How Do I Know If I Have A Low Thyroid Problem?

Do you have signs of a low thyroid problem you’re thinking of having checked out? It’s important to seek care for any health-related symptoms, and this includes those typically associated with low thyroid. 

Some of the symptoms low thyroid patients notice include: 

• Lethargy; chronic fatigue
• Depression and/or anxiety
• PMS or menopausal symptoms
• Muscular and/or joint pains
• Fibromyalgia
• Heart disease
• Digestive disorders
• Hair loss
• Dry or itchy skin; eczema or rashes
• Low libido
• Cold hands and feet
• Weight gain
• Inability to lose weight despite diet and exercise
• Memory problems or brain fog

In reviewing this list, you may notice that many of these low thyroid signs are commonly associated with other conditions–or the simple fact of aging. Women often assume many symptoms of low thyroid are inevitable due to menopause. Yet it’s never a good idea to suffer with health problems, even if they seem ‘minor.’ 

If you find yourself taking the attitude that you must ‘learn to live with’ feeling extra tired, irritable or depressed, or with aches and pains you didn’t used to have, seek out health care. Nothing will be gained by taking a ‘wait and see’ approach and delays may make care for low thyroid or other conditions more challenging. 

Most people understand that the thyroid plays a big role in metabolism regulation. A significant weight gain for no apparent reason, lack of energy or low sex drive are some of the symptoms that commonly prompt low thyroid patients to seek care for their condition. 

Yet the lesser-known symptoms that seem unrelated to the thyroid are also important indicators of problems your body may be having related to thyroid function. Be sure to tell your doctor about all of your symptoms, even if you think they seem irrelevant or unrelated to your thyroid.  If you seek out support from your regular medical care provider, it’s likely you will be tested for thyroid problems through blood work. Tests will be used to determine whether or not the problem is thyroid related, or possibly something else. However, some thyroid conditions require a much more in-depth approach to evaluation and care.

If you are told your thyroid is ‘fine’ based on blood work results but you still have symptoms, you may benefit from a more comprehensive approach to care. The same may be true if you are taking medication for low thyroid with little to no improvement in how you feel. 

Patients seeking a more in-depth approach to their health and wellness may want to consider working with a functional medicine specialist to address thyroid symptoms. Very detailed testing will identify exactly what is going on in your body’s organs and systems, including the thyroid. Once you’ve been thoroughly evaluated through comprehensive testing and information received from you on how you feel, you can look forward to the type of care that will help you feel better. Customized therapy and support can improve your condition as quickly as possible and in the long term. 

Your Device Is Killing Your Sleep – The Blue Light Backlash

Oxygen, water, food, sleep. These are the four requirements for life. Without them (in varying lengths of time) people die. Sleep is an important factor as it heavily influences our performance at work, our risk for chronic disease, and our overall quality of life. Sleep researchers, however, aren’t clear on the exact reason why humans even need to sleep. From an evolutionary perspective sleep would certainly have left primitive humans vulnerable to attack so it must offer some great advantage. Generally speaking, sleep is thought to allow our brains and our bodies to heal and repair from the damage of the day; synaptic plasticity is managed, brain pathways that are not being used are pruned, muscles are repaired, and energy stores are replenished.

America is Tired

Short sleep duration (defined as less than 7 hours of sleep per night) is common. In the United States 24% – 48% of people report it. If you are obese, a smoker, consume excessive alcohol, or are physically inactive you are more likely to report short sleep duration.¹ Sleep is an active process. In other words, you don’t fall asleep simply because your brain is tired. Sleep is actively maintained throughout the night. Disruption of this careful balance between arousal and sleep results in, what else, disrupted sleep.

Circadian Rhythm is Important

Humans display a 24-hour circadian rhythm. This rhythm is endogenous meaning it is maintained even in the absence of environmental cues. Human beings placed environments with no light, no time cues, no social cues, etc., will still display a 24-hour rhythm. However, external timing cues do modulate and adapt the rhythm to the environment. For example, sunlight, in humans, is a powerful cue to have the waking phase of our 24-hour cycle during the day. Other mammals, like rats and mice, have most of their waking phase at night. These rhythms were created through many years of evolutionary pressure. Light cues, which modulate our circadian rhythm, are extremely powerful. Circadian rhythm is endogenous so an internal pacemaker is necessary. The suprachiasmatic nucleus in the hypothalamus is a major part of the internal pacemaker of humans. This part of the brain is connected to the retina via the retinohypothalamic tract.² This direct and powerful connection shows just how important light is for controlling circadian rhythm.

Stages of Sleep

Sleep is divided into two forms – non-REM and REM. Non-REM sleep is further subdivided into 4 stages, each with its own properties. During non-REM sleep neuronal activity is low, metabolic rate and brain temperature are at their lowest, heart rate decreases, blood pressure lowers, and muscle tone and reflexes are intact. Contrast this with REM (rapid eye movement) sleep where brain activity is similar to that of the awake brain. For this reason, it is sometimes referred to as paradoxical sleep. In REM sleep brain temperature and metabolic rate rise and there is complete loss of muscle tone with the exception of the diaphragm (so you can breathe), the eye muscles, and some muscles within the inner ear.

The Adverse Effects of Blue Light

A recent study of about 1,500 Americans found that 90% of adults use an electronic device within 1 hour of bedtime at least a few times per week. Devices may be an important contributor to insomnia because of the short-wavelength-enriched light that is emitted from them. Exposure to light in the evening and the early part of the night, even at low intensity, has several sleep-disturbing effects. First is suppresses melatonin delaying the onset of sleep. It shifts the circadian clock to a later time making it harder to fall asleep at a regular hour. Finally, it increases alertness and arousal.³

In one interesting study, 12 adults were randomly assigned reading from a light-emitting eBook for 4 hours before bed or reading from a print book for 4 hours before bed for 5 consecutive evenings. They found that those reading an LE-ebook displayed decreased subjective sleepiness, decreased EEG delta/theta activity, suppressed melatonin secretion, lengthened sleep latency (increased time to fall asleep), delayed and reduced REM sleep, and impaired morning alertness.³ 

Why does blue light have this effect? Human eyes have rods, cones, and intrinsically photosensitive retinal ganglion cells. Rods and cones are mostly responsible for image-forming vision. Intrinsically photosensitive retinal ganglion cells are responsible for regulating circadian rhythm and other biologic functions. Retinal ganglion cells form the beginning of the retinohypothalamic tract which transmits light data from the retina to the hypothalamus to regulate circadian rhythms throughout the body. Retinal ganglion cells respond powerfully short-wavelength light like the blue-colored light emitted from most devices and LED televisions. This blue light will cause a high rate of fire from the eyes to the hypothalamus, which will change hormonal and circadian rhythms.⁴ Blue light also has the ability to stimulate other areas of the brain which are responsible for producing norepinephrine, a neurotransmitter that has potent arousal properties.⁵

With the knowledge that the blue light emitted from almost all devices and LED TVs is disruptive to the foundational pathways for sleep, it’s important to take steps to remedy this if you’re having trouble sleeping. First and foremost, do not use your device in bed. At all. In fact, you should avoid using it at least an hour before you plan to go to bed. Do not watch TV in bed either. If your symptoms are severe, avoid TV for at least an hour before you plan to retire. If you have to use a device for some reason, avoid long exposure. You should also consider wearing red-colored lenses for about an hour before bed. The red-color of the lens blocks the blue light from reaching the retina. Blue-light blockers that are clear also exist. You could consider purchasing a pair of these and using them in the evening and while you’re using your device. I’ve recommended a pair from this website: www.blepeyewear.com. As devices age, they tend to emit more blue light. If possible, consider getting a newer device. Finally, many devices come with a night-shift mode. This mode shifts the hue of the screen to a warmer, redder tone. This has been studied to see if it offset the negative effects of the light from a device. Unfortunately, it did not. Melatonin levels were still reduced when using night shift mode.⁶

In the end, if you suffer from insomnia, reducing your device exposure is likely to have a measurable effect on your sleep. Our devices have become extensions of our lives so it may be difficult to completely eliminate exposure, however, your brain (and your boss) will thank you for the better sleep.

 

 

¹https://www.cdc.gov/sleep/data_statistics.html

²Kandel, et al., editors. “Sleep and Dreaming .” Principles of Neural Science, 4th ed., McGraw-Hill, 2000, pp. 936–947.

³Proc Natl Acad Sci U S A. 2015 Jan 27;112(4):1232-7.

⁴Molecular Vision 2016; 22:61-72.

⁵Blue-Light Therapy following Mild Traumatic Brain Injury: Effects on White Matter Water Diffusion in the Brain. Front. Neurol. 8:616.

⁶Sleep, Volume 40, Issue suppl_1, 28 April 2017, Pages A290.

Fix your pain with your diet

Inflammation is all the rage lately. And rightfully so. Research has shown that chronic inflammation is at the core of most, if not all, of the chronic diseases that affect Americans. But what about chronic pain? Could chronic joint pain, back pain, or muscle pain be caused by chronic inflammation? And can it be alleviated by changing your diet? The answer is yes.

What is Inflammation?

First, we must understand what inflammation is. Inflammation is the term given to describe the biological response that occurs as a result of tissue damage. Bacterial infections, trauma, chemical exposures and dying tissue may all start the inflammatory cascade. In human physiology there are two kinds of inflammation. First, there is the acute form. In this form of inflammation the body responds to an injury by creating an environment that is conducive to healing and tissue repair. The body does this by sending fluids and blood to the area. That’s why the injury swells, turns red and becomes warm to the touch. This is a necessary step after an injury. Acute inflammation is a good thing for the body.

The second type of inflammation, called chronic inflammation, is not a good thing for the body. Chronic inflammation is a lower grade inflammatory response, but it is persistent. Unlike acute inflammation, which resolves, chronic inflammation is a continuous phenomenon that persists silently for years on end. The chronicity of the response is precisely what makes it so problematic. It increases the risk of heart disease, cancer, Alzheimer’s disease, diabetes and many other conditions.

Chronic Inflammation and Pain

How does chronic inflammation affect your pain level? First, it’s important to remember the most widely used pain relievers in the world like ibuprofen, acetaminophen, and aspirin work by reducing inflammation, not by working directly on nerves. This should illustrate the importance of inflammation in producing pain in the human body. However, there are ways to reduce inflammation without resorting to medications, which have serious side-effect profiles, even when taken as directed. The diet is the key.

Dietary-induced chronic inflammation produces an assortment of inflammatory chemicals capable of sensitizing the pain pathways. Moreover, if this sensitization of the pain pathways persists, adaptive responses by the brain cause the sensation of the pain to become exaggerated or inappropriate. The key to fixing this is to reduce the chronic inflammation.

The Pro-Inflammatory Diet

In this country, most people eat a “pro-inflammatory” diet.  That is, they consume food that consistently feeds the inflammatory cascade in the body, leading to chronic inflammation.  As previously pointed out, chronic inflammation leads to tissue destruction and many disease states.  In order to fully understand why our diets lead to this state, we must understand the basics of fatty acids.

Fatty acids are individual molecules that make up triglycerides in our body.  Triglycerides are the storage form of fat that humans use for energy.  In human physiology there are three important fatty acids.  There are omega-3 (n-3), omega-6 (n-6) and omega-9 (n-9) fatty acids.  Omega-3 and omega-6 fatty acids are essential in the human diet.  This means that we must consume them in our diet in order to survive.  Omega-9 fatty acids are classified as non-essential because we are able to synthesize them from other unsaturated fats in our body.  It is the balance of these fatty acids that is critical for controlling and reducing inflammation in human physiology.

First, we must examine the role of fatty acids in our body when speaking about inflammation.  Fatty acids work to produce a variety of chemicals in the body called eicosanoids.  These chemicals are at the heart of the inflammatory cascade.  Some eicosanoids are beneficial while others can contribute to inflammation.  The harmful eicosanoids that contribute to the inflammatory cascade are related to an omega-6 fatty acid called arachidonic acid.  If arachidonic acid is incorporated into a specific eicosanoid then it becomes pro-inflammatory.  If it is not incorporated it becomes anti-inflammatory.  It is arachidonic acid that will fuel the inflammatory cascade, eventually resulting in the production of chemicals capable of sensitizing the pain pathways.

So, we must take a closer look at this specific fatty acid called arachidonic acid.  Arachidonic acid is found preformed in animal products, especially meat.  In addition, it is easily converted in the body from the fatty acids found in grains and vegetable oils like corn, safflower and sunflower oil.  Also, animals fed a steady diet of grain are exceptionally high in arachidonic acid.

Obviously, what we eat will determine our fatty acid profile and potentially contribute to chronic inflammation and pain.  One might think, based on the information given above, that becoming a vegetarian would significantly reduce one’s overall inflammatory load.  And it does make sense especially if we take into account that arachidonic acid is preformed in meat.  It has been shown, however, that the opposite is true.

The average American diet has unfortunately shifted to promote excessive production, storage and utilization of arachidonic acid.  This leads to the over-production of pro-inflammatory eicosanoids.  Research has shown that man evolved with a ratio of omega-6 fatty acids to omega-3 fatty acids of about 1:1.  Today, the average ratio in the diet is anywhere from 10:1 to 20-25:1.  This is disadvantageous because we know that omega-3 fatty acids are anti-inflammatory and have a wealth of other health benefits.  Plainly put, our diets have shifted to favor inflammation.

As mentioned earlier, it would seem that vegetarian diets would be most beneficial in creating an anti-inflammatory state because animal products are high in preformed arachidonic acid.  This hypothesis, however, has not held up in clinical studies.  It has been shown that vegetarians, in fact, have a higher plasma level of arachidonic acid and an essentially equal level of arachidonic acid found in red blood cells when compared to meat eaters.  The study also showed that vegetarians have lower levels of the protective and anti-inflammatory omega-3 fatty acids, specifically EPA and DHA. This suggests that  vegetarian diets shift people closer to an inflammatory state than they probably desire.

A diet high in fruits, vegetables and healthy proteins and fats it ideal for stopping and preventing chronic inflammation.  This type of diet will invariably be low glycemic.  The glycemic index refers to the effect on blood sugar that a particular food will have.  A food that has a low glycemic index (GI) will raise blood sugar much more slowly than a food with a high GI.  Foods with a low GI are much more beneficial for controlling inflammation because low glycemic foods cause a much smaller response from the hormone insulin.  Insulin is the hormone that’s required for most of the cells in our body to use and store sugar for energy.  Insulin, which is secreted from the pancreas, actually stimulates an enzyme that converts omega-6s into the dreaded arachidonic acid.  So a diet that is high glycemic will cause one’s body to over secrete insulin and further drive the inflammatory cascade.

So a diet high in fruits, vegetables, protein and healthy fat will lead to lower inflammation and greater pain control, but are there are other things you can add into your diet to help? As it turns out, there are. Certain spices have powerful anti-inflammatory effects. Turmeric, ginger, garlic and black pepper all have the potential to reduce inflammation when consumed in the diet. There are many other spices that have anti-inflammatory properties so go ahead, spice up your food! Your body may thank you for it.

Your Cholesterol Matters Less Than You Think

The Cholesterol Hypothesis

The cholesterol hypothesis is the prevailing theory on why human beings develop heart disease. It goes something like this; elevated total cholesterol and, especially, elevated LDL cholesterol, is the primary cause of atherosclerosis and cardiovascular disease. Further, replacing saturated fat in the diet with vegetable oils lowers serum cholesterol and, therefore, lowers cardiovascular disease risk. This information is decades old and has become medical dogma. Unfortunately, it’s not true.

Much of this information comes from the Seven Countries Study originating in the 1950s, although data is still analyzed today to glean more knowledge from it. It tied fat consumption to heart disease. The lead author, Ancel Keys, found the more fat a society consumed the higher the rate of heart attacks. It seemed to be very convincing evidence. This observation helped shape health policies for governments and the medical field. In fact, to some degree, it still does today.

Missing or Unpublished Data

There was a problem with it, though. Data showed that there were populations of people who consumed lots of fat but had low heart attack rates. Conversely, there was data showing there were populations of people who consumed very little fat but had high rates of heart attacks. This information was omitted from the study. The study also failed to account for the fact that the people who consumed the most fat were also most likely to consume the most sugar. While nutrition science is notoriously difficult, these seem like variables that shouldn’t have been ignored.

Superimpose the above inconsistencies with interventional studies conducted in the same time period and you’ll quickly see you’ve been misled. Ancel Keys’ study was an observational study. This means he observed a connection between two sets of data. Observational studies cannot prove cause and effect. For example, imagine this headline; “New science has observed a connection between high heel wearing and breast cancer.” Does wearing high heels cause breast cancer? Of course not. It just happens that people who wear high heels (mostly women) also develop the majority of breast cancer. This silly example shows just how easily an observational study can get it wrong.

The gold standard for proving cause and effect is an interventional study where populations are randomized and given either an experimental intervention or are controls, generally receiving a placebo. In dietary trials, placebos are difficult, if not impossible, to give so participants diets are often left unchanged for the control population.

The Sydney Diet Heart Study and the Minnesota Coronary Experiment

Around the same time that Ancel Keys was doing his work, two interventional studies were conducted. One was called the Sydney Diet Heart Study and the other the Minnesota Coronary Experiment. Both of these studies were incompletely published (data was missing) or went completely unpublished for reasons no one really knows. It is likely because they contradicted accepted dogma and scientific journals were hesitant to put their reputations on the line for something they viewed with skepticism. We know about them now because a group of researchers recently uncovered the unpublished data, reanalyzed it with modern methods and found some shocking results. The reanalysis of both studies was published in the British Medical Journal.

In both of these experiments, totaling about 10,000 participants, saturated fat was removed from the diets of the experimental group and replaced with vegetable oils. This is precisely what the American Heart Association says you should do. What did they find? They found that by removing saturated fat, the participants’ cholesterol went down. This is not unexpected. What they didn’t expect to find was that in both studies the low saturated fat group experienced more cardiovascular disease, more coronary heart disease, and an increase in all-cause mortality.

So let’s summarize; Removing saturated fat and replacing it with vegetable oils lowers cholesterol. But lowering cholesterol raised the risk of heart disease? Yes. This puts an enormous, truck-sized hole in the cholesterol hypothesis. In fact, in the Minnesota Coronary Experiment for every 30 points a person’s cholesterol dropped their risk of death increased by 22%.

This information is counter to everything nutrition science says. Three other randomized controlled trials have confirmed the results. Couple this with another very recent study evaluating over 68,000 elderly people which found an inverse relationship in those over 60 between LDL level and mortality, and I think we seriously need to evaluate the cholesterol hypothesis.

The Real Cause of Heart Disease

If cholesterol doesn’t cause heart disease, what does? It’s quite simple actually – endothelial damage. The endothelia are the cells that line your blood vessels. There are things that are known to damage this lining – high blood pressure, inflammation, high blood sugar, smoking, oxidative stress, and aging. These triggers, and pursuant damage, set into motion a cascading set of events that allows your immune system (in the form of white blood cells) to infiltrate the lining of the vessels. Only after they do this do they begin the process of engulfing cholesterol, which eventually leads to arterial plaque formation. Control those triggers and you will never develop heart disease. If you do not control those processes, it doesn’t matter how low your cholesterol is. You will still develop heart disease. I hear you saying, “But how do I control aging?” That is more difficult as we will all age, but living a healthy lifestyle helps with all of those factors, including aging. Plus, aging alone is unlikely to be a significant cause of heart disease.

It’s important to recognize that cholesterol is not your enemy. Sedentary lifestyle, smoking, a diet high in refined food, the excess consumptions of sugar, and poor stress management are much more serious concerns. Lowering cholesterol for the sake of lowering it has no beneficial effect on your heart. As a matter of fact, the research shows it could be downright dangerous for it. So if you’ve been told you have high cholesterol and that lowering it will lower your risk, you might want to consider the information above and seek an alternative.

5 Tips For The Tired Office Worker

We’ve all experienced it, haven’t we? You get to the office, start the day strong but go to lunch and come back feeling like you need to sleep for a week. This afternoon fatigue is a common complaint, and it can affect your productivity at work. To avoid it, many turn to coffee, energy drinks, or sugar. These provide a temporary boost but set you up for failure again the next day.

This slump in energy in the afternoon is a sign that your metabolism isn’t working like it should. Let’s review the ways our bodies use fuel. There are two major ways our cells can get energy; we can burn sugar or we can burn fat. Most people have spent too many years training the sugar burning system making the fat burning system inefficient. This leads to insulin resistance, weight gain, pre-diabetes, and if not changed, it eventually causes diabetes.

How does this affect your energy in the afternoon? When you’ve trained your body to burn sugar but not fat, you’ve signaled your pancreas that you need lots of insulin when you eat. Insulin is the hormone that allows us to use the sugar we eat as fuel for our cells. The more insulin you secrete the faster your cells gobble up sugar. Sounds good, right? Wrong. When your cells use up your blood sugar quickly, your blood sugar drops precipitously. This is when you start to feel a sloth stuck in quicksand. The drop in blood sugar leads to fatigue, sleepiness, mental fog, and the desire for a short (or long) nap.

To prevent this from happening follow the tips below, and in no time you’ll be feeling energetic and productive in the afternoon.

Retrain your metabolism

Begin this process by changing your diet. Remove processed carbohydrates and add in healthy fats. Instead of that bagel for a mid-morning snack, have some nuts. They are loaded with good fats and other nutrients. Have a salad at lunch instead of that burger and fries. Use olive oil and vinegar for dressing and add an avocado to the salad. Make sure you get enough protein. Protein provides the building blocks for the neurotransmitters in your brain. Without these, you’ll feel foggy and disconnected. Instead of having cereal for breakfast, have a couple of eggs. They’re nutrient dense and provide a good source of choline, which is essential for memory function.

Move

Regular exercise will help regulate insulin levels. A hallmark of the sugar burner is high levels of insulin in the blood, even when you’re fasting. By exercising these levels will fall and your pancreas will begin to secrete normal levels of insulin. Your cells will also become more sensitive to insulin. Through multiple feedback mechanisms, this will also help keep you from producing too much of it. The end result is better blood sugar control with no more of the precipitous drops and associated symptoms.

Also, consider getting up from your desk and moving during the day or afternoon. This is often a good way to reset and refresh

Sleep Better

This one is rather obvious, but a lack of sleep sets you up for failure. Along with being tired, not getting enough sleep will make you crave sugary, processed food. As has been discussed, this is ultimately the cause of the afternoon slump. Try to get to bed at a reasonable hour, and at the same hour, each night. This trains your body’s internal clock to be ready for bed at the same time every night so you don’t spend hours laying awake waiting to fall asleep. Turn off all the lights in your room and even consider covering any LED alarm clocks, too. Do not watch TV or use a handheld device in bed either. They’re likely to keep you awake. Shoot for at least 7 hours of sleep each night.

Drink More Water

Even mild dehydration can cause fatigue. How will you know if you are dehydrated? Just listen to your body. If you have other symptoms like headaches, dizziness, constipation, or dry mouth there’s a good chance you’re dehydrated. To rehydrate do not drink sports drinks. They are loaded with sugar and are only appropriate for vigorous exercise. Aim for half of your body weight in ounces of water per day. For example, if you weigh 150 pounds, try to drink 75 ounces of water throughout the day. This will prevent you from becoming dehydrated.

Have A Mid-Afternoon Snack

Having a snack in the afternoon can be a great way to prevent your blood sugar from falling. The key here is to make it a healthy snack. A quick, sugar-filled one will only be a temporary fix, leaving you vulnerable the next day.

Making these simple changes will profoundly affect how you feel in the afternoon. What’s better is they will also be good for your health in the long run. Whether you’re going after that promotion or just trying to feel more alert and productive at work, taking these steps will work for you.

Our Trip To Ghana

For those of you who don’t know, Kate (my clinical assistant) and I recently took a trip to Ghana in West Africa. A Ghana-based group called Autism Action Ghana (AAG) invited us to come evaluate and treat children with autism. Our trip was a resounding success. From the people we met, to our experience in the country, to the children we helped, we were received with open arms. I hope you’ll enjoy this account of our experience.

More About AAG (Information from AAG)

Autism Action Ghana is a registered, Non-Governmental Organization, founded in 2014 by Peter and Dr. Araba Fordjor after their 2 ½ year-old son was diagnosed with Autism Spectrum Disorder (ASD). Having been told there was no hope, they were even more awestruck by the lack of support, information and resources that accompanied the diagnosis and the hopelessness and despair that they faced on their lonesome journey.

Autism Action Ghana (AAG) seeks to create awareness of Autism Spectrum Disorders in a bid to generate understanding of the disorder amongst the general public, shatter the stigma and facilitate early diagnosis. But perhaps most importantly, AAG seeks to provide families with current clinical and behavioral evidence-based interventions and approaches that will directly impact children with autism and equip them to attain their maximum potential.

In Ghana, awareness of autism as a medical or neuropsychiatric disorder that can be treated is lacking. Many children’s symptoms are attributed to poor parenting and spiritual beliefs leading to stigmatization, inappropriate care and denial of their basic rights and opportunities.

How Did This Come To Be?

Many have asked me how we came to be invited to treat these children half a world away. It’s a bit of a long, convoluted story so I’ll try to make it short. The Vreeland Clinic had a previously existing patient with ties to Ghana. She put us in contact with a woman whose child had autism. Through this connection, Dr. Fordjor heard of us. Several patients actually traveled from Ghana to see us in Vermont. Eventually, Dr. Fordjor invited us to come to Ghana to see those who were unable to make the journey. After much careful thought, we decided this was an opportunity we could not miss.

AAG offered to cover my costs to get to Ghana and all costs while I was there (lodging, food, etc.) I decided that in order to be effective, I would need some help. I was going to need someone else there to help me with patient flow, note taking, dietary questions, etc. I knew there would be A LOT of questions from the parents, and I simply wouldn’t have time to answer all their questions and see all of the patients without help. That’s why Kate was on the trip. She helped coordinate patient flow, wrote down instructions, took notes, discussed dietary changes, and counseled patients on all the changes they were going to have to make to be successful. Now that we’re back and I have some perspective, there is absolutely no way I could have done this alone. I would have not been nearly as successful without Kate there.

Our Journey

Our journey really began months before we left. We needed to be vaccinated for yellow fever. Both Kate and I elected to get the hepatitis A vaccine as well given the ease with which it is transmitted and the effectiveness of the vaccine (98%). We also wanted to do what we could to offset the costs for AAG. I came up with the idea of starting a GoFundMe page. Using the great power of crowd funding, we were able to raise $9,575. This allowed us to see every single child at no cost and help greatly offset the costs AAG would have to absorb to set up the weeklong clinic. Our goal was to raise this money so AAG could use its funds in other helpful ways, and I’m certain we achieved that goal.

Leading up to our departure on April 22^nd there was a lot of planning, but I’ll spare you the boring details. AAG took care of everything on their end. They booked our hotel accommodations, secured a room (with an air conditioner!) for us to see the children in, and even secured someone to cook all of our meals while we were there. It was a blessing not to have to worry about that! We booked the flights on our end. We took a short flight from Burlington, VT to JFK airport in New York. Then we had a direct flight from JFK to Accra, Ghana. AAG contacted Delta (our air carrier from NYC to Accra) and they kindly upgraded our seats to Delta Comfort Plus free of charge. The extra legroom and food was nice on the 10-hour flight. 

Our flight from JFK was uneventful and we landed in Ghana at about 7AM on the 23^rd. We were both a little tired, but very happy to be in Africa. We exited the plane and I immediately noticed how hot it was! The humidity is always high in Ghana so it makes it feel even hotter. As we made our way into the airport, we were screened for Ebola by means of a thermal camera. Basically, they’re looking to see if you have a fever. We passed the test. Then we went through customs and grabbed our bags.

Dr. Fordjor and her husband, Peter, met us at the airport. As we discussed our travel and how hot we felt it was, they remarked that it had been quite hot recently even for them! We departed the airport and they took us to breakfast. I’m not sure what I was expecting, but we had a very nice buffet breakfast at a local hotel. There were eggs, omelets to be made, French toast, potatoes, etc. It was quite good and it felt nice to have some food in our bellies. They dropped us off at our hotel and provided us with a Wi-Fi hotspot so we’d have Internet service wherever we went. This is so nice to have!

Our hotel was great. We each had a room with air conditioning and a refrigerator. Strangely, they did not provide towels, washcloths, or, of all things, a trash can. Fortunately, Kate and I each brought a towel thinking we might make it to the beach one day. We never made it to the beach, but the towels sure did come in handy. We also did not have any hot water, but we did okay without it. It was somewhat nice in the evening to take a cool (cold?) shower.

The next day was Sunday and our only completely free day to explore Accra. AAG provided us with a driver. His name was Robert, and he took us all over Accra. We saw many sites from the very busy, modern downtown district, to a fishing village in which no one had running water, sewage, or electricity. The people living in the fishing village hand carved their wooden boats and used them to catch small fish in the ocean. The fish were then spread out over the ground to dry out, then they were smoked and brought to the market to sell. The fishing village was directly in the shadows of the Jamestown fort, a very large castle-like structure that was once used to imprison the locals before they were shipped off the Europe and the United States as slaves. The pier they led the slaves to where large boats waited to take them to other parts of the world still stands today.

We also visited a local market where we bought several souvenirs for our families. Haggling is the name of the game there. Our guide to us to reduce the price they were offering by a factor of 4 and that would likely be a good deal. It was kind of intense, but perhaps because culturally we did not understand the bargaining nature. It’s just how they do business in the markets. To us it sounded very much like arguing, but we were assured it was just business.

We had a nice lunch on the coast where we were right on the ocean. It was hot, so some food and water felt quite nice. After lunch we continued our exploration, driving around some more. Eventually, we went by the US Embassy. It was fun to see. We headed back to our hotel and got prepared for the start of our long week of seeing patients.

The Patients

We spent Monday-Friday seeing patients from 8AM to 6PM. They were long days, but they were worth it. In all, we were able to see 44 patients, most who had been diagnosed with autism. We saw just a handful that were not.

I think the overall theme from the week was about the stigma that is attached to autism in Ghana. We were told about it, but until we started seeing patients and were exposed to it, we could not fully understand the depth of it. Many, particularly the men, believe a child with developmental challenges reflects poorly on the family. Or in the case of men, it reflects poorly on them. This is such a powerful stigma, men may completely abandon their family if they have a child on the spectrum. It is hard for us in the US to imagine, but I bet if you dig deep enough you can see it here too.

People have asked me, “What exactly can you do for autism? Is it really treatable?” The answer is a resounding, “Yes!” With autism spectrum disorders comes a host of documented changes in the way their central nervous systems and their metabolisms work. There are changes in the circuitry of their brains that, when assessed properly, can be improved through eye exercises, light and sound therapy, balance exercises, tactile exercises, PT, OT, speech therapy, primitive reflex remediation, and the list goes on and on. The list of exercises that can rewire the brain is endless. You are only limited by your imagination!

So, our job was to determine what exercises would be most beneficial for each patient.  I did this by putting each child through a comprehensive neurologic exam looking at eye movements, primitive reflex testing, balance tests, etc. This allowed me to pinpoint which areas of the brain are struggling and recommend the correct therapy. Each parent was given a list of 3-5 exercises to begin to work on with their child. It is very common for children on the spectrum to skip developmental milestones as they grow. Commonly, they do not crawl or they crawl for only a very short period of time. We saw this in about 80% of the children we attended. Therefore, one of the main exercises we recommended was to properly establish a cross crawl pattern of gait in each child. This is done by having the child alternate touching their opposite knee to their elbow. They do this for 2 minutes, twice per day, and it abolishes the homolateral crawl pattern their brain is stuck in. Remediating primitive reflexes like this helps the brain organize itself in a way that is more efficient and allows for better brain function.

Metabolically, children with ASD are known to have changes in gastrointestinal function characterized by bacterial and/or yeast and fungal overgrowth, changes in the efficiency with which they produce energy, or changes in the efficiency with which they detoxify environmental and endogenous toxins. As some of the children had stool and metabolic testing prior to our arrival, we were able to see this firsthand. One thing that struck me was the large use of antibiotics. Most of the children had 2-3 courses per year from the time they were born through the age of 3 or 4. Knowing the effects of the gut on the brain, this was especially concerning to me. The testing confirmed my concerns and revealed massive bacterial and yeast overgrowth. Metabolic testing confirmed many of the children had a reduced capacity to produce energy and detoxification pathway weakness. For the children who were unable to get the testing done, my clinical experience combined with the knowledge of the research guided my therapeutic recommendations. The recommendations for this are generally in the form of supplements. Most, if not all of the parents had contacts in the US or the UK to send them the supplements we were recommending. While we were there I met a pharmacist who wanted to set up a local pharmacy to sell the supplements we were recommending. This is an exciting prospect and I hope we can set that up.

Dietary changes were also recommended. The diet was shifted to a very low fermentable diet in order to reduce microbial overgrowth in the GI tract. This was a difficult shift for them to undertake. Much of the Ghanaian diet is high in starch, which means it is also generally quite fermentable. Shifting away from this caused a bit of anxiety for the parents, but they were willing to make the shift if it meant an improvement for their child.

All of the parents have access to me via email and we’ve seen a pretty steady stream of questions coming in since we returned. Additionally, we can connect via phone or Skype in the future if need be.

The experience was a good one. I think we learned as much from them as they did from us. I hope to continue our relationship with AAG in whatever form that takes. Until we have the chance to return, we’ll continue to monitor these wonderful children from afar and make the necessary adjustments to help them reach their maximum potential.

Fat, sugar cause bacterial changes that may relate to loss of cognitive function

A study at Oregon State University indicates that both a high-fat and a high-sugar diet, compared to a normal diet, cause changes in gut bacteria that appear related to a significant loss of “cognitive flexibility,” or the power to adapt and adjust to changing situations. This effect was most serious on the high-sugar diet, which also showed an impairment of early learning for both long-term and short-term memory. The findings are consistent with some other studies about the impact of fat and sugar on cognitive function and behavior, and suggest that some of these problems may be linked to alteration of the microbiome — a complex mixture in the digestive system of about 100 trillion microorganisms. The research was done with laboratory mice that consumed different diets and then faced a variety of tests, such as water maze testing, to monitor changes in their mental and physical function, and associated impacts on various types of bacteria. The findings were published in the journal Neuroscience, in work supported by the Microbiology Foundation and the National Science Foundation. “It’s increasingly clear that our gut bacteria, or microbiota, can communicate with the human brain,” said Kathy Magnusson, a professor in the OSU College of Veterinary Medicine and principal investigator with the Linus Pauling Institute. “Bacteria can release compounds that act as neurotransmitters, stimulate sensory nerves or the immune system, and affect a wide range of biological functions,” she said. “We’re not sure just what messages are being sent, but we are tracking down the pathways and the effects.” Mice have proven to be a particularly good model for studies relevant to humans, Magnusson said, on such topics as aging, spatial memory, obesity and other issues. In this research, after just four weeks on a high-fat or a high-sugar diet, the performance of mice on various tests of mental and physical function began to drop, compared to animals on a normal diet. One of the most pronounced changes was in what researchers call cognitive flexibility. “The impairment of cognitive flexibility in this study was pretty strong,” Magnusson said. “Think about driving home on a route that’s very familiar to you, something you’re used to doing. Then one day that road is closed and you suddenly have to find a new way home.” A person with high levels of cognitive flexibility would immediately adapt to the change, determine the next best route home, and remember to use the same route the following morning, all with little problem. With impaired flexibility, it might be a long, slow, and stressful way home. This study was done with young animals, Magnusson said, which ordinarily would have a healthier biological system that’s better able to resist pathological influences from their microbiota. The findings might be even more pronounced with older animals or humans with compromised intestinal systems, she said. What’s often referred to as the “Western diet,” or foods that are high in fat, sugars and simple carbohydrates, has been linked to a range of chronic illnesses in the United States, including the obesity epidemic and an increased incidence of Alzheimer’s disease. “We’ve known for a while that too much fat and sugar are not good for you,” Magnusson said. “This work suggests that fat and sugar are altering your healthy bacterial systems, and that’s one of the reasons those foods aren’t good for you. It’s not just the food that could be influencing your brain, but an interaction between the food and microbial changes.”

Source: Fat, sugar cause bacterial changes that may relate to loss of cognitive function — ScienceDaily

 

 

3 Things That Happen To Your Brain With Leaky Gut

Gut health is essential for overall health. That connection is fairly easy to make. But what about your brain? Can the health of your gut really affect your brain? The answer is a resounding yes! Here are three things that happen to your brain when you have a leaky gut.

1. Depression – the bacteria that naturally exist in our GI tract are mostly beneficial. However, if metabolic byproducts and cell constituents are able to escape the gut they cause a potent inflammatory response. This happens through a “leaky gut.” The resulting response alters levels of inflammatory hormones called cytokines. These cytokines have the ability to communicate with the brain and eventually change neurotransmitter levels. This change in neurotransmission actually begins to rewire the brain leading the changes in how we think and feel. Most often, people begin to feel depressed. 
2. An Inflamed Brain – through the mechanisms just mentioned, not only do your neurotransmitters and thoughts/feelings change, your brain becomes inflamed. This signals the immune cells within the brain, called glial cells, to become very active. This may sound like a good thing, but it’s not. As a result of being activated glial cellsgenerate more inflammation and create oxidative stress. This means the glial cells begin breaking down the brain. This may increase your risk of brain fog, fatigue, depression, anxiety, cognitive decline, and possibly even neurodegenerative disorders like Parkinson’s disease and Alzheimer’s disease.
3. Blood Brain Barrier Breakdown – there is a barrier than exists that separates what is circulating in our blood from our brain. Only things that are beneficial for the brain are supposed to have access to it. The blood brain barrier is an exceptionally important structure. With increased inflammation from a leaky gut and glial activation, the blood brain barrier breaks down. Now toxic byproducts, inflammatory hormones, and other noxious chemicals have free access to the brain. This is a disastrous consequence that interferes with brain function leading to a multitude of symptoms which include depression, brain fog, anxiety, and more. Leaky gut leads to a leaky blood brain barrier!

Gastrointestinal health is essential for brain health. Knowing how to fix the gut can lead to dramatic improvements in how you feel cognitively and emotionally.

For much more information and strategies to improve your gut and brain health join me for a FREE webinar on Tuesday, November 10th at 7:30PM called “The Gut-Brain Connection – Mood, Food, and More!” We’ll explore the amazing connection between gut health and brain health and give you tips and tricks to make both healthy.

Dr. Vreeland is a nationally recognized expert and author in functional medicine and will present information that will be life changing! You don’t want to miss this event!

Click here to register: http://www.anymeeting.com/PIID=EC51D98085463A

4 Unconventional Things You Didn’t Know Were Making You Fat

The human body is a strange and wondrous place. There are many reasons why a person might gain weight. Eating the wrong kind of food, the wrong amount of food, or not enough exercise are well established reasons. However, there are some no-so-common reasons that might play a role as well.

Road Traffic Noise

Exposure to a combination of road traffic, rail, and aircraft noise may pose the greatest risk of acquiring a spare tire — otherwise known as central obesity, and thought to be one of the most harmful types of fat deposition around the body. In a recent study researchers assessed how much road traffic, rail, and aircraft noise 5075 people living in five suburban and rural areas around Stockholm, Sweden, had been exposed to since 1999. The analysis indicated no link between road traffic noise and BMI. But there was an association between road traffic noise and waist size, with a 0.21 cm increase for every additional 5 dB increase in exposure, although this was only significant among women. Similarly, there was a link to waist:hip ratio, with a change of 0.16 for every 5 dB increase in noise exposure to road traffic; this association was stronger in men.

What gives? Noise exposure may be an important physiological stressor and bump up the production of the hormone cortisol, high levels of which are thought to have a role in fat deposition around the middle of the body, researchers suggest. Additionally, noise exposure might disrupt sleep, another known factor to contribute to weight gain.

Too Many Food Choices

A new study in mice by researchers in the Virginia Tech College of Agriculture and Life Sciences and the Edward Via College of Osteopathic Medicine has shown that the environment in which a child lives may be an equal if not stronger force in determining obesity than their mother’s diet. Researchers found that having too many food choices increases the obesity problem. In fact, researchers found that having a choice of a high-fat and low-fat diet does not help — offspring in this situation tended to eat even more. Their findings were recently released in the journal Endocrinology. “We like variety,” said Deborah Good, an author of the paper and an associate professor of human nutrition, foods, and exercise at Virginia Tech. “But when there is a choice, we eat more than when there is not any variety.” Moral of the story? Simple is better for our waistlines.

The Inability To Stay Warm

A new study suggests that a biological inability to create sufficient core body heat could be linked to the obesity epidemic. The study found that obesity is associated with a significant reduction of body core temperature during daytime hours. Journal Editor Francesco Portaluppi explains that the reduced ability of obese people to spend energy as heat compared to lean individuals could result in long term weight gain (about 2 kg (4.5 lb.)) per year, depending on the lifestyle. “Since body core temperature represents a marker of energy expenditure, results from this study suggest that a diurnal thermogenic handicap can play a crucial role in favoring weight gain in obese subjects,” said article co-author Pietro Cortelli, MD, Ph.D. The fix? Generate more body heat. And how does one do that? Exercise of course!

Environmental Pollution

A team of Spanish scientists, which includes several researchers from the University of Granada, has confirmed that there is a relation between the levels of certain environmental pollutants that a person accumulates in his or her body and their level of obesity. Subjects with more pollutants in their bodies tend to have higher levels of cholesterol and triglycerides, which are important risk factors for cardiovascular disease. The research has analyzed the levels of pollutants accumulated in adipose tissue (fat) in nearly 300 men and women, who were attended in the surgery services of two hospitals in the province of Granada (Spain). The substances analyzed, known as persistent organic pollutants (POPs), can remain in the environment for years, even decades, without degrading.

“Humans are exposed to POPs mainly through diet. Besides, POPs accumulate gradually in body fat, and this is the reason why the median levels in our study give us an idea of an individual’s accumulated exposition over a number of years,” says Juan Pedro Arrebola, the main author of the article. There is evidence that human exposure to certain chemical substances called “obesogenic” could favor the growth and proliferation of adipocytes (fat cells), and provoke therefore an increase in body fat.

Do your best to avoid exposing yourself unnecessarily to chemicals that might be problematic. Perhaps the most powerful way to do this is avoid processed food which is loaded with these chemicals from their own packaging.

How to develop healthy eating habits in a child: Start early and eat your vegetables

A healthy diet promotes success in life — better concentration and alertness, better physical health that translates into good mental and emotional health.

But even the best intentioned parents can expect food fights with their children, said Tanda Kidd, associate professor of human nutrition and extension specialist at Kansas State University. Developing good eating habits in your children is worth the effort, she said.

Good eating habits also are a front-line defense against obesity, a scourge of the nation that happens when a child eats many more calories than he or she uses up.

Nearly 1 in 4 children ages 2 to 5 is overweight or obese, said Paula Peters. An obese child is at risk for developing diabetes, high blood pressure, asthma and sleep apnea. Peters is an associate professor of human nutrition and assistant extension director for family and consumer sciences at Kansas State University.

“No parent wants her child to be sick. No parent wants her child to feel like an outsider in social situations, or be teased or bullied because of her weight,” Kidd said.

Peters and Kidd both conduct research in the area of childhood obesity prevention.

A primary key to teaching a child to make healthy food choices, Peters said, is to start early.

“Give the child a wide variety of healthy food options and let her choose which and how much to eat. A child may start by eating nothing or eating too much, but she has an innate ability to know when she’s hungry and when she’s full.”

A child learns about new foods at a time when she is exploring the world around her. And she learns to make decisions for herself.

Make the selection nutrient dense — not calorie dense. That means fruits and vegetables, not cookies for snacks. A glass of soda and a glass of 100 percent juice may have the same number of calories, but a juice is a healthier choice because it does not contain added sugars, said Kidd, a registered dietitian.

Soda and other sugar-sweetened drinks have empty calories, meaning they are “empty” of nutritional value.

According to the Centers for Disease Control, empty calories from foods high in added sugars, such as ice cream, cookies, candy, fruit drinks and some breakfast cereals and solid fats such as donuts, pastries, hot dogs, sausages, bacon and regular ground beef, contribute to 40 percent of daily calories for children and adolescents ages 2 to 18 years.

Kidd and Peters offer other suggestions:

• Do not use food as a reward for good behavior or other achievements. Kidd suggested other awards like reading a book together or playing a child’s favorite game.

• Eat your veggies, Dad. A child learns food habits — what to eat, how much to eat, when to eat, where to eat — from parents.

• Eat with your children so they can see you making good food choices.

• Be aware of what a child is eating away from home. Peters said that more than 25 percent of children ages 2 to 4 are in day care 20 to 40 hours a week. Check out meals and snacks offered to your child.

• Limit screen time — television — that encourages “mindless” eating.

• Avoid putting a child on a diet, even if he or she is slightly overweight. “That sets up the child for issues such as eating disorders later in life,” Kidd said. Instead, offer healthier food options and increase physical activity.

Kidd and Peters also encourage parents to teach their children about healthy food choices in other ways:

• Planning and taking a trip to the grocery store gives a child ownership in food choices. Reading labels and comparing costs offer other lessons.

• Plant a garden. Peters said a child is more likely to eat vegetables he or she helped grow and harvest.

• Cook together. During special time with Mom or Dad in the kitchen the child will learn more than cooking skills.

Kidd and Peters are concerned about both food deserts and food swamps. The former defines area where fresh foods are hard to get, perhaps because grocery stores are far from the family home.

Food swamps describes areas that are so crowded with fast food options that making healthy eating choices is more challenging.

They also stress the vital role that physical activity plays in childhood health. Although there is no specific recommendation for kids ages 2-5 years old, parents should offer opportunities several times a day for active play. However, kids 6 and over are encouraged to be physically active at least 60 minutes each day, Kidd said.

“Parenting styles and family characteristics affect what a child eats, of course,” Peters said. “So do community, demographic and societal characteristics such as school physical education programs, access to recreational facilities, school lunch programs and neighborhood safety.

“Weight gain is an indicator of an unhealthy society,” she said. “We have to focus on ways to be healthier.”

Week of the Young Children, sponsored by the National Association for the Education of Young Children April 12-18, focuses on the foundation for a child’s success in school and later life.

via How to develop healthy eating habits in a child: Start early and eat your vegetables — ScienceDaily.

Dr. Court’s Comments:

I agree with everything written above with one exception. I do not believe fruit juice should be a regular part of a child’s diet. On occasion, it’s fine. However, the vast majority of time, water should be the choice. Parents often are concerned that their children are somehow “missing” something if they aren’t given juice or sweet snacks. They are missing something; they’re missing the opportunity for cavities. They’re missing the increased risk of being overweight or obese. They’re missing out on poorer brain function. They’re missing out on learning healthy habits.

In all seriousness though, parents are legitimately concerned about depriving their children of delicious treats. However, this is purely the parents’ perspective, not the child’s. If the parent believes they would miss those treats themselves (most likely because of their own upbringing and food choices), of course they’re going to believe their children would miss them too. Here’s the caveat though. Children only know what you teach them. They won’t miss out on anything if they’re taught to love the healthy food. They’ll feel just as fulfilled and loved with the good food as they would feel with the unhealthy food.

This is not to suggest treats should never be given. They must, however, be just that – treats. Making a regular habit of bad food choices sets up a child for a lifetime of health issues.