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7 Benefits of Stable Blood Sugar

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Diabetes is a chronic medical condition characterized by high blood sugar levels as a result of your body’s inability to properly regulate insulin, the hormone responsible for controlling glucose levels. Diabetes is best managed with a proper diet, lifestyle changes, and in some cases, the use of medication such as insulin or oral hypoglycemic agents.

If you have Type 1 diabetes, your body does not produce insulin on its own. If you have Type 2 diabetes, your body doesn’t produce enough insulin or the cells become resistant to insulin’s effects. In both cases, this dysregulation of insulin levels can lead to periods of high and sometimes low blood sugar levels. This can negatively impact the body so maintaining stable blood sugar levels is essential for your overall health and well-being.

Kaplan Center’s approach to managing diabetes addresses all of the root causes that are driving your condition. In contrast to conventional medicine, our functional medicine approach emphasizes prevention through lifestyle and dietary modifications and promotes overall health and wellness. Please give us a call today, we can help.

Here are seven benefits of having a stable blood sugar

1 – Enhanced energy levels

When your blood sugar level is stable, your body can efficiently convert glucose into energy. This means you will be provided with a steady and constant energy supply throughout the day and reduce the amount of fatigue or sluggishness that you experience.

2 – Better weight management

It is important that you maintain a stable and healthy body weight with diabetes and having a stable blood sugar level can help. When your blood sugar remains steady, you’re less likely to experience intense hunger or cravings that can lead to overeating or making unhealthy food choices.

3 – Increased focus and concentration

Blood sugar imbalances can affect cognitive function, leading to difficulties in concentration and focus. In fact, Alzheimer’s disease, dementia, and cognitive impairment are now being dubbed by researchers as Type 3 Diabetes due to the strong link between insulin resistance and cognitive decline/impairment. Interestingly, this could also help explain why dementia patients always crave sweet things.

Because the brain is the most energy-demanding organ and uses one-half of all sugar (energy) in the body, stable blood sugar will not only help promote better brain function and improve mental clarity but will also help lower your risk of developing Alzheimer’s disease and dementia.

For more information on insulin resistance, its relationship with cognitive function, and strategies on how to stabilize your blood sugar, you can read the following articles by Dr. Lisa Lilienfield, “Pre-diabetes: Are You at Risk?” and “Addressing the Fear of Cognitive Decline & How to Be Proactive.”

4 – A reduction in the number of diabetes-related complications

Consistently high blood sugar levels are associated with long-term damage to various organs including the eyes, kidneys, heart, and nerves. By maintaining a stable blood sugar, your risk of these complications is reduced. This is important because the complications can be serious; complications include macular degeneration of the eyes, reduced kidney function, or issues affecting your nerves.

5 – Improved mood and mental well-being

Fluctuating blood sugar levels can lead to mood swings, irritability, and even anxiety. One study found that greater glycemic variability may be associated with a lower quality of life and negative moods. So, by maintaining stable blood sugar, you promote better emotional balance and overall mental well-being.

6 – Improved cardiovascular health

High blood sugar levels can damage your blood vessels and increase your risk of cardiovascular diseases such as heart attacks and strokes. A stable blood sugar can help you maintain a healthier cardiovascular system which reduces your risk of many life-threatening cardiovascular issues and heart disease.

7 – Enhanced overall health

Stable blood sugar levels can positively impact various aspects of your health such as supporting your immune function. This boosts your body’s ability to fight off infections and illnesses more effectively. Additionally, stable blood sugar is known to contribute to better sleep quality, hormonal balance, and overall longevity.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References

https://hms.harvard.edu/news-events/publications-archive/brain/sugar-brain

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317401/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246646/

Are Bioidentical Hormones for You?

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As a family practitioner who specializes in women’s health, I often hear stories of frustration from my patients who are entering menopause. During menopause, a woman’s body dramatically decreases its production of estrogen, progesterone, and even testosterone. For many women, these hormonal changes can cause a range of symptoms including:

  • Sleep disturbances
  • Hot flashes
  • Irritability
  • Difficulty concentrating / brain fog
  • Sporadic periods
  • Difficulty regulating body temperature
  • Fatigue
  • Muscle aches

Although there is no single solution that works for every woman, hormone replacement therapy can relieve many of the unpleasant symptoms that most women experience during menopause.

When I explore the possibility of using hormone replacement with my patients, I make sure they understand both the benefits and the risks. Our discussions usually involve reviewing the latest medical research, but they always include evaluating each woman’s personal medical history, family history, and symptomatology.

This is what I tell my patients…

Hormone replacement is not risk-free. Years ago the Women’s Health Initiative (WHI) reported research results correlating the use of hormone replacement therapy with higher rates of breast cancer, strokes, and heart disease. These results were very disconcerting, but it is important for everyone to understand what the WHI did and did not study.

The WHI focused on studying the effect of two hormones: “conjugated equine estrogen,” a hormone extracted from the urine of pregnant mares and marketed as “Premarin,” and “progestin,” a synthetic version of progesterone, which is marketed as “Provera.” Both of these hormones are similar to, but not the same as, the hormones that women naturally produce. And both of the studied hormones produce metabolites as they pass through the liver, which in turn stimulate the production of proteins associated with heart disease, such as C-reactive protein, activating protein C, and clotting factors.

What the WHI did not investigate was the effect of treating menopausal women with “bioidentical” or “natural hormones”, the approach that I and many other physicians who specialize in women’s health take with patients.

Briefly described, a bioidentical hormone is one that has been synthesized from a botanical source, which, by itself or in combination with other hormones, mimics the body’s natural state. Although Premarin may be “naturally occurring” in the sense that it is biologically produced by a horse, it does not mimic the effects of a woman’s own hormones as closely as bioidentical hormones made from plant extracts.

A longitudinal study helped to further refine our understanding of the risks associated with hormone replacement therapy. Conducted by a group of French scientists and published in 2008 in the journal Breast Cancer Research and Treatment, the study evaluated more than 80,000 women who were taking hormone replacements. It concluded that the particular type of progesterone that a woman took with estrogen significantly affected her risk for breast cancer. Specifically, it showed that while Provera increased a woman’s risk for breast cancer, the bioidentical progesterone did not.

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So, what should we do with all this information?

Most importantly, how can we safely treat the symptoms of menopause that, at least for some women, can be so debilitating? To buffer the health impacts associated with lower estrogen levels, I often recommend the bioidentical hormone “Estradiol” because it most closely imitates the effect of estrogen on a woman’s body. A synthetic hormone made from soy and yam extracts, Estradiol can be administered by itself via transdermal patch or gel, or in combination with another bioidentical hormone, Estriol (a weaker estrogen), and used as a cream. The latter would be made at a compound pharmacy, while the patch or gel is available at most pharmacies. Bioidenticals can be taken orally, but I prefer to prescribe transdermals because this delivery method bypasses the liver, thereby allowing the hormones to be absorbed directly through the skin, into the bloodstream, and onto the target cells (e.g., the brain, skin, vagina).

Another approach to delivering bioidentical hormones is via subcutaneous pellet therapy. For those who don’t like patches or gels or who may have inconsistent results due to irregularities in absorption or possible skin irritation, pellet therapy is another safe and effective option. Hormone pellets are implanted in the fat layer under the skin (typically in the buttocks/hip area) and release an even and consistent dose of hormone over the course of several months, depending on the hormone. For those who are taking estrogen, pellets are administered every 3-4 months and every 5-6 months for patients taking testosterone.

If a woman still has her uterus, it is important that her hormone replacement include both estrogen and progesterone. This combination protects the uterus from unopposed estrogen, which can cause the lining of the uterus to grow too much (“endometrial hyperplasia”), a condition that can lead to uterine cancer. Even if a woman’s uterus has been removed, however, I usually recommend taking progesterone for its own health benefits, such as reducing irritability and sleep disturbances and improving cognition. I often prescribe the oral form of micronized progesterone called “Prometrium.” (Avoid this product if you have a peanut allergy!) I also prescribe a compounded progesterone cream that women can use transdermally. Both of these progesterone products are derived from yams. When low libido presents a problem, testosterone also can be added to the bioidentical hormone cream or gel.

Once a woman begins taking bioidentical hormones, we closely monitor her symptoms and retest her hormone levels as needed, adjusting her treatment accordingly. I always remind my patients that choosing hormone replacement therapy is never a lifetime commitment; it is always a choice, and at any time you can decide to wean off and utilize other methods to improve your well-being, such as herbal and nutritional remedies, acupuncture, meditation, and exercise. Furthermore, even when hormone therapy is an important part of feeling physically healthy and emotionally balanced, it is still just one piece. A woman’s activities, satisfaction with work, general health, relationships, nutrition, and exercise habits also will affect her overall sense of well-being.

If a woman chooses to go on hormone replacement, it is crucial that she continue to get her regular mammograms, pelvic exams, and pap smears. Annually, I meet with each patient to review her test results, and to discuss the latest medical literature on hormone replacement therapy. Then, in light of her particular health and life circumstances, we evaluate whether to continue treatment.

So, if you or a woman you love is in menopause and is suffering from any of the symptoms described above, please know that you have options, including bioidentical hormone replacement therapy. For more information or to schedule an appointment so we can help you evaluate the best course of treatment for you, please call us at 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in May 2010. It was reviewed and updated in July 2023.

hypothyroidism_lilienfield

A Functional Medicine Approach to Autoimmune Hypothyroidism (Hashimoto’s Thyroiditis)

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Autoimmune hypothyroidism is characterized by too little thyroid hormone in the bloodstream. It occurs when the body attacks and inflames its own thyroid gland. Hashimoto’s Disease (or Hashimoto’s Thyroiditis) is the most common cause of autoimmune hypothyroidism.

Thyroid disorders are commonly associated with a person’s energy level but the symptoms vary from person to person and can also affect appearance and mood, often making it even more difficult to cope. The most common symptoms include:

Dr. Lisa Lilienfield explains the Functional Medicine approach to treating autoimmune thyroid disease vs conventional practices. She discusses its ATMs (antecedents, triggers, and mediators), testing, and treatment options that may include dietary changes, supplementation, adrenal function, and hormone replacement.

Click here to read more on hypothyroidism: https://kaplanclinic.com/hypothyroidism/

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

hormonal_balance

Hormones, The Great Communicators

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A look at some of the causes of hormonal imbalance.

Somewhere in the middle of the brain is a control center called the limbic system, or the old mammalian brain. Here, amongst a host of structures, are two glands of the endocrine system: the hypothalamus and pituitary glands. These glands act as a hub for the body’s chemical messengers called hormones.

Hormones travel from one endocrine gland to the next to communicate messages from the brain that control a number of biological functions. For example:

  • The hypothalamus tells the pituitary to produce thyroid-stimulating hormone (TSH), which tells the thyroid to produce thyroid hormone, which feeds back to turn down the hypothalamus and pituitary. This is called a feedback loop.
  • The pituitary produces a hormone that travels down to the gonads (ovary and testes) to tell them to produce estrogen or testosterone.
  • The hypothalamus and pituitary tell the adrenals to produce cortisol, which is needed in times of an acute stressor, to increase blood pressure, glucose production, and suppress the immune system.

This whole structure is called the Hypothalamic Pituitary Adrenal Thyroid Gonadal Access, or HPATGA.

With age, both women and men undergo natural changes that interrupt this communication system and produce hormonal imbalances; but most of the time it’s external factors, like environment, diet, and lifestyle, that are to blame.

Symptoms that individuals experience vary greatly; among the more common symptoms are sleep disruptions, unexplained weight gain or loss, changes in mood, sex drive, and energy levels. When left unchecked these imbalances can contribute to more serious clinical conditions.

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Causes of hormonal imbalances

Let’s start with the diet.

First and foremost, the gut and its entire bacterial flora are intricately connected to our immune system. We know that 1% of the U.S. population has Celiac disease, a condition where the gluten in wheat, barley, and rye causes inflammation in the gut and destroys the natural barrier in the small intestine to large proteins and toxins. This has been associated with autoimmune disorders like rheumatoid arthritis, lupus, multiple sclerosis, Type 1 diabetes, and autoimmune thyroid disease.

Similar issues are observed in people who are gluten intolerant, which by some estimates account for over 6% of the population.

There has also been identified a non-gluten protein in wheat called ATI (amylase trypsin inhibitor) that has been associated with autoimmune disorders[1].

For example, in autoimmune thyroiditis, the thyroid gland is attacked and becomes inflamed. As a result, it can produce too much thyroid hormone (Graves’ disease), or stop producing thyroid hormone leading to hypothyroidism (Hashimoto’s disease). A leaky, inflamed gut from gluten and other wheat proteins can be the cause or further aggregate these conditions.

What about lifestyle?

A busy, high-stressed lifestyle can cause the overproduction of cortisol from the adrenal gland which can results in an increased risk of diabetes, inflammatory diseases like heart disease and cancer, disruption of sleep, and an increase in anxiety and fatigue. Since cortisol suppresses the immune system, those who are chronically stressed get sick more easily. Cortisol also suppresses estrogen and testosterone, and interferes with the conversion of T4 thyroid hormone to the more active T3, resulting in fatigue, weight gain, irregular menses, chronic pain, and depression.

How does the environment affect hormones?

There are environmental toxins called endocrine disruptors that actually bind to hormone receptors and increase or decrease these hormones unnaturally. Examples of endocrine disruptors include pesticides like DDT, plastics that contain phthalate and bisphenol A (BPA), and industrial chemicals like PCBs. There are also glyphosate-based weed killers (like Roundup®) that are used in agriculture and end up in our food. These herbicides damage DNA and act as an antibiotic killing off our good digestive bacteria and disrupt the proper functioning of the immune system.

How to support hormonal balance

1. EVALUATE DIET AND MEDICATIONS. 

What we eat and the medicines we take make a difference. Food is code, meaning food turns genes on and off. If someone carries genes for Celiac disease, diabetes, or cancer, these genes can be turned on – or off – by specific types of food. Eat to minimize inflammation in the gut and promote the growth of highly diverse, good bacteria, which research shows is associated with good health.

There is evidence that over the past several decades, the newer wheat strains like dwarf wheat which are so loaded with gluten and other proteins, are causing more and more people to develop Celiac and non-Celiac gluten wheat intolerance, leading to leaky gut and autoimmune disorders[2]. Anyone with an autoimmune thyroid condition or other autoimmune disorder should eliminate gluten.

In addition, the overuse of antibiotics and other pharmaceuticals reduce the beneficial bacteria in the gut. Minimizing the use of medications, and eating fermented foods, probiotics, and dietary fiber that feeds our good bacteria promotes good gut health and decreases the likelihood of autoimmune disorders.

2. ASSESS STRESS LEVELS.

Stress can lead to chronically elevated cortisol. How can we lower cortisol levels and restore the natural cortisol pattern? We need to take the time to assess our stress levels. Are we working too many hours, sitting too long, staying up too late, worrying about yesterday and tomorrow, and coming up with excuses for not exercising and eating poorly? All of these practices increase cortisol which increases the risk of diabetes, hypertension, and heart disease, and affect our hormones. It is imperative that we slow down, prioritize, take time to move, eat well, sleep, seek help and support when needed, and get connected with the community and loved ones.

Yoga, Tai Chi, meditation, weight training, and aerobics help tremendously with stress and lower cortisol. Research is now showing that sitting too long can be as bad as smoking!

3. ELIMINATE TOXINS.

Environmental toxins are tougher to deal with, but minimizing the toxins we are exposed to, and eating foods that naturally detoxify like deeply colored and cruciferous vegetables, foods with omega 3 fatty acids (i.e. fish oil or other sources), and supplementing with magnesium, vitamins B and C, are just a few ways to support the liver’s detoxification process.

Every year since 2004 the Environmental Working Group assesses the sampling of pesticides in our food source from the U.S. Department of Agriculture and the Food & Drug Administration and makes a recommendation as to which fruits and vegetables should be consumed as organic and which are safe as non-organic (EWG Guide to Pesticides in Produce). As previously mentioned, herbicides like Roundup® are showing up in wheat, corn, soybeans, and a host of other foods. Shopping wisely for foods like grass-fed beef (not grain-fed), free-range chicken and eggs (organic may not be enough), wild-caught fish (rather than farm-raised), dairy products without hormones, and buying organic produce from the list put out by EWG, are ways to minimize your exposure to toxins.

Household cleaners, personal care products, and plastic bottles can also have endocrine-disrupting chemicals, so using glass instead of plastic, and minimizing exposures to these chemicals is recommended.

As we age, there is a natural decline of our gonadal hormones (estrogen, progesterone, and testosterone) and in some cases replacement hormones are beneficial. There are ways that we can minimize the risk associated with hormone replacement by using bio-identical hormones, which are closest to natural hormones, and by supporting the metabolic process with diet to reduce any harmful metabolites of hormones that could increase the risk of disease.

To support you in your journey to good hormonal health, I recommend hormonal testing, functional digestive testing when indicated (stool, urine, and breath tests), a dietary consultation to plan a healthy low-inflammation diet, meditation, yoga, a regular exercise plan, adequate sleep, and a look at any potential toxic exposures that could disrupt your hormones, the Great Communicators!

1 Consumption of wheat amylase trypsin inhibitors enhances autoimmune encephalitis in mice. Oral presentation, 16th International Celiac Disease Symposium, 2015, Zevallos

2 Akil Palanisamy, MD, The Paleovedic Diet

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Breast Cancer Awareness

Minimizing Breast Cancer Risk

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According to the American Cancer Society, about 276,480 new cases of invasive breast cancer will be diagnosed in women in 2020. A further 2,620 new cases of invasive breast cancer are expected to be diagnosed in men.

The causes of cancer are complex; genetics and our environment can play a large role. So while there is no sure way to prevent it, the tests, supplements, and lifestyle recommendations outlined below, along with the guidance of a trusted physician, can help minimize your risk.

Lifestyle Choices in Minimizing Cancer Risk

Lifestyle can play a very important role in minimizing your risk of cancer. I highly recommend the book, Keeping aBreast, by Dr. Khalid Mahmud, which offers the following suggestions for maintaining an optimal lifestyle (some of these also appear in well-regarded studies).

  • Nutrition: Good nutrition and targeted supplementation can help to reduce cancer risk. A low-glycemic diet that includes lean protein and more than 5 daily servings of vegetables is recommended. (See below for some of the best cancer-fighting foods and supplements.)
  • Exercise: Exercise programs emphasizing an increase in lean muscle mass offer benefits twofold by decreasing inflammation which in turn lowers cancer risk. On the other hand, an excess of fat in the body can increase levels of estrogen which increases the risk of breast cancer. One should aim for a BMI (body mass index) of 25.
  • Red Wine: Drinking red wine in moderation (less than 3 small glasses, 5 ounces each, per week) can reduce free radicals that damage DNA.
  • It’s important to note that drinking in excess and smoking increase the presence of free radicals, and interfere with the body’s ability to repair potential cancer cells.

Risk Assessment Tests

There are currently many tests available to assess the risk of breast cancer – for the purpose of this article I have chosen 3 to mention:

    1. Estrogen-Metabolism Assessment: This valuable tool evaluates how your body metabolizes and processes estrogen. Certain types of estrogen metabolites may increase the risk and worsen the prognosis of breast cancer. Testing the levels of these metabolites in your blood or urine can help determine whether lifestyle changes, such as diet and exercise, are warranted in reducing the level of unhealthy estrogens in the body.
    2. BRCA Gene Testing for Women and Men with a Strong Family History of Cancer: Certain gene mutations can indicate that some women and men have a higher risk of developing breast and ovarian cancers. Those who have inherited the harmful BRCA gene mutation are about five times more likely to develop breast cancer in their lifetimes than if they were without it. Also, certain ethnic and geographic populations, such as Ashkenazi Jews, Norwegians, Dutch and Icelandic people have a higher prevalence of BRCA 1 and 2 mutations. Knowing whether or not you carry the mutation can help you understand your personal risk of developing breast or ovarian cancer as well as passing it on to children.
      While the BRCA gene mutation is the most common mutation associated with breast cancer, over the past few years other gene mutations have been identified. If there is a strong family history of cancers, genetic counseling would be advised.  
    3. DUTCH (Dried Urine Test for Comprehensive Hormones) test: The DUTCH test is an advanced hormone test that can help identify symptoms of hormonal imbalances. DUTCH testing can help patients manage risk, based on their unique hormonal profile.

Cancer-risk testing, although not yet perfect, is highly recommended, especially if you have a family history of the disease. Taking these tests can also help your doctor proactively tailor your care, depending on any medical predispositions.

Eat More Cancer-Fighting Foods

Click Here to Download the Infographic: Cancer Fighting Foods & Supplements PDF

Consider Seeking an Integrative Medical Practitioner

A board-certified physician with experience in functional medicine can work with you to safely tailor a vitamin and supplement plan based on your personal test results and health concerns.

If you are concerned about breast cancer, our doctors at The Kaplan Center for Integrative Medicine can work with you to tailor a scientifically-based program designed to lower the risk of cancer, while also helping you enjoy a healthy and active life.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional References:

[1] Brew, C.T., Aronchik, I., et al. 2009. “Indole-3-carbinol inhibits MDA-MB-231 breast cancer cell motility and induces stress fibers and focal adhesion formation by activation of Rho kinase activity.” International Journal of Cancer, May 15;124(10):2294-302.
[2] Simonpoulos, A.P. 2002. “The importance of the ratio of omega-6/omega-3 essential fatty acids.” Biomed Pharmacother, Oct; 56(8):365-79.
[3] Dietrich, M., Traber, M.G., et al. 2006. “Does gamma-tocopherol play a role in the primary prevention of heart disease and cancer? A review.” Journal of the American College of Nutrition, Aug;25(4):292-9.
[4] Garland, C.F., Gorham, E.D., et al. 2009. “Vitamin D for cancer prevention; global perspective.” Annals of Epidemiology, Jul;19(7):468-83
[5] Rosanoff, A., Weaver, C.M., et al. 2012. “Suboptimal magnesium status in the United States: Are the health consequences underestimated?” Nutrition Review, Mar; 70(3): 153-64.
[6] Chen, P., Li, C., Li, X., Li, J., Chu, R., and Wang, H. 2014. “Higher dietary folate reduces breast cancer risk.” British Journal of Cancer, 110(9):2327-38.

Updated: September 24, 2018.