Candida: Brain Fog, Fatigue, Sugar Cravings, Hypothyroidism

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I have been thinking about Candida a lot lately because it tends to be one organism, that left unchecked, can cause persistent issues in a patients.  I always say that every patient is different, and it’s so true.  I recently started treating an existing patient for Candida overgrowth (and I won’t give too much other background to maintain anonymity) but this is NOT what the patient originally came to me for.  What is interesting about this case is that along the way, the patient has done an amazing job listening to their body and was noticing certain foods causing issues.  We navigated through that and after realizing Candida could be a real issue, all the pieces fell into place in my mind.  I can’t emphasize enough how much of a puzzle complex cases are and it requires not only the doctor to be thoughtful throughout the journey, but it requires tremendous awareness and communication on the patient’s part, too.  Often times, the patient knows the experience better than the physician, but the physician often has the knowledge to help piece things together into a picture that makes sense and can be TREATED.  Without either person’s contribution, progress is often non-existent.

What is Candida?

Candida is a yeast known as Candida albicans. While everyone has Candida living in/on/around them, not everyone has an overgrowth.  The most common condition people are aware of including Candida overgrowth is a vaginal yeast infection.  However, you can have this infection in many other places including the gut, the ears, the mouth (thrush), sinuses etc.  It tends to love dark, warm, moist environments within a susceptible host.

Who gets yeast overgrowth?

This is often a condition we will see in people that have suppressed immune systems.  Immune suppression could be from AIDS, where seeing thrush is very common.  It could be immunosuppressants as in the case with Autoimmune patients.  Or, it could be a perfect window after antibiotic use, which is common.  Last, but not least, your primed for take over during pregnancy, too.  Why? Because your immune system is naturally dampened during pregnancy because of the mechanisms that don’t want you to attack too much foreign tissue that would include your baby.  (This is also often why an autoimmune condition will go into remission during pregnancy)

What are the symptoms of overgrowth?

Just wait.  These symptoms are common and often can be associated with other conditions, especially thyroid dysfunction.  That is often why this goes misdiagnosed and the patient doesn’t seem to improve. Patients can have just a few of these or all of the below.

  • Brain fog
  • Fatigue
  • Itchy ears, vagina, anus
  • Thrush
  • Joint pain
  • Sugar cravings
  • Allergies
  • Hormone issues
  • Anxiety

What’s the treatment?

Conventional treatment of recurrent yeast infections is Diflucan.  However, this tends to enter a patient into a vicious cycle and never eradicates the problem.  They may go on cycles of this medication multiple times a year.  Alternative treatment focuses on starving the food sources of the yeast, rebalancing the microbial environment within the body (after all, healthy people have Candida, too…it’s just balanced), and addressing the tricks Candida has to hide from the immune system.

Alternative Foundations:

  • low sugar/low carb diet
  • probiotics
  • antimicrobials (many are herbs like oregano)
  • coconut oil consumption and application

Alternative Foundations are what most alternative care providers will prescribe; however, I have found there to be some critical additions to protocols if someone isn’t responding to traditional alternative recommendations.  These could be things to consider if you are treating Candida naturally but still seeing reoccurrence.

  • biofilm disrupters via herbs or enzymes
  • refrain from sex with your partner for a period of time and have them undergo treatment, as well.
    • I often see women get better and have another infection following intercourse.  Your partner is passing it back to you, and just doesn’t have the same symptoms
  • enemas to reduce something known as a Herx reaction.
    •  As Candida begin to die, they release toxins that make people feel very ill.  This will often result in discontinuation, but can be drastically improved by backing down dosing or introducing enemas
  • consider a low oxalate diet

Why would you worry about oxalates in the diet?

Admittedly, this is a new concept to me, but as I continue to learn, evolve, and treat more patients, I think it’s worth sharing information!  I have not toyed with this clinically, so take it for what it is, but I was listening to a very seasoned physician talk about this topic, and some very interesting patient puzzle pieces fell into place.  Foods high in oxalates are things like nuts, berries, spinach, and chocolate.  Candida impairs your ability to break down this component of these foods and produces a precursor to oxalates itself.  It can also take collagen and transform it into oxalates.   Oxalates are the very thing that cause painful kidney stones, and you need to be able to break these things down.  When people change their diet, often times they are making smoothies with spinach and nut milk, they are eating more greens, they use nuts as a snack, and they are increasing bone broth in their diet.  HELLO OXALATES!  This was interesting to me because my patient kept saying they had more itchy orifices when they ate cashews.  Everyone is different, so I just cut them out and moved on.  Looking back, this could’ve been a queue because in addition to using bone broth in the face of autoimmunity (what they originally came to me for), we could have been pushing the limits with oxalates.  Without addressing the Candida, we were noticing those symptoms!

What was so weird about your patient?

Hindsight is 20/20, but looking back, it sort of made sense all of a sudden.  A person presents with an autoimmune disease that can absolutely account for fatigue, brain fog, poor exercise recovery, mood imbalance and hormone issues.  However, the person has taken antibiotics which wipe out any balance that exists with your microbiome, then had a baby, which suppresses the immune system, and then gets an autoimmune disease.  This can be a common scenario, but what I did not take into account is that trigger of the autoimmune disease could very well have been the Candida overgrowth.  This person came to me not being completely open initially about the yeast symptoms (understandably so!), but brought them up when they were feeling better but those symptoms were persisting.  Maybe I missed the mark?  I don’t know.  The person then started to notice issues with cashews….(oxalates.) The patient would then notice symptoms improving and then they would reoccur after intercourse. This patient also had some strange depressive patterns, and Candida makes estrogen.  That how it puts a wrench in the hormone system.  HOW DID I NOT PUT THIS TOGETHER?!  After introducing a biofilm disruptor, treating the sexual partner, and addressing the Candida, now this person can officially say they are improved from autoimmunity (what they came to me for), and don’t have weird symptoms persistently because of a yeast overgrowth.

If I did not have constant communication with this person, I would never have tied all the dots.  People are complex and a case is like an onion.  It’s layers upon layers to get to the bottom and hopefully reaching recovery.  This takes time.  So, don’t give up! How much of the symptoms from my patient were from the Hashimoto’s and how much were from the Candida, I will never know.  But I don’t need to know.  I will carry this case (and tidbits like this from every case) into the next set of patients.  It’s part of the art of medicine and what I love about being a doctor.

 

 

Oral Contraceptives: What You Need to Know

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Oral Contraceptives AKA birth control.  As the name suggests, this a prescription that alters a women’s hormones in efforts to prevent pregnancy.  And let’s be real here, IT DOES A REALLY GOOD JOB!  I have no issues with anyone’s decisions about what is right for them or their young girls; however, I think knowledge is power and ignorance isn’t an excuse.  So, read forth and consider all the information before deciding what is right for you.

Why is birth control such a hot topic?  

Most people have 1 of 2 reasons why they are using birth control:

  • to prevent pregnancy
  • to balance hormones, which means they usually have a symptom of disruption such as, PCOS, heavy periods, irregular cycles, PMS, acne, mood disturbance, cramps, ovarian cysts

The reason this may be such a hot topic is because many moms don’t want to give their teen daughters birth control to control symptoms of hormonal imbalance.  OR, they feel as though preventing pregnancy through birth control is an invitation that it’s ok to have sexual intercourse.  The debate of abstinence is not what I care about, but the early use of hormones to regulate such important chemicals in a young female’s body, is.

The common story: “the pill” for period problems

Personally, this was my story, and the story of many of my friends in high school.  Heavy periods, painful periods, or irregular periods lead you to your first OB/GYN appointment, and you leave with a prescription to clear things right up.  You begin taking them, things are great, and you continue to take your magic pills for the next several years, maybe even a decade or more!  Most women don’t get off of them until they wish to start a family.  Let’s think about this, you go on them around the age of 16, and you may not go off of hormones until 10 years later!  What a crucial time in your natural hormone development.  Some women have real issues transitioning off with all the symptoms flooding back with a vengeance, and some women don’t notice a thing.

What’s the big deal with taking birth control?

Taking birth control to artificially “fix” hormone symptoms is like taking pain meds to forget something hurts.  It doesn’t address the source of the issue and it can have huge impacts on the endocrine system long term.  Synthetic hormones are the not the same as your own hormones being made inside your body, and they can have serious health repercussions such as stroke, pulmonary embolism, hormone cancers or infertility.  A side note to that is the new versions of the pill that are low dose like Yasmin, Alesse, etc, have huge increases in the risk of cardiovascular complications!  They know this, and  the FDA updated the risk level for any pills containing drospirenone. You can read more here.

The artificial supplementation of hormones doesn’t address the reason hormones were off in the first place.  Can you imagine the amount of dysfunction that could build up over the course of 10 years if left unaddressed?!  What if you had a thyroid condition that was throwing off your hormones and you were prescribed birth control without ever realizing your thyroid was in crisis?  I would call that an epic fail.  What if you were developing PCOS and had no idea that your blood sugar was such an issue?  Another birth control fail.

What do we do instead?

Regulating hormones comes down to foundations.  Stress, diet, and exercise are all part of the picture. Conventional  animal products contain unhealthy hormones and hormone disruptors.  Certain plants act like estrogens.  Dairy is a huge driver of androgens.  Stress requires cortisol production, which is a hormone.  Too much cortisol can cause someone to have major shifts in their sex hormones.  Lack of fiber means free hormones are not bound and eliminated.  Excessive exercise is notorious for altering body fat percentages that don’t support normal menstruation.  We have all heard of young gymnasts who don’t get a period until they quit training.  On the flip side, lack of movement can predispose young people to store more fat.  Fat produces estrogen!  You can see how lifestyle is so huge.

There are also options in the herbal department, too.

  • Chasteberry is an herb that has been used for many years to regulate hormones by acting on the hypothalamus and the pituitary glands.  It ends up naturally raising progesterone levels without acting as a hormone.  Low progesterone give women the blues, heavy periods, or bad PMS.
  • Maca is a root vegetable that has been used for fertility in certain cultures because it balances hormones.  It aids in estrogen balance, and supports adrenal and thyroid function.
  • Saw palmetto is an herb that balances testosterone that can cause acne.
  • Black cohosh is an herb that can naturally boost estrogen levels.

Depending on someone’s imbalance, a combination of these ingredients can be a lifesaver in the symptom department!  Hormones can really dictate how stable a young person’s emotions are, how confident they are in their body, and how healthfully they develop a fertile environment for child-bearing years.

Are there things I should do if I decide to take oral contraceptives?

Oral contraceptives deplete certain nutrients like B-vitamins, vitamin D, Calcium, Magnesium, Zinc, and Folic Acid.  Yup, folic acid, that B-vitamin necessary to keep a child from having a cleft palate. They can also alter balance in the bacteria living in the gut called the microbiome.  So, if you decide to take an oral contraceptive, I would NOT take one like Yaz or Alesse because of the increased risk in clotting.  I would also supplement with the following:

  • B-complex
  • Reacted mineral
  • Vitamin D
  • Probiotics

This is just scraping the surface, but I hope it helps you make a decision that is right for you!

 

Paleo Cinnamon and Cream Cheese Muffins

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Cheese is always a fading memory for those that have made a transition to dairy free, and many people are fine with that.  However, when there is a dairy free option that is still conducive to meeting their health goals, they wouldn’t mind partaking!  I ran across Kite Hill Almond Cream Cheese Spread and decided to try it out.  If you aren’t spreading it on a bagel, what on earth do you do with cream cheese?  I decided to try baking first to see if it would hold it’s own under heat.  I really enjoyed this cheater version of cinnamon rolls with cream cheese frosting, and they are so much easier than making cinnamon rolls.  Stay tuned on FB and instagram for how the cream cheese story unfolds in different applications.
Paleo Cinnamon and Cream Cheese Muffins
Ingredients:
1/2 cup coconut milk
2 eggs
1/4 cup maple syrup
1 tsp vanilla
2 cups almond flour
1/2 cup arrowroot powder
1/2 tsp baking soda
1/2 tsp salt
2 Tbsp cinnamon
7 Tbsp or so of almond cream cheese by Kite Hill (I didn’t measure)
Directions:
Preheat over to 325F.  Stir dry ingredients together.  Add the wet ingredients (except cream cheese) and combine.  Place batter in greased or lined muffin tins and dollop a Tbsp or 2 on top of muffin.  Bake for 20-25 minutes or until the top springs back at you. The cream cheese will not melt but will be creamy to eat.

Guide to Health-Conscious Foodie Dining: OneFourteen

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I have had a series of restaurant reviews in the hopper for a long time now.  Like 3 years… I’m officially ready to give you my opinions on some dining options.  I wanted to accomplish a couple things when doing these reviews so it fits the needs to my readers.

  • Quality of ingredients
  • Adaptability for dietary needs
  • Taste
  • Experience
  • Price and accessibility

I wanted to follow a set of rules when going through the dining experience because I believe food is somewhat of an art, and I think going in changing everything alters the original intention of how the dish was intended, the experience around it, and the flavor profile.  So, here are couple rules I plan to follow with every review:

  • Order as it’s intended on the menu
  • Order anything that is hard to find elsewhere
  • Order a meal and a cocktail (if available)
  • Ask the server about their favorite thing on the menu

Welp, here it goes.  A review of my experience at the new restaurant in Mishawaka/South Bend called One Fourteen.

Here is the website. Here is the menu.

What I ordered: Parm Fries, the Onefourteen burger and the Cold Killa cocktail

Quality of ingredients:

While there isn’t a lot of information provided on the ingredients used, it does appear that they are trying to use ingredients that are thoughtful.  You will not find grassfed beef on the menu despite the array of burger options, but you will find plenty of options that include plants.  Since quality screams nutrient content in my opinion, this is important to how high somewhere rates for my readers.  The burger I ordered had pate and marrow.  These are ingredients you won’t find in many places and are packed full of nutrients!  Organs are one of my favorite things that patients are recommended to experiment with, and if they can have someone else prepare them, it’s a win-win.

*Update: I got some more details that I thought I should update!  The get their meat from Sawyers Meats in South Bend Farmers Market, buns from Breadsmith of South Bend and as much local produce as they can find.  Every sauce, dressing, and condiment is made in house!

Adaptability for dietary needs:

If you are trying to avoid gluten, meat, or dairy, you WILL be able to eat.  I ordered the burger with the bun, which came to me packaged with gold leaf on top.  You heard me right.  My bun had actual gold leaf on top. A nice touch that you may miss if you order sans bun.  I ate some of the burger with the bun but, quickly ditched it.  You could order any burger without a bun.  They also have plenty of vegetarian and vegan options for those avoiding meat.  Since vegan options are available, that means some alternative dairy, as well.  If you are trying to stay low carb, there are veggie options to replace fries.  I do not know if they rotate, but asparagus was the option when I went.

Taste:

This is the one everyone cares about, right?  Who cares how healthy or unhealthy if it doesn’t taste good.  The burger was good.  Since my burger choice was fatty in nature, I thought it could have used an acidic addition to cut through the richness.  I notice they do this with many dishes by using kimchi.  It was messy, which doesn’t bother me because I usually don’t hold it anyway.  The fries were amazing.  They are thoughtfully seasoned with herbs that I couldn’t pinpoint exactly, but I do believe rosemary is part of the blend.  They are well seasoned and there’s nothing fake about them.  I have a place in my heart for places that do fries well.  The cocktail was a smoky mescal garnished with a beautiful flower and the rim dipped in coarse salt.  I usually HATE smoky drinks, but this was pretty perfectly balanced.  I would definitely order it again just to drink with my eyes if nothing else!  I also tasted the herb spritzer and this is right up my alley being refreshing, herby, and light.  This would be my go-to if I was a frequent flyer.

Experience:

The service was attentive but not pushy, which is just how I like it.  The place is a little gangsta with a modern twist.  The décor is clean with thoughtful touches such as a penny floor as you enter, navy napkins that liken to denim, and a winged selfie wall in the bathroom.  I love the idea of interaction.  There aren’t many places you can go where Tupac adorns the wall and gold leaf tops your burger.  The perfect match for the age group that grew up listening to Biggie, Tupac, and Dré but has developed a palate for interesting flavor profiles and twists on the classics.

Price and accessibility:

I order the most expensive burger on the menu topping it out at $18.  However, I’d say most pricing was standard for a sit-down burger joint with craft cocktails.  It is somewhat quaint inside, and they do not take reservations.  So, it may be a wait if you go during peak times and if you are coming from Elkhart, it’s a jog.  However, it’s got an antique shop next door that can occupy the time while you wait, and they have plenty of standing room in the bar area for a cocktail.

Overall, I would give onefourteen an 88% if I’m throwing back to my professor days.  I think they have done an awesome job as a new restaurant because let’s face it, starting a restaurant isn’t easy!  They have dared to experiment and offer interesting options, and they have thought about the experience.  I have to take away some points for quality in terms of healthy meaning top shelf: grassfed, organic, local, etc.  I would love to hear about your personal experience!  If there are any other pieces of information you would like me to touch on, let me know and I will try to include that in future reviews.

Patient Journey: Crohn’s

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Despite working with patients for several years now and wanting to share everything I possibly can to make a difference, I have never taken the time to share any stories of patient journeys.  I have never pressured any patients to write testimonials and, quite frankly, I feel like sometimes they can be a little inauthentic.  If you think about it, who is going to agree to write a testimonial and say anything bad?!  However, I have sent my patients a journey worksheet to help me decide what was the most influential, what they believed to be the most impactful moments along the way, and what they would say to those that may be on the same path.  I have used these journey worksheets to help mold my treatment methods, but I feel guilty for not sharing them!  I’m ready.  I hope to share some patient journeys over the next few months so you can understand what healthy looks like through the eyes of patients like yourself.

First up? a Crohn’s patient that will actually be a case study published in my upcoming book on treating immune dysfunction! It’s interesting for me to see how patients perceive our work together, and as you will see, food was a huge part of this autoimmune journey!  I will let you know the question and response, unedited, completely honest and raw…..

  1. What health issues were you struggling with when you began to work with Dr. Angela? I was diagnosed with Crohn’s disease about 5 years ago. I struggled finding the “safe” foods to eat without knowing what was really in food and how it was prepared. So honestly I would usually eat once maybe twice a day because it was just easier than getting sick…I lost about 40lbs within the first 6 months (only weighed 140lbs at lowest weight, so pretty low for a 6’ tall male). I also became very sheltered and was afraid to go out to eat, go to movies or just basically afraid to leave my comfort area “in case I got sick”
  2. What treatment methods had you tried prior to Dr. Angela’s program? The doctor had me taking 3 – 3mg Budesonide (equivalent to Entocort) each morning and then taking 2 Pentasa four times a day…so taking 11 pills a day. Basically tried to stay away from food the doctor told me to avoid. Also took a food allergy test which was 100% waste of my time after spending one short visit with Dr A
  3. What health benefits did you gain from working with Dr. Angela? Where do I start…I can eat without being too worried about getting sick, I can leave the house more often because now I know what I eat and where it came from and I am slowly gaining my weight back. I just finally feel better, but I still have my days but overall I feel better and I am currently taking 3 prescribed pills a day along with my other healthy pills.
  1. What was your biggest struggle during the transition to a healthier lifestyle? The first two weeks were the worst EVER!! I was basically having chicken broth for breakfast, lunch and dinner to clear my system of anything that was bad…it was 100% worth it and yes I would do it again it I had to. Another struggle is making breakfast, lunch and dinner is a chore on some days but when I get to sit down and eat and know that I will feel full and probably not get sick is a great feeling. It’s either all or nothing when choosing this lifestyle so get ready for the ups and downs but once you find some go to meals its fun and worth every penny you are paying.
  2. What did you find most beneficial to you in the program? That I am getting my life back, that I can feed my family good food and stay away from all the processed food. Becoming a better cook is also the fun part because I can cook more meals than I ever thought I could. Also I can eat dessert again and that is always great because Dr A has some amazing recipe’s for any sweet tooth out there.
  3. Did your food options taste good? Sometime they taste too good, like the almond butter chocolate chip cookies are the best thing ever. Its also amazing what you can do with honey, I never liked honey before meeting Dr A but I basically put it in/on everything…and not the fake honey you get in the store, it has to be the real stuff.
  4. Did you have an ah-ha moment that helped you commit to the change? If so, what was it? My moment was when Dr A had us take everything out of the pantry/house that had corn in it and I realized just how much crap we were eating and if I got rid of it. Also was when we learned how some of the cooking oils were made/processed…GROSS!!
  5. If you were going to give a piece of advice to someone on the fence of following a program like Dr. Angela’s, what would you say to them in order to help them decide? Give it time, it is worth it. There will be days that you’re not going to want to get out of bed to make another meal or make another trip to stupid fancy grocery store but I promise you that it does get better, there will be tears and there will be family fights because of what you can and can’t eat but hang in there, my wife also followed along by my side and after all the fights and tears shared we are both better and healthier. When you are addicted to anything, bad food in our case, it tough quitting that habit and you’ll have ups and downs but now we have a lot more ups then downs and love almost every step we are taking….it’s not easy but if I can do it know that anyone can.

Dr. Angela’s perspective:

This patient had evidence of intestinal permeability, some underlying infections that needed addressed, excessive stress in certain areas of life, and a list of about 50 foods that “he wasn’t supposed to eat.”  Thank goodness for that list of foods, because his wife contacted me (after hearing from one of you about me) at a complete loss as to how to cook for him with such restrictions.  This is often how it starts.  I get contacted with an intention, and after a short consult, we have a completely different direction that focuses are correcting the underlying cause of disease.  This patient has since removed all his meds and had a COMPLETELY CLEAR colonoscopy.  Every patient has a different journey, but especially with autoimmunity, I insist on the education component because the children of that patient inherent the DNA.  While DNA doesn’t cause the disease, it sets the stage for it.  So, the process he mentions about removing corn was a random idea I came up to get the kids involved in understanding just how many foods may contain things that make dad (and many others) sick.  Like I said, no two patients are the same, and therefore, I don’t think I’ve ever done exactly the same thing with any of them.  You are unique, your body is unique, your lifestyle is unique, and the things that matter to you are unique.  That means you need a plan that fits your unique circumstances.

 

Paleo Pizza Popovers

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I am pretty sure every person reading this blog enjoys pizza.  I’m also fairly certain that most people reading this blog either eat unhealthy versions of pizza or go way out of their way to try and make a healthy version?  I may be wrong, but sometimes you really want PIZZA (and there are recipes for that), and sometimes you just want the pizza flavor.  This is for the time when you feel lazy, don’t necessarily need the bread texture, but do crave some Italian without the guilt.  These popovers can be made tons of different ways.  I currently have a sweet and savory option on the blog, but the pizza version gets it’s own post.
Paleo Pizza Popovers
Ingredients:
3 Tbsp arrowroot or tapioca starch
2 Tbsp coconut flour
1/4 tsp salt
4 large eggs, room temp
1/4 cup canned coconut milk
1/4 cup water
1 Tbsp ghee or coconut oil
1 tsp Italian seasoning
5 slices pepperoni minced
Directions:
Preheat oven to 450F. In a small bowl combine the flours and salt.  In another medium bowl, whisk the eggs lightly and add the coconut milk and water.  Add the flour mixture and combine until smooth. Add in the seasoning and pepperoni. Put a little oil in each of the 6 muffin tins.  Put the muffin tin and oil into the oven for 5 minutes and remove.  Pour 1/4 cup batter into each muffin tin.  Cook for 15 minutes and reduce heat to 350F.  Cook until golden brown, which could be another 15 minutes. Serve over homemade basil pesto or red sauce.  Garnish with fresh basil.

PCOS: Where to Start

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Polycystic Ovary Syndrome, commonly termed “PCOS,” is something I am seeing more and more in my practice.  Often times, women have no clue this is an issue until they try to become pregnant.  Since infertility is one of the negative repercussions of such condition, trouble conceiving is often the red flag.  However, many women may notice something isn’t right before that and not associate it to PCOS.  For example, common symptoms of PCOS include things like:

  • Weight loss resistance
  • Blood sugar regulation issues
  • Increased hair growth in all the wrong places
  • Depression
  • Decreased hair in all the right places
  • Irregular periods
  • Sometimes high blood pressure
  • Pelvic pains that come and go
  • Often times high LDL levels

How’s that for a good time?  Overweight, with acne and facial hair, not knowing when you’re going to get your period, and depressed.  Then you feel like you can’t even do something as basic as get pregnant.  You know how many people get pregnant and don’t even try?!  This is the PCOS story.

What do doctors traditionally do about it?

They usually prescribe birth control pills and metformin (diabetes drug).  Since PCOS is an issue of hormone regulation, the birth control is supposed to put someone on a normal cycle with “normal” hormone levels.  The thought is also that the reason this occurs is due to blood sugar issues, which is why women often improve with diabetes medications.  This sounds great until you start asking why it started in the first place.  Not only does Metformin not address the issue, but it depletes your body of B vitamins and CoQ10, so you may even have decreased energy. If your blood sugar issues started it, why wouldn’t you change the habits associated with poor blood sugar?  Instead, those continue and everything associated with those is still taking place.  Your body is making too many androgens, which is what you can thank for those hair growth patterns and acne.  Taking a pill with estrogen does not remove the inappropriate hormone production patterns.  This treatment protocol is likened to adding green food coloring to water and to make someone think it’s juiced vegetables.  You may make things APPEAR differently, but once you look (or taste) further, you notice it doesn’t taste like green juice, it doesn’t have benefits of green juice, and it may be even worse because we had to add chemicals to the water just to make it APPEAR differently. Wouldn’t it be easier, and better, if we just made some green juice?!

What SHOULD your labs look like?  What should be the goal?

  • A1C should be 5.4 or less
  • fasting glucose should be 75 or less
  • Insulin should be 6
  • Homocysteine should be 6-8

Insulin levels are often not tested because we tend to test glucose more often; however, insulin decreases something called sex hormone binding globulin (SHBG).  The point of SHBG is to bind free hormones and if it’s ability to do so is impaired, we see elevated testosterone levels.  Testosterone is one of the androgens we touched on earlier.  This is why adding estrogen via a birth control pill can sometimes make your body APPEAR improved, but we are really just creating that appearance by adding green food coloring. Inside, we still have the issue of it just being dyed water.

Why does this even matter?  Is it that big of a deal?

For women who desperately want children, YES.  That can be a huge deal.  For the rest that don’t mind the childless lifestyle, having PCOS increases your risk for heart disease, hormone driven cancer, blood pressure issues, and if you have irregular periods, you are 7 times more likely to develop diabetes.  We don’t want to go down the rabbit hole of diabetes, but think diabetic neuropathy, limbs removed, eye sight issues, and a huge stealer of quality of life.

What things can we do from a lifestyle perspective?

  • Eat balanced macros with a focus on protein and healthy fats (this will help regulate blood sugar)
  • Increase fiber intake (think around 30g/day) (this helps bind hormones and cholesterol)
  • Avoid sugar and processed foods (this impairs normal blood sugar)
  • Avoid caffeine (this can drive androgens)
  • Decrease stress (stress drives cortisol and disrupts your hormone production)
  • Clean up your beauty products (these are often endocrine disruptors meaning they damage receptor capabilities for hormones)
  • Exercise (this sensitizes cells to normal blood sugar responses)
  • Drink spearmint tea (this decreases testosterone)

That’s great Dr. Angela, but I’m in deep.  Will I need more than just lifestyle changes?

This could be the case and often is by the time someone sees me.  THIS IS NOT MEDICAL ADVICE, and each patient is different, but I want to share some things that are often common with improvement.

  • Essential Fatty Acids-consider a good fish oil, cod liver oil, or fatty acid blend
  • Antioxidants- consider taking a spectrum of antioxidants because studies show one single antioxidant does not work the same
  • Detox- sometimes increasing detoxification pathways can be helpful
  • Herbs- Inositol, Fenugreek, Cinnamon, Vitex, Black Cohosh, Nettles, Green Tea, Licorice, Spearmint
  • Saw Palmetto-240-260mg 2x’s/day-lowers testosterone
  • Progesterone- day 14-25 days of the cycle taking 20mg transdermal or 110-130 mg oral (this should be started low and slow and directed by your health care provider who is testing)
  • Berberine-200mg 2x’s/day for those who also have high LDL levels

The take away message here is that cysts on the ovaries are a sign that something is going wrong with hormones and blood sugar regulation inside.  Taking medications for these issues acts like a bandaid and doesn’t address the underlying mechanisms.  I encourage you to take lifestyle changes seriously and find a knowledgeable practitioner who will talk to you about solutions to CORRECT the issue and not jump to birth control or metformin.  This is not a life sentence, and many women address these issues naturally.

 

 

Guide to a Coffee Sabbatical: Reducing Caffeine Intake

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I am a huge fan of coffee, and I don’t make that a secret. If you follow me on Instagram, you may have noticed that I recently took a 2 week coffee sabbatical. I kept getting asked why I was embarking on this caffeine-reduction journey, and the simply answer was:
“I love coffee, but too much of a good thing can be a bad thing.”
With my current work situation, I am waking up earlier, having more meetings, and doing more after lunch runs to Starbucks. I have always had coffee every morning before noon. However, lately it has been a venti bold before 10:30am, a 12oz before lunch, and an Americano for the afternoon. Let’s just say that this adds up to a lot of caffeine and lot of bad habits. I’m an all-or-nothing personality, so when I need a reset, I need to do the whole cold turkey thing. So, I decided to give up coffee for 2 weeks. I almost cried, got over it, and decided it was going to make it a mission to find alternatives! I have been giving alternative suggestions to patients for years, but wondered if there were new options out there. I’m here to report the deets! Keep a couple things in mind, number one on this list is really the only alternative that feels and somewhat tastes like coffee, and the rest are just fun alternatives to try. The other thing to keep in mind is that some of these options are completely caffeine-free and others have a little, so if you are trying to give up all caffeine, no green teas.

List of Coffee Habit Alternatives: (that aren’t sugar bombs and would be enjoyed by the health-conscious)
1. Dandy Blend

  • This stuff is by far the closest taste and feel to coffee!  It’s bitter, rich, and somewhat frothy
  • Caffeine free
  • Good for liver function
  • Buy on Amazon or at a health food store
  • Powder that just dissolves in liquid: hot or cold
  • Make coffee-flavored stuff with it like my Dandy Blend Ice Cream recipe!

2. Rebbl Maca Mocha

  • This you can find at Whole Foods
  • This tastes like a treat, let’s be honest
  • Dark cocoa, chicory, and coconut milk
  • Superfood addition: maca; I love maca for hormone health
  • Somewhat expensive if you want to have it often.  Think around $3 for 12 oz

3. Rebbl Reishi Chocolate

  • Buy at Whole Foods
  • This is like chocolate milk
  • Dark cocoa, vanilla, and coconut milk
  • Superfood addition: Reishi; I love the idea of using beta-glucans to improve immune function and liver detoxification
  • Somewhat expensive but remember you get a 10% discount at Whole Foods if you buy a case at a time

4. Starbucks Shaken Iced Tea: Passion Fruit

  • This is sort of fruity with a hint of cinnamon?
  • It’s pink and refreshing
  • Order unsweetened
  • Great option if you’re with people at Starbucks
  • Similar cost to your coffee

5. Starbucks Shaken Iced Tea: Peach Green Tea

  • If you like peach tea, this is a subtle version with a little bitter hint of green tea
  • This is also refreshing
  • Order unsweetened
  • Green tea has many anti-aging benefits and plant chemicals that improve health
  • Has some caffeine because of the green tea

6. Green juice

  • If you have a Whole Foods or Trader Joe’s nearby, you can buy these pre-juiced
  • If you have a juicery close to you, it can be a good “get out of the office” run
  • If you have a juicer at home, it can replace your morning habit of making coffee to making juice
  • FULL of nutrients and great for your health and beauty
  • Store-bought needs to be cold pressed and not pasteurized, which can be tough to find
  • Juicery prices can be steep
  • You’ll have to clean up if you do it at home

7. Herbal Tea

  • Experiment with all kinds of flavors. You may find one that you love more than coffee!
  • Mint tea is great for those with PCOS
  • Ginger and turmeric are great for inflammation
  • Chai is usually a black tea base so has some caffeine, but this is a great alternative

8. La Croix

  • This is a fizzy, store-bought drink that comes in a can like soda
  • Grapefruit is the only flavor I like
  • You can buy it by the case
  • May fill the afternoon drink necessity

9. Flavored water

  • Flat or carbonated water will do
  • Add herbs like sage or mint
  • Add citrus like lemon, lime, or grapefruit
  • Possibilities are endless and free

10. Dandy Blend Mocha Latte

  • Use dandy blend to make 10 oz hot water and 1 1/2 Tbsp
  • Add a splash of almond milk
  • Add a TBSP collagen
  • Add TBSP of cocoa powder
  • Blend until mixed and pour into travel coffee mug and feel like a starbucks treat has been served at home

Why would I take people off of caffeine or coffee?

There are many reasons but many people don’t realize that coffee is contributing to the following issues:

  • Headaches
  • Jittery feeling or racing heart
  • Anxiety
  • Diarrhea
  • Allergies
  • Sleep disturbances
  • Hormone issues
  • Acne
  • Energy dips

If you decide to take a coffee sabbatical, set a time frame and just monitor how you feel.  If you feel great, then maybe you shouldn’t have it daily.  Sometimes I will then set limitations such as one day a week and one day on the weekend.  Many times these issues are due to exceeding a threshold.  Maybe it’s fine to have on occasion, but not so fine to have daily.  It’s your body, and you know it better than anyone.  Experiment on yourself!

 

Has Your Chiro Ever Said “You don’t need adjusted today?”

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When I was in chiropractic school trying to figure out HOW I wanted to adjust people, I had to ask myself some pretty hard questions. One burning question that always went through my mind was “How do I know that I NEED an adjustment?!” It seemed like you could walk into any chiropractic office on any given day, get adjusted, walk down the street to another chiro, get adjusted, and you could repeat that ALL DAY LONG! If an adjustment is helping to correct the problem, then why would every single chiropractor in that string of visits tell me I need an adjustment?! That makes you wonder: Are they lying to me? Did the first adjustment not do its job? Am I really THAT messed up?! I have to think that patients think this way, too….unless I am the only crazy one.😉 I did not feel comfortable with assessment methods that did not allow for the possibility that someone could NOT need an adjustment. There are absolutely moments in time when the body is doing a perfectly good job on its own and needs no intervention at all!

I had a patient come in yesterday that did not need adjusted after I did my assessment. It was “gold star” moment on their chart! Believe it or not, that patient was EXCITED to see that their body was holding their adjustment, and it was a good sign that they can go a longer time frame between adjustments! That is the entire goal in the adjusting process. I WANT your body to be adapting to the environment on its own, without assistance. However, if I did not have good, sound, objective measures to help me determine that, then I would probably just adjust you every single time I saw you! That’s often what gives chiropractors a bad name in terms of people thinking that they have to go five million times over the next 10 years.

While treating people in clinic, I worked really hard to find methods of evaluation that would allow me to KNOW when their nervous system was failing to adapt. There were times when I would see patients multiple times before they ever got a single adjustment. As a student trying to get my adjustment numbers in, that could be frustrating; however, I was positive that they were not being over-adjusted and that I was not influencing the nervous system when it was already doing a great job! I think it was important for me to develop that skill because it would be absurd for me to adjust every single person that walks into my office, every visit, and assume that they “needed” it. The body is an amazing creation, and most of the time, it doesn’t take much to put it on the right path for healthy function.

Having said that, there are tons of things that contribute to whether you need adjusted: posture, diet, work, stress, etc. If these sources of stress to the body are not kept in balance, then you probably need adjusted more often. Poor posture breeds bad patterns in your neurology, therefore, you are reinforcing a bad pattern in your body for 23 hours and 55 minutes when I only get 5 minutes to have an influence. What you decide to do in your own time makes a much bigger difference in how healthy you are, if you need adjusted, and how good you feel. Adjustments are meant to supplement a healthy lifestyle when the body needs a little help adapting. If you get both hips, both sides of the neck, 2 areas in the midback, etc adjusted EVERY SINGLE time you walk into the chiro’s office, I have to wonder if you needed every single area adjusted?

This is simply food for thought. I love chiropractic. I love adjusting people. However, I do find that people respond better to care when they are ONLY getting adjusted WHAT they need adjusted, WHEN it needs adjusted. People’s body’s have patterns, so it is very feasible that you will often need similar spots adjusted….just probably not every single time. Most people have no idea if their chiropractor is evaluating whether they need adjusted because it happens without you knowing it most of the time! They check your leg lengths, they may scan temperature, they may have you perform actions in order to elicit response. It is all part of determining whether or not a patient needs adjusted. However, it is also our job to address the underlying issues if someone is constantly needing adjusted. There is a reason that you are not holding your adjustment, and it could be anything from work to diet. These issues need addressed or you are just using chiropractic like an expensive aspirin. YOU have the biggest impact on your health and your chiropractor is simply there to help you along the way, not do it for you.

Matcha Mint Lemonade (Cocktail optional)

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I have this repeating issue at Starbucks.  I love coffee, but I don’t always want it during later times in the day, and sometimes I avoid that much caffeine.  So, what’s a girl to order?  Sometimes they have some tasty-sounding options like Matcha Lemonade!  However, you look up the ingredients and they are almost always sugar bombs.  So, I leave with a coffee.  That doesn’t stop me from adopting some of the flavor ideas and making them delicious and healthy!!!  I have matcha powder from Trader Joe’s and who doesn’t love lemonade in the summer?!
Matcha Mint Lemonade
Ingredients:
3 leaves of mint
handful ice cubes
juice from 2 lemons
can of plain soda water
1 tsp matcha powder
optional: 2 oz clear alcohol (Gin, Vodka, Rum)
Directions:
Blend together, serve with a decorative straw, and enjoy!