Outstanding in the Field: A Magical Food Exerience

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I recently had a magical food experience with a company called “Outstanding in the Field.”  As a doctor, I can’t emphasize enough just how important connection TO your food and with others OVER food is to your health.  The simple act of seeing where it was grown, picking it, touching it and the dirt it thrives in, chopping it, and putting love into its preparation changes the physiology behind the nutrition, digestion, and health benefits.  You heard me right.  Your connection to your food changes how much it nourishes you.  If you add the way in which you enjoy it on top of that, I may even venture to say that even an unhealthy choice can then have health benefits.  That discussion is for another time, but today, I want to talk about this idea of going to a farm, meeting the farmers, touring the grounds, having a professional chef pour love into the ingredient preparation, and sharing a table with hundreds of other people talking and eating family style.  That, folks, is exactly what Outstanding in the Field has developed.

I arrived at Kinnikinnik Farms in the early evening with a plate.  Why would I bring a plate?  Because it is tradition at the dinners to have guests bring a plate to further enhance the uniqueness of each event.  Even a dinner on the same farm will change based on what is in season, the chef taking artistic liberty in preparation, and the plates that sit atop the table.  The conversations will be unique, the animals on the farm will be new, and the farm will inevitably be different from year to year. The moment in time is taken as a place in time to celebrate all those farmers providing us food to nourish our bodies and souls.  Without farmers, what would you eat?  To take it one step further and honor the hard work that goes into farming organically and sustain-ably, they choose farmers that exemplify this at these dinners.

There was a cocktail hour, where a fantastic Chicago restaurant, called North Pond, provided champagne and a craft cocktail called the Cucumber-basil cooler.  While enjoying the cocktails and walking around the farm exploring, bite size tastings were offered:

Watermelon gazpacho

Goat cheese mousse, pickle gel and spiced pecan

Buttermilk egg salad, dilly beans, and a tart cherry

Roasted eggplant socca crepe, nectarine, and yogurt

These were all one bite (one delicious bite), and I tried really hard not to fill up before dinner even started! Walking around, I explored the tents they rent out for those wanting to unplug and experience life on a farm, the apple trees that have been there for years as gifts to the farmers, and the donkeys that brought me back to my time in the Peace Corps.  Donkeys were abundant in Mali, and I remember how beautiful I thought their marking were.  After a word of thanks to the farmers and getting a little bit of history of the farm, they took us on a tour.  This particular farm used to be mostly vegetables.  The farmers used to have regular jobs.  Just as the market, demand, and life evolve, so did the farmers that bought the farm, lived in a trailer, then above the barn before they could afford to renovate the farmhouse on the property.  As organic vegetable farming becomes less lucrative, the animal husbandry venture becomes much more appealing.  It was fascinating to hear how they evolved, how their animals live, and what they see for the future of the farm as they age.

Then it was time for dinner at a long table in the field, at sunset, family style with strangers.  You know how sometimes you eat something you’ve had quite a few times before and somehow this time it feels like the best thing you’ve ever eaten?  That is how every course (of the 4 courses) were.  I don’t eat bread typically, but I could not NOT enjoy and partake in breaking bread with my neighbors, smeared with cultured butter.  The bread was laid out on the table for tearing and I am pretty sure many hands touched it.  In some ways this seems unsanitary, and in other ways, this is a traditional way to gain exposure to a diverse set of probiotic microbes.  History can often unveil how important certain things are for our health today.

Every course had its own thoughtful wine pairing and the heirloom tomatoes made my eyes roll back…and I don’t even like tomatoes.  This is real talk.  Another way you know your food is magical: when things you don’t enjoy become somewhat addicting in that moment.  I won’t go through every dish served because descriptions don’t do them justice, but I remember thinking to myself how impressed I was with the thoughtful simplicity of the food.  The chef did an amazing job letting the food itself shine without any crazy techniques or wow factors, and sometimes that’s exactly how it should be enjoyed.  The experience lasted about 6 hours, and guess what?  I didn’t have my phone, and I’m not sure anyone sitting around me looked at theirs once (if they even had them available).  It was refreshing to enjoy a meal outside, at sunset, without the interruption of technology.

Needless to say, I will be back and encourage all of you to consider it if you are in the area of one.  It’s an experience of a lifetime, and will certainly enhance your appreciation for the land, the food it provides, the farmers that tend to the land, the environment you eat in, and the people which you share the simple act of eating with. If I could sum it up in one idea, it would be: “An experience of food from the land to moment you realize the satisfaction and nourishment it provided you.”

I think it’s important to also point out that you do not have to participate in an event like this to get to know local farmers, grow some food, prepare food, or share your food.  I encourage each of you to do more of each of those things, and you’ll never look at food the same ever again because it will always have a story.  Life is nothing more than a series of stories that fill up your soul.  Enjoy it! These were the only pictures I could wrangle without a phone!

Patient Journey: Anxiety and Depression

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As promised, I am sharing patient journeys without any edits or influence! I ask the question, and they give you unadulterated answers to your burning questions. What is it really like to be on a healing journey through my patients’ eyes. Anxiety and Depression is a common patient complaint that land on my doorstep and the current treatment methods need a lot of work. There should be an approach that addresses the problem at the root. That could mean doing something much more drastic than taking medications; it could mean changing how you do life, how you eat, how you think, how you ARE.

1. What health issues were you struggling with when you began to work with Dr. Angela?
Anxiety and depression. Constant (almost daily) headaches. Also some issues that I did not know “could be” helped, like eyes watering, or eczema, lack of energy.

2. What treatment methods had you tried prior to Dr. Angela’s program?
Anti-anxiety and –depression meds prescribed by my MD.

3. What health benefits did you gain from working with Dr. Angela?
I feel like a “better me”, I have more energy, my mind is sharper, my memory is better, my mood is better. I can clearly identify certain triggers that happen when I eat “bad” foods and I do not want to feel that way.

4. What was your biggest struggle during the transition to a healthier lifestyle?
The ups and downs. Feeling good for days then having a setback. Forgetting that I have been one way for 39 years and only “my brand new healthy self” for few months. Giving up sugar (candy) was difficult but finding sweet treats to make from healthier alternatives was wonderful.

5. What did you find most beneficial to you in the program?
Understanding how the human body works and how everything affects everything. Also, learning to set up boundaries for myself as far as how much coffee I can enjoy per week etc. I am still learning the little triggers that set off certain reactions in my body.

6. Did your food options taste good?
Yes everything tasted so good. In fact both my son and husband told me that I make the best foods in the world. I am sure not all of it is my cooking ability, it has to be the good foods we are eating too.

7. Did you have an ah-ha moment that helped you commit to the change? If so, what was it?
When my MD told me that I would have to take meds for the rest of my life for anxiety. The side effects were horrible. I did not want to feel addicted to a pill that I have to take for the rest of my life. To me that was not normal.

8. 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?
“You will not know how amazing you can feel, until you try it”. In the long run with all the medications and doctor visits you will throw out more money and still not get better than what the program with Dr. Angela costs; the difference is Dr. Angela’s program will heal you inside out. And you will feel better than you ever can think of. It is amazing how many people are on the fence about it, even though they could only start trying it for 30 days. What’s 30 days, it is a short amount of time!

 

Dr. Angela’s perspective:

This patient case had some food sensitivities involved, so reactions to food stimulants, and some actual allergies, too.  It’s always a puzzle with many pieces to find a home for.  That takes time, which is why it’s impossible to successfully treat or correct complex health issues in a visit every few months.  It’s a process and if I didn’t take adequate time, I would have missed valuable pieces of the puzzle.  For example, once everything was corrected for this patient, she wanted to continue care to address some other things such as eczema.  Some simple investigation and it was completely cleared with a supplement because of determining her particular cause: an environmental allergy.  In some ways, I wish treating patients was simple, but then I wouldn’t enjoy the “investigative hunt,” and that is half the fun for me.  Like many patients before this person, she did not commit to care until traditional treatments failed her.  I’m always waiting when a person may want to try a different route.

How Good is Your Massage Therapist?

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I am the biggest fan of massage therapy!  I think EVERYONE should have a massage therapist, and I think everyone should get a massage at least once a month.  This article is not about the benefits of massage, but it is about whether you have found a good one!  Since moving, I have been dragging my feet to find a new massage therapist because the thought of vetting people sounds exhausting.  However, I got a massage this weekend and remembered just how important that appointment is to me, and how I assess whether I have a found a good therapist.  I get asked a lot for recommendations of good therapists, and just like doctors, there are different strengths within each therapist.  Because there is such an art to the practice of massage, you are really looking for someone that fits your needs. For example, maybe you’re a woman who would feel uncomfortable with a male therapist and therefore you need a certain gender to be able to relax.  That doesn’t mean the male is a poor therapist, but it does mean you need to find a female.  Having said that, there are a few things that I think are really important when determining if a therapist is right for you:

  1. Do they have a sense of where muscles are tight or may be sore without you telling them?

I think communication with your therapist is important, so being vocal about your problem areas is a must.  However, every single time I get a massage, I realize there are places on my body that feel tight or sore that I had no idea existed.  A good therapist will often pause at these places, revisit them, or even ask upon feeling them “Is this spot sore?”  When you use your hands for a living, you get really good at feeling tiny changes in the tissue, knowing what normal motion feels like, and seeing patterns in how patients feel when certain tissue changes happen.  This is the same thing with your chiropractor.  Without a patient even stating what is bugging them, often times the chiropractor can tell them just based on what they are feeling in the assessment.  This intuition comes with time and experience, so often times, therapists that have been around a long time will have a better grasp on this.  However, I have met a few young therapists that just have that intuition in their hands and you know it when you receive a massage that they have a bright future ahead.

2.  Do they have respectful coverage techniques?

Nothing makes people more tense (especially women) than feeling like they are exposed when they don’t want to be.  Your therapist should always make you feel covered, comfortable, and they should never go to those covered places unless there is medical necessity that has been discussed prior.  For example, there are a lot of muscle insertion points around the butt crease and front of the thigh.  They should be explaining what’s going to happen and ask permission to treat those areas before ever going there.  Your body parts should be fairly covered at all times except when they are working on them.  This keeps you warm, and it increases security and comfort which increases relaxation.

3.  Do you leave feeling better?

This one can be a double-edged sword because sometimes you have injuries or painful places that are sore after working on them, and you may not perceive that as feeling better.  However, when I say “feeling better,” I mean a few different things.  One thing is energy.  If you have a therapist that is negative, stressed, or full of poor energy, you receive that through touch.  I know that we are getting into quack world when we talk about this, but it’s true.  You are energy, you interact with energy, and when someone has contact with you, you inherit some of their energy.  This is also why therapists can sometimes be exhausted by the end of the day!  If they see people in pain, bad relationships, stressed out, etc, they inherit a little of that from their patients, too!  It’s important to enter a massage with the intention of focusing on how your body feels, relaxing your muscles, and being present.  That’s your duty as the patient.  It’s the therapist’s duty to come in with good energy, focus, and attentiveness.  With these two things alone, you will have a totally different experience than if you received the same massage from a stressed, distracted, angry therapist.  Trust me.  You can pass on the bad juju.

As far as physically feeling better, that can go either way in acute situations, but should be consistent with maintenance.  If you are going in for a maintenance massage, you should leave with a feeling of relaxation, better range of motion, and better awareness of your body.  If a therapist goes too deep and you can’t relax, you most definitely won’t have a great massage.  (There are times and places for deep, just for clarification).

This may be a short list, but beyond those three things, we are talking preference.  If you have found someone great in those three categories, then you may want to consider the following that I would consider exceptional:

  • great ambiance, lighting, temperature
  • calming music selection that you like
  • oil quality being top notch
  • use of essential oils for certain benefits
  • how well they explain what they found while working with you
  • how well they can dictate a treatment plan if you are injured

If you find the top 3 with the bottom bullets, hang on and never let go!  The first step is just to schedule a massage, try people out, and stick with one that you leave feeling great about.  Sometimes it’s simply an energy thing, and that’s impossible to measure on paper.

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!

 

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.

 

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.

The Carb Challenge Part 4.5: Sprouted Grain English Muffin (and Quinoa)

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I have some sad news: 1. I did the challenge with quinoa and forgot my glucose monitor at home, so I will not repeat it.  However, based on it’s performance during a meal, my guess is that it reached the same ballpark as banana. 2. I decided to test out a sprouted grain product that most people (including myself) would consider to be fairly healthy for most individuals….and it was almost as bad as the oats!  I scarfed those slices of Ezekiel cinnamon raisin English muffin down without any issues and 2 hours later, I forgot to test my sugars.  So, I did it 2 hours and 20 minutes later, which should mean I had 20 extra minutes to bring my blood sugar down and it was still 104.  I was secretly hoping that it would be a good reading so I could justify to myself why I could eat these delicious bread products without issue.  The reason I would never really eat them before all this carb talk was because they have wheat in them, and I try fairly hard to stay gluten-free.  So, there are 2 strikes against them now in my book.

Now that we have some sad news behind us, you want to know something funny?  I ate 2 paleo donuts the morning before to do a blood sugar test for my friend, Kristen, and THEY WERE BETTER FOR MY BLOOD SUGAR THAN EZEKIEL SPROUTED ENGLISH MUFFINS.  Now that I have done this carb challenge with a variety of foods, I want to point out something very interesting: My worst blood sugar responses were to oats and sprouted grain English muffins.  My blood sugar did fine with white rice, banana, and quinoa.  I tested meals with sweet potatoes and paleo donuts and those were fine, too.  How interesting that if I gave you that list of foods and asked which you thought would give the worst blood sugar response, you would likely say white rice because there’s no fiber, donuts for sure, and fruit because we all know fruit has sugar.  The last things to come to mind would be your heart healthy oats (which were soaked), and sprouted whole grains!  But the reality is, I should not eat these foods if I can avoid them.  For me personally, they just don’t do me any favors.  So, it’s a good thing I have plenty of other carb sources to choose from.

But Dr. A, we all know fat slows down metabolism of carbs, so you should have added fat.

I did.  I had butter with both the oats and the sprouted grain English muffin.  I did not add any fat sources to the banana, rice, or sweet potato.

Why do you think this is?

We are all individuals and we all respond differently to different food sources.  This is why individualized nutrition and medicine is important.  Often times, your body gives you signals that support this.  You may feel really hungry shortly after, or get a sugar crash, maybe brain fog, perhaps excessive weight gain or digestive issues.  Listen to your body.  If you don’t respond well to something, choose a different source of nutrients.  If you are a hardcore science person then get a meter and test!  I have a cheap one in my store tab that will give you 50 opportunities to see you sugar results.

Who should pay attention?

On some level, everyone should pay attention but those that suffer from diabetes, hormone issues, stress, digestive disorders, or sleep issues should all consider taking a closer look. Blood sugar regulation is a huge part of those issues and ignoring it is an opportunity to unlock some of the underlying causes.  Another population that should take a closer look is those with abnormal cholesterol levels.  Triglyceride levels often follow inflammation levels due to glucose metabolism.  These people are told to eat whole grains to improve their risk of heart disease; however, it may be contributing to the source of cholesterol abnormalities!

Summarize your numbers, would ya?

Oats:       pre# 74- post# 122
banana: pre#69- post# 84
Rice:       pre# 90- post# 99
Paleo donuts: pre #82-post#92
Ezekiel Cinnamon Raisin Sprouted English Muffin: pre#82-post#104

Now that I am done with the carb challenge, I can go back eating my normal meals.  However, it has changed what I may choose as my carb sources for workout refueling.  The results also give me a good example to share with patients about why certain foods may never be a good idea to reintroduce.  It all depends on your body!