Injured? Stressed Out? Try Yin Yoga

While planting my organic dye garden today, I banged my little toe. Ouch. Probably not broken, but my first thought was, “What about my rockin’ yoga habit?”

What to do when injured? From healing injured shoulders to little toes, yin is the answer.

Practice Yin Yoga. Check it out.

Yin yoga developed in the Taoist lineage in Ancient China. It’s based on passively-held yoga asanas, usually seated, that work the trunk, hips and legs. You hold these poses for 5-10 minutes. And you will be amazed at how these asanas unblock your chi flow through the meridians of your body, which happen to run through the connective tissue of your body. Connective tissue is where the action is -- it's what is worked, nourished and hydrated by Yin Yoga, and it's where injuries are healed by the action of fibroblasts and your immune system.

Local Abundance: Sarah Powers. We’re blessed in the Bay Area with Sarah Powers, a leading yoga teacher who lives in Marin. She teaches a combination of yin and yang practices and finds that yin prepares the body optimally for more invigorating yang practices. Check here for an interview with Sarah on Yin Yoga, and here to see her schedule. Sarah is a busy mama yogini, and teaches all over the world. Go work with her at Esalen or Jakarta, or go local at her newly opened Insight Yoga Institute in Marin - click here for more info on the local offerings.

At Gottfried Center for Integrative Medicine, we offer Sarah's DVDs and audio CDs for sale as well as workshops on Yin Yoga for healing particular conditions and aging optimally. The CDs, DVDs and workshops will help you establish a home practice of Yin Yoga.

But I have no time! Sarah recently taught at her series in Deer Run that if you are short on time, sit in baddha konasana (see my photo by Angela Lang, above) with the bottom of the feet together, and bend forward over your feet. You should rest your forehead on a block (unlike the photo), a pillow, or make fists, stack your hands and lean your head on your fist tower. This works most of the meridians and helps your flow of chi.

Further north, in Ashland, Oregon lives another great contributor to the field, Paul Grilley. Here are his thoughts on Yin or Taoist Yoga:

Yin Yoga is not “yet another” brand name of Yoga postures, it is part of a larger conception of Yoga that can be called Taoist Yoga. The fundamental tenet of Taoism is that all things can be described by their mutually complementary Yin and Yang aspects. Yin and Yang can be used to describe all things we are capable of experiencing whether they are clouds, stars, forests, our thoughts or our bodies.

And here's a little more. Basic examples of Taoist analysis would be: There is always a front and a back to a coffee cup but we can never experience both at the same time. The exposed part of the cup is Yang, the concealed part is Yin but both are necessary to form the cup. Or consider the fact that inhaling and exhaling are opposite movements. Inhaling is Yang, exhaling is Yin but together they are the “Tao of Breathing.”

A Taoist analysis of Yoga practice emphasizes the critical difference between Yin and Yang tissues of the body. Muscles and blood are Yang, connective tissues and joints are Yin. Yin and Yang tissues do not respond to training in the same way and a student’s practice becomes more effective when the difference is understood.

Go on... Most forms of Yoga practiced today are Yang, they emphasize muscular movement and contraction. By contrast Yin Yoga targets the connective tissue of the hips, pelvis and lower spine. Yin postures are held three to five to ten minutes at a time. This type of practice complements the more muscular styles of Yoga and is a great aid for learning to sit in meditation.

Paul has several helpful DVDs, which are available on his website as well as sold at The Gottfried Center.

Try Yin, especially when injured. I especially recommend Yin for adrenal dysregulation. Your bones, joints, tendons, ligaments, fascia, and other "yin" elements of your body with thank you with abundant healing.

Yoga: Proven Benefits for Anxiety, Depression & Adrenal Dysregulation

If you practiced yoga daily, you wouldn’t need us doctors at the Gottfried Center to help you feel optimized. Yoga will change your life, for the good, but only if you commit deeply. You cannot proceed casually and expect transformation. Part of my job is to provide evidence to you – evidence that, in this case, yoga heals and transforms. What follows is the science supporting yoga for anxiety, depression and adrenal dysregulation, conditions that affect 100% of you. Please also keep in mind the wise words of BKS Iyengar:

“Words fail to convey the total value of yoga. It has to be experienced.”

Anxiety. There is 100% incidence of anxiety in our culture. There is a broad spectrum here from a little worry to the more debilitating problems such as obsessive thinking, insomnia, migraines, panic attacks, shortness of breath and palpitations. Excessive worry blocks healing. Simple tools such as deeper, belly breathing can help. Specifically, deep, slow breathing activates the Parasympathetic nervous system and releases the body’s own valium – GABA. Generally, we know that yoga increases our GABA levels. Other scientific evidence? Two studies show that yoga is as or more effective than tranquilizers such as Xanax or Ativan. In Germany, a group of 24 women with anxiety were randomized to two 90-minute yoga classes per week for 3 months or a waitlist. Significant reductions in both anxiety symptoms and salivary cortisol levels were found in the yoga group. Also interesting was that the women who reported headaches or back pain noted marked relief from pain.

Depression. Don’t co-opt the message from your conventional doctor that the answer to your sluggish mood and lack of joy can be found in a pill. Here’s the science: (1) A randomized trial from UCLA of 28 women with mild depression were treated with yoga twice/week compared to a control group placed on a waitlist. The yoga group had significant improvements in mood and anxiety, after only 2.5 weeks in class. (2) Another study of 80 people found that yoga for 3 to 6 months was as effective as a older treatment for depression – a tricyclic antidepressant (TCA), imiprimaine. Both yoga and the TCA raised serotonin and resolved symptoms, and while yoga took a little longer to have a significant effect, the effect lasted longer when patients stopped the therapies. Another randomized trial of Mindfulness-Based Stress Reduction showed it cut the recurrence rate for depression in half.

Adrenal dysregulation. If you have high cortisol levels, yoga has been shown to lower cortisol. High cortisol can cause depression, bone loss, poor memory and thick waistlines. Yoga activates the parasympathetic nervous system, which balances our chronically-activated sympathetic nervous system, or “fight or flight.”

Many of us look for a quick fix for depression, anxiety, fear, insecurity, stress, relationship problems, feeling numb, and emotional immaturity. Go with the long view: figure out what's not working for you and slowly manifest what would suit you better. Yoga helps you cultivate joy, peace, radical self-acceptance and vibrant health. It's proven.

Clearing Negative Beliefs

Just reading Shakti Gawain’s Reflections in the Light, and found this “Clearing” exercise to be very helpful for myriad issues: establishing a home yoga ractice, reigniting your spiritual path, cutting out sugar, getting a new job that aligns better with your values, etc.

This is quoted directly from Shakti’s book.

Here is a basic clearing process that you can use to clear out negative beliefs in order to attain a goal. First, state your goal in the form of an affirmation. Second, write “The reasons I can’t have what I want are:” and then start listing every thought that comes into your head. Third, decide which of the negative statements have the most power over you, and make a mark by those. Write an affirmation to counteract each one. Meditate on these affirmations every day along with your original goal.

I am now clearing my negative beliefs.

Click here for more info on Shakti’s inspirational and original work. We’re working on incorporating some of her processes into our next round of yoga and integrative medicine workshops. Sign up here for our newsletter for more info.

A+ Vacation: How to Recharge the Batteries

My husband and I just returned from Vancouver where we had four blessed days, sans kids. David was there to give his “New World of Green” speech – and if you don’t know the man, here’s his claim to fame: he’s done more than any individual to reverse climate change over the past 15 years through his visionary leadership and founding the world’s fastest-growing nonprofit, the USGBC, and the World GBC.

Here’s what we found in Vancouver: the best battery recharge ever. We arrived Friday to extraordinary weather, and a gorgeous hotel room overlooking the water and Stanley Park.

We dined Friday at Radha and ate scrumptious, lovingly prepared raw and cooked vegan food. Radha is a revolutionary spot that has manifested my long-held vision of combining yoga with extraordinary food and community. Add some integrative physicians and you have my vision.

I’ve noticed recently that vegan and raw food both deepen my meditation experience profoundly – I don’t fidget, I don’t get distracted, I stay on task.

Saturday, after researching every yoga teacher within a 10-mile radius, I settled on Christine Price Clark at YYoga in Yaletown. She is an Anusara teacher, and the class was for intermediate-advanced folk.

I walked into a densely filled, sweaty room tense with the anticipation of students devoted to their teacher. In walks guru Christine, singing “Business Time” by Flight of the Conchords. When I did my teacher training in 2002, we were taught to set carefully a healing container at the beginning of class, a vessel to hold the energy and emotion of our students during class. Christine claimed her container as loving, playful, irreverent and totally original.

Class was intense. She set an intention of us all getting connected to our Grand Vision. She told a story of her family member’s lukewarm enthusiasm for her own Grand Vision to step away from an unsatisfying job and into the flow of yoga teaching.

Class was outstanding. Intense, meaningful, the right mix of artful language and creative sequencing. I walked home to the hotel, inspired and connected to my Grand Vision – you know, the one about being a High Priestess of Energy and Libido, helping women connect to their inner priestess and deep well of vibrant energy and vitality. I found David finishing up the refinements to his speech, and we walked together in the sunshine to the Vancouver Art Gallery to learn about Emily Carr and be transported by her vivid charcoals of the British Columbia forests.

I won't give you all the details, but suffice it to say I went to every class Christine taught, bought some gold lame hot pants, and we arrived home yesterday flush with energy, love and vitality. The formula for this vacation worked.

Are Those Pearls on your Ovary?

Polycystic Ovarian Syndrome (PCOS) is a problem of hormonal imbalance that creates sputtering ovulation and hyperandrogenism (too much male hormones, which causes increased male-pattern hair growth and acne). Most important in the diagnosis is exclusion of other causes, as no single lab result leads to the diagnosis. Over 6-10% of women have PCOS.

Other findings include multiple cysts on the ovary (called the “string of pearls” sign on ultrasound - see image below), overweight or obesity, high blood pressure, and acanthosis nigrans – a weird skin finding of darker, velvety skin on the back of the neck.



While the cause is unknown, we mostly consider PCOS to be a metabolic problem. About half of women with PCOS have high insulin levels (or hyperinsulinemia). Lowering insulin levels with exercise, eating low-glycemic foods, and other measures can correct erratic ovulation. Some of the natural therapies that have been shown to be helpful in PCOS include bioidentical progesterone use and cinnamon. Tieraona Low Dog, MD, showed in a small study published in Fertility and Sterility in July 2007 that cinnamon (0.5 teaspoon per day) lowers insulin resistance in PCOS.

I want to emphasize the role of exercise – it’s essential in PCOS, no exceptions! I recommend 30 minutes per day, 4 to 5 days per week, of cardio exercise at a minimum as the primary treatment.

One of the findings of PCOS is estrogen dominance – too much estrogen versus progesterone. Reducing estrogen levels can be very effective and I suggest the following measures:

• Meat/Dairy: avoid conventionally raised meat and dairy products, which contain growth promoters that act as xenoestrogens - these stimulate estrogen receptors in the body and disrupt normal hormonal signaling. Omnivores should choose organic products.

• Cruciferous Veggies: increasing consumption of cruciferous vegetables, such as broccoli and brussel sprouts, which increase metabolism of estrogens.

• Gluten-free: reducing gluten lowers your estradiol levels by 30% or more.

Finally, natural progesterone, prescribed and monitored by a knowledgeable provider, can also help balance estrogen dominance.

Women with PCOS are at greater risk of type 2 diabetes and metabolic syndrome, and should be additionally screened with glucose testing and a full fasting lipid profile.

Adrenals Burned Out?

Adrenal fatigue or dyregulation is the change in the ability of the adrenal glands to carry out their normal job. The main symptoms is fatigue, or in the case of hyperadrenalism, feeling tired but wired.

In response to chronic stress, many folks suffer from adrenal dysregulation, which can be either low production of adrenal hormones (hypoadrenalism) or high production, or a combo of the two. Many of my patients wake up in the morning with low cortisol, drink a cup of coffee to wake up, and then have high cortisol (coffee raises cortisol) and feel wired. Then they’re exhausted when the caffeine wears off by 2-4pm.

What causes adrenal fatigue? At Gottfried Center for Integrative Medicine, every case is individualized, but there are four common causes as identified by Dr. James Wilson:

• Disease that overwhelm the body such as auto-immune conditions or cancer;
• Physical stress such as poor nutrition, addiction (especially to sugar and/or flour), injury, exhaustion;
• Environmental stress, e.g., toxic chemicals in air, water, clothing or food;
• Emotional stress – usually arising from relationship, work or psychological sources.
  

Overlap with other hormone systems
Over 80% of people with adrenal dysregulation suffer from some type of decreased thyroid function. We often find that people who have both adrenal dysregulation and hypothyroidism do not get relief from thyroid replacement alone, and need adrenal support to get better. Dr. Marsha Nunley, MD, and Dr. Charlotte Massey, ND, L.Ac., are especially good at addressing both simultaneously. Dr. Nunley is available to coach patients who live outside of California, but you must visit her in Oakland to receive prescriptions.

Testing
We recommend saliva or blood testing to check your adrenal function. For your adrenal home test, order a diurnal cortisol test. Alternatively, ask your doctor to order a morning cortisol level in your blood. For your thyroid, we recommend TSH, free T3 and free T4 tests.

Weight Gain in PeriMenopause & PostMenopause

Good post on how estrogens, when they are reduced by perimenopause and menopause, lower your metabolic rate. Unfortunately, this can start at early as age 35-40. Welcome to Perimenopause, My Friends! But there are things we can do about it. Read on....

Question: Does exercise attenuate or prevent the weight gain that occurs during peri- and post-menopause?

Commentary from:
Wendy M. Kohrt, PhD
Professor of Medicine
University of Colorado, Denver
in Menopause E-consult by the North American Menopause Society

The short answer is, yes, exercise can attenuate
or prevent weight gain during peri- and
postmenopause. The prevention of weight gain
at any age requires only that energy intake not
exceed energy expenditure. Thus, it is possible
to maintain body weight by modifying exercise
and/or eating habits. However, although simple
in theory, there are physiologic changes that
make it particularly challenging for middle-aged
women to maintain energy balance (ie, intake =
expenditure). Because the menopause transition
occurs over a number of years, it is difficult to
determine whether the increased propensity for
weight gain at midlife is primarily a
consequence of the menopause transition or of
advancing age. Both involve factors that make
weight maintenance a challenge.

Menopause-related factors that promote weight
gain. Studies of laboratory animals provide
compelling evidence that estrogen plays an
important role in the regulation of body weight.
Oophorectomy has consistently been found to
cause excess weight gain, and this is prevented
by estrogen replacement.1 There appear to be
multiple mechanisms by which estrogen
deficiency leads to weight gain in animals,
including increased food intake, decreased
spontaneous physical activity, and a suppression
of metabolic rate. If such effects of estrogen
deficiency also occur in humans, this would
suggest that there is a “biological drive” around
the time of menopause toward weight gain.

In fact, there is evidence that estrogen regulates
body weight in women. A number of large,
randomized, placebo-controlled, and open-label
trials of estrogen-based hormone therapy (HT)
have provided strong evidence that weight gain
and, more specifically, fat gain, is attenuated in
women on HT when compared to women on
placebo or no HT.2 Suppressing sex hormone
levels in premenopausal women with
gonadotropin-releasing hormone (GnRH)
agonist therapy also causes fat gain. For
example, women treated for 16 weeks with a
GnRH agonist gained 1.0 kg of fat, which
equates to an energy excess of about 80 kcal per
day.3 Because it is difficult to accurately
measure changes in energy intake and
expenditure of this magnitude in humans, it is
not clear whether the suppression of sex 2
hormones influences eating and/or exercise
habits. However, short-term hormone
suppression has been found to cause a decrease
in resting metabolic rate of 40 to 70 kcal per
day.4 This reduction in metabolic rate would be
expected to cause weight gain if not
accompanied by a compensatory decrease in
energy intake or increase in physical activity.

Aging-related factors that promote weight gain.
Even if the menopause transition does not alter
bioenergetics in a way that promotes weight
gain, there are unavoidable factors related to
aging that do so. Two important factors are the
loss of muscle mass and the decline in maximal
aerobic power. Lean body mass is an important
determinant of resting metabolic rate. As lean
mass declines with aging, there is a decrease in
metabolic rate and, therefore, daily energy
expenditure. The decline in metabolic rate will
result in weight gain unless appropriate
behavioral changes are adopted (ie, decrease in
energy intake or increase in physical activity).

Maximal aerobic power, also referred to as
aerobic capacity or VO2 max, is a direct index of
the rate at which an individual can expend
energy during exercise. For example, a healthy
young woman with an average VO2 max for her
age can easily increase her energy expenditure
by 8 to 10 kcal per minute during exercise.
However, there is a decline in VO2 max with
aging that cannot be avoided, due in part to the
inevitable decrease in maximal heart rate (ie,
maximal heart rate = 220 minus age).
Accordingly, with advancing age there is a
decline in the rate at which energy can be
expended during exercise, even in people who
maintain a vigorous level of physical activity.5
Rather than being able to increase energy
expenditure by 8 to 10 kcal per minute during
exercise, middle-aged women may be able to
burn only 6 to 8 kcal per minute. This has an
important impact on how women can use
exercise to maintain body weight as they age.
Because the rate at which energy can be
expended decreases gradually with aging,
maintaining the same level of total exercise
energy expenditure may require an increase in
the amount of exercise time.
Do physically active women gain less weight
than sedentary women during peri- and
postmenopause? Exercise can prevent weight
gain in peri- and postmenopausal women, but
factors related to menopause and aging make
weight maintenance a challenge. Even though
regular exercise does not come with a guarantee
against weight gain, prospective studies of
perimenopausal women indicate that the most
active women gain the least weight.6,7 Most
important, women should not abandon their
exercise habits if they become discouraged by
what they perceive as a lack of effectiveness of
exercise to prevent weight gain. Exercise has
numerous health benefits that are independent of
its effects on body weight regulation.8

Disclosure: Dr. Kohrt reports: Research support—
National Institutes of Health.

References:
1. Shi H, Clegg DJ. Sex differences in the regulation of
body weight. Physiol Behav 2009 Feb 27. [Epub ahead of
print]
2. Lobo RA. Metabolic syndrome after menopause and
the role of hormones. Maturitas 2008;60:10-18.
3. Yamasaki H, Douchi T, Yamamoto S, Oki T,
Kuwahata R, Nagata Y. Body fat distribution and body
composition during GnRH agonist therapy. Obstet
Gynecol 2001;97:338-342.
4. Day DS, Gozansky WS, Van Pelt RE, Schwartz RS,
Kohrt WM. Sex hormone suppression reduces resting
energy expenditure and beta-adrenergic support of resting
energy expenditure. J Clin Endocrinol Metab 2005;90:
3312-3317.
5. Hawkins SA, Marcell TJ, Victoria JS, Wiswell RA.
A longitudinal assessment of change in VO2 max and
maximal heart rate in master athletes. Med Sci Sports
Exerc 2001;33:1744-1750.
6. Sternfeld B, Wang H, Quesenberry CP Jr, et al.
Physical activity and changes in weight and waist
circumference in midlife women: findings from the Study
of Women’s Health Across the Nation. Am J Epidemiol
2004;160:912-922.
7. Macdonald HM, New SA, Campbell MK, Reid DM.
Longitudinal changes in weight in perimenopausal and
early postmenopausal women: effects of dietary energy
intake, energy expenditure, dietary calcium intake and
hormone replacement therapy. Int J Obes Relat Metab
Disord 2003;27:669-676.
8. Haskell WL, Lee IM, Pate RR, et al. Physical activity
and public health: updated recommendation for adults
from the American College of Sports Medicine and the
American Heart Association. Circulation 2007;116:1081-
1093.