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Understanding The Ketogenic Diet

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The ketogenic (“keto”) diet is a high fat, moderate protein, and low to very low carb diet.

Its composition challenges what the nutrition industry has promoted as healthy eating over the last century. Despite this, it has become one of the most popular diets of the moment.

However, the Ketogenic diet should not be considered just a fad diet – it has been prescribed by physicians and nutritionists for nearly a century.

Conditions that benefit from a ketogenic diet

Patients who have tried the ketogenic diet have reported improvements in overall health including weight loss, increased energy levels, heightened mental clarity, and success in stabilizing insulin levels. Clinicians have also seen great results with modified keto diets as an adjunct treatment for the following conditions:

  1. MOST INFLAMMATORY CONDITIONS. By adopting a high-fat ketogenic diet and limiting carbohydrate intake, you will reduce the overload of reactive oxygen species produced while burning glucose which exacerbates inflammation.
  1. INSULIN RESISTANCE. Inflammation resulting from sugar toxicity is most of the time accompanied by insulin resistance. Insulin resistance is among the leading causes of type 2 diabetes and cognitive decline and is a serious problem in the U.S. and around the world. By adopting a ketogenic approach, the body relies on ketones for energy production, which improves glycemic control and has shown to reduce the dependency on diabetes medications and may even completely reverse it. 
  1. WEIGHT LOSS. Several research studies are proving the benefits of a high-fat ketogenic diet for weight loss, especially for obese people, as it accesses the body fat for energy production.
  1. LOWERING THE RISK OF CANCER. All body cells can use both glucose and ketones for energy production and optimal functioning, except cancer cells. They only rely on glucose for survival and do not have the flexibility to adapt to ketones, which causes them to starve and die when the person adopts a ketogenic diet. 
  1. PREVENTING & REVERSING COGNITIVE DECLINE. Adopting one specific variation of the ketogenic diet known as “RECODE” protocol or “Ketoflex 12/3”, the body can restore proper brain growth and reduce neuroinflammation, increase insulin sensitivity, and excrete toxins. With close monitoring and lifestyle changes, these benefits will improve mild cognitive decline and early Alzheimer’s. This variation was developed by Dr. Dale Bredesen, an internationally recognized expert in the study of neurodegenerative diseases such as Alzheimer’s disease. (More about how the ketogenic diet benefits the brain below.)

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So why the popularity now?

One could say in part that it’s a social phenomenon; thanks to a few celebrity endorsements and tweets, social media has thrust this diet in the spotlight. But more importantly, recent revelations about how Big Sugar has influenced our models of proper nutrition, along with the steady increase in chronic illness rates in the United States, have prompted us to rethink the hierarchy of the foods we choose to put on our plates.

Sugar consumption in the U.S.

The World Health Organization (WHO) and the American Heart Association (AHA) recommend that adults should ideally consume 25 grams of sugar/day, and no more than 50 grams to avoid sugar toxicity. This translates to approximately 5-10% of daily caloric intake. But CDC statistics show that on average men and women in the United States consume approximately 13% of their daily calories from added sugars, and unfortunately that percentage increases to 16% for children.

Soft drinks are the leading source of added sugar in the American diet and can deliver a whopping 30+ grams in just one 12-ounce can. Pastries like cakes, cookies, and donuts have become staples in the American diet and sit at the top of that list as well, but much of the sugars we consume are hidden away in the carbs we love to eat, like bread (even the “healthy” ones), granola bars, flavored yogurts, condiments, and dressings.

 

Carbs vs fat

When you eat a meal high in carbohydrates, the body burns glucose, a form of sugar, as the main source of energy for both muscle and brain activity. It is the simplest molecule to convert and is immediately available and metabolized when needed. Excess glucose gets stored in the liver and muscles as glycogen. But the human body was not designed to process large amounts of sugar so when those stores are filled, excess glycogen then gets stored as unhealthy fat around the body’s tissues and organs.

But unwanted body fat is not the only consequence of a high-carb diet. There is an increasing body of evidence that confirms excessive sugar consumption is tantamount to poison and is directly related to the increasing prevalence of metabolic disorders like diabetes, obesity, and cardiovascular disease.

When your body burns glucose for energy it creates toxic byproducts called reactive oxygen species (ROS). ROS are harmful free radicals that can damage brain cells and DNA when they overwhelm antioxidant levels in the body. The result is oxidative stress (OS). OS is a major contributing factor to widespread inflammation present in metabolic disorders as well as cancer, arthritis, chronic pain, and cognitive decline.

In comparison, minimizing carbohydrate intake forces the body to rely on dietary and stored fat, not glucose, as a primary fuel source, and this is the basic premise of the ketogenic diet. By severely restricting the daily intake of carbohydrates to approximately 20-50 grams, glucose levels are kept in short supply and the body is forced to find an alternative energy source. The ketogenic diet essentially puts the body into “starvation mode” and forces the body into a state of ketosis. In this state, fat molecules are broken down by the liver and are converted into what are called ketone bodies, made up of acetone, acetoacetate (AcAc), and beta-hydroxybutyrate (BHB). Ketone bodies travel through the bloodstream and are utilized by all the healthy cells in the body and brain.

The ratio of carbohydrates to fats changes depending on the condition you are adopting the ketogenic diet for. In most cases, carbohydrate intake varies between 5% and 10% of total caloric intake, and fats represent 70%-80%. However, protein intake should be in a moderate amount as excessive protein intake promotes gluconeogenesis, converting protein to glucose for energy. Ideal protein intake on a ketogenic diet is approximately 0.8 – 1 gram per kilogram of body weight, representing 20%-25% of total caloric intake.

How the ketogenic diet benefits the brain

The ketogenic diet was originally developed in the 1920s as a treatment to help control epileptic seizures in children and is still used as such by some physicians. Since then, and particularly over the last 20 years scientists have looked into the diet as a possible intervention for other neurological conditions. Studies show that the ketone bodies created during ketosis have neuroprotective benefits, which include:

  • Ketone bodies burn more efficiently than glucose and have the ability to deliver more energy to brain cells per unit of oxygen consumed compared to glucose. As the brain uses more energy than any other organ in our body, this is particularly important, especially for the aging brain.
  • Ketone bodies lower the production of free radicals which in turn will help keep inflammation levels down in the body.
  • Ketone bodies help keep the ratio of GABA/Glutamate in balance. Glutamate is a neurotransmitter that helps with brain function. When glutamate levels are elevated it can cause cell damage. GABA (gamma-aminobutyric acid) is responsible for “quieting down” heightened neuronal activity.

What about fasting?

Food availability, prolonged exposure to screens, and artificial light are a few of the modern-day amenities that have contributed to the disruption of our internal clocks resulting in extended awake time and feeding times. In the body, this can translate to an imbalance in hormone secretion, cellular repair, and digestion. Insulin is the perfect illustration; every time we eat we produce the hormone insulin to control the glucose surge from the foods we consume, and the more we eat, the more insulin is pumped into the bloodstream leading to an avalanche of chemical reactions that contribute to insulin resistance and other metabolic diseases we are seeing today.

A recommendation many ketogenic diet proponents give their patients is intermittent fasting (IF). Alternating normal daily caloric intake with a period of fasting promotes health by:

  • Stabilizing insulin secretion – When we abstain from food for several hours, insulin levels go back to normal;
  • Promoting autophagy – Autophagy is an important cell recycling process that helps clean our bodies of damaged or dysfunctional protein components and mitochondrial waste. This process is crucial for the regeneration of cells – including brain cells;
  • Fasting also drains the liver of its glycogen stores for use as energy. Remember, glycogen is the stored form of glucose. This means accessing the glycogen that the body has been accumulating. Once you use all the stored glycogen, the body is already in fat-burning mode; and,
  • Promoting ketosis – Fasting and the ketogenic diet work hand in hand to activate the ketosis process. When you fast, your body will use whatever is available as a source of fuel, and because you’re already restricting carbohydrate intake, the body instantly shifts to using ketones.

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What to eat and avoid on a ketogenic diet

There are plenty of food options for someone on a ketogenic diet. Here are some “yes” and “no” foods to keep in mind. This is not a complete list so talk to your physician for more detailed information on foods that should be included or should be avoided before you start!

  • “YES” FOODS
  • Fish/Seafood (fatty fish like salmon, mackerel, sardines – wild-caught is best)
  • Meat (grass-fed is best)
  • Poultry (grass-fed is best)
  • All non-starchy vegetables (examples: avocado, asparagus, Brussels sprouts, broccoli, cabbage, celery, eggplant, cucumber, bell pepper, kale, okra, summer squash, spaghetti squash, tomatoes)
  • “Good for you” oils (olive oil, coconut oil)
  • Some dairy (cottage cheese, unsweetened yogurt, butter)
  • Eggs
  • Nuts, in moderation
  • coffee & tea (unsweetened of course!).
  • “NO” FOODS
  • All grains
  • All types of sweeteners (agave, maple syrup, sugar, honey, etc…)
  • Candies/pasteries
  • Starchy vegetables (like potatoes, parsnips, or corn)
  • Alcoholic beverages
  • Fruits
  • Pasta
  • Most legumes
  • Sodas

It may not be for everyone…

Starting a new diet plan can be difficult under any circumstances, and particularly when drastic changes are made. Although researchers and clinicians have demonstrated that a ketogenic diet can benefit multiple health conditions and can have a positive influence on overall health, we don’t advise undertaking a ketogenic diet without the guidance of a Dietitian Nutritionist or physician. Under proper supervision, the initial transition can be closely monitored in order to catch any changes or symptoms that may arise.

A ketogenic diet may not be a good choice under the following conditions:

  • Pregnant women
  • Breastfeeding women
  • Naturally thin physique
  • Pancreatic Insufficiency (needs monitoring)
  • Gallbladder removed (needs monitoring)
  • History of kidney stones
  • Have an eating disorder, especially Anorexia
  • Children and adolescents still growing

In sum, excessive sugar consumption and sedentary lifestyles have had an enormous influence on the health decline in the United States. The ketogenic diet, which focuses on unprocessed foods that naturally lower inflammation, combined with lifestyle modifications and monitoring, can reverse and improve a number of inflammatory illnesses like diabetes, obesity, cardiovascular problems, cancer, arthritis, chronic pain, and depression.

If you would like to meet with a Kaplan Center physician or dietitian to learn more about the ketogenic diet – or to find the ideal diet for your optimal health – please call 703-532-4892 for an appointment or use this contact form to send us a message.

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

Essential Turmeric Oils: A Hopeful Treatment For Ulcerative Colitis

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The positive health effects of turmeric have been touted by age-old healers as well as modern science. Turmeric’s active ingredient, curcumin, has powerful antioxidant and anti-inflammatory properties that help prevent free radical damage and calm the inflammatory process at the root of many chronic diseases.

However, the use of turmeric in treating chronic illness on a grander scale has been limited due to its relative low bioavailability, or “the proportion of a drug or other substance that enters the circulation when introduced into the body and so is able to have an active effect.”

Because of this limitation, research has primarily focused on ways to enhance absorption.

Past studies have shown that combining turmeric with other compounds, one such example being piperine (found in black pepper), can increase bioavailability, and there are supplements* now available formulated to allow maximum absorption.

Adding to this research, a new study authored by Dr. Ajay Goel, director of gastrointestinal research and translation genomics and oncology at Baylor Scott & White Research Institute, and published in Nature: Scientific Reports, confirmed that combining curcumin with essential turmeric oils (ETO-curcumin) significantly enhanced anti-inflammatory efficacy in DSS-induced colitis animal models (dextran sulfate sodium (DSS) is frequently used to induce colitis in experimental animals).

Clinical applications

Possible clinical applications of curcumin currently include neurodegenerative diseases, osteoarthritis, and rheumatoid arthritis. There is also evidence that curcumin can kill certain types of cancer cells, as well as reduce the development of several forms of cancer in lab animals.

Dr. Goel’s research highlights the anti-inflammatory potential of turmeric and suggests it may also have a place in the treatment of large intestinal diseases like ulcerative colitis.

Crohn’s disease and ulcerative colitis are autoimmune, inflammatory bowel diseases (IBD) that can cause a lifetime of painful symptoms. It is estimated that nearly 3 million people in the United States are living with IBD. Conventional treatment typically involves medications such as antibiotics, immunomodulators, or corticosteroids, amongst other types. However, a growing population of patients are exploring natural healing options instead of – or in conjunction with – medications. Our experience with IBD has shown that with the right lifestyle changes and dietary modifications, including supplementation and nutritional support, many people will see an improvement of symptoms.

“The takeaway for patients who want to experience the health benefits of curcumin through a commercially available supplement is to look for products that include additional compounds of turmeric – specifically, essential turmeric oils,” says Dr. Goel.

Remember, supplements are not regulated by the FDA, so before purchasing or taking any commercial supplements, speak to your physician who can recommend trusted sources, and more importantly, rule out any possible interactions with other medications.

**Theracurmin® HP is available for purchase from the Kaplan Medical Center Store.

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

 

opioids

The Problem With Opioids for Chronic Pain

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Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. – Hippocratic Oath

When it comes to the treatment of chronic pain, the medical profession may be in violation of what can be regarded as the first medical ethic: First do no harm.

In 2015, a report – The Role of Opioids in the Treatment of Chronic Pain – published by an independent panel of experts convened by the National Institutes of Health, stated:

    Together, the prevalence of chronic pain and the increasing use of opioids have created a “silent epidemic” of distress, disability, and danger to a large percentage of Americans. The overriding question is: Are we, as a nation, approaching management of chronic pain in the best possible manner that maximizes effectiveness and minimizes harm?

More recently, the Centers for Disease Control in an attempt to address the massive public health crisis identified by the NIH issued a new set of twelve guidelines aimed at reducing the risk of opioid over-prescription and over-use. Although these recommendations are not yet mandated, they are a necessary first step in rethinking how we look at chronic pain treatment and how narcotics are prescribed.

A Brief History of Opioid Medication Use/Misuse

In 1997, the American Academy of Pain Medicine, in an acknowledgment of 1) the severity of the suffering of patients with chronic pain, and 2) the medical profession’s inability to provide many of these patients with acceptable treatment solutions, issued a consensus paper endorsing the use of opioid medications for the treatment of chronic non-cancerous pain. The Academy openly acknowledged that one of the problems with the long-term use of opioids is addiction. In response, the medical profession began making the distinction between addiction and dependence. Addiction was defined as a craving for opioids with the intention of getting “high” consistent with drug-seeking behavior. Dependence, on the other hand, was defined as any situation in which an opioid medication was prescribed for medical reasons, with a dosage sufficient to control the pain, and a significant improvement in the quality of life of the patient. While the intention was noble, the consequences have been quite disastrous.

Since the release of the AAPM’s paper, the sales of prescription opioid medications measured in grams has skyrocketed. Between 1997 and 2007, sales rose by 866% for oxycodone, 525% for fentanyl, 280% for hydrocodone, and 222% for morphine. As reported in Pain Physician in July 2012, “Gram for gram, people in the United States now consume more narcotic medication than any other nation worldwide.” The report goes on to document that over 90% of patients taking opioid pain medications were prescribed these medications for the treatment of chronic pain.

In 2011, approximately 17,000 drug overdose deaths involved prescription opioid medications. The CDC also reported that “In 2007 there were more opioid analgesic deaths than overdoses involving heroin and cocaine combined.” While a significant number of these drug overdose deaths are associated with diversion of the medication to people who were not originally prescribed the medication, 60% of the deaths occurred in patients that were given prescriptions based on the prescription guidelines by medical boards.

Furthermore, significant side-effects from opioid medications include increased risk of birth defects, falls and fractures, addiction, constipation, heart attacks, a decrease in the production of testosterone, and in some cases, hyperalgesia, an actual worsening of the pain.

Deciphering the Problem

While the NIH report and recent CDC guidelines offer a number of important policy and institutional points to address, I believe that the fundamental basis of our problem comes from a lack of understanding of what we’re treating. Acute pain and chronic pain (not associated with ongoing tissue damage such as in cancer) are two very different phenomena in the body.

1. Chronic pain is not a thing but one manifestation of a complex physiological process that frequently impacts many body systems, including sleep, gastrointestinal, psychological, and endocrine. Thus, we must take a whole-person approach in our diagnosis and treatment, which requires looking at multidisciplinary treatment options.

2. Unquestionably the evidence supporting the use of long-term opioids in the treatment of chronic pain is insufficient. We need better studies to help us understand when long-term use is beneficial.

3. Physicians need to be better educated about the diagnosis and treatment of patients suffering from chronic pain. Ultimately the use of long-term opioid medications is an admission of treatment failure. The recent CDC guidelines are a step in the right direction in this regard.

As a pain specialist, I believe there is an important role for opioid medication, but that role should be limited. Opioids should only be prescribed with close monitoring by the diagnosing physician, for the purpose of relieving pain and improving quality of life when all other medical approaches have been exhausted.

First, do no harm. Opioids should be medications of last resort.


Dr. Kaplan explains how treating the symptoms of chronic pain is contributing to a system of mismanagement in this country. He discusses why we must shift the way chronic pain is treated by addressing its root cause – inflammation of the Central Nervous System.

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Low-Dose Naltrexone: Can a Higher Dose Lead to Better Results?

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Q: I have a question about low-dose naltrexone for chronic pain, I understand you use this in your clinic. The standard dose appears to be 4.5 mg in almost all of the information I can find. There are a few chronic pain MDs in the U.S. that seem to be using higher doses with success — a couple say to go up as high as 10 mg while another one is using it up to 4.5 mgs 3xday with great success for those who do not respond to one dose of 4.5 mgs. Do you have any thoughts on this? What I’ve read is that one should not give up on this medication if not getting benefits at 4.5 mgs. Thank you.

A: LDN, or low-dose naltrexone has recently become popular as a method to boost the immune system for a number of conditions, such as HIV, cancer, Crohn’s disease, multiple sclerosis, neurodegenerative disorders, chronic neuropathic pain, fibromyalgia, and other autoimmune diseases.

How Low-Dose Naltrexone Works

LDN works by temporarily blocking endorphins in the brain which causes a reciprocal boost in natural endorphins, and by down-regulating the inflammatory effect of immune cells called microglia in the brain that get turned on in certain situations. At a low dose, the side effects are minimal. Higher doses can cause sleep disturbances and may cause elevation of liver enzymes. Although I don’t usually go higher than 4.5 mg, most likely the doses you are talking about – 10-14 mg – are far from the 50 mg or higher dose that is used to block opioid overdose, and are therefore are probably safe. I don’t see any research on the efficacy of using higher doses, however.

–Dr. Lisa Lilienfield

 

reading labels, hidden food allergies

Are Hidden Food Allergies Making You Miserable?

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How to figure out if food allergies are causing inflammation—and making you hurt

Sure you should eat that?

When it comes to chronic pain and depression, there’s no reason why you “just have to put up with it.” We now know that these states—and a host of conditions that accompany them—are caused by the inflammation of microglia in the brain. The microglia (your brain’s immune cells) turn on inflammation, and when they reach a tipping point, they become hyper-reactive, after which the slightest assault can set them off, triggering system-wide inflammation that can be difficult to stop.

This means that we have more reason than ever to eat well, exercise, meditate and make sure our bodies have the nutrients they need—avoiding the foods that are the likely culprits for allergies and sensitivities.

Here’s how to figure out if your diet is what’s causing your inflammation:

Try a low-inflammation diet

For 6 weeks eat only brown rice, fish, chicken, eggs, fresh fruits, and vegetables. This diet eliminates most of the foods people are allergic or sensitive to, such as wheat, soy, and milk products. Organic, grass-fed beef can be included in the diet as well.

Start an “eating and aftereffects” diary

When you’re trying a low-inflammation diet, it’s important to keep a food diary. In addition to writing down what you eat and when you eat it, you will also check back in with yourself throughout the day to see how the food made you feel. Allergies and food sensitivities may not show up for hours after you eat the offending food or spice, but if you are alert, you’ll increase the odds of making connections between the food and your response. Be sure to write down exactly how you feel at the beginning of the diet, so you can make an accurate comparison in 6 weeks.

Avoid stimulants

This means no caffeinated coffee, tea, or alcohol. It also means no NSAIDS to inflame your gut. If you typically drink more than 2 cups of coffee a day, it might be best to cut your consumption in half every few days until you are coffee-free. If you normally drink 6 cups, cut it down to 3 cups for a few days, then 1.5 cups for a few days. After a week or two easing off caffeine, you should be able to go without coffee and not get a headache.

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Evaluate your process

Rate the following factors in your diary: Energy Level, Ability to Focus and Concentrate, General Pain Level, and Specific Pain Level. Complete the diary at the same time every day. Feel free to add comments about your sleep, digestion, and any other aspect of your health or mood. Make note of any unusual life events.

Add back foods

After 6 weeks, gradually add back new categories of food, one at a time, one week at a time. A good food to start with is dairy. Pay close attention to whether bringing dairy back causes gas, bloating, or other reactions. The next week, add soy products, such as tofu, soybeans, miso, and soy sauce. The following week, add wheat, such as bread, cereal, pasta, and canned or frozen foods with wheat fillers.

You will be the best judge of whether or not these foods have a negative effect on your energy level, your mood, or your ability to concentrate.

Signs of allergies

If you lose as much as 5 pounds or more the first week, it may be a sign that you’ve been eating foods you’re allergic to and your tissues have been swollen. Other signs of allergies include migraines, numbness in the arms or legs, inability to focus, poor concentration, fatigue, depression, brain fog, headaches, mood fluctuations, itchiness, sneezing, gas, diarrhea, sinus congestion, and skin rashes.

Delayed reactions are not uncommon. You may get a headache in the morning from something you ate the night before. This is why it’s important to add foods back into your diet very slowly.

Prepare for the toughest part

It’s likely that the first 2 weeks will be the hardest. Old habits can be tough to change. The next difficult part comes at the end, after the 6 weeks, when you are feeling better but starting to add in new foods. It can be frustrating to learn that you are having a negative reaction to one of your favorite foods. Maybe you add gluten in for a few days, but soon realize you’re experiencing bloating, congestion, and brain fog. Many people will ask: “Does this mean I can’t eat wheat anymore?!” The truth is: You can eat whatever you want. It depends on whether or not you’re willing to accept the consequences.

Published date: Apr 10, 2014 / This article was first seen on Prevention.com. Read more about the new connection between inflammation and chronic pain — and what scientists are doing about it — with Is Depression Ever Just Depression?

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

 

8 Reasons Your Pain Won’t Go Away

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by Julia Westbrook | As first seen on RodaleNews.com.

What you don’t know is hurting you.

Gary Kaplan, DO, author of Total Recovery and founder of The Kaplan Center for Integrative Medicine, recently held “office hours” during a Rodale News Facebook chat. One of only a handful of physicians in the country who is board-certified in Family Medicine and Pain Medicine, Dr. Kaplan was able to apply his pioneering perspective to help answer one of the most difficult questions plaguing our country: What is causing my pain? If you weren’t able to make the chat, we’ve pulled out 8 key takeaways to consider when you’re trying to figure out why your pain just won’t go away.

#1: Inflammation, part of the normal repair process, may have gone awry.

Cytokines are chemical messengers secreted by the body. They have effects ranging from inciting nerve repair to causing inflammation. In the case of chronic pain, we know that the microglia, which are the innate immune system in the central nervous system, are “stuck” in a mode where they continue to excrete predominantly inflammatory cytokines. Under normal circumstances, microglia will shift from producing inflammatory cytokines to making anti-inflammatory cytokines and call in other cells to initiate the normal repair process.

Balance is restored by eliminating all of the factors that caused the microglia to get turned on in the inflammatory state and then doing things such as meditation, exercise, getting adequate sleep, and using things such as low-dose naltrexone (LDN) and turmeric to get the microglia to go back to their resting state.

#2: Allergies can make your pain worse.

Anything that incites an inflammatory response in the body has the potential to spill over into the brain and worsen the inflammation in the central nervous system, as with fibromyalgia. The allergies are not the cause of the fibro, but something that is further aggravating it.

#3: Your diet can cause inflammation.

I would start by thoroughly looking at your diet and make sure there is nothing still in your diet causing inflammation. I saw one woman who is a vegan, and it turned out she was allergic to blueberries. For ongoing inflammation in the brain, turmeric may be helpful.

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#4: Your fatigue may be a symptom. Don’t ignore it.

Sleep is not a thing, but rather a series of different brain waves divided into stages 2, 3, 4, and REM. People who are deficient in 3 to 4 sleep will present with chronic pain. If you have sleep apnea, where you stop breathing at night, it can cause chronic pain. If you have restless leg syndrome, it can also cause chronic pain. A proper evaluation of the quality and amount of sleep is necessary for anyone suffering from chronic pain and depression.

#5: A migraine problem isn’t just in your head–it’s in your nervous system.

Dehydration, alcohol, bright lights are all triggers that can cause migraines. The underlying cause of the migraine is an irritated nervous system. The nervous system is irritated because of an underlying inflammatory condition in the brain. The key to preventing migraines is to identify what it is that’s causing the inflammation. I would start with an anti-inflammatory diet of rice, fish, chicken, fresh fruits, and vegetables.

#6: Overlapping problems can come from the same source.

  • Migraines and depression: Brain inflammation
    The basis of both migraines and depression is inflammation in the brain. I address this at length in my book, Total Recovery. Yes, the two are related and the cause of the inflammation needs to be identified.
  • Chronic pain and weight loss problems: Gut imbalance
    One of the reasons that you may not be able to lose weight might be related to either food allergies or sensitivities or mold toxicity. We know that the composition of the bacteria in your gut has a very significant effect on your ability to lose or maintain weight. Skinny people have different gut flora than people who are overweight. If you have other symptoms, it’s very likely you have a chronic inflammatory condition but the cause has not been discovered or addressed.

#7: The underlying root cause may still need to be identified.

  • Arthritis (…which isn’t always arthritis)
    Sometimes arthritis in knees and joints can be from Lyme disease, sometimes from rheumatoid arthritis, and sometimes from tendinitis. It can also be associated with food allergies and food sensitivities. The first issue is getting a clear diagnosis.
  • Complex regional pain syndrome
    Also known as CRPS, it is a horrific pain condition. I see a number of patients who suffer from CRPS, and the solution can, unfortunately, be elusive. Again, it’s important to try and understand what it is that has caused the nervous system to be so hyper-reactive. Get evaluated for Lyme disease and its co-infections, celiac disease, gluten intolerance, and neurotoxins associated with mold, along with a number of other conditions that I address in my book. I am familiar with Calmare therapy, and the research on it looks very exciting. While we do not do this therapy in our office, I have referred patients for this therapy. It is certainly worth the trial for anyone suffering from CRPS.
  • Tinnitus
    Tinnitus can be an extremely difficult problem to address and can be a result of multiple issues and not a single problem. Meditation and yoga are extremely effective in reducing inflammation, as is curcumin. You also need to identify the causes of the inflammation, such as the trace mineral imbalances, as well as eliminate anything that may be poisoning your system.

#8: Your body may be more responsive to alternative therapies.

We find that acupuncture can be extremely effective for a large number of pain conditions. But most commonly our treatments are layered, involving a number of therapeutic approaches, which work synergistically for a comprehensive solution. I also recommend meditation or yoga.

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

Is Your Medication The Root Of Your Chronic Pain?

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5 Pills That Might Be Hurting You

By Julia Westbrook

It’s time to stop ignoring the aches and pains and finally live a healthy life.

More Americans are suffering from chronic pain than have diabetes, according to a panel of researchers at the National Institutes of Health. While 29 million people are diagnosed with diabetes, the panel estimated that 100 million Americans live with chronic pain.

While the statistics are staggering, the scary truth is that, despite the apparent universality of pain, there isn’t nearly enough research on safe, effective treatments.

“We learned that sufficient clinical research doesn’t exist to show physicians how best to treat chronic pain in adults, many of whom suffer from multiple health problems,” said panel member and founding director of the Indiana University Center for Aging Research, Christopher Callahan, MD.

Instead, our medical system is heavily reliant on painkillers, both over-the-counter and prescription, despite the fact that, according to the panel, clinicians recognize that pain narcotics aren’t the solution for long-term pain treatment. (Here are 5 reasons over-the-counter painkillers are a bad idea.)

Gary Kaplan, DO, author of Total Recovery: Solving the Mystery of Chronic Pain and Depression, explains that medication—either for treating pains or treating other conditions—can be at the root of chronic pain. “Because of the powerful, short-term effectiveness of many drugs, we’re beginning to experience polypharmaceutical problems, where patients end up taking one drug to treat the side effects of other drugs,” he explains.

“The rough guideline I give my patients about taking medications is this: A drug has to work better than the side effects it creates,” he says. “If it doesn’t, get rid of it.” Of course, it’s important to do so under the supervision of your doctor, he adds.

While it’s easy to tune out the side-effect disclaimer on pharmaceutical ads, you may want to talk to your doctor if you’re experiencing chronic pain and are taking one of these prescriptions:

Statins

Statins are commonly used to lower cholesterol. “They can be the cause of cataracts and unexplained muscle pain. Some studies show they may increase your risk of developing diabetes,” says Dr. Kaplan.

Diet can have a big impact on cholesterol. Consider eating avocados, as research has shown that they’re a food that helps lower cholesterol.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

In the ultimate irony, your painkiller might be causing you more discomfort. “More than 70 percent of people chronically taking NSAIDs—such as ibuprofen (Advil, Motrin), naproxen (Naprosyn), diclofenac (Voltaren), and aspirin (Bayer, Bufferin)—will get ulcers in their small intestines, creating a permeability problem (aka leaky gut syndrome),” says Dr. Kaplan.

Leaky gut is associated with all kinds of painful issues, including food sensitivities, joint pain, headaches, and psoriasis.

Antibiotics

Speaking of your gut, taking antibiotics may be causing more painful inflammation than the infection itself. “Multiple treatments of antibiotics for any reason can profoundly change the gut flora,” says Dr. Kaplan. “Those changes can then damage the intestinal tract enough to create leaky gut syndrome, which will result in inflammation and activate the microglia.”

While he doesn’t dismiss the lifesaving importance of antibiotics, Dr. Kaplan recommends balancing their use with a probiotic supplement. And be sure to support a your gut bacteria with healthy foods.

Opioids

Another counterintuitive finding: Dr. Kaplan says that opioids can heighten your sensitivity to pain. “Additionally, these painkillers—such as codeine, hydrocodone (Vicodin), morphine (Avinza), and oxycodone (Percocet)—can lead to depression, constipation, and sexual dysfunction,” he says.

Instead of popping a pill for your pain, consider meditation as an effective treatment.

Sleeping Pills

Sleep is so important for your health, but popping a pill to get there isn’t the answer. “A chronic reliance on any type of sleeping pill—such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata)—can, in the short term, make it hard to focus and, in the long run, even shorten your life span,” says Dr. Kaplan. Plus, you might be missing key warning signs of sleep apnea.
Article reprinted from www.RodaleNews.com, Jan/2015