Friday, February 20, 2009

What Is Healing?

My family and I are spending "Ski Week" in Point Reyes, a vast coastal area of tremendous natural beauty, and for my husband and me, reconnection to what heals us.

But what is healing? I first thought about healing when I was a medical student and read Health and Healing by Andy Weil, MD, published in 1983. His sage observations include the idea that healing is an inside job - it's the body's attempt to restore equilibrium when equilibrium is lost. It doesn't come from external sources and cannot be prevented, although we all create obstructions to our expression of healing. He describes how we all have an innate capacity and birthright to heal, and while medicine and healers can either speed healing or remove obstructions to healing, they do not give you what you do not already have.

Andy also refers to a brilliant quote from a social club called the Aesculapian Club at Harvard Medical School: "We dress the wound, God heals it." That is, in medicine, even integrative medicine, we can facilitate healing -- remove obstacles, motivate the sick to get well, and perhaps pump up vitality in those disconnected to theirs. That is all we can expect to do.

My husband and I know healing when we see it: inspiring natural landscape, deep breaths of fresh air, dense quiet, long and deep conversation, tuning into each other and relationship, friendship, restorative sleep, quiet time, meditation, play, reading without goal, organic food, gratitude, Toby's Feed Barn; in short, simplifying our lives. We also know what does not heal us: endless email, and included with that - immediate access in all fronts (computer, text, cell phones, home phones, work phones), running our businesses and being overly driven by it, being too busy, driving everywhere, rushing, stress, anger, resentment, material consumption, acquisition, retirement planning. It makes us sick. It poisons us. It blocks our connection to True Self, or Higher Power, or Source Energy, or whatever you wish to call the power outside of yourself.

Seems worthwhile to insert here one more bit of wisdom from Dr. Andy -- his 10 principles of health and illness.

1. Perfect health is not attainable
2. It is all right to be sick
3. The body has innate healing abilities
4. Agents of disease are not causes of disease
5. All illness is psychosomatic
6. Subtle manifestations of illness precede gross ones
7. Every body is different
8. Every body has a weak point
9. Blood is a principle carrier of healing energy
10. Proper breathing is a key to good health

My husband and I were talking about healing the earth and the green movement. He listed the three strategies/behaviors for healing the earth:
1. Less bad behavior (e.g., use less water, use compact fluorescent light bulbs, recycle)
2. Net zero behavior (only use as much energy as you generate, use as much water as you captures from the rain or recycle gray water).
3. Restorative behavior
4. Regenerative behavior

I thought of how we can apply these strategies to health and healing, i.e., you can choose if you want to eat less bad food or have a less bad lifestyle, or you can go for optimal health by regenerating your gut with what you eat, regenerating your brain with your supplements, and regenerating energy so that you feel you have more than enough when you get up in the morning. What does a regenerative life look like in your context?

Wednesday, February 11, 2009

Male Menopause or "Irritable Male Syndrome"

If you read the article in last Monday’s San Francisco Chronicle about male menopause and “Irritable Male Syndrome,” you might have recognized your mate. Few men like to acknowledge that they, too, suffer from loss of hormones as they age.

What are the symptoms? Men become angrier and grumpy; they feel less like themselves.
Depression, weight gain and loss of muscle despite a good workout program, feelings of restlessness, difficulty sleeping, a decline in libido, even erectile dysfunction are signs of lower levels of testosterone. Untreated hormonal decline in men may lead heart disease, diabetes, or other age-related diseases.

The Good News?

Male menopause, more commonly called andropause, can easily be corrected. The key is balancing hormones to restore quality of life, vitality, and energy.

Dr. Derek Abbassi, an expert in bioidentical hormone replacement and optimal aging, is our new specialist at Gottfried Center. His focus is the prevention of age-related decline.

“There are diseases related to aging, and there is healthy aging,” Derek says. “Aging doesn’t mean a man has to expect physical, sexual, and mental decline or a life of taking numerous drugs. An integrative medical approach makes it possible for a man to regain vibrant personal and sexual health.

“Bioidentical hormone replacement therapy (BHRT) is core to aiding men as well as women with optimal aging. The natural balance of all the body’s major hormones— the adrenal, thyroid and pancreatic as well as the sex hormones—is critical to maintaining health. A prescription is based on an individualized study of each person’s unique biochemistry as well as their lifestyle and medical history. The results are dramatic and satisfying.”

Dr. Derek Abbassi attended medical school at school at The Ohio State University College of Medicine and completed his residency in OBGYN at the University of Southern California. He has received additional training in Age Management and Anti-Aging Medicine through the Cenegenics Institute and the American Academy of Anti-Aging Medicine. For more information, go to the Gottfried Center online to read about Dr. Derek and the other doctors, including Drs. Marsha Nunley, MD, Sara Gottfried, MD and Charlotte Massey, ND, all of whom are specialists in bioidentical hormone therapy. Both Drs. Nunley and Abbassi specialize in male menopause or andropause.

We welcome your call to Gottfried Center for Integrative Medicine at 510.893.3907. Let Dr.Derek become your age management health practitioner and create a partnership that lasts for your long and healthy lifetime.

Stress, Neurotransmitters, Hormones & YOU!

Are you less stress resilient than you used to be? More overwhelmed by your demands? Irritable and burned out?

The four of us, Drs. Abbassi, Nunley, Massey and me, have been discussing this a lot as we have seen many patients recently who have been under chronic stress for a long, long time. They have sleep problems, brain fog, and do not wake up restored in the morning.

We have many patients who recall life in their 20s: able to focus, concentrate, stay on task, cope with the exigencies of daily life. They rested and relaxed when they could, and enjoyed their time off. Now the weekend is not enough: relationships are more conflictual, home life is not the respite it used to be, achievement doesn't come as easily, which only adds to the stress.

Here are some of the results of chronic stress:

  • Insomnia
  • Autism
  • Poor mood, mood swings
  • Anxiousness, irritability, agitation, tension, panic attacks
  • Difficulty concentrating, focusing or remembering
  • Headaches
  • Fatigue, lack of energy
  • Weight issues, especially food cravings

Often these symptoms are a result of the body's difficulty responding to chronic stress. The adrenals and brain just can't keep up with the demand. The supply of feel-good neurotransmitters and hormones are limited by diet, genetics and often exposure to toxins.

One helpful approach we've found is to take the following approach:
1. Replace the hormones that are depleted or out of balance, all with bioidentical hormones, all tailored to you and your particular physiology and integrated with your risk factors and genetic disposition. This includes estrogen, progesterone, DHEA, testosterone, cortisol, and thyroid. We often use supplements and nutrition to optimize results.
2. Measure neurotransmitters and develop a customized amino acid protocol based on your results.
3. Make lifestyle and nutritional adjustments, along with refinement of bioidentical hormones and amino acids as needed in the long-term.

We've found this is the best approach for reversing the impact of chronic stress. The result? Vitality. Joy. Love. Less conflict. Connectedness to True Self. Satisfaction. Contentment.

Monday, February 9, 2009

Maca Improves Anxiety, Depression & Lagging Libido

A new study just published in Menopause showed that in a small group of post-menopausal women, a botanical named Maca, also known as Peruvian Ginseng, improved many of the issues our patients at the Gottfried Center complain of, namely anxiety, depression and low libido. Maca was also shown not to affect estrogen or androgen levels. The study was a randomized, controlled clinical trial, the "gold standard" in terms of high quality evidence.

Maca is thought to influence monoamine oxidase levels, one of the targets of prescription anti-depressants. However, as we all know, prescription antidepressants lower libido, whereas maca seems to improve it.

The improvement in libido I think may also be related to effects on the adrenals. This study confirms a previous study showing improved libido in both men and rodents with maca.

We treat both men and women now with symptoms of andropause and menopause, often with bioidentical hormones. In some, it may be more prudent to try proven botanicals first, such as maca.

Sunday, February 8, 2009

Food Addiction = Disease: Stages & Consequences

I'm going to draw heavily again from Kay Sheppard's book on food addiction along with my professional and personal experience to lay out for you the stages and consequences of the disease of food addiction. It's when we look at food addiction as a bad habit that needs to be changed by sheer force of will that we get into trouble - we fail inevitably and then the roller coaster of despair, anxiety, depression, mood swings and self-loathing begins.

The conventional medical world has been slow to see the connection between food addiction and obesity, or food addiction and anorexia and/or bulemia. The link is obvious to me, although the classic criteria of food addiction have not made it into the conventional bible of such problems: Our Diagnostic and Statistical Manual of Mental Disorders. However, if you look under "Bulemia," you'll find there is tremendous overlap with food addiction.

Kay Sheppard states that the path of food addiction is one of ups, downs and many side trips. I happened to own my food addiction relatively early in the process, mostly because I had the blessing to care for many women who were food addicts who recovered through an abstinent eating plan and 12-step. I had never seen people maintain a healthy weight as these women, and it intrigued me.

Kay talks about how young food addicts have more interest in food than their peers, who can often take it or leave it. She recommends a careful assessment of past behavior and attitudes as they relate to food to reveal addiction. Below is a list of symptoms taken directly from her book.

Stage I: Preoccupation with Food
Food addicts spend an "inordinate amount of time seeking, talking about, and involving" himself or herself with food. Movies = popcorn, Holidays = special food (e.g., my mom's yummy Yorkshire Pudding for Christmas, latkes for Hannukhah) ; "the food addict sees life in relationship to the next opportunity to eat."

Other facets of Stage I: Sneaking food and/or stealing food & money; discomfort in no-food situations; keeping secrets; concern about weight; self-loathing; and eating after others stop.

Stage II: Loss of Control and Attempts to Control
Kay describes this next phase as loss of control over the amount of food consumed and over behavior. Life becomes unmanageable. This leads to many attempted diets: Weight Watchers, Jenny Craig, Fat Flush, Nutrisystem, etc.

Other features? Self-deception; making excuses; lethargy, irritability and depression.

Stage III: Final Stages -- Efforts to Control Binging Fail Repeatedly.
This includes over-exercising, use of laxatives or diuretics, and cycles of failure may become more frequent.

Eventually there is a withdrawal phase of greater isolation and "numbing out" in food - with loss of interest in family, friends and other pursuits, work and family problems, emotional , physical, moral and mental deterioration, neglect of good nutrition, food is the main source of security, panic: obsession and compulsion take over, and then, in time, complete defeat.

Medical consequences of food addiction are legion: high blood pressure, pre-diabetes or diabetes (adrenal fatigue helps hasten this regardless of weight), high cholesterol and cardiovascular disease (our #1 killer in the US), and cancer. There are also lesser known conditions such as gallbladder disease, hepatic steatosis, lung impairment, hormonal imbalances (especially estrogen dominance and adrenal fatigue), obstetric complications, gout, joint dysfunction, etc.

The emotional and psychological effects may be even worse: bulemia, depression, anxiety, guilt, poor self-esteem, shame and self-contempt.

Fortunately, there is a solution. Kay's book is a great start along with joining a 12-step program such as Overeaters Anonymous or Food Addicts. If you are suffering and want to heal, call today or show up at a meeting.

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I'm an organic gynecologist, yoga teacher + writer. I earn a living partnering with women to get them vital and self-realized again. We're born that way, but often fall off the path. Let's take your lousy mood and fatigue, and transform it into something sacred and useful.