Mental Health Impacts on Immunity

Everyone has heard that they need to have a more positive outlook or stress is bad for their health.  Try telling that to someone who is sick and has more bad days than good!  It’s not an easy place to be those with any chronic disease, let alone autoimmunity or cancer, but there’s some evidence to suggest that having a positive outlook and a healthy mental state pays dividends in the immunity department!

There is a field of research called psychoneuroimmunology.  Let’s break that down: pyscho (mental)-neuro (nervous system)-immunology (immune system).  There’s an entire of field of research targeted at uncovering the mysteries of how these systems work together.  Do we have it figured out? Nope.  I don’t even think that will happen in my lifetime.  Just because we don’t have the mechanisms explained, doesn’t mean we don’t see some of the correlative effects of optimistic attitudes like:

  • -better natural killer cell activity (NK cells keep cancer in check and help you fight infections)
  • better ratios of helper to suppressor T-cells (T-cells tipped out of balance equals autoimmunity)
  • -increased sIgA function (this is crazy important for the gut barrier that can be compromised in autoimmunity)

Ways to improve mental outlook

There’s nothing more frustrating than recognizing that your attitude sucks, you have negative self-talk, and maybe even some depression and someone telling you to “stop, be more positive.”  What does that even mean?!  Of course, I’d be more positive if I knew how!!!!  These tips are going to feel forced initially, but I will list some helpful suggestions in order of ease.  The top of the list is where you should start if you feel stuck and “being positive” feels forced.  The better you get, work your way down!  Be gentle, because some people take years before they can do some of the lower list comfortably.

  • volunteer– find an organization that helps people, and simply show up to help.  Animal shelters, soup kitchens, Habitat for Humanity, after-school programs.  You ALWAYS have a positive mood when you’ve made another person’s life better.
  • random acts of kindness– randomly throughout your day, do something small for someone that you may not have done otherwise.  Buy their coffee, open a door, let them out in traffic, give a stranger a compliment, look at someone and smile.  Little things go a long way.
  • write and send thank you cards– not only does this task make you think of people who mean something to you, but it also gives you a purpose to remember why your thankful for them, and then you will also feel amazing when they feel good about someone recognizing them and being grateful for their presence.  I do this every year around Thanksgiving, but this is an insta-feel-good anytime you’re feeling down.
  • start a gratitude journal– simply writing 3 things you are grateful for down every day for 21 days without repeating any will force your brain to focus on the blessings.  Your brain will begin to search for these things as a part of everyday life.
  • meditate– being able to practice checking in with yourself, letting go of expectations, knowing that how you are in the moment is enough and exactly how it’s supposed to be is extremely freeing.  Try downloading the headspace app or purchase one of Chopra Center’s meditation series.  I LOVE the Chopra meditations because they start with telling you what to focus on and how to relate it to your life.  You’ll be better at starting yourself as time goes by.

When you think about the fact that cancer patients in studies have been proven to have better outcomes when they visualize and create positive environments over those with negative thoughts, it’s definitely worth a shot.  If for no other reason than the opening the door of opportunity in a time when your immune system needs some help, smile and make a small step towards finding the silver lining!  It will pay you back in ways you never imagined. 

Hair Loss: What Ladies Need to Consider

Did you know that 30% of women report substantial hair loss by the time they are 30?  By the time they are 50, the stat jumps to half.  Half of women have a complaint that is somewhat of a vanity concern, but it could very well be a real health condition , as well.  I want to visit a few reasons why women may be dealing with hair loss, what you may do to address the root cause, and what you may want to do in the meantime to keep those strands on your head.  Before we start, I just want to say, you would still be beautiful if you were bald.  Ok.  I’m ready.

Causes of hairloss in women:

  • high androgens (male dominant hormones)-do you also have acne? deflated breast tissue? increased body odor?
  • low iron-are you also fatigued?
  • thyroid conditions-do you have TSH levels above 2.5?  Have you every had antibodies tested? Are you also constipated? Dry? Weight gain?
  • insulin resistance- Do you have belly fat? PCOS? diabetes?
  • stress-induced-Do you find yourself with lots of anxiety?  Putting too much on your plate? Emotional frequently?
  • autoimmunity- Have you ever had your ANA levels tested?

Tests you can run to decide if any of these things are your issue:

  • ferritin levels- this assesses your iron stores
  • TSH, T3, T4, reverse T3, both antibodies- these will look at thyroid function and rule out autoimmunity
  • cortisol panels- this can peek into your ability to handle your stress
  • glucose levels or A1C- these are pictures of how your blood sugar is doing
  • hormone panels- this can tell you if you are dominant in testosterone

Depending on what the root cause is, there will be some things that are important you could start regardless of knowing a definitive diagnosis:

  • increase fiber- this important for the removal of excess hormones like testosterone so they can be removed by the body and not reabsorbed
  • decrease sugar intake- this does nothing good for your blood sugar
  • start some type of exercise- weight loss can be important because it’s often associated with PCOS, diabetes, and hormone imbalance
  • eliminate dairy- dairy and even eggs can drive inflammation, which can pump up androgens like testosterone
  • consider supplement support or eating liver to cover your bases of minerals and iron

Let’s say you are in the process of identifying and treating the root cause, but don’t want to be bald and beautiful while you’re patiently waiting, here is a list of some things you can consider:

  • topical therapies that stimulate oxygen and blood flow to the scalp
  • get a massage and have them do some work on your head
  • use products that don’t have chemicals
  • drink red clover tea, spearmint tea, and decrease caffeine- these could have positive influence on hormone imbalance if androgens are the cause

Just like anything, the best solution is based on a good diagnosis.  If you have positive results with some topical stuff, keep searching for the root cause, because the hair loss is likely just one symptom of a bigger problem. To some extent, it’s somewhat normal to have some fluctuations in things like hair and skin as you age.  Don’t neglect your lifestyle, because that is often the last thing people look to but has the largest impact.  Hope this helps!

Supplementation: Probiotics

Probiotics are one of the essential supplements that everyone should be taking.  Most people do not realize that they have 10 times more bacteria in their body than they do cells!  There’s about 1kg of probiotic bacteria in the intestines alone, and about 90% of your immune function is dictated by bacteria levels.  Most people have come across a yogurt label that says L. acidophilus.  That is just one strain of healthy probiotic that lives in our body.  In addition to the healthy bacteria, there are also infectious bacteria strains living in our bodies.  Everyone reading this post right now has Strep. in their throat and E. coli in their stool.  However, most of you probably do not have Strep throat or explosive diarrhea!  What’s the difference between those that have an infection and those that simply have the bacteria but NOT the infection?  It comes down to the balance of bacteria levels.  If the levels of the good bacteria outweigh the levels of bad bacteria, then sickness stays at bay.

If bacteria levels have so much influence on our immune function, what can we do to ensure we have enough?  Every time you put something in your mouth, you are deciding whether to feed the good bacteria or the bad bacteria.  Guess what the good bacteria like to eat?  Fruits and vegetables!  Guess what the bad bacteria like to eat?  Sugar!  So, every time you choose a donut, cookie, pasta or sandwich over a salad, apple, or guacamole (had to throw in my favorite snack), you are choosing to HELP THE BAD BACTERIA REPLICATE!  If anyone has ever been in a biology lab, they know that the best way to grow infectious bacteria quickly is to put it on a petri dish full of agar (aka sugar).  Think of your gut as a petri dish, and the environment within it decides which bacteria will grow. Plain, unsweetened Greek yogurt, kefir, sauerkraut, and kombucha all have very high levels of probiotics in them.  Fermented foods are great sources of good bacteria; however, most people do not consume significant amounts of these foods on a daily basis.  In addition, if you take an antibiotic, drink alcohol, consume medications or have high levels of stress, you are negatively affecting good bacteria levels in your gut.  As a result, I find most people benefit from supplementing with a probiotic.

I encourage people to take a multi-strain probiotic.  That means that when you look at the label, it has at least 5 weird names on the back.  I also advise patients to take 1 capsule a day for maintenance.  Our capsules contain 22 billion live, active cultures.  Often times, patients will bring me the probiotic that they purchased at a convenience store, and I quickly point out that they would have to be taking 10 pills in order to get the amount of organisms needed.  What seemed like a cost-effective alternative has now cost more in the long run.  Also, probiotics that you find at doctor’s offices are highly regulated in terms of temperature regulation at the production facility, refrigeration during storage, and cooling mechanisms during the shipping process.  Once the probiotics are in a temperature controlled facility, their bacteria levels are guaranteed until the expiration date on the label.  Bacteria quickly die when exposed to excessive heat.  If you purchase a bottle of bacteria from a store that has not ensured its temperature regulation, you may be wasting your money on dead probiotics!  I also encourage patients to take them away from meals in order to ensure the least amount of digestive activity; this allows more active cultures to make it to the intestinal tract.

If you are someone who has digestive issues, an autoimmune disease, ear infections, autism, or chronic infections, you need probiotics the most!  I hope this clears up some confusion about what probiotics are and why they are important, but I encourage you to leave me questions! Once again, the “store” tab on the blog has suggestions for my favorite brands that I use with patients including Orthobiotic, PrescriptAssist, and Biokult.  I have different reasons for choosing different brands with people, but they are all generally good.  It’s also a good idea to rotate your probiotics to increase strain exposure.  If you have been taking one kind for months, try switching to a new kind this month.

Stress and Autoimmunity (Part IX)

Stress is something that is unavoidable.  We will all experience stress on a daily basis in some way shape or form.  Stress can be anything from mental and emotional stress to exercise and food sensitivities.  All of these things have a breakdown mechanism in the body that elicits the the same physiological response.  Stress activates the autonomic nervous system and you can’t control this.  It’s very difficult to recognize that is happening and actually stop it.  For example, when you lie, your body has a stress response.  This is the reason people say “Secrets keep you sick.  Or Secrets kill.”  This is the exact reason we use lie detector tests!  You can tell your conscious brain to settle down or you’re not nervous all day long, but most of the time, if it is stressful, you still express stress physiologically.  Your palms get sweaty, your voice may waver, your heartbeat increases, and you breathe a little more rapidly. We use those to our advantage to detect stress but what about the hormonal response?  The release of cortisol, the decrease in immune cell production, the disruption in hormones and catecholamines?

The more you experience stress, the more your body runs on sympathetic (fight or flight) dominance.  This leaves you feeling like you wish you could just disappear tomorrow.  Maybe disappear to an island far far away where you could be in silence.  This is often why most people cry at the thought of coming back from vacation.  You body is exhausted from living in this state and if you fall asleep on the couch an hour after coming home from work, you know what that exhaustion feels like.  This is probably hitting home for a lot of you right now in a very doom and gloom way.  Why? Because heaven forbid you have an autoimmune disease, feel there’s no way to get away from stress, you are slowly killing yourself, and there’s nothing you can do about it.  I’m here to tell you that without changing your situation at all, you can reduce stress.

The most important thing you have control over is your thoughts.  They will creep in and try to dictate, but simply recognizing that and repeating what’s really happening in that moment, you won’t get carried away by “what ifs. ”  I see this a lot with people when it comes to work relationships.  A boss said something the wrong way so the employee gets instantly freaked out that they may lose their job, and if they lose their job they will have no money, if they have no money they will lose their home, if they lose their home then their kids will get taken away, then they will have no insurance and they’ll just die because they won’t have any healthcare options for their illness.  STOP!  If this is the type of road your mind takes you down, get good at recognizing when you start down the path.  Bring yourself back to present.  Close your eyes and breathe deeply in one nostril and out the other.  Do not let yourself entertain ideas of things that may or may not happen UNTIL THEY HAPPEN.  The funniest part is that I have asked every single person whether any of these things have actually happened and not a single one has lived this story.  All that time slowly killing our cells over something that has no real likelihood of happening!

Step one is controlling your thoughts from spiraling down a path of worst case scenarios.  The second step is to smile and laugh.  EVEN FAKE ONES.  You heard me right.  There’s also a proverb that laughter is the best medicine because it REVERSES the physiology of the stress response.   You could say that it’s impossible to be stressed and joyous simultaneously.  Go to a funny movie, watch a hilarious youtube video, talk to your friend about old time shenanigans, go to a comedy show.  Smile at everyone you see.  When they are real, they have a huge impact.  When they are fake, they STILL have the same impact.  Laughing reduces cortisol, soothes the nervous system, and improves hormone regulation.  In our society, we tend to become more and more isolated by technology and busy schedules.  Keeping your social connections is so important.  It is not a luxury.  It’s actually good for your health!  I may even dare to say that having a beer with a good friend has more positive effects on your physiology than negative despite the fact that your consuming glutinous alcohol!  That’s how important these things are to your health.  Even a tough love doctor is telling you laughing with friends is possibly more important than what you eat in some instances!

That brings me to the third thing that you can do to reduce stress.  Exercise outside.  We can make this life scenario even more appealing by saying “Go for a walk with a friend, tell stories, laugh, and “touch” goodbye.”  I say “touch” because anything from a hug, a high five, a kiss, whatever, it all has a positive impact.  Movement helps distract the nervous system from obsessive behavior.  It likes to move forward.  You see this with dogs, too.  They are much more behaved in a pack, walking because it is calming to their nervous system.  We are animals, too.  Going to a group fitness class is the same thing.  Moving with friends, laughing, and making connections.  Doing some of this outside is that much better because of the air quality and restorative nature of nature.  No pun intended. ;)

The last and final thing you can do is engage in physical touch.  In my profession, I would be touching people all day long.  However, sometimes patients would come in and that would be the first touch they experienced all day.  I am not a touchy feely person, but that doesn’t mean I don’t experience the same physiological effects of touch.  I’m just more choosy about who I touch! hehe, I couldn’t resist.  Back on track.  Hug your child or spouse goodbye, hug a friend when you see them, get a massage, go to the chiropractor, hire a professional cuddler (that really does exist), have sex or kiss your partner.  These things are not luxuries either!  They are hugely necessary to our well-being as humans.  They counteract stress.  We are hardwired to need touch.  Think about yourself as a child.  Everyone wanted to hold you, give you kisses, touched you constantly to help you maneuver the world.  Then you became a little more developed and touch can be misconstrued as sexual so it happens a little less.  That is until you go looking for it from a teenage boy/girl.  What if you find yourself as a single adult.  You may literally go days without touch.  Heck, the way we greet people in ANY country has to do with TOUCH.  Maybe its a handshake or a kiss on the cheek.  May it’s a hug.  It has and always will be imperative to normal nervous system function.

These are simple, free, yet hard things for some people.  For those less expressive, it may be good to start with the thoughts and movement.  From there start planning social activities to get out there and connect with friends and family!  If you are a single person with an autoimmune disease, even seeing a massage therapist can gain you touch benefits.  Hope you guys are enjoying the series as it is coming to an end!  I will have one final article to address a few questions people had for me.  If you have a question you would like answered in that article, please let me know!


Heartburn and Autoimmunity (Part III)

I can’t count how many patients I’ve worked with over the years that have heartburn.  Most take some type of buffering agent to neutralize the acid such as Tums.  However, for the more severe cases, they will be prescribed a Proton Pump Inhibitor.  This is such a huge deal that I make my physiology students look this up and write an entire paper on how they work!  You do NOT want to inhibit the function of your cell membrane’s proton pump!  Most people can get on board that shutting down a system in the body may not be a good idea, but they don’t know the alternative options available.  That’s where understanding exactly why stomach acid is getting in the wrong place is imperative to fixing the problem for good.  That topic may be for another time, but for now, we are going to make the general statement that most cases of heartburn are actually cases of NOT ENOUGH stomach acid.  Therefore, taking meds to decrease the production even further drives us into a hole that is tough to get out of.  If you just trust me on that statement for the time being, we can look into why decreased stomach acid may play a role in the development of an autoimmune disease.

The stomach is the first stop in the tube after you swallow your food.  It has been designed to have a very acidic environment by the production of HCl.  The reason we need such an acidic pH (around 2), is because that acidity will start the breakdown of your food, kill many bacterial organisms that we do not want making it into the small intestines because they could make us ill, and is needed for vitamin and mineral absorption.  This acid is specifically important in the breakdown of proteins into their legos, amino acids.  (Remember how we need to first breakdown all of our food into it’s smallest components in order to absorb it.)  If this stomach acid plays so many crucial roles, you can imagine the domino of effects that may occur if there is not enough of it around.

When you aren’t producing enough stomach acid, the pancreas and liver aren’t getting the signal to release digestive enzymes and bile, which will mean your food will further lack breakdown.  If these stages of breakdown don’t occur, you can end up with nutritional deficiencies because you aren’t able to absorb things in such large forms.  I see this a lot with Crohn’s patients; men especially can be so skinny because they simply aren’t able to get nutrition absorbed! So, now we have undigested food in the small intestine, which creates the perfect environment for opportunistic bacteria and yeast to grow out of control.  If you have heard the term SIBO (Small intestinal bacterial overgrowth), you know how this can be troublesome for patients who are “eating perfectly” because that specific case requires  therapeutic protocols to actually fix it.  Until the overgrowth is addressed, you won’t digest anything appropriately no matter how perfect your diet.

Low stomach acid specifically impairs the digestive process and creates the perfect environment for bacterial imbalance in the gut.  Remember me talking about how you have 10 times the amount of bacteria in your gut then cells in your body?!  It’s crucial to have abundant good bacteria, and minimize opportunistic microorganisms.  Without balance, we have something called dysbiosis.  Dysbiosis is at the root of so many health conditions including autoimmune diseases because of the risk of infections, nutrient malabsorption, and the impaired integrity of the intestinal wall.  We don’t want an environment where the wall can be leaky, we have bad bacteria hanging around, and large protein structures on top of it.  If those things cross over the wall of enterocytes and  come in contact with the immune cells on the other side, we have just triggered an immune system response to our food.  All of this being a domino effect of NOT HAVING ADEQUATE STOMACH ACID!  That Nexium or Prilosec isn’t helping matters.

I want to throw out a couple things that can be common in patients.  One is H. Pylori.  This organism can overgrown in patients with low stomach acid and the infection NEEDS to be addressed before you can move forward.  The test I use cost about $100 and is worth every penny.  The other thing is that patients don’t often need stomach acid reducing meds, they need supplements that encourage the production of more!  When your body produces enough stomach acid, it’s the signal to the esophageal sphincter to close.  The reason you feel burning in the esophagus is typically because that “door” between the stomach and the esophagus hasn’t closed adequately.  Stomach acid in the esophagus doesn’t feel good and if left alone chronically, it can cause Barrett’s esophagus and cancer.  No good.

You can increase stomach acid by taking HCL/pepsin supplementation with meals, eat digestive bitters, drink a glass of water with lemon juice or apple cider vinegar in it 20 minutes before a meal, or indulge in a little kombucha.  I would also suggest a good probiotic to patients in this situation because you need to rebalance the microbiome.  I have links to ones I like in the “store” along the top bar.  It will send you to the products through Amazon. While these are great tips, I want to caution people from taking this upon themselves because if HCl is taken in conjunction with asprin, Advil, corticosteriods, etc, it can actually cause serious damage to the gut lining and cause ulcers.  Also, if a pathogen is present such as H. Pylori or SIBO, then more steps have to be taken to address that.  Moral of the story is that if you are taking meds to lower stomach acid, you most definitely have an underlying issue that is not being addressed.  You are simply masking the symptom of acid getting into the esophagus.  I would encourage you to ask why it would get there in the first place?  That is not normal.  Stomach acid was created for proper digestion and nutrient absorption, so any substances that would try to increase the pH to be more alkaline, is going to have a detrimental effect.

If you have an autoimmune disease that you are taking an immunosuppressant for, can you imagine the environment we are setting up for disaster if you have stomach acid issues that are allow bacteria to overgrow AND the meds you take are shutting down your immune system?!  Oh my.

I want your heart to be on fire, but just not due to low stomach acid.  Love you guys!