supplements to aid sleep

7 Dietary Supplements to Aid Sleep

Sleep disorders not only rob us of a restful night, but they also have side-effects that go far beyond our simply feeling tired in the morning. Sleep apnea and insomnia are two of the most common sleep disorders and both pose long-term, serious health risks if left untreated.

If you have trouble falling asleep or staying asleep, if you disturb the sleep of others, or if you often find yourself needing a “cat nap” during the day, these issues should be discussed with your doctor. In particular, if you know you snore, and you often feel exhausted, you could have Sleep Apnea. According to the National Institutes of Health, sleep apnea affects more than 12,000,000 Americans…. and 85% of them don’t know it!

The Epworth Sleepiness Scale is a simple questionnaire that can be taken in under 5 minutes, offering a simple and quick way to assess your level of daytime sleepiness. A score of 10 or higher indicates that you need to improve your sleep hygiene and/or see a sleep specialist for further evaluation.
Other actionable steps to help ensure you’re getting some much-needed rest include:

  1. Keeping a consistent pattern of sleep – even on weekends – that allows for 7-9 hours of sleep every night
  2. Avoiding all caffeinated beverages after 3 pm
  3. Getting regular physical exercise (3 – 4 times a week)
  4. Avoiding artificial light from your computer screen at night due to the fact that it may interfere with melatonin production; and,
  5. Proper room temperature, ideally 68-70º F

Sleep Aids for Sleep Disorders

Sleep aids can help individuals who have difficulty falling asleep (as is the case with insomnia), but it’s not uncommon to experience brain fog (forgetfulness, trouble concentrating, and in some cases, confusion) along with drowsiness when these are taken. Over-the-counter and prescription medications, nutritional supplements, and Chinese herbs can all have side effects or cause drug interactions. When shopping for supplements, it’s also very important to note that the FDA does not regulate the supplement industry with the result that some products may have labeling inaccuracies. For these reasons, be sure to talk to your doctor before taking any type of sleep aid.

The following 7 supplements help to regulate sleep, naturally:

Magnesium helps to calm the body’s nervous system and relax the muscles which is critical for a good night’s sleep. Most people do not get enough magnesium from dietary sources alone. If your magnesium level is low, you may experience problems with nerve conduction, muscle contractions, muscle cramps, and insomnia.

▪ Cortisol Manager is a stress hormone stabilizer that promotes relaxation and helps relieve fatigue. It’s safe to use every night.

▪ Phosphatidylserine is a supplement that stops hyperactive production of cortisol in the body, allowing unhealthy, elevated cortisol levels to decrease, and consequently, more restful sleep to occur.

▪ Melatonin is a hormone produced by the pineal gland and it plays a role in regulating the sleep-wake cycle. Melatonin supplements are commonly used to help people recover from jet lag by reorganizing the sleep cycle, but it has also shown to help shift workers who have difficulty falling asleep.

▪ L-Tryptophan is a serotonin-precursor and an amino-acid that can help initiate sleep and can also be used to reduce chronic pain and depression.

▪ 5-HTP (5-hydroxytryptophan) is a naturally occurring amino acid found in the body. It’s also found in the plant species, Griffonia simplicifolia. 5-HTP increases the production of the chemical serotonin, which can have a direct effect on sleep.

L-Theanine is a naturally occurring amino acid found in green tea. Much like Valerian, L-Theanine is thought to improve sleep by stimulating the production of GABA (gamma-aminobutyric acid), which is responsible for “quieting down” heightened neuronal activity.

Sleep disorders can seriously disrupt your life and the lives of those around you but there are many ways to improve the quality and quantity of sleep, naturally.


Provider Spotlight: Sraddha Laura Elizabeth Dorsett

“Provider Spotlight” is a series that highlights the wonderful team of healthcare providers and specialists here at the Kaplan Center for Integrative Medicine.
Sraddha Laura Elizabeth Dorsett
Laura Elizabeth Dorsett has always been fascinated by the relationship between spiritual life and physical health. She leads a free drop-in meditation class for all levels every Wednesday from 7:30 – 8:30 pm.

Why did you choose your specialty?

After experiencing the competitiveness of the ballet world for much of my life, Yoga gave me a way to experience my body in a room without mirrors. I was able to begin a new relationship with my body that was based on what my body felt like, rather than what it looked like to others in a performance environment. Little did I know that it was really a way of connecting more deeply to my inner life.
Around that time, I was also grieving the loss of my father, with whom I was very close, and who transitioned from this life when I was 23. I had no understanding of how to relate to grief and I lived in denial for several years, experiencing anxiety attacks, pain in my body at the same location as his tumor, and general emotional paralysis. It was Yoga that broke open the dam; in reconnecting to my body in a loving and conscious way, I was able to experience the feelings that had been locked up inside me. As I faced these feelings, the most astonishing thing happened: a tremendous peace would come over me right in the midst of the most emotional intensity. It was here that my spiritual life was born. For me, Yoga became the means of a profound spiritual awakening. And yet this awakening of spirit occurred within the context of the physical body, of listening to it, accepting it, and letting its intelligence guide me toward greater awareness and acceptance.
Just as Yoga changed my life, my dharma (Sanskrit for “calling” or “duty”) in this life is to awaken others to its profound possibilities.

What is the biggest challenge in your practice and how do you overcome it?

When self-judgment arises, I usually recognize it relatively quickly – “Ah, here we go… Hello, self-judgement.” I breathe into it, acknowledge it by placing a hand on my heart, and I reassure myself as if I am reassuring a small child. If I am really stuck in it, I sometimes do some gazing with my husband. We simply look in each other’s eyes and focus on our breathing for about a minute. It is an excellent way of bringing myself back home to presence and to feeling unconditionally accepted. I encourage people to try this with their partner, friend, or even – and perhaps more effectively – their pet! Having the unconditional presence of another being with you, especially while experiencing a harsh and unkind inner environment, is extraordinarily healing.

What’s the one piece of advice that you give to all of your patients?

You are exactly where you are supposed to be. Feel Life’s perfection working through you and as you, letting go of your ideas of how things are supposed to be and opening to how they are… a great surprise awaits you when you do this.

What are some of your interests and/or pastimes outside of work?

I love singing kirtan (devotional yoga music and mantras), spending time in nature with my family, curling up with a book, cranking up some music and having spontaneous dance parties around the house… lately we’ve been putting on the song “Afreen” from the “100 Foot Journey” soundtrack (highly recommended stress release!)

If you could choose another career, what would it be?

There is nothing else I would be doing other than what I am doing!

one minute yoga

One Minute Yoga Practice To Do Anywhere/Anytime

At this moment, do you notice accumulated stress in your body? That slight clenching in your jaw, furrow in your brow, tension in your shoulders, tightness in your belly?
The tools of Yoga Therapy are so powerful because they are accessible and meet us right where we are. The following exercise can help to release tension in 1-2 minutes.

One Minute Yoga to the Rescue:

  1. Sit comfortably, hands palms down on your lap, close your eyes, and feel your feet on the floor.
  2. Honor the intention of taking 1-2 minutes to relax your body and mind.
  3. Inhale through the nose, shrugging your shoulders up toward your ears.
  4. Exhale through the mouth with a sigh (if a sigh feels conspicuous, you can just exhale through the mouth), dropping your shoulders, imagining any buildup of stress falling off your shoulders.
  5. Repeat 3 times.
  6. Next, inhale through the nose, filling your belly.
  7. Exhale through your mouth as if you are exhaling out through a straw (lips pursed together creating a little opening between them as if you were holding a straw in your mouth).

This breath technique effortlessly extends the length of your exhale, stimulating your parasympathetic nervous system to release a cascade of stress-reducing hormones that calm and restore your system.
Repeat 3-5 times, inhaling through your nose and exhaling out through the ‘straw’.
Close by repeating the affirmation silently 3 times: “I am relaxed and at ease.” If you have a spiritual life/practice, take a moment to honor its presence in your life. Notice the effects of this simple practice in your body – does your body feel more relaxed? How about your mental state – do you feel more expansive?

bacteria in the gut

5 Ways To Establish A Healthy Gut

Research over the last 10 years has revealed a great deal about the nature of bacterial flora (the microorganisms that live in our digestive system) and the vital role they play in our health. Because the immune system is largely housed in the intestines it makes sense that the 100 trillion (100,000,000,000,000!) bacteria in the gut help to determine the body’s ability to fight infection and prevent disease.

Health Benefits of Good Bacteria

While we’re used to thinking of bacteria solely as agents of devastating diseases, their beneficial capacities are just as remarkable:

  • Bacteria can improve nutrient absorption. Lactobacillus acidophilus and bifidobacteria have been shown to improve the body’s ability to absorb calcium, copper, iron, magnesium, manganese, and other vitamins and minerals.
  • Bacteria can ward off infection. In 1988, a U.S. surgeon general report announced that  “normal microbial flora provide a passive mechanism to prevent infection” and since then, a number of studies have strengthened that finding. In 2008, an NIH study confirmed that “good bacteria” housed in the gut can help defend the body against infection. And in 2012, scientists at Arizona State University confirmed that certain strains of bacteria can be beneficial in preventing food-borne infection.
  • Bacteria produce vitamins. Not only do bacteria improve nutrient absorption, but they also produce vitamins! Bifidobacteria and lactic acid bacteria (LAB) produce B-complex vitamins, including biotin, thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), cobalamin (B12), as well as folic acid and vitamin K.
  • Bacteria manufacture antibiotics. Acidophilin, an antibiotic that fights off streptococcus and staph infections, is produced by acidophilus.[1]

We know only too well that not all bacteria are beneficial, however. They’re also incredibly resilient. As a defense mechanism, bacteria are able to mutate and become more resistant to treatments aimed at destroying them. Then, once successfully transformed, they are able to “communicate” their strategy to other strains of bacteria and multiply.

Bad Bacteria’s Effect on the Gut

If harmful bacteria successfully infiltrate the gut, this destroys the good bacteria and can compromise the protective filtering system within the intestines. This is known as Intestinal Permeability – or “leaky gut”- and it allows all sorts of macromolecules and toxins (like metals, pollutants, chemicals, and partially broken down food) that would normally have been kept within the gastrointestinal (GI) tract and eliminated, into the bloodstream. Then, because blood transports nutrients and vital components like oxygen throughout the body, these unfiltered elements and toxins in the bloodstream are transported to all of the vital organs.

5 Ways to Establish Gut Health

  1. Add live probiotics. A daily dose of live probiotics can help “seal” a leaky gut and restore essential bacteria. When choosing a probiotic supplement, look for one that provides multiple strains over a single strain. Alternatively, try eating fermented foods such as yogurt, kimchi, kefir, sauerkraut, and pickled vegetables, which are chock-full of probiotics, to introduce more good bacteria to the gut.
  2. Eat more fiber. Dietary fiber can help move unwanted organisms out of your intestines; 35-40 grams per day of a combination of both soluble and insoluble fiber is optimal. Most people consume far less fiber than this per day, so examine your food choices and add more high-fiber foods to your plate wherever possible.
  3. Avoid processed & refined foods. A diet loaded with processed and refined foods can wreak havoc on the gut by encouraging harmful bacteria to multiply. Consume as much “whole” or non-processed food as possible to prevent harmful bacteria from taking over, and to reap optimal nutritional benefits.
  4. Cut back on NSAIDs. Regular use of non-steroidal anti-inflammatory drugs medications (NSAIDs) such as Ibuprofen or Aspirin can cause a massive disruption of the gut flora. NSAIDs simultaneously reduce pain and prevent healing, and because the lining of the intestines is repaired and replaced every 3 to 5 days, the mechanism of NSAIDs dangerously interrupts and blocks that process.
  5. Supplement with Glutathione and Glutamine. Glutathione (GSH) is the most abundant of the endogenous, or self-made, antioxidants in the body and plays a major role in the body’s detoxification process. When glutathione levels become depleted as the liver works to remove toxins, supplementing the body’s own supply of glutathione will boost its ability to remove toxins from the body. Glutamine is an amino acid that helps tissues recover from damage – particularly in the GI tract. A glutamine supplement will help reestablish good gut mucosa and gut lining

By making smart choices about diet and nutrition, it is possible to improve the integrity of the gut. Be good to your gut and your gut will be good to you!

[1] Lipski, Digestive Wellness.

brain health

3 Steps to A Better Brain

Memory loss and cognitive decline is a battle most people will face as they age. But it is this really part of the “normal” aging process? Not necessarily. Current research is revealing that what we believed to be degenerative changes in the brain associated with the normal aging process could actually be the result of years of unresolved chronic inflammation in the brain.

This means that, at any age, when routine tasks seem more difficult, and moments of confusion occur more often, symptoms of neurodegeneration of the brain due to inflammation need to be considered.

The inflammatory process

The responsibility of collecting and removing pathogens and debris from our brain falls to the microglia, the innate immune cells in our brains. They do this by initiating a temporary inflammatory response to attack “invaders,” consuming the foreign substance, and then returning to their normal resting state when the danger has been removed.

However, when the body has suffered too many assaults (for example, through infection, physical or mental trauma, chronic stress, poor dietary habits, exposure to toxins), the microglia are unable to down-regulate and they remain in attack mode. The result of this is a chronic, wildfire-like inflammation in the brain. Furthermore, as we get older, and the microglia have a longer history of activation, they move into a more inflammatory state as their resting state. This heightened inflammatory state, over time, eventually damages neurons and affects cognitive functioning and memory.

But there is good news! Our brains are resilient, and when given the opportunity, the degenerative effects of chronic inflammation can be reduced – or even reversed – with certain lifestyle changes.

So, what can you do to reduce inflammation and improve memory and cognitive performance? Here are 3 steps to maintain a better brain:

1) Get regular aerobic exercise: Simply put, aerobic exercise increases blood flow to the brain, which helps your brain create new neurons and improve neural connections. A study by the University of Maryland School of Public Health, published in July 2013, showed that people who increased their heart rate with daily moderate exercise “improved their memory performance and showed enhanced neural efficiency while engaged in memory retrieval tasks.”

Regular exercise also down-regulates microglia in the brain. Try to incorporate just 30 minutes a day of moderate physical exercise – such as walking – for a significant impact on your brain health.

2) Eat smarter: Not surprisingly, diet also plays an important role in brain health and there is an impressive amount of research confirming that essential fatty acids, like Omega-3’s, are very beneficial. If DHA levels are low (DHA is a form of Omega-3) the brain is more susceptible to degeneration. Omega-3 fatty acids also help scavenge free radicals (atoms, molecules, or ions with unpaired electrons) that attach inappropriately to tissue and damage it.

Since our bodies are unable to produce these fatty acids on their own, foods rich in Omega-3’s like salmon, shrimp, sardines, eggs, walnuts, and almonds, should make a regular appearance on our plates.

Fruits and vegetables, high in a type of anti-oxidant called flavonoid, also play a major role in brain health. Foods rich in flavonoids offer a number of neuroprotective properties, and can decrease rates of cognitive decline and potentially slow the progression of many neurodegenerative diseases, such as Alzheimer’s Disease. Foods rich in flavonoids include tea (black, green, oolong), bananas, blueberries and other colorful berries, onions, apples, citrus, Ginkgo biloba, parsley, red wine, and chocolate!

3) Meditate: Meditation is neuro-regenerative. A study conducted by Massachusetts General Hospital found that mindfulness meditation, over the short period of only 8 weeks, increased the amount of gray matter in regions of the brain involved in learning and memory, regulation of one’s emotions, and self-awareness.

Bottom Line: You don’t need to be a bystander in the battle against cognitive decline. By following these 3 simple tips, you’ll be taking important steps toward optimizing your brain health, at any age!


Research has shown that certain nutritional supplements may help limit and possibly even reverse the damage of inflammation in the brain, by calming the neuro-inflammatory process that can damage neural tissue, cause or exacerbate physical pain and emotional suffering, and erode mental clarity.

View Dr. Kaplan’s guide to 10 Brain-Boosting Nutritional Supplements to nurture and even heal the brain for improved memory, mood, and overall cognitive health!


Download the Guide!

Provider Spotlight: Jeanne Scheele, PT

“Provider Spotlight” is a series that highlights the wonderful team of healthcare providers and specialists here at the Kaplan Center for Integrative Medicine.
Jeanne SpotlightJeanne Scheele has practiced physical therapy in Northern Virginia for 40 years and serves as the Kaplan Center’s Physical Therapy Director. Over the last several years, Jeanne has focused her continuing-education efforts on pain management, and in particular, on the use of physical therapy to decrease women’s pelvic pain and to manage incontinence.

Why did you choose your specialty?

I have been focused on women’s health and pelvic floor problems for about 16 years. I became interested long ago because I had patients who had orthopedic problems and confided in me that they were also “leaking.” At the time, I did not have an answer so I investigated. I am still learning.

What is the biggest challenge in your practice and how do you overcome it?

The biggest challenge in my practice, because each woman is unique with special needs, is how to do an evaluation and produce a plan of care for that individual. It cannot be a cookie cutter approach.

What’s the one piece of advice that you give to all of your patients?

One piece of advice? Think positive. Find a way to be quiet within yourself and de-stress.

What are some of your interests and/or pastimes outside of work?

Outside of work, I love to travel with my husband, experiment with gourmet meals, read historical novels, make greeting cards, exercise and meditate, see my children and grandchildren.

If you could choose another career, what would it be?

I honestly do not know of another career. I chose physical therapy at the age of 16 and never looked back!

Provider Spotlight: Michele McLellan, PT, OCS, CLT

“Provider Spotlight” is a series that highlights the wonderful team of healthcare providers and specialists here at the Kaplan Center for Integrative Medicine.
MicheleMcLellanMichele McLellan joined the Kaplan Center in staff 2015 and has since become an indispensable part of the Kaplan team. She has been practicing physical therapy for over 30 years and is a board certified Orthopedic Clinical Specialist – a distinction only 4% of physical therapists in Virginia have achieved – as well as a Certified Lymphedema Therapist.

Why did you choose your specialty?

When I was in high school I always enjoyed and did well in science, and was particularly curious about movement. At one point, I was given a school assignment to explore a career which required me to interview a person in a particular field. My sister, Joyce, had broken her elbow and was attending physical therapy so we arranged for me to attend her PT visits and interview her therapist. As I learned about the profession and how physical therapists help people to heal and regain movement from injuries, surgeries, or illness, I knew this was the career path for me.
To this day I feel very lucky to love what I do as a physical therapist. I look forward to the privilege of applying my gifts, tools, and knowledge to further my patients on their healing journey each and every day.

What is the biggest challenge in your practice and how do you overcome it?

This question is tough for me to answer because my work feels easy – or natural – to me! I rise to the challenges that present themselves and enjoy innovating and constantly learning and adapting my approach to each patient’s particular needs. And, in order to have as many tools in my “tool bag” as possible for use in my practice, I attend continuing education (and tend to be a bit of an over achiever!).
My practice also benefits from being part of a very talented team at the Kaplan Center. This team approach gives us the ability to help patients with multiple health challenges simultaneously, making us a stronger “whole” than we may each be as a part.

What’s the one piece of advice that you give to all of your patients?

I constantly think about a patient’s current stage of healing – or lack thereof – and what can be done to improve movement that’s challenging at that moment but not out of reach. I help my patients to self-identify what the aggravating and relieving factors of their current condition are. For example, if sitting down worsens symptoms, I will look closely at how the patient sits – looking at angles, posture, and even the chairs he or she uses. I may suggest alternative activities to what’s typical for the patient in order to get in front of the pain before it starts.

What are some of your interests and/or pastimes outside of work?

Outside of work, I enjoy being with family and friends to laugh, be silly, and have fun! Being active and eating in a healthy way are important for me. As a Master Gardener, I enjoy volunteering and cooking with ingredients from our organic vegetable garden. In a recent year, I had many “volunteer” cherry tomatoes. One day I picked 8 1/2 pounds of cherry tomatoes, followed by 5 1/2 pounds just 2 days later! Sharing them at work was fun!

If you could choose another career, what would it be?

I would be a figure skater! That may seem random, but I loved skating on ponds and public rinks growing up in New England in a large family. I took lessons, and advanced quickly, which helped me to love the winter months. Even today, watching the grace and athleticism of skaters on TV or in-person is something I thoroughly enjoy.

Provider Spotlight: Lisa Lilienfield, MD

“Provider Spotlight” is a series that highlights the wonderful team of healthcare providers and specialists here at the Kaplan Center for Integrative Medicine.
spotlight lilienfieldDr. Lisa Lilienfield has been with the Kaplan Center for over 16 years. She is board certified in Family Medicine and practices Acupuncture and Osteopathic Manipulative Medicine, with an expertise in both Women’s Health and Sports Medicine.

Why did you choose your specialty?

When I was in medical school I really enjoyed all of the different aspects of medicine, including Pediatrics, OB/GYN, Adult Medicine, and Psychiatry. When I learned about family medicine, which incorporates all of these specialties, I knew it was the right choice for me. Family medicine allows me to see all different age groups and practice all of the different types of medicine I really enjoy.

What is the biggest challenge in your practice and how do you overcome it?

In our practice we see patients with very challenging and difficult cases, many of whom have already been to multiple physicians. For me, the biggest challenge centers around the concern I feel about whether or not I am going to find my patients a solution. I want to help each one of them find the right answer and feel better.
One of the wonderful and unique things about the Kaplan Center is our weekly collaborative meetings, where all of our providers put our heads together to find the appropriate solution for each patient in our practice. Fortunately, we have a team of really smart providers and we are never alone in finding the right path for our patients.

What’s the one piece of advice that you give to all of your patients?

The one piece of advice that I give all my patients is to find balance in their lives. Life isn’t all about work. We have to find balance with play and creativity. We need to take care of ourselves by eating good food, getting enough sleep, exercising, and socializing. It’s easy to fall into a pattern where you are out of balance, so this is the one piece of advice I wish all of my patients would follow.

What are some of your interests and/or pastimes outside of work?

Outside of work I am presently completing advance yoga teacher training. I have really enjoyed learning about the philosophy and history of yoga because there’s a lot more to it than most people think. This training has taken up a good amount of my extra time. I also have a big family – kids, step-kids, and grand-kids – and fortunately we are able to spend a lot of time together.

If you could choose another career, what would it be?

This question really stumps me! I actually decided to go into medicine when I was in the 7th grade. My father was a physician, not a clinical physician, but a professor, so at an early age I decided that it was also the path for me. Quite frankly I can’t imagine doing anything else!
To read Dr. Lilienfield’s complete bio, click here.

8 Commonly Overlooked Causes Of Anxiety And Depression

If you’re one of the many Americans seeking relief from depression or anxiety, you’re no doubt aware just how elusive successful treatment can be. In fact, studies find that as many as 40% of people with depression fail to respond to treatment, while just over half report even a partial response to therapy.
These dismal figures raise an important question. Could it be that we’re thinking about — and therefore treating — these conditions in the wrong way?
A growing body of research now suggests that depression and anxiety might not be mental disorders in and of themselves, but rather symptoms of a physical inflammation stemming from the brain. This gives the medical community and those living with these debilitating conditions new hope. In thinking about depression and anxiety as symptoms, we’re afforded new insights into potential root causes, as well as alternative methods of treatment.
Here are eight often-overlooked causes of depression and anxiety that you should consider:
1. Celiac disease or a gluten intolerance.
PB-wheatAbout 1% of Americans have celiac disease, an autoimmune disorder caused by the body’s negative reaction to gluten, the protein found in wheat, barley and rye. And gluten intolerance — also called non-celiac gluten sensitivity — is estimated to impact six times as many Americans.
While we don’t yet understand the mechanism of gluten intolerance in the body, the impact can be very similar to that seen with celiac disease. While intestinal complaints are most common, research is showing that people with these conditions may, in fact, present with anxiety and depression as the only symptoms.
You can test for celiac disease with a simple blood test. The only way to test for gluten intolerance is to go gluten-free for six weeks and watch for any improvement. (Before making any major dietary changes, make sure to consult your physician or a registered dietitian.)
2. Sleep apnea.
There are two types of sleep apnea. Obstructive sleep apnea is the more common form and occurs when the soft tissue in the back of the throat collapses, thereby blocking the airway during sleep. Central sleep apnea, although not as common, is a result of the brain forgetting to tell the body to breathe. A 2003 study found that nearly one in five people with depression also suffer from a breathing-related sleep disorder.
If you get plenty of sleep but never feel quite rested, or you find yourself often nodding off, a first step you can take is to answer the 8 questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your doctor.
3. Toxic mold exposure.
Exposure to certain indoor molds can result in a wide range of symptoms, including depression, ADHD, difficulty concentrating, fatigue, chronic sinus infections, and various pulmonary and neurologic issues. If you fear that you’ve been exposed to indoor molds, it’s critical that you speak with a physician who is familiar with mold toxicity disorder.
4. Thyroid disease.
Both an under-functioning thyroid (hypothyroidism) and an over-functioning thyroid (hyperthyroidism) can present as depression or anxiety — not to mention other symptoms like weight changes and exhaustion. If you suffer from depression or anxiety, you may wish to have your thyroid hormone levels checked in order to rule out any disorder.
5. Medications.
FI-pillsIt’s also possible that regular medications may be causing or worsening your depression or anxiety. Beta-blockers used to treat high blood pressure are known to cause depression, and acne-fighting Accutane, birth control pills, and even statins all list depression as a possible side effect.
If you take medication regularly, I recommend talking with your doctor about the chances that your medication is bringing you down or making you anxious.
6. Coffee.
Several studies have demonstrated a link between coffee consumption and heightened depression and anxiety. While most people can tolerate one to two cups of coffee per day without issue, if you are prone to depression or anxiety, you may want to rethink your morning pick-me-up.
Try cutting out coffee altogether for at least two months, and observe whether or not your mental state changes as a result.
7. Unhealthy diet.
In 2011, a study published in the journal Public Health Nutrition found that individuals who consumed a diet high in baked goods and fast food had a 51% increased risk of developing depression.
On the other hand, eating a diet high in omega-3 fatty acids (fish oils, walnuts and flax seed) and antioxidants (colorful fruits, berries and greens including spinach, broccoli and collards) can help provide the brain with the nutrients it needs to repair free radical damage and optimize function.
8. Lyme disease.
Lyme and other tick-borne diseases are becoming increasingly prevalent. While the most common symptom is joint pain, these diseases can also be associated with depression and anxiety disorders.
This link between Lyme disease and neuropsychiatric disease was first documented in 1994 in the American Journal of Psychiatry, and has been widely documented since, but the potential connection is frequently overlooked when diagnosing those with psychiatric illness. If you are suffering from chronic pain and a mental disorder, this diagnosis should be considered.
This article first appeared in Dr. Kaplan’s column on

Healthy Aging Can Be A Balancing Act

Have you ever been in a situation where your mind said, “You can do it! You can do it!,” then your body said, “No, STOP – you can’t!”? In the case of a fall, it’s possible that the second message came a little too late.
Most of us know exactly what it feels like to experience a fall. It can be a very scary moment when you know you have lost your balance and a fall is imminent. Oftentimes, there is nothing you can do about it but hope for a soft landing and no fractures.
In the United States, nearly one third of adults over 65 fall annually, causing 95% of the hip fractures seen each year. Among older adults, falling has become the leading cause of fatal and non-fatal injuries. So – what is this thing called BALANCE, and why does it get worse with aging?
Balance is a state of equilibrium where there is an even distribution of weight enabling someone to remain upright and steady. Having good balance means having control over your body’s position, whether you are moving or remaining still. Ahhh… if only that would stay with us as we age. The unfortunate reality is that our risk and frequency of falling increases the older we get because our natural ability to maintain balance is compromised by a number of factors, including:

  1. Musculoskeletal factors: This includes muscle weakness (most notably in the core, but could be in the extremities as well), joint and soft tissue stiffness, and poor posture which changes our center of gravity.
  2. Neurological factors: Reflex sensitivity and reaction times are reduced as we age and there is a diminished sense of spatial awareness.
  3. Age-related Vestibular disorders: These include dizziness, vertigo, lightheadedness, blurry vision, BPPV (Benign Paroxysmal Positional Vertigo), and inner ear disorders.
  4. Age-related Visual disorders: Visual acuity, depth perception, peripheral vision, and contrast sensitivity (being able to see the difference in patterns and shading, i.e. hotel carpeting on steps without a defining border).
  5. Ankle instability*: The older we get, the stiffer our ankles tend to become. Another common issue is decreased mobility in the mid-foot and toe regions, especially the great toe (big toe) which is used to push off into a walk.
  6. Hip stability*: Corrective motion in gait occurs primarily around the hips, which need to be open and mobile but are less-so as we age.
  7. Pain: Pain anywhere in your body, will affect how you hold yourself thereby altering your sense of orientation in space and your center of gravity.

*With aging comes osteoarthritis which affects these weight bearing joints.

4 steps you can take to decrease your risk of falling:
  1. Exercise is VERY important and needs to be targeted to potential problem areas in the body. A good exercise program will include gentle movements that focus on improving core strength, along with weight bearing exercises to increase bone density.
  2. If you are taking medication (which is the reality for most of us as we age), there is a possibility that your medications may be adding to your visual or vestibular difficulties. Consult your physician to rule out this possibility.
  3. Don’t ignore your pain. Whether your pain is acute or chronic, make sure to address it immediately with your physician or a pain specialist.
  4. Be kind to your feet! Shoes need to be supportive so we can move more efficiently and experience greater ease in having to stand still for a long period of time.

If you think you could be at risk for a fall, make sure to have a talk with your physician or physical therapist to relay your concerns as soon as possible. You can always do something to feel and move better!!