. This should ideally be under 2.

I’ll use my own numbers to illustrate 1 and 2 above.

TC = 194  HDL = 68 LDL = 116 Triglycerides = 61

My HDL/TC ratio is 68/194 x 100 = 35% > 24%

My triglyceride/HDL ratio is 61/68 = 0.89 < 2

As you can see from the ratio calculations, LDL is not even a factor considered in assessing heart disease risk. This indicates that lowering LDL does not have as much influence in lowering your risk as raising HDL and lowering triglycerides levels do.

3) NMR lipoprofile: This test measures the “bad” LDL levels discussed above, the “smaller more damaging LDL particles.” These particles can cause inflammation and are also connected with insulin and leptin resistance.

4) Check your fasting insulin: Normal insulin levels are under 5, but should ideally be under 3.

5) Check your fasting blood sugar: Those with a fasting blood sugar of 100-125mg/dl have almost 3 times the risk for heart disease than those with levels under 79mg/dl.

6) Waist to hip ratio (waist measurement/hip measurement) is a much better indicator than Body Mass Index (BMI) because BMI underestimates obesity rates by not accurately measuring your visceral, or belly fat. An ideal ratio for men is under 0.8. For women, the ideal ratio should be under 0.7. A ratio over 1 for men and over 0.85 for women is considered high risk.

7) Iron levels: Excess iron levels can potentially damage blood vessels, increasing the risk for heart disease. Check your ferritin levels and make sure they are under 80mg/dl. The best way to get rid of excess iron is donating blood.

Should I take statins if I am at risk or already have heart disease?

I rarely, if ever, prescribe statins. And if a patient comes to me on a statin, I will usually take them off the statin and use diet, supplements, and herbs to treat them. The only benefit that has been seen with statins is with middle-aged men who already have documented heart disease (according to cardiologist Dr. Stephen Sinatra) or those born with a genetic defect called familial hypercholesterolemia which prevents them from normalizing cholesterol levels (these patients come in with extremely high numbers: TC >300 and triglycerides > 400). Even then, your total cholesterol levels do not need to be lowered below 150mg/dl nor does your LDL need to be below 70mg/dl. Lowering your cholesterol to these levels puts you at risk for cognitive issues including depression (low cholesterol levels may indirectly link to lower serotonin levels in the brain since cholesterol is needed in nerve cell membranes for serotonin receptors to work properly), memory loss, and Alzheimer’s dementia (with low HDL levels as a risk factor). Instead, use the ratio calculations above to make sure your lipid profile is in the optimal range.

Another valid reason to take the lowest dose of statins, if you must take them, is because there have been hundreds of studies (900!) validating the damaging side effects from statins including muscle pain, cognitive loss, neuropathy, anemia, frequent fevers, cataracts, and sexual dysfunction. In addition, studies have shown that lowering cholesterol levels with statins don’t lower mortality rates from cardiac related deaths but actually increase the mortality of cancer. Researchers now also believe that high LDL levels are not the culprit of heart disease risk since those people dying from heart related diseases had the lowest levels of cholesterol ever (i.e., the 3 year mortality rates of heart attack patients with low LDL were twice as high)!

Also, if you are taking a statin — you must supplement with at least 100mg of CoQ-10 daily (if not 200-300 mg) as this is depleted in those taking statins. And if you are over 40, it is better to supplement with the ubiquinol form of CoQ-10 (more about this later).

Coming soon: I’ll talk about effective ways to improve your cholesterol health and prevent heart disease. For now, be comforted in knowing that eating foods high in cholesterol and saturated fats such as eggs and uncured bacon, as well as foods high in unsaturated fats such as avocados are a step in the right direction towards these goals.

What does your cholesterol profile look like?

In health and wellness,
Dr. Elain

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The ABC’s of Omega-3’s

April 2, 2015
Pink Salmon Omega 3's

In the last 30 years, there have been over 10,000 studies published validating the many health benefits of omega-3 fatty acids. This really should be no surprise as omega-3’s are a crucial component of all our organ and tissue membranes. In addition, they play a critical role in our metabolism, cardiovascular and immune system, brain development and cognitive function, as well as skin, joint, and eye health. Let’s look at the key points of omega-3’s.

What are omega-3’s and where do they come from?

Omega-3 essential fatty acids are polyunsaturated fatty acids (PUFA) necessary for normal metabolism. They are considered essential because our bodies cannot synthesize them, and we must acquire them either through diet or supplementation.  The three types of omega-3’s are:

  • α-Linolenic acid, or ALA (short-chained fatty acids) found in plants such as flaxseed oil, hemp oil, and chia seeds.
  • eicosapentaenoic acid or EPA (long-chained fatty acids) found in algae oil or marine oil such as fish or krill oil.
  • docosahexaenoic acid or DHA (long-chained fatty acids) also found in algae or marine oil.

ALA is a precursor to EPA and DHA, but our bodies are very inefficient at converting ALA into EPA and DHA. This process also worsens with age. Because the greatest health benefits come from DHA and EPA, we should be getting our omega-3’s directly from either fish, fish or krill oil, or algal oil for vegetarians.

What are the health benefits of DHA and EPA?

DHA comprises about half of the omega-3 fatty acids in the brain and is naturally found in breast milk. Some of its roles include:

  • infant brain and eye (particularly retinal) development
  • cell communication
  • memory and cognitive health
  • lowering the risk of cardiovascular disease and lowering triglyceride levels if combined with a healthy lifestyle
  • supporting eye health and reducing the risk of age-related vision issues, such as macular degeneration

Because DHA is so critical in infant development, pregnant and breastfeeding women should supplement and have a diet high in DHA (at least 300 mg/day if not more). This is especially critical during the 3rd trimester, where DHA concentrations increase dramatically (up to 300-500%) in the infant brain.

EPA is useful and applicable in later stages of life. For children, EPA is important once they start school to aid in cognitive development and social adjustment.  For adults and the elderly, EPA helps to decrease inflammation, improve cardiovascular function, support cognitive function, and treat depression.

What is the best way to get omega-3’s?

The American Heart Association (AHA) recommends consuming 3.5 ounces of cooked fatty fish at least 2-3 times a week (for a total of 7-10 ounces), in order to supply ourselves with all the omega-3’s we need. However, mercury, heavy metals, and radioactive poisons found in fish now make it much more difficult to maintain the levels of omega-3’s our bodies need.

The best fish to eat is wild salmon, herring, and mackerel, (which have the highest concentrations of DHA and EPA with lowest amounts of mercury per 3 ounce serving), or smaller fish such as sardines and anchovies, which will be less susceptible to mercury contamination due to their size. Fish should be baked or grilled and not fried, as frying eliminates much of the nutritional content of the fish. It is best to avoid larger fish such as king mackerel, swordfish, shark, and tilefish due to high levels of mercury. Beware also of farmed salmon, which may contain polychlorinated biphenyls (PCB’s), chemicals that can cause serious long term health effects.

If you cannot eat enough fish in your diet or are strictly vegan, then supplementation will be essential.

What should you look for in an omega-3 supplement?

The best omega-3 supplement will be fish oil in the triglyceride form, which is the natural bioidentical form found in fish for our bodies to maximize absorption. This is opposed to fish oil in an ethyl ester form which results in lower absorption and lower assimilation into our cells and tissues.

The fish oil should be pollution-free and purified of any mercury, lead, harmful chemicals, or pesticides. It should also be non-GMO and hexane free.

It should be fresh without any fishy odor or taste. The oil should be burp free, found in products where the fish protein is completely removed.

Finally, it should be eco-friendly and come from a sustainable source.

The two brands I recommend for my patients are:

If you are vegan, then Nordic Naturals offers a vegetarian option algal oil:

For babies and children, Nordic Naturals has several options:

  • Baby’s DHA, liquid form for babies 5-35 lbs, with 350 mg EPA, 485 mg DHA, and 300 I.U.’s Vitamin D
  • Baby’s DHA vegetarian, liquid form from microalgae source for babies 5-35 lbs, with 225 mg EPA and 450 mg DHA
  • Ultimate Omega Junior, for children 5+ with 325 mg EPA and 225 mg DHA in 2 soft gels

Note: I usually recommend the formulations with the highest concentration of EPA and DHA. These concentrations are good for everyone in general, and especially for pregnant and nursing women as well as those with documented coronary heart disease, as recommended by the AHA. However, everyone responds differently, may have different needs, or may be sensitive to higher concentrations. Higher concentrations of fish oil may also increase the risk of bleeding, particularly for those who are on blood thinners such as Coumadin. Please use with caution.

Now time to bake that salmon!

In health and wellness,
Dr Elain

References:

Healing with Whole Foods by Paul Pitchford
Mercola.com
Fish 101 AHA recommendations

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