Friday, August 27, 2010

Vacation: Rejuvenation Station

In my work as a hormone guide, I find the adrenals are the hardest to nurture and tonify. Our lives are so hectic, particularly in the Bay Area. But nothing nurtures and tonifies as much as a fabulous vacation.

In Ayurveda, they say that illness develops when you move to fast, when your body cannot catch up with your Being. This happens with trips that require airplanes or long car-rides. Solution? Bolinas!

I'm blessed to own my integrative medicine practice and to set up at the outset that I will be unavailable (the doctor is "out") for the month of August and for a month mid-December to mid-January. My adrenals demand it. It allows me to connect to my true Self, to reconnect to what is important, and to develop new ideas about to help you even more deeply and efficiently.

Here are some highlights of what was particularly helpful and healing on my August vacation.

First, one word: Bolinas. Ah, I just love to say it: Bolinas, Bolinas, Bolinas. We stayed in the house above for three days. It was so deeply relaxing, it felt like three weeks. Why? Soulful space.

We, as a family, did yoga daily, meditated, ate amazing local food from the Bolinas' People's Co-op, drank tea, had Big Thoughts, Big Conversations, Lingering Dialogues.

And then there was the Japanese soaking tub. OMG. Fantastic. I'm sitting there, chillin', or perhaps more accurately, sweatin', and in hops a little frog.

Hello, Sweet Frog. He hopped away before I could kiss him.

Darling Husband, David Gottfried, loved Bolinas because we were off the grid. He loves that in a vacation destination.

I just love getting re-energized about my path. Spent the month thinking about how aligned I am with my dharma or purpose. How can I make adrenal buoyancy more a daily part of my life for both me and my patients. Ideas? I'm reviewing Ayurveda and the wisdom it offers to us householders and forest dwellers. Stay tuned! Vacation ends Monday, August 30.

Thursday, August 5, 2010

Input > Output

A funny thing happened on the way to my massage therapist: I met a mystic and received a transformative massage. Stan Barrett is a brilliant healer and the wisdom he shared during my time on the table was nothing short of miraculous.

I arrive this morning a few minutes late, jogging the last few blocks on Piedmont Ave to limit the damage to our first impression. I'm out of breath, sweaty and my monkey mind is at full throttle.

Stan is calmly seated in the waiting room. I take a deep breath. I'm so not zen. He is. He's got lovely energy. He shakes my hand, introduces himself and genuinely reassures me with "no worries" on my late arrival.

I'm liking things so far. I'm a week into my supposed August vacation, and I'm failing miserably at the vacation aspect. I'm checking email too much. I'm texting my assistant obsessively. I'm guzzling oolong tea. You could argue that I'm overexercising. I'm freshly back from a trip to Point Reyes that was supposed to be two weeks on the Inverness Ridge, but our rental was on a highway and peaceful it was not. I'm nuts. I'm acutely aware that I'm obstructing the expansion of my consciousness with busyness and overinvolvement with work. My output is unsustainable. I've been looking forward to this vacation all year and I'm hopelessly squandering the opportunity.

I also know a therapeutic opportunity and a fellow seeker when I see one. This man is the Real Deal.

I ask: "How do you find balance?" Stan's response was exactly what I needed to hear, especially since I'm mildly burned out and struggling significantly to get into my August-vacation-state-of-mind.

"Low output!" says Stan. He is vigilant about how he books sessions, sees only three to four 90-minute clients per day, four times per week, and takes a 30-minute break in between so he can clear the space and not rush, uses a great online scheduling system that keeps no-shows to a minimum.
I rush from one patient to the next and often lack the time to pee in between. Not Stan:  "I schedule 30 minutes at the end of each massage session, which gives you time to collect yourself unrushed, for us to chat and bring closure to the intimate connection, and for you to have my time and attention exclusively without the baton being passed to my next client with you standing right there in lane 5.  That simple step allows me to remain more grounded throughout the day.  It looks different for each of us."

How sane is that? I left Kaiser four years ago but I still stack up the patients like Mother Kaiser is my employer. Hello? I'm self-employed. Like Stan, I run the schedule and set the flow but I'm running the schedule as if I were drill sargent and not a sentient being.

He claims Tuesday mornings for fun mountain bike rides: "I often go alone, but I have a couple friends who join me every so often.  I find it's important to carve out time for things that feed my soul and make me scream Yahooooo!  I first had to figure out what that was, and I'm still working on it."
Process work: therapy, mending his connection with his father. It's usually either your mom or your dad that's bringing you down, depleting your energy, limiting your output, he tells me. Time to get conscious, People.
He adds: "I'm a fan of psychotherapy, but currently not sitting/talking with anyone.  I've been in the clear for a few years now and in a 'productive' stage.  Meaning the barriers that held me back regarding family are no longer in my path.  It's nice to have a light heart and strong arms from having put down all that baggage.  Also, I find the more I'm enmeshed with my partner and my clients, the less I'm able to be present for myself and for the moment.  Maintaining the space where I end and you begin is a learned skill, I find."

Light heart and strong arms from putting down the baggage? Sign me up!
Then there's Stan's self-care or INPUT: 7+ hours of sleep regularly. Pilates weekly one-on-one with a woman who works out of her home. Chiro semi-weekly, alternated semi-weekly with massage. He expounds on this input thing: "It helps create the foundation on which to build other things.  I know myself well enough that my first appt. is never before 11am.  Many people look forward to evening massages post-work, so a full day takes me until 8pm.  I always take an hour for lunch. For brain chemistry, it's fish oil, B and C."
Stan contrasts his measured output with that of his much-revered Pilates instructor who is, in his words, "Agro." I request a translation. "She's got more on her plate than anyone I know."

OMG, I think I'm agro.

"My incredible Pilates instructor has big output." Stan continues. "She's got 3 kids and her belief is that more fun fills the cup. You know? Fun with the kids: trapeze arts - things like that."
I want to channel Pilates Mom and Stan. But can I do both?
I ask for more details about Pilates Mom Who Has Fun With Her Kids. I have fun with my kids sometimes, maybe 20%, but a lot of the time I’m nagging them to get dressed, eat their broccoli, brush their teeth and floss, do their homework, get their tushies out the door because we're late again, buckle their seat belts, or I'm bribing them.
He continues, "She's is an advocate of the fun factor.  No matter what commitments we have on our plate (and she has the most of anyone I know), so long as we fill our cup with hilarious fun no matter the flavor, our energy will go further.  She loves looking at hats and Adidas shoes for example.  Sometimes she buys them, most often she just tries them on and smiles, gives them back to the salesperson and goes home.  Sometimes she and her youngest kid go to Sports Authority and play with all the toys in there.  Again, not necessarily buying anything.  And her girl time is essential.  Once a week she leaves the man and kids at home for a night in the city with her CRAZY girlfriends.  A little tequila... you're a doctor, you know these things.”
I ask his permission to blog about him.

"What is a blog really? An online journal?" he asks.

Clearly, low connectivity is another crucial part of managing output that I've failed to master, but meanwhile he agrees to let me blog about him.
I ask if he'll hand me my iPhone so I can record his genius commentary, because I'm 43 and my memory is more shot than my adrenals.

"Dude, you'll remember what you need," he replies.
He refuses to hand me the iPhone. He adds: "Besides, I won't look at it, so it doesn't matter whether you get the quotes right."
"I find it's best to offer up my own experience and let people ask questions of themselves.  But here's a loving nudge for you... what does your self-care and input look like? Feel like?  Would carving out some you time, time with your girlfriends over a beer, or whatever it takes to help push the reset button - would that do the trick?  Regular date night with your man?  Make a list of all the crazy ideas you wish you could do and work towards one of them.  Running is the you time?  Workshops - giving back and connecting with your community in a leader role - awesome.  You know all this stuff, Woman!"
"I usually talk with my hands, so you threw me a good curve, got me gabbing, and wanted to record it!  So funny!  Enjoy yourself."

Wow. I got a massage from an enlightened being. I feel transcendent; the massage was phenomenal. He's a gifted, intuitive and strong body worker. I give him my highest endorsement. For those of you women who won't go to guy for a massage, you're missing out on something special. Stan is a powerful hybrid of sacred masculine and feminine, and he's got the energy flow of input and output down like nobody's business. Thank you, Stan!

Stan Barrett
Massage Therapist
4315 Piedmont Avenue
Suite # 203
Oakland, California 94611

Wednesday, August 4, 2010

How to Raise Your Good Cholesterol

If your doctor is still ordering the standard cholesterol test of total, LDL, HDL and triglycerides, you are in the dark ages. See, the problem is that 75% of the folks who have a heart attach have a normal LDL and HDL. Get your doc to order the most current tests: a VAP cholesterol or a Berkeley Heart Lab test so that you can check your subfractions; that is, check your good vs bad subfractions of LDL and good vs bad subfractions of HDL. And in women in particular, your Lipo(a) is crucial to know. We also like to measure the level of inflammation with both the cardio (or high-sensitivity) c-reactive protein (hscRP) and homocysteine.

Seventeen years ago I did a fellowship with the American Heart Association while at Harvard Medical School. To this day, one of my favorite aspects of preventive medicine, or as I call it aggressive preventive medicine, is to help my patients understand the importance of their markers of heart disease, particularly since this remains the most common cause of death among men and women. After menopause, women catch up to men by age 60 in terms of their risk of heart disease.

Cardiology has advanced hugely in the past 30 years, mostly because heart disease is the leading killer of productive white corporate men. Lots of research dollars = lots of research achievement and progress.

For women, it's all about the triglycerides (I recommend TRG < 100) and HDL > 50 (your "good cholesterol."

Here's the short version....

These lipid subfractions are all good: HDL2, HDL1, LDL2, LDL1, Large-HDL, Large-LDL

These lipid subfractions are all bad: sdLDL (small dense LDL), HDL3, Small-HDL, LDL3, Small-LDL
What lowers HDL2?
  • American Heart Association Low-Fat/Step 2 Diet - makes your particles dense
  • Lack of lean muscle tissue
  • High insulin (fasting insulin > 6)
  • Lack of exercise or overtraining 
  • Belly fat
  • Adrenal dysregulation
  • Too many carbs
  • Sugar, processed foods
  • Inadequate fish oil (omega 3s)
  • Smoking
  • Too much alcohol (Per day: 2-3 or more drinks for men; 2 or more for women)
What raises HDL2?
  • Paleo Diet
  • Estrogen
  • Andogens (taking DHEA, testosterone)
  • Niacin (see below)  
  • Vitamin D (Note that you need a higher dose if you have a problem with your vitamin D receptor)
  • Intermittent fasting  
  • Generation of ketone bodies (low carb, mod-high prot/fat)  
  • Exercise (avoid excessive endurance training)  
  • Strength/resistance training  
  • Reduction in belly/visceral fat  
  • Reduction in insulin (eliminating wheat, reducing carbs)  
  • Tobacco cessation  
  • Elimination/moderation of alcohol 
  • Eating protein, esp Leucine, Taurine, etc 
  • Carotenoids (astaxanthin, krill oil, seafood, grassfed meat, etc)  
  • Fish oil/EPA+DHA: supplemention, grassfed meat/dairy; fatty fish, mackerel, tuna, herring, hamachi, trout, cod liver oil, mollusks, krill, crustaceans, etc  
  • If high inflammatory state: Ultra high dose 8-10 g/day EPA DHA fish oil for 6-18mos (Goal: fatty acid profile test, omega-6 to omega-3 ratio = 1.5)]  
  • ALA, monounsat fats: flaxseed oil, olive oil, nuts/seeds, etc  
  • Plant sterols, grass-fed ghee  
  • Eating some saturated fats (not TRANSFATS which are toxic to HDL2)  
  • Eating some CHOLESTEROL (via omega-3 eggs, seafood, grassfed meat/dairy, etc)
Niacin & HDL2
Niacin raises HDL2 by 200-300% in 18-36 months.

Fish Oil Studies in Greater Detail
  • Take 4.5 g/d x 6wks EPA + DHA resulted inHDL2 increase of 74% with a concomitant 19% decrease of HDL3-C (Metabolism, 1991).

Tuesday, August 3, 2010

Toxins Muckin' with My Thyroid

A kind gesture from my dentist today - she graciously offers plastic bottles of water in her waiting room - turns out to be a disaster for your thyroid. My daughter eagerly grabbed a bottle and started drinking. I love my dentist, but those bottle contain bis-phenol A (BPA) and they slow down our thyroid receptors. My TSH may not reveal the injury, but my weight does, as does my sluggish morning energy.

You’ve heard the dire news on environmental pollution. I used to pitch it into the file of “things I can’t worry about right now,” but then I realized that I too was affected. Turns out my lazy thyroid was rooted in mercury toxicity and too much BPA. What I thought 5 years ago was a healthy lunch once/week of brown rice/tuna sushi rolls from Whole Foods was slowly poisoning my system as mercury mounted and shut down my thyroid hormone production. My hair fell out, I gained weight despite an aggressive exercise campaign and I was tired most of the time.
Second-hand smoke has also been shown to impair your thyroid, particularly in younger kids and infants.
If your bod can’t keep up with the steady diet of toxins that we encounter, your liver metabolism takes a hit. Leptin rises. You become cranky, irritable and tired. You develop dark circles under your eyes. The main organ tasked with detoxification is your liver, and toxic backlog is a common diagnosis in my integrative medical practice. This is well-summarized by integrative nutritionist Byron Richards:
“It is like pouring sand into the gas tank of a car, It does not matter whether the car is old or new, when the engine gets clogged, it will not run correctly. The liver must be clear all such chemicals.”
There is a definite correlation between the severity of hypothyroid symptoms and toxic exposure. Being overweight is especially complex, because toxins are stored in fat. Toxic folks have tremendous difficulty losing weight, and here’s the worst part: when you manage to lose a few pounds of fat, you get re-exposed to the toxins stored in the fat you’re burning. So unfair!
What’s a thyroidista to do?
1.    Reduce exposure – you know that it’s best to drink from glass or stainless steel containers. Use them exclusively. Read Time Magazine’s recent review of what toxins do to your endocrine system and how to limit your risk. Recent data also shows that probiotics limit your absorption of BPA. Cracks in your metal dental fillings are another source of mercury – if you have metal amalgams, consider replacement with your dentist.
2.    Cleanse your liver – I recommend to my patients a 30-day cleanse every 6 months. Check out our website for more information.
3.    See if you have mercury toxicity – there are many tests available commercially. I recommend a provoked test with a chelator such as DMPS. Testing is available for $79-100. Contact my staff for more info and to order your test at 510.893.3907.
For more info, check out the NRDC's excellent article on BPA-free water containers.
 Reposted from

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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.