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3 Things That Can Happen After GLP-1s

3 Things That Can Happen After Stopping GLP-1s

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What are the aftereffects? Why am I regaining weight? Help!

You did the injections. You lost the weight. You reached your goal. Now, you’re wondering: when is the right time to stop?

GLP-1 medications such as Mounjaro, Wegovy, and Ozempic have been tools used to help with weight loss, diabetes, and/or metabolic syndrome. However, what happens when you stop taking the injections? Let’s take a look at a few of the more common aftereffects.

1 – Rapid Weight Regain

Old eating habits creep back in after reaching your goal. A common misconception is that once you reach your goal, that’s it. You can stop the medication and you will live happily at your goal weight. That is a myth. Studies show not only changing the quantity of food consumed, but the quality of food as well can help to keep the weight off.¹

2 – Hunger Cues Change

Feeling even hungrier than before? Hunger hormones and satiety cues spike the hunger hormone (ghrelin) back up, which is what signals the brain that you are hungry and that it is time to eat. GLP-1 medications suppress ghrelin which is why many of the cravings go away and you feel less hungry while taking the medication. When the medication is discontinued, more ghrelin is
produced. Sometimes it can be overproduced and cause a feeling of intense hunger. This often leads to overeating.²

3 – Set Point Conflict

Your body viewed your rapid weight loss as “survival” versus a permanent “lifestyle change.” Once off of the medication, your body remembers where your “set point” (your weight thermostat) used to be and it saw the weight loss as a threat rather than a friend. Here is where your body betrays you and begins to activate mechanisms to restore the lost weight.³

But, stopping GLP-1 antagonist medications does not mean all of your hard work needs to go to waste. 

You’ve invested time, energy, and dedication into improving your health. Don’t let the progress slip away after GLP-1 therapy. Weight regain isn’t a matter of just “willpower” and “calorie counting”  it’s understanding your body’s biology.

With the right nutrition plan, strength-building exercises, and accountability, you keep the results you worked so hard for. Book a nutrition call with Chardonèe today to help you with your journey!

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:

¹ Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society Mozaffarian. Dariush et al. The American Journal of Clinical Nutrition, Volume 122, Issue 1, 344 – 367

² Quarenghi, M., Capelli, S., Galligani, G., Giana, A., Preatoni, G., & Turri Quarenghi, R. (2025). Weight Regain After Liraglutide, Semaglutide or Tirzepatide Interruption: A Narrative Review of Randomized Studies. Journal of Clinical Medicine, 14(11), 3791.

³ Wu, H., Yang, W., Guo, T. et al. Trajectory of the body weight after drug discontinuation in the treatment of anti-obesity medications. BMC Med 23, 398 (2025). 

 

managing_medications

8 Tips To Help You Manage Your Medications

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For many ailments, treatments most often involve some type of medication. Whether it’s an antibiotic to treat an infection, a statin to control cholesterol, or even a simple daily aspirin to reduce the risk of heart attack, we take the medications our providers recommend and hope for the best.

Painkillers, statins, sleeping pills, and other commonly prescribed medications all have their proper place in managing our health but can have unintended side effects. It is the provider’s responsibility to carefully explain what to expect from taking a particular drug.

Routinely evaluating prescriptions is extremely important, especially for older adults whose bodies are less efficient at metabolizing and clearing medications from the bloodstream, which can increase the risk of being overmedicated. Those who take multiple medications must be particularly aware of possible side effects and interactions with other drugs.

Here are 8 important tips to help you safely manage your medication intake.

1) Keep a list of all the medications and supplements you are taking, the prescribed dosages for each, why you are taking them, and the prescribing provider. Provide a copy to a family member, friend, or caretaker and keep a copy of this list in your wallet or on your refrigerator in case of an emergency.

2) Review your medications with your provider on a regular basis to ensure that the medications and doses are still appropriate.

3) Report any new symptoms you are experiencing as a result of taking a new medication to your provider as soon as they occur.

4) Be sure to tell your provider about all of the herbal remedies and nutritional supplements you are taking as they can interact with your prescribed medications.

5) Before you start a new medication, ask your provider about any potential side effects or interactions of your medications, medicinal herbs, and supplements.

6) If your medication seems ineffective, make sure to speak up so your provider can reconsider the drug or dosage.

7) Missing your meds may trigger unexpected symptoms or side effects so make sure to take your medications as directed to avoid complications.

8) If at all possible, use the same pharmacy for filling your prescriptions. This allows the pharmacist to determine if there are any interactions or side effects you should be aware of – especially if multiple providers are prescribing for you.

In summary, be sure you know what medications you’re taking and why. If you have questions, ask!  Your provider and pharmacist are important resources and can help guide and manage your medications.

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 March 2015. It was reviewed in October 2024.

Food & Mood; These Dietary Recommendations are Positively Uplifting!

Food and Mood – These Dietary Recommendations are Positively Uplifting!

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The connection between nutrition and your physical health is unequivocal. Excessive sugar consumption can lead to obesity and is also linked to inflammation and other chronic diseases such as diabetes; a high intake of unhealthy trans-fats increases your risk of future cardiac events; deficiencies in essential vitamins can accelerate cellular degeneration, thereby heightening your susceptibility to cancers and other serious illnesses. While these connections may appear simplified, their validity is well-supported by scientific evidence.

Yet despite the growing body of research illustrating the connection between a nutritious diet and enhanced mood and cognitive function, your dietary habits are often disregarded as a factor contributing to your emotional distress.

Research is increasingly confirming that inflammation of the central nervous system is a key factor in many chronic conditions, including mental health disorders such as anxiety, depression, and more severe disorders such as Major Depressive Disorder. Eating foods that are high in sugar and saturated fats can elevate inflammatory markers in your body and impact mental health by exacerbating anxiety, depression, and mood fluctuations. Dietary changes aimed at reducing inflammation and oxidative stress, as well as enhancing the gut microbiome — crucial for nervous system development and function — can substantially enhance your mental well-being.

If you would like to discuss strategies on how to improve your nutritional intake to optimize your mental and overall health, please give us a call today at 703-532-5892. We use a functional medicine approach to treatment; our goal is to treat the “whole you” so that all areas of your health are improved.

In the meantime, as the old saying goes, “you are what you eat,” so with your emotional wellbeing in mind, here are some dietary tips on how you can improve your mood and mental health.

1. Incorporate more foods rich in B-vitamins (B12, B6, Folate).

B-vitamins are involved in a number of important processes in the brain: they support cellular energy production, proper functioning of the nervous system, red blood cell formation, DNA formation, and the regulation of hormones. Studies show that deficiencies in certain B vitamins can result in an increased risk of depression.

Foods rich in B vitamins include beans, lentils, raw spinach, asparagus, romaine lettuce, broccoli, avocado, fish, shellfish & eggs.

2. Talk to us about supplements.

Even if you think you have a relatively healthy diet, supplements can provide additional support to your immune system and lower your risk of developing a host of inflammatory conditions, including depression.

Vitamin D (serotonin synthesis), vitamin C, magnesium (stress support), vitamin E (mood regulation), CoQ10, glutathione, and Omega-3 are additional examples of supplements with clinical applications in depression, anxiety and other mental health disorders.

3. Eat foods that provide gut support.

One of the many neurotransmitters used by the brain is serotonin. Among its many functions, serotonin is involved in regulating mood. We now know that as much as 95% of serotonin is produced in the intestines so maintaining the integrity of your gut microbiome with a proper balance of good and bad bacteria will help keep the production of serotonin in balance as well.

Regularly eating foods like fermented vegetables, sauerkraut, miso, and bone broth will keep your gut microbiome stocked with good bacteria.

4. Eat high protein foods at every meal to support neurotransmitter production.

Your body produces neurotransmitters by utilizing nutrients in the food you eat, primarily amino acids. For example, serotonin is a byproduct of the amino acid tryptophan; noradrenaline is made from the amino acid tyrosine, which is also converted to dopamine. Serotonin, noradrenaline (aka norepinephrine) and dopamine belong to a group of neurotransmitters called monoamines that play a major role in mood & cognitive function.

High protein foods like raw nuts, cold water fish, beans, and eggs, consumed on a regular basis, will ensure that your body is getting enough of the building blocks it needs to produce these important chemical messengers that will keep your mood stabilized.

5. When snacking, always balance carbs with fats and protein.

Keeping your carbohydrate and protein intake in balance will help stabilize mood and mental clarity and while avoiding the peaks and valleys of blood sugar levels that can also lead to other serious conditions like insulin resistance and pre-diabetes.

What does a complete protein and carb combination look like? Try combinations like: hummus with celery, bell peppers and/or carrots; apple, pear, or banana with almond butter (or any nut butter); sunflower seeds and raisins. For more combinations, click here.

6. Saffron and turmeric may support people with anxiety & depression.

Foods with turmeric and saffron have for ages been eaten for medicinal support. A study published in Journal of Affective Disorders, reported that a treatment of curcumin (the active ingredient in turmeric) and saffron were effective at easing anxiety and depressive symptoms in people with major depressive disorder.

The anti-inflammatory and antioxidant properties in turmeric and saffron help calm inflammation. Add them to your foods for flavor and anti-inflammatory benefits.

While more severe mental health conditions may necessitate treatments such as psychotherapy and medication, especially if your emotional well-being poses a risk of harm to yourself or others, your diet remains as an effective healing resource. When complemented by other strategies that address inflammation, such as exercise, meditation, and stress-reduction techniques, the result can be a brighter and more positive perspective on your 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

References:

Gorbachev D, Markina E, Chigareva O, Gradinar A, Borisova N, Syunyakov T. Dietary Patterns as Modifiable Risk Factors for Depression: a Narrative Review. Psychiatr Danub. 2023 Oct;35(Suppl 2):423-431. PMID: 37800271.

Ma Q, Xing C, Long W, Wang HY, Liu Q, Wang RF. Impact of microbiota on central nervous system and neurological diseases: the gut-brain axis. J Neuroinflammation. 2019 Mar 1;16(1):53. doi: 10.1186/s12974-019-1434-3. PMID: 30823925; PMCID: PMC6397457.

Marx W, Moseley G, Berk M, Jacka F. Nutritional psychiatry: the present state of the evidence. Proc Nutr Soc. 2017 Nov;76(4):427-436. doi: 10.1017/S0029665117002026. Epub 2017 Sep 25. PMID: 28942748.

Petridou ET, Kousoulis AA, Michelakos T, Papathoma P, Dessypris N, Papadopoulos FC, Stefanadis C. Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging Ment Health. 2016 Sep;20(9):965-73. doi: 10.1080/13607863.2015.1049115. Epub 2015 Jun 8. PMID: 26055921.

Elizabeth Lipski, Digestive Wellness: How to Strengthen the Immune System and Prevent Disease through Healthy Digestion, 3rd ed. (New York: McGraw-Hill, 2004)

Roth W, Zadeh K, Vekariya R, Ge Y, Mohamadzadeh M. Tryptophan Metabolism and Gut-Brain Homeostasis. Int J Mol Sci. 2021 Mar 15;22(6):2973. doi: 10.3390/ijms22062973. PMID: 33804088; PMCID: PMC8000752.

Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2017 Jan 1;207:188-196. doi: 10.1016/j.jad.2016.09.047. Epub 2016 Oct 1. PMID: 27723543.

cognitive benefits of curcumin

Cognitive Benefits of Curcumin

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The daily consumption of curcumin, the active compound in turmeric, can have significant benefits on cognitive health.

According to the National Institutes of Health (NIH), more than 88 million Americans over the age of 65 will be diagnosed with neurodegenerative disease by 2050. The progression of neurodegeneration has been associated with the imbalance between the level of antioxidants and the increased oxidative damage by free radicals to proteins, DNA, and lipids.

Curcumin is a chemical compound found in plants, with anti-bacterial, anti-inflammatory, anti-proliferative, and antioxidant properties. Research has seen an astounding success proving the benefits of curcumin as an antioxidant and anti-inflammatory, with over 7000 articles published in the last two decades. Its neuroprotective properties help prevent free radical damage and calms the inflammatory process at the root of many chronic diseases. Studies have shown it to be effective against many gastrointestinal diseases and metabolic diseases such as diabetes and obesity, certain cancers, cardiovascular disease, and neurodegenerative diseases such as Alzheimer’s. In fact, curcumin has long been suspected to be the reason behind the low rates of Alzheimer’s disease in India, where turmeric spice is widely and frequently used in curry meal preparation.

However, curcumin is unique in that it is not easily absorbed by the body on its own. In order to increase its bioavailability, it must be paired with other compounds, one such example is piperine, a compound found in black pepper.

But for those who don’t have a taste for this beautiful golden spice, supplementation can be key. Research on the supplement Theracurmin* a bioavailable (more easily absorbed by the body) form of curcumin, has shown it contains significantly higher plasma concentration of curcumin than other leading brands of supplements. Clinical studies have also shown it to have benefits in osteoarthritis, muscle fatigue after exercise, and clearing alcohol metabolites. There are on-going clinical trials investigating the effects of Theracurmin on other inflammatory diseases.

A 2019 study on curcumin, led by Dr. Gary Small, director of geriatric psychiatry at UCLA’s Longevity Center, was conducted over an 18 month period and included 40 adults that ranged in age from 51 to 84. Twenty-one randomly selected participants were given twice daily doses of Theracurmin, and the remaining 19 participants were given a placebo. Cognitive assessments were taken every 6 months and curcumin levels were measured at both the start and end of the study. In addition, 30 participants (15 placebo & 15 curcumin) underwent PET scans to measure levels of the proteins amyloid and tau in their brains both at the start of the study and after 18 months. These two proteins are targeted because of their association with neurodegenerative disorders; when accumulated in the brain, they are thought to contribute to the breakdown of neurons which can potentially lead to symptoms of Alzheimer’s disease.

At the end of the study, researchers concluded that the daily intake of Theracurmin resulted in “improved memory performance and attention in non-demented adults.” Based on the PET findings, the study further concluded that “behavioral and cognitive benefits are associated with decreases in plaque and tangle accumulation in brain regions modulating mood and memory.”

While this study was quite small, the results are indeed promising and warrant continued research. Supplementation with a bioavailable form of curcumin, like Theracurmin, shows tremendous potential as a preventative measure against age-related cognitive decline. Furthermore, the effect curcumin has on decreasing existing amyloid plaque and tau accumulation in the brain shows that it may play a significant role in delaying the onset of other neurodegenerative diseases such as Alzheimer’s dementia.

As research continues to reveal turmeric’s bounty of health benefits, including its ability to limit and possibly reverse the damage of inflammation in the brain, it is becoming more and more evident why it is widely referred to as a miracle spice!

Before taking any supplement consult with your physician to discuss any potential side effects.

*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

References:

https://www.sciencedirect.com/science/article/pii/S1064748117305110?via%3Dihub

https://www.ninds.nih.gov/health-information/disorders/dementias

https://link.springer.com/chapter/10.1007/978-3-030-56153-6_18

https://pubmed.ncbi.nlm.nih.gov/36367124/

https://ajcn.nutrition.org/article/S0002-9165(23)46260-0/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833931/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835707/

https://www.alzheimersorganization.org/turmeric-curcumin-and-alzheimers

https://pubmed.ncbi.nlm.nih.gov/36720711/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9097512/

https://www.ncbi.nlm.nih.gov/pubmed/29326901

 

This article was originally published in Feb 2018. It was reviewed and updated in November 2023.

Living An Anti-Inflammatory Lifestyle

LISTEN NOW: Living an Anti-Inflammatory Lifestyle with Dr. Gary Kaplan

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Uncover the complexities of inflammation in this informative episode of Wild Health Podcast featuring Dr. Mike Stone and special guest Dr. Gary Kaplan, DO.

In this episode, “Living an Anti-Inflammatory Lifestyle”, you’ll learn about:

  • practical interventions aimed at combating inflammation.
  • effective lifestyle adjustments and avenues for testing.
  • the role of narcolepsy, sleep apnea, and the role of meditation in sleep quality – and how they are all linked to inflammation.
  • the connection between nutrition and inflammation and actionable steps to identify inflammation-inducing foods
  • how supplementation can address inflammation head-on.
  • the profound influence of inflammation on brain function.
  • inflammations impact on the mind.

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

treating peripheral neuropathy

Treating Peripheral Neuropathy

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The peripheral nervous system includes the nerves that lead from the brain and spinal cord throughout the body. There are several different types of peripheral nerves including motor nerves, which carry messages that make our muscles work; sensory nerves, which carry sensations from our skin, muscles, and organs including touch, temperature, vibration, and pain; and nerves that control autonomic function (involuntary) such as heart rate, breathing, blood pressure, and digestion. Peripheral neuropathy is a term used to describe damage to these peripheral nerves.

Symptoms of peripheral neuropathy depend on what types of peripheral nerves have been damaged but typically can include numbness, tingling, pain, and weakness, as well as digestive difficulties and bladder dysfunction. The peripheral nerves most commonly damaged are those that deal with sensation, therefore the most common symptom of people suffering from peripheral neuropathy is pain, which can unfortunately be quite severe.

Damage to the peripheral nerves can be caused by many conditions, including:

  • Infections such as shingles, Lyme disease, and HIV. Research is also suggesting that COVID-19 increases the risk of developing neuropathy both during and after the infection.
  • Autoimmune diseases such as Celiac disease, pernicious anemia
  • Alcohol abuse
  • Side effects from medications (chemotherapy, for example)
  • Metabolic disorders such as diabetes, hypothyroidism, and nutritional /vitamin deficiencies
  • Trauma
  • Hereditary disorders such as Charcot-Marie-Tooth (CMT) disease.

Treating Peripheral Neuropathy

Treatment is first and foremost aimed at addressing the underlying cause and finding the appropriate solution to resolve and/or manage it. Unfortunately, in approximately 30% of the cases, an underlying cause cannot be identified, and this is called idiopathic peripheral neuropathy.

The next goal of treatment is to alleviate pain and preserve function. In our Center, we typically start with acupuncture and herbal supplements that stimulate the body’s natural healing process. Both of these therapies have been very effective for a large number of our patients over the years. Physical therapy can also be helpful. Topical medications such as lidocaine patches or creams that we have compounded specially for our patients are our next line of therapy.

Next, we consider the use of antidepressant medications such as amitriptyline or nortriptyline, or anticonvulsant medications such as gabapentin or Lyrica, as both types of medications can be helpful in moderating pain by altering neurotransmission in the peripheral nervous system. All of these medications have potential side effects, and unfortunately, none of the therapies are 100% effective.

For those who are diabetic, management of blood sugar is crucial to control the progression of the neuropathy. There are several supplements such as magnesium and chromium picolinate that might be helpful as people who have diabetes are typically low in both. Also, there is a significantly higher risk of celiac disease and thyroid disease in people who have Type-1 diabetes. If you have not already been evaluated for these diseases, you need to be tested. A simple blood test can be done for both conditions.

Peripheral neuropathy can also put you at higher risk of injury from a fall and other types of accidents. Ask a family member or friend to help you organize your home in a way that minimizes clutter and keeps walking areas open.

Peripheral neuropathy can improve with time if the underlying condition is addressed, but unfortunately in some cases, the damage may become permanent. If you’re suffering from nerve pain don’t delay talking to your provider about your symptoms. A healthy lifestyle combined with a holistic treatment approach can improve the physical and emotional effects of peripheral neuropathy and help you re-engage in 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

This article was originally published in May 2015. It was reviewed and updated in September 2023.

Managing Fibromyalgia Pain with an Integrative Approach

Managing Fibromyalgia Pain

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Characterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.

Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.

A functional approach to treatment

Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. As a functional medicine practitioner, my approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.

For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)

A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.

Another treatment to consider is Low-Dose Naltrexone (LDN). When chronic pain is a result of neuro-inflammation (brain inflammation), LDN can help by reducing the upregulation of the microglia that cause this inflammation.

If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).

Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.

As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration to help you recover or better manage your illness.

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 Resources:

Consumer Guide: 18 Things You Should Know Before Choosing a Doctor to Treat Your Fibromyalgia

Healthy omega 3 fats

Build a Healthier Brain With Fat!

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We don’t usually associate increasing the amount of fat in our diets as a way to improve health, but when it comes to a particular type of fat, that’s exactly what the doctor ordered!

Omega-3 fatty acids are polyunsaturated fatty acids (PUFAs), a type of essential fat involved in several metabolic processes, and they are a crucial component of good health.

Research shows omega-3 fatty acids reduce inflammation and may reduce the risk of chronic diseases such as heart disease, cancer, and arthritis – conditions that often have a high inflammatory process at their root. But most impressive is the research that confirms Omega-3’s benefits on the brain.

There are 11 different types of omega-3s, but the most well-known for their beneficial properties are Alpha-linoleic acid (ALA), Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA).

Dietary sources of ALA, DHA, and EPA

The modern American diet is typically low in Omega-3 and high in Omega-6 fatty acids, another form of polyunsaturated fatty acid found in some vegetable oils (like corn, soybean, and cottonseed oils), nuts and seeds. Too much Omega-6 causes inflammation; therefore, avoiding processed foods that contain them is important. Interestingly, too much Omega-3 can also be bad; it’s all about keeping the ratio of Omega-3 to Omega-6 in check.

A well-balanced diet with natural sources of ALA, DHA, and EPA is fundamental to maintaining a healthy ratio that prevents inflammation and promotes long-term health.

DHA and EPA are found in fatty, cold-water fish, such as salmon, trout, cod liver, herring, mackerel, and sardines, as well as shellfish such as shrimp, oysters, clams, and scallops. Fish is the best source of Omega-3s as DHA and EPA are more bioavailable, meaning it is easier for the body to absorb it over ALA. Whenever possible, purchase wild-caught fish and check out SeafoodWatch.org to see which fish are lowest in mercury and other environmental toxins.

ALA comes from plants and is the most largely consumed form of Omega-3 in the typical American diet. It serves as an energy source for our cells and a small percent is converted into DHA and EPA. Dietary sources of ALA include flax seeds and flax oil, walnuts and walnut oil, chia seeds, pumpkin seeds, hemp seeds, and hemp oil, mustard oil, most leafy green vegetables, and tofu.

Some research is being done on algal oil, as it contains both DHA and EPA making it more bioavailable than other plant sources of Omega-3s. For vegans and vegetarians, this may be a promising alternative to fish oils. Some supplement brands have already started creating vegetarian EPA/DHA supplements from algal oil for those who prefer not to take fish oils.

Supplementation

When diets don’t meet the mark, supplementation may be recommended, but should always be done under the supervision of a doctor and dietitian for these reasons:

1) A doctor and/or a dietitian-nutritionist can monitor the ratio of Omega 3:6. Certain health conditions may benefit from additional Omega-3; in this case, proper dosage should be determined by a doctor.

2) When a diet is already rich in Omega-3, supplementation may throw a proper Omega 3:6 ratio off-balance and unintentionally cause inflammation.

3) There are some supplements of omega-3 that are actually inflammatory. Many retail brands of Omega-3 or fish oils come from sources of fish that are fed an atypical diet of corn and soy, which alters the composition of fatty acids in the fish oil. This can cause inflammation. As supplements do not require FDA approval, a dietitian or doctor can recommend a trusted brand.

Effects of Omega-3 Fatty Acids on the Brain

– Neuropsychiatric conditions: Research shows that Omega-3 fatty acids can be effective in treating depressive conditions, such as Major Depressive Disorder and bipolar disorder.

– Post-stroke & post-concussion: A study published in the Journal of American College of Nutrition found that giving DHA post-concussion helps in the repair and recovery from injury.

A 2015 study published in the Journal of Neuroimmunology found evidence that supported the clinical use of Omega-3 in treating “stroke and other acute neurological diseases” due, in part, to its anti-inflammatory and anti-apoptotic (prevention of cell death) properties.

– Neuropathic pain: Neuropathic pain, or pain due to damage of the peripheral or central nervous system, can cause debilitating pain for those affected.

A 2018 study found that patients with neuralgic pain who were treated with omega-3 fatty acids in conjunction with conventional medicine, reported more improvement in pain intensity and quality of life than those who received conventional medicine alone.

In 2010, a review of case studies found that patients with neuropathic pain who were treated with high doses of Omega-3 fish oil had “clinically significant pain reduction” and improved function.

– Migraines: Diets high in Omega-3 fatty acids have been found to lessen the frequency and occurrence of migraine headaches.

– Neurodegenerative disease: DHA is extremely important for brain development and function. Studies show that when DHA levels are low, the brain is more susceptible to degeneration.

Omega-3 fatty acids help scavenge free radicals (atoms, molecules, or ions with unpaired electrons) that attach inappropriately to tissue and damage it.

A study published in The FASEB Journal found that “omega-3 polyunsaturated fatty acids, which are found in fish oil, could improve the function of the glymphatic system, which facilitate the clearance of waste from the brain, and promote the clearance of metabolites including amyloid-β peptides, a primary culprit in Alzheimer’s disease.”

Studies also show that DHA supplementation can improve cognitive performance.

How much is enough?

Eating a Mediterranean diet with plenty of fruits, vegetables, whole grains, nuts, lean meat, and cold-water fish will help a person consume more Omega-3’s on a regular basis. Current literature advises that at least 2, 3.5 oz. portions of oily fish should be eaten weekly, but does this amount support long-term health?

Determining the correct intake of Omega-3 fatty acids depends on an individual’s age, the overall state of physical and mental health, and whether there is a history of trauma that suggests heightened inflammation. To find out the amount that is best for your unique condition, make sure to consult with your health care provider or schedule an appointment at the Kaplan Center.

 

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 on December 2016. It was reviewed and updated in June 2023.

Additional research:

Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids.
Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: a randomized trial.
Association between serum long-chain omega-3 polyunsaturated fatty acids and cognitive performance in elderly men and women: The Kuopio Ischaemic Heart Disease Risk Factor Study
Omega-3 fatty acids and brain resistance to aging and stress: body of evidence and possible mechanisms.
Therapeutic use of omega-3 fatty acids in severe head trauma.

 

supplement labels

Sleep Supplement Study Exposes Label Inaccuracies

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During the Covid-19 pandemic, many people turned to sleeping pills and supplements to improve disturbed sleep cycles either for themselves or for their children.

In 2022, prompted by a large increase in pediatric melatonin poisonings, particularly during the pandemic, researchers from the Cambridge [MA] Health Alliance and the University of Mississippi looked to assess several brands of the popular sleep supplement, melatonin. What they specifically wanted to examine was the quantity of melatonin as compared to its label and if any other non-labelled ingredients such as cannabidiol (CBD) were present.

The study, which was published in JAMA in April 2023, looked at 25 over-the-counter brands of melatonin gummies and found that most of them (88%) contained more melatonin than the labeled quantity, in some cases far more, and five brands even contained CBD! While the study only looked at a small sample of supplements, this is not very reassuring for the supplements industry.

To understand how this can happen you have to understand how the Federal Drug Administration (FDA) “regulates” supplements. The FDA does not approve dietary supplements before going to market; their role in regulating supplements begins after the product is available to consumers. According to the Dietary Supplement Health & Education Act of 1994 (DSHEA)

  • Manufacturers and distributors of dietary supplements and dietary ingredients are prohibited from marketing products that are adulterated or misbranded. That means that these firms are responsible for evaluating the safety and labeling of their products before marketing to ensure that they meet all the requirements of the Federal Food, Drug, and Cosmetic Act as amended by DSHEA and FDA regulations.(1)
  • FDA has the authority to take action against any adulterated or misbranded dietary supplement product after it reaches the market.(2)

Again, it is the manufacturer’s responsibility to provide a good, safe product that is effective and free of impurities and contaminants. The FDA will act only when an issue has been brought to their attention.

Now, are all sleeping aids bad? Do you have to stop buying supplements? Absolutely not. But we must work within the framework we are given, which means when it comes to buying supplements, making sure you’re buying from a trusted source.

Once restricted to just our patients, in 2021 we opened The Kaplan Center Store to the public. Now anyone looking to buy high-quality supplements can access our store. Our providers have taken the time to vet every one of the manufacturers we carry and can attest to the fact that they provide a quality product that’s been thoroughly tested and contains the ingredients it claims to contain.

Supplements are not a replacement for a healthy diet and lifestyle but can provide essential nutrients and support when deemed necessary. And remember, before you start taking any new supplement or medication, make sure to talk to your provider to avoid any possible drug interactions or adverse reactions.

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

(1),(2) U.S. Food & Drug Administration / Dietary Supplements

Drug Free Migraine Treatments

5 Ways to Treat a Migraine without Drugs

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As migraine sufferers will attest, a migraine headache can be caused by any number of factors, meaning that there is no one-size-fits-all remedy. Therefore, keeping an open mind and exploring some alternative treatments could actually be the key to becoming migraine-free. Fortunately, people seeking migraine relief have a wide range of treatments available to them, outside the realm of conventional medicine, that are clinically-proven to help reduce migraine frequency and severity.

Here are 5 drug free migraine treatments that can help keep your migraine at bay:

1. Craniosacral Therapy — By using a gentle, “light-touch” to help release both emotional and physical imbalances that have been stored in the body’s membranes and connective tissue, craniosacral therapy allows the body to respond and relax. Practitioners trained in craniosacral therapy are able to feel and monitor changes in the body by placing their hands in the areas that are the source of dysfunction, following the body’s cues as it works to release the tensions that are causing pain. Over time this non-invasive touch helps decrease the symptoms of headache and migraine.

2. Acupuncture — According to a review of 22 clinical trials studying more than 4,000 migraine sufferers, acupuncture was found to be as effective as medication – and sometimes even more effective than medication – for preventing migraines.

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3. Nutritional Supplements — People who suffer with frequent migraines often look to vitamins and/or supplements in place of prescription medication. Riboflavin (vitamin B2), magnesium, and coenzyme Q10 (CoQ10) have all demonstrated protective effects against migraines.

Although side-effects are generally milder than those from prescription medications, supplementing is not risk free. Make sure to buy from a reliable source and talk to your doctor about dosages and possible interactions with other medications.

4. Trigger Point Therapy — Sometimes headache pain can be caused or worsened by trigger points or a strain/sprain located in the neck. If this is the case, trigger point injections can be very effective in relaxing tight areas in the neck and back, thereby reducing the incidence and severity of migraines.

5. Osteopathic Manipulative Therapy — Osteopathic Manipulative Therapy (OMT), also known as Osteopathic Manipulative Medicine (OMM), is a non-invasive, manual therapy that relieves tense muscles, tendons, and ligaments to allow the body to work more efficiently. A number of studies have shown that the hands-on techniques used in OMT, including massage, soft tissue and muscle stretching, and joint mobilization, are particularly effective for preventing migraines.

When it comes to migraines, symptoms vary from individual-to-individual, so prevention and treatment options may have mixed levels of success depending on an individual’s medical condition, history, and specific needs. Thinking outside-the-box when considering treatment options is the best approach when searching for relief from migraine symptoms.

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 originally appeared in Dr. Kaplan’s column on MindBodyGreen.com. It was reviewed and updated on 4/4/2023.