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THERE HAS NEVER BEEN A BETTER TIME TO TAKE CONTROL OF YOUR HEALTH AND REDUCE COVID-19 RISK.

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Reduce COVID-19 risk (Step 3 of 3) Have a plan

 

IT'S TIME TO TAKE CONTROL OF YOUR HEALTH.
A THREE-STEP PLAN TO REDUCE COVID-19 RISK USING NUTRITION, LIFESTYLE FACTORS, AND TARGETED NUTRACEUTICALS.


Step Three - Have a plan should you become infected.

As the COVID-19 pandemic continues to evolve, I remain committed to providing my patients and followers with useful and accurate information. I encourage you to use these resources to help in making informed decisions on how to go about your daily activities in a safe and healthy way. Please share with friends!

I routinely post relevant articles and information on my Facebook page. Not a Facebook member? I have made my Facebook posts available on the homepage of my website.

In conjunction with recommendations from the Institute for Functional Medicine, I have developed a three-step plan to reduce COVID-19 risk using nutrition, lifestyle factors, and targeted nutraceuticals.

  • Step One - Support your immune system.
  • Step Two - Reduce inflammation.
  • Step Three - Have a plan should you become infected.

You can refer to Step One and Step Two in my earlier blogs. These first steps are key in reducing your risk! According to experts, this virus isn’t going away anytime soon, so I strongly encourage you to use this time to take steps to boost your immune system function and reduce inflammation in your body.


Today’s blog will highlight Step Three: Should you become ill with COVID-19 infection, don’t be caught off-guard - have a plan!

Let’s start with a brief review of terminology. The term “coronavirus” actually refers to a group of viruses that get their name because of their crown-like shape seen under a microscope. Of the known coronaviruses, 9 are known to infect humans, including the common cold. This new coronavirus at the root of the current pandemic is called SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2). Those infected with the virus SARS-CoV-2 may then go on to develop COVID-19 infection (Coronavirus Disease 2019).

SARS-CoV-2 is the new coronavirus that causes COVID-19 infection. For simplicity's sake, I have been using the term COVID-19, which refers to infection with this new coronavirus.

Next, let’s acknowledge the fact that a majority of those who develop COVID-19 will recover without complications, and many infected by SARS-CoV-2 will never develop symptoms. According to the US Centers for Disease Control and Prevention, most people with COVID-19 have mild illness and are able to recover at home without medical care. Johns Hopkins University is among few institutions that have been tracking recovered cases as part of it’s reporting of comprehensive COVID-19 data and you can view real-time data on their public dashboard.


SYMPTOMS OF COVID-19 INFECTION
It’s important, again, to emphasize that some people infected with the virus have no symptoms, yet can still be contagious. That is why it is important to wear a mask in public!

According to Harvard Health, common COVID-19 symptoms include:

  • fever
  • dry cough
  • fatigue
  • loss of appetite
  • loss of smell
  • body ache

More severe symptoms which often indicates pneumonia may include:

  • high fever
  • severe cough
  • shortness of breath

As new data is being collected, specific neurological and gastrointestinal symptoms have also been highlighted, which may occur with or without respiratory symptoms:

  • loss of appetite
  • nausea, vomiting
  • diarrhea
  • abdominal pain or discomfort
  • loss of smell and/or taste
  • muscle weakness
  • tingling or numbness in the hands and feet
  • dizziness
  • confusion
  • delirium
  • seizures
  • stroke

 

HOW LONG DOES IT TAKE TO DEVELOP SYMPTOMS AFTER EXPOSURE?

While the time of exposure to symptom development ranges from 2-21 days, greater than 90% of people who develop symptoms will do so within 14 days.


Now that we’ve covered the basics, let’s start making a PLAN.


KNOW YOUR OPTIONS FOR HEALTHCARE AND TESTING

WHO IS YOUR PRIMARY CARE PROVIDER (PCP)? 
You may want to check to be sure you are still considered an active patient with your PCP. I’ve had many clients report that their PCP had “dropped them” as an active patient if they had not been seen in a period of time. Become familiar with your PCP’s hours of operation and policies as they relate to COVID-19. Ask if they are willing and able to order COVID-19 testing. If you don’t currently have a PCP, establish one, or become familiar with local urgent care facilities.

A note to my patients: While I do not provide traditional Primary Care services in my office, I will be available to evaluate and prescribe COVID-19 testing when needed, and will be able to consult with patients via Tele-health during active COVID-19 infection.

WHAT TYPE OF COVID-19 TESTING IS AVAILABLE IN YOUR COMMUNITY?

This situation is rapidly evolving, so find your city or county’s health department COVID-19 website and bookmark it. Emmet and Charlevoix County residents click here

 

HAVE A PLAN FOR HOME QUARANTINE
At the first sign of COVID-19 infection, a home quarantine plan is essential to reduce the risk of others in your home and to be sure that you have the supplies you need. I encourage you to talk through this first with your spouse or partner, and then second with your children. These are not fun conversations, but they are important ones. If you are able to talk openly with your family now, it will be easier to “kick into gear” should you encounter infection.

If you live with others (when possible) designate a home quarantine bedroom and bathroom. Should you become ill, this is where you should retreat at the earliest sign of illness. While this will not be possible for everyone, this room should ideally have a window for fresh air and a private bathroom nearby. Unless you require care outside of your home, you should plan to remain in this space until deemed not contagious by your healthcare provider.


ENSURE YOUR HOME IS STOCKED WITH NEEDED SUPPLIES SHOULD YOU OR A FAMILY MEMBER BECOME ILL: 

  • adequate amounts of surface disinfectant and laundry detergent
  • extra cloth masks (these need to be washed frequently when caring for an infected person)
  • a working thermometer


CONSIDER STOCKING YOUR PANTRY WITH:

  • ingredients to make your own electrolyte drink for hydration (there are many recipe variations) online
  • bone broth - most infected do not have much of an appetite, so think about nourishing liquids to sip on
  • frozen or canned soups


I ALSO RECOMMEND YOU CONSIDER HAVING THE FOLLOWING HOME MEDICAL DEVICES AVAILABLE (ESPECIALLY FOR THOSE AT HIGH RISK):

  • home nebulizer with a prescription solution or a sterile saline solution - become familiar with how to use and clean your device
  • pulse oximeter to monitor oxygen saturations at home. There are a variety available on Amazon, or check out this new pulse oximeter APP.  You should plan to routinely monitor blood oxygen levels if experiencing shortness of breath or respiratory symptoms. Nail polish needs to be removed for accurate results. A normal blood oxygen level via pulse oximeter is 95-100%. If your oxygen level falls below 92% you should contact your healthcare provider.


A FEW NOTES:

Thermometers are in short supply and a home nebulizer and pulse oximeter can be expensive. Nebulizers and other equipment can be ordered from a local medical supply store by your PCP should you become ill. Some feel more comfortable having on hand. You can also work with a group of families together to pool resources in a COVID-19 emergency kit or plan, with supplies being shared if needed.

I encourage you to read about the use of nebulizers in COVID-19 patients by Dr. David Brownstein at the Center for Holistic Medicine. You can find his blog here


CHECK OUT THESE ADDITIONAL CDC RESOURCES: 

 

WHAT TO DO IF YOU THINK YOU HAVE COVID-19
If you think that you have COVID-19, contact your PCP via phone. Only in the case of severe symptoms or emergency should you leave your home. Evaluation and testing orders should be able to be completed vis Tele-health services. Ideally, testing is done through a drive-through center or at home.

 The CDC has a useful self-checker tool available. 

IF YOU HAVE BEEN DIAGNOSED WITH COVID-19 AND YOU FEEL YOU NEED TO BE EVALUATED AT THE HOSPITAL
If your COVID-19 symptoms become severe, and you feel you need to be evaluated at the hospital - be prepared! Most likely, you will need to enter the hospital alone and you will not be permitted to have visitors. Plan to wear your mask and bring with you:

  • a typed, accurate list of all medications and supplements - including doses and time of day you take them (having three paper copies as well as a copy on your smartphone is ideal)
  • a typed identification card that includes contact information of 1-2 family members or close friends
  • a copy of your signed and notarized Medical Power of Attorney and Living Will (if you don’t have these now is the time to create them)
  • mobile phone and tablet or laptop for communication - don’t forget chargers!
  • a bottle of Vitamin C, and any other nutritional supplements in your emergency care plan

 

NUTRACEUTICALS FOR USE DURING ACTIVE COVID-19 INFECTION
In my two previous blogs, I have outlined targeted nutraceuticals for support of the immune system and reduction of inflammasome activation. Several of these supplements have also been designated by the Medical Education Team of the Institute for Functional Medicine as appropriate for use during active COVID-19 infection. The choice of which and how many nutraceuticals to incorporate into your prevention plan will be different for each person. Consult a healthcare practitioner prior to use.

VITAMIN C

  • For prevention, 500-1000mg daily
  • During active infection, 2000-6000mg daily starting at the very first signs of illness. I recommend 1000mg per hour for up to six hours daily, reducing your dose if you develop diarrhea. Continue higher dosing for seven days.
  • Choose a buffered form of Vitamin C for less stomach upset
  • Vitamin C has been shown to both decrease viral growth and reduce symptoms.


CURCUMIN

  • During active infection, 500-1000mg twice daily
  • Curcumin has been shown to both decrease viral growth and reduce symptoms


QUERCETIN

  • During active infection, 500-1000mg twice daily
  • Quercetin has been shown to both decrease viral growth and reduce symptoms


ZINC (acetate, citrate, picolinate, or glycinate)

  • During active infection, up to 60mg daily for seven days in the form of zinc lozenges spaced throughout the day
  • Zinc has been shown to both decrease viral growth and reduce symptoms


N-ACETYLCYSTEINE (NAC)

  • During active infection, 600-900mg twice daily
  • NAC has been shown to reduce symptoms of respiratory infection, but not to decrease viral growth


GREE TEA OR EGCG

  • 4 cups daily (green tea), 225 mg daily (EGCG)
  • EGCG Has been shown to reduce symptoms of respiratory infection and decrease viral growth


RESVERATROL

  • 100-150 mg orally, 2x daily
  • Resveratrol has been shown to decrease viral growth but has not been shown to reduce symptoms


ELDERBERRY

  • 500mg orally, daily
  • Elderberry has been shown to decrease viral growth but has not been shown to reduce symptoms.


MELATONIN

  • 3-20mg, taken at bedtime
  • Melatonin has been shown to decrease viral growth but has not been shown to reduce symptoms


PALMITOYLETHANOLAMIDE (PEA)

  • PEA is a naturally occurring anti-inflammatory agent that has been shown to improve outcomes in acute respiratory disease and influenza.
  • PEA modulates the endocannabinoid system
  • Functional Medicine specialist Kara Fitzgerald, ND recommends Metagenics Hemp Advantage (with PEA): 2 caps daily for prevention, increasing to 2 caps three times per day with first symptoms. Continue for six weeks


An additional consideration perking my interest:

Specialized pro-resolving Lipid Mediators (SPMs)

  • SPMs are biosynthesized from the omega-3 fatty acids. Some people cannot efficiently synthesize SPMs from omega-3 fats (think fish oil) and may benefit from taking SPMs directly
  • There are a host of studies demonstrating that SPMs rapidly resolve inflammation
  • Functional Medicine specialist Kara Fitzgerald, ND recommends Metagenics SPM Active: 2 caps daily for prevention, increasing to 2 caps 2-3 times daily during active infection

 

Please note: Due to the novelty of COVID-19, no peer-reviewed research has been published regarding the effectiveness of dietary or lifestyle interventions for its prevention or treatment. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider prior to use of any nutraceutical, especially if taking prescription medication that could have potential interactions.



Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Physicians specializing in Functional Medicine are trained and experienced in providing personalized guidance to patients in the use of nutrition, nutraceuticals, and lifestyle to prevent, reverse, and decrease the burden of complex, often chronic medical conditions. I continue to see both new and returning clients via our secure video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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Reduce COVID-19 risk (Step 2 of 3) Reduce Inflammation

 

IT'S TIME TO TAKE CONTROL OF YOUR HEALTH.
A THREE-STEP PLAN TO REDUCE COVID-19 RISK USING NUTRITION, LIFESTYLE FACTORS, AND TARGETED NUTRACEUTICALS.


Step Two - Reduce INFLAMMATION to reduce your risk.

As the COVID-19 pandemic continues to evolve, I remain committed to providing my patients and followers with useful and accurate information. I encourage you to use these resources to help in making informed decisions on how to go about your daily activities in a safe and healthy way. Please share with friends!

I routinely post relevant articles and information on my Facebook page. Not a Facebook member? I have made my Facebook posts available on the homepage of my website.

In conjunction with recommendations from the Institute for Functional Medicine, I have developed a three-step plan to reduce COVID-19 risk using nutrition, lifestyle factors, and targeted nutraceuticals.

  • Step One - Support your immune system.
  • Step Two - Reduce inflammation.
  • Step Three - Have a plan should you become infected.


Today’s blog is focusing on Step Two - Reducing inflammation to reduce your risk.

The statistics are clear. Those with certain chronic medical conditions are at a higher risk for both contracting the novel coronavirus, and suffering complications from the virus. In addition to those who are immunocompromised, chronic medical conditions associated with increased risk include:

  • Hypertension
  • Diabetes
  • Chronic lung disease or moderate to severe asthma
  • Serious heart conditions
  • Severe obesity (body mass index [BMI] of 40 or higher)
  • Chronic kidney or liver disease

What do many of these chronic conditions that pose a higher risk have in common? Each is associated with increased INFLAMMATION.


KEY TERMS AND CONCEPTS RELATED TO INFLAMMATION AND COMPLICATIONS FROM COVID-19 INFECTION:

  • Cytokines are substances produced by cells of the immune system that promote inflammation. In certain patients infected with COVID-19, a cytokine storm is responsible for driving lung and tissue damage and increased risk of death.
    Think of this cytokine storm as an overwhelming, massive burst of inflammation which eventually leads to lung damage, heart damage, and multi-system organ failure.
  • Inflammasomes are a big driver of the cytokine storm. Inflammasomes are cellular complexes that detect infections and other “danger signals” in the body, and in turn, activate inflammatory cytokines.
  • When Inflammasomes detect infection (such as the COVID-19 virus), they activate cytokines which turn on inflammation. In those who become most ill with coronavirus infection, this “cytokine storm” of inflammation is responsible.

We don’t know why some people infected with the COVID-19 virus get the cytokine storm and some do not. Researchers have speculated that those with more mild illness or even asymptomatic illness may have a more robust innate immune response (see part one of this series to learn more about innate immunity and prevention), and have also suggested that those exposed to or mounting a lower viral load may have improved outcomes.

What we do know:
1. The NLRP3 inflammasome is what is activated by the COVID-19 virus.
2. Inflammasomes can also be activated by a variety of other factors, including:

  • poor diet (think high sugar and processed foods)
  • nutrient insufficiencies
  • gut infections/dysbiosis
  • increased intestinal permeability (“leaky gut”)
  • emotional stress
  • cells damaged by reactive oxygen species (ROS) due to antioxidant imbalance and
  • oxidative stress
  • damaged mitochondria
  • toxins

Given this, the goals of today’s recommendations are to:

  • Identify and reduce your personal risk of everyday inflammasome activation.
  • Identify natural inhibitors of the NLRP3 inflammasome to potentially reduce the risk of coronavirus infection and cytokine storm.

 

REDUCE INFLAMMATION AND RISK

If you have a chronic medical condition such as diabetes, hypertension, arthritis, asthma, or COPD, now is not the time to stop your medication! This is the time to be vigilant in managing your condition and doing everything you can to keep blood pressures and blood sugars under control, keep lungs clear, and reduce arthritic flares. Many primary care providers and specialists are offering tele-medicine services, so utilize your time at home to check-in and optimize your health!

DIET

  • Every time you eat or drink something, you are making the decision to either increase or decrease inflammation in your body. It’s really that simple!
  • To lower inflammation, eat real food. Avoid sugar and processed foods. Choose healthier fats and eat more plants.
  • Eating a nutrient-dense diet replenishes nutrients needed to combat inflammasome activation.
  • Eating a low glycemic-load diet lowers blood sugars and insulin, which in turn lowers inflammation.
  • Eating a diet rich in colorful fruits and vegetables provides antioxidants to reduce oxidative stress, which can trigger inflammasomes.

TOXINS
Toxic load and impaired detoxification can lead to “danger signs” in the body and activate the inflammasome response.

  • When possible, choose organic whole food. Check out the Dirty Dozen and Clean Fifteen lists by the Environmental Working Group (EWG) to help guide your choices.
  • Choose non-toxic cleaning products. The EWG also has a guide to help chooses after cleaning products.
  • Take time each day to sweat. Sweating is an effective, natural way to detoxify your body!
  • Drink at least 64oz of clean, filtered water daily to help flush toxins out of your body.
  • Avoid constipation! If stool sits in the bowel for too long, toxins and hormones can re-enter your bloodstream and cause harm. Increase fiber. Try Magnesium Glycinate 100-300mg at bedtime - this can help both sleep and bowel movements.

CLEAN UP YOUR GUT
Your gut can be a major source of inflammasome activation. Increased intestinal permeability (“leaky gut”), allows substances to get into the bloodstream that might otherwise have not, sending a “danger signal” which can activate inflammasomes. Dysbiosis (overgrowth of unwanted bacteria or yeast n the gut) can also trigger inflammasome activity.

  • If you have chronic gut inflammation, such as IBS, bloat, irregular bowel movements, or GERD, now is the time to seek treatment! Consider working with a Functional Medicine specialist to outline a personalized treatment program.
  • Even during stay-home orders, helpful testing such as stool analysis, urine organic acids, and food sensitivity testing can be done from home without a blood draw.
  • If you have known gut dysbiosis, talk with your practitioner about adding Berberine 500mg three times daily for the next three months. Berberine has many anti-inflammatory and anti-microbial activities. It is also used to lower blood sugar and cholesterol.
  • You may also want to consider other gut-healing nutrients such as bone broth, collagen, and/or L-glutamine. I often recommend a bovine colostrum-derived immunoglobulin powder to my patients - putting an immune-boost directly into the gut. I also like combination gut-soothing powders (such as GI Revive by Designs for Health) for a variety of inflammatory gut conditions.

 

NUTRACEUTICALS TO REDUCE INFLAMMASOME ACTIVATION AND THE INFLAMMATORY RESPONSE

These featured substances were chosen by the Medical Education Committee of the Institute for Functional Medicine both because they are known to have multiple anti-inflammatory mechanisms, and also have been studied to be specifically effective in NLRP3 inflammasome inhibition. The nutraceuticals are recommended, at standard dosages, to prevent activation of the NLRP3 inflammasome, to decrease inflammation, and to potentially inhibit COVID-19 replication. The number of nutraceuticals chosen and the dosing will depend upon a variety of factors, including patient desire, pre-existing inflammation, multiple co-morbidities, higher risk, budget, etc. Consult a healthcare practitioner prior to use.

CURCUMIN

  • 500-1000mg twice daily
  • Curcumin has been shown to reduce inflammation and decrease viral activity for COVID-19.

QUERCETIN

  • For prevention, 500-1000mg daily
  • Has also been found to be effective in treating seasonal allergies and asthma
  • Found in fruits and vegetables and has a wide range of benefits, including decreasing viral growth.

OMEGA-3 FATTY ACIDS

  • 2000-2500mg EPA+DHA daily (read your label carefully)
  • Omega-3 fatty acid deficiency makes turning off an inflammatory response difficult
  • For those at higher risk, including those with underlying inflammatory conditions such as Diabetes, consider Specialized pro-resolving Lipid Mediators (SPMs). There are a host of studies on SPMs and inflammation, including inhibition of the inflammasome.

MELATONIN

  • 3-20mg, taken at bedtime
  • In addition to promoting restful sleep, melatonin has been shown to reduce inflammation.

PALMITOYLETHANOLAMIDE (PEA)

  • For prevention, 300mg twice daily
  • PEA is a naturally occurring anti-inflammatory agent that has been shown to improve outcomes in acute respiratory disease and influenza.
  • PEA modulates the endocannabinoid system

GREEN TEA OR EGCG

  • Drink 4 cups green tea daily, or take EGCG 225 mg daily
  • In addition to reducing inflammation, green tea enhances the immune system and targets one of the processes involved in COVID-19 replication.

RESVERATROL

  • 100-150 mg orally, twice daily
  • A natural compound found in red grapes has many beneficial health effects and has been shown in the lab to attack a relative of the COVID-19 virus.

Please note: Due to the novelty of COVID-19, no peer-reviewed research has been published regarding the effectiveness of dietary or lifestyle interventions for its prevention or treatment. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider prior to use of any nutraceutical, especially if taking prescription medication that could have potential interactions.



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Physicians specializing in Functional Medicine are trained and experienced in providing personalized guidance to patients in the use of nutrition, nutraceuticals, and lifestyle to prevent, reverse, and decrease the burden of complex, often chronic medical conditions. I continue to see both new and returning clients via our secure video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

  540 Hits

Reduce COVID-19 risk (Step 1 of 3) Immune System Support

 

IT'S TIME TO TAKE CONTROL OF YOUR HEALTH.
A THREE-STEP PLAN TO REDUCE COVID-19 RISK USING NUTRITION, LIFESTYLE FACTORS, AND TARGETED NUTRACEUTICALS.


Step One - Support your Immune System

As the COVID-19 pandemic continues to evolve, I remain committed to providing my patients and followers with useful and accurate information. I encourage you to use these resources to help in making informed decisions on how to go about your daily activities in a safe and healthy way. Please share with friends!

I routinely post relevant articles and information on my Facebook page. Not a Facebook member? I have made my Facebook posts available on the homepage of my website.

Lately, it seems we are doing a lot of waiting.

Waiting for the coronavirus pandemic to pass, waiting for social restrictions to be lifted, and for many of us, waiting and wondering if/when we will become infected with COVID-19.

It’s time to stop waiting and take control of your health.

In conjunction with recommendations from the Institute for Functional Medicine, I have developed a three-step plan to reduce COVID-19 risk using nutrition, lifestyle factors, and targeted nutraceuticals.

  • Step One - Support your immune system.
  • Step Two - Reduce inflammation.
  • Step Three - Have a plan should you become infected.


Today’s blog is focusing on Step One - Immune System Support.

Your innate immune system is your first line of defense against any type of infection, therefore it makes sense to have your innate immune response optimized, primed and ready to recognize and attack COVID-19 should you become exposed.

The innate immune system is often described like an army. You want healthy, well-educated troops ready to respond quickly and efficiently to any situation they are faced with.

LIFESTYLE FACTORS
You have the control to adjust key lifestyle factors and boost your immunity.

DIET/NUTRITIOUS FOODS 
How many servings of vegetables and fruits are you eating each day? Research indicates that brightly colored vegetables and fruits boost immunity better than most supplements.

  • Aim for 10 servings of vegetables and fruits per day.
  • Try to incorporate different colors of vegetables and fruits throughout your day.
  • Include fermented vegetables or other probiotic-containing foods (work up to 1/4 cup per day).
  • Focus on real food, limiting processed foods.
  • Consider time-restricted eating, extending the window from when you stop eating at night to when you begin eating in the morning. Work up to a 12-14 hour overnight fast.


STRESS REDUCTION
Chronic stress can negatively alter immune system responses, making you more likely to get sick. Identify your personal stress reduction strategies and practice them regularly.

  • Consider meditation. Taking even a few minutes out of each day for a breath-focused meditation can work wonders on your stress response. I frequently recommend the apps “Headspace” and “Calm” to patients for guided meditations.
  • Go for a walk in the woods. Research reveals that environments can increase or reduce our stress, which in turn impacts our immune system. What you are seeing, hearing, experiencing at any moment is changing not only your mood, but how your nervous, endocrine, and immune systems are working.
  • Work with a licensed counselor or therapist. Many professionals are now offering tele-health services via video or phone.
  • If the COVID-19 pandemic has your stress levels at a peak, consider working with your Integrative/Functional Medicine practitioner on herbal options to help manage your stress response.


SLEEP
Do not underestimate the importance of sleep! Sleep has a big influence on immune function itself, and quality sleep can also reinforce your stress response.

  • Practice good sleep hygiene by maintaining consistent sleep hours. Turn off screens and ensure your room is cool, quiet, and dark.
  • Chronic sleep problems? Consider referral to a sleep specialist or a counselor certified in sleep management (remotely, of course).
  • If needed, consider melatonin, CBD, or other herbals to promote quality sleep.


EXERCISE
Are you keeping up your exercise routine? Moderate, regular physical activity helps to boost immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones.

  • Exercise not only boosts immunity, but it also works to counteract the stress response and improve detoxification.
  • At a minimum, aim for 150 minutes of cardiovascular exercise weekly. Get your heart rate up and break a sweat!
  • Try to add-in 2-3 days of strength training weekly to build muscle mass.
  • There are MANY online exercise-at-home platforms. Some of my favorites are HASfit.com, FitOn.com and the 90-day free trial of Peloton on-demand classes (meditations too).

 

NUTRACEUTICALS
There are a number of nutraceuticals that have demonstrated immune-boosting properties. The choice of which and how many nutraceuticals to incorporate into your prevention plan will be different for each person. Consult a healthcare practitioner prior to use.


VITAMIN C

  • For prevention, 500-1000mg daily
  • Choose a buffered form of Vitamin C for less stomach upset
  • Vitamin C contributes to immune defense by supporting various cellular functions of the immune system. Vitamin C has been used in hospital ICUs to treat COVID-19

 

VITAMIN D

  • For prevention, 2000-5000IU Vitamin D3 daily with food
  • Enhances immune system function, reduces viral growth, and can reduce upper respiratory infections.

 

ZINC (acetate, citrate, picolinate, or glycinate)

  • For prevention, 20-40mg daily for three months
  • A large body of research shows that zinc has strong anti-viral properties against many viruses.


QUERCETIN

  • For prevention, 500-1000mg daily
  • Has also been found to be effective in treating seasonal allergies and asthma
  • Found in fruits and vegetables and has a wide range of benefits, including decreasing viral growth.


N-ACETYLCYSTEINE (NAC)

  • For prevention, 500-600mg daily
  • Promotes the production of glutathione, a potent antioxidant that supports immune function. It also reduces the severity of the flu


ELDERBERRY

  • 500mg orally, daily
  • Packed with vitamin C, dietary fiber, and antioxidants. It has been used extensively in the prevention of influenza.


GREEN TEA or EGCG

  • 4 cups daily (green tea)225 mg orally, daily (EGCG)
  • In addition to reducing inflammation, green tea enhances the immune system and targets one of the processes involved in COVID-19 replication.


RESVERATROL  

  • 100-150 mg orally, 2x daily
  • A natural compound found in red grapes has many beneficial health effects and has been shown in the lab to attack a relative of the COVID-19 virus.

 

Please note: Due to the novelty of COVID-19, no peer-reviewed research has been published regarding the effectiveness of dietary or lifestyle interventions for its prevention or treatment.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider prior to use of any nutraceutical, especially if taking prescription medication that could have potential interactions.



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Physicians specializing in Functional Medicine are trained and experienced in providing personalized guidance to patients in the use of nutrition, nutraceuticals, and lifestyle to prevent, reverse, and decrease the burden of complex, often chronic medical conditions.  I continue to see new and returning clients using our secure, easy video-visit format.  If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

  578 Hits

The coronavirus is HIGHLY CONTAGIOUS - tips to protect yourself and the ones you love.

 

The coronavirus is HIGHLY CONTAGIOUS.
TIPS TO PROTECT YOURSELF AND OTHERS.


As the COVID-19 pandemic continues to evolve, I remain committed to providing my patients and followers with useful and accurate information. I encourage you to use these resources to help in making informed decisions on how to go about your daily activities in a safe and healthy way. Please share it with friends!

I routinely post relevant articles and information on my Facebook page. Not a Facebook member? I have made my Facebook posts available on the homepage of my website.

Today’s blog is about how HIGHLY CONTAGIOUS the coronavirus is, with tips on how to protect yourself and others.

By now, most of you should understand the vital importance of social distancing to “flatten the curve” of the coronavirus pandemic, and reduce the burden on our healthcare systems. This importance has been reinforced by government mandates such as the “Stay Home, Stay Safe” mandate in Michigan, and we are now living in a new reality of social distancing and social isolation that is likely to be measured in months rather than weeks.

Our daily lives have changed dramatically, and in order to protect yourself and your family, I am encouraging you to go beyond social distancing and use an abundance of caution and vigilance in your daily activities to reduce your risk of contracting or transmitting the coronavirus.

The coronavirus can be spread silently, without symptoms.
Asymptomatic transmission of the coronavirus is real, and there is growing data showing that a significant number of cases are a result of asymptomatic exposure.
Even today, as I finish this blog, there is suggestion that simply talking, not coughing/sneezing, can be a source of spreading this virus.

What this means:

  • you could become infected with the virus from somebody who does not have any symptoms
  • you could potentially be a source of infecting others if you contract the virus but do not have symptoms

 

For the time being, reduce the amount of time you spend in public places.
This (obviously) excludes those with essential jobs such as healthcare workers. The rest of us need to stay home. If possible, stock up on 14 days worth of groceries at a time. This requires planning ahead!

  • Keep track of food and essential toiletries available in your home, and levels of cleaning supplies.
  • Plan menus ahead of time to anticipate grocery needs.
  • If you take medications or nutritional supplements on a regular basis, stock up with a three month supply.

 

When in a public place, conduct yourself in a manner that assumes that anyone you come in contact with is infected with the coronavirus.
You can also take that one step further and assume that you are infected and capable of transmitting the virus to others.

  • Stay a minimum of 6 feet away from other people.
  • Only touch what you need to touch.“You touch it, you buy it.”
  • Wash hands frequently, and use hand sanitizer as a back-up.
  • Stop touching your face!
  • Consider covering your nose and mouth with a cotton mask or scarf when in public (the CDC is currently considering a statement about this)

 

Be vigilant about SURFACES.
In a study published March 24, 2020, NIH scientists found that the virus that causes COVID-19, can be detected:

  • In the air for up to three hours
  • On cardboard for up to 24 hours
  • On plastic and stainless steel surfaces for up to three days

Another study, published on the CDC’s website found that traces of COVID-19 genetic blueprint were found on surfaces throughout the Diamond Princess cruise ship as long as 17 days after passengers and crew had disembarked from the voyage. My take on this? When you are in public - assume all surfaces are contaminated with coronavirus and take appropriate precautions.

Disinfect EVERYTHING that enters your home.

PACKAGES
Packages delivered to your home have likely been handled by several people, and we know that the coronavirus can live on cardboard up to 24 hours and plastic up to three days, so you need to have a plan:

  • move mail and packages into your garage and if able, let them sit for several days before opening
  • be vigilant about disinfecting your doorknobs and washing hands immediately after transferring packages and mail
  • leave envelopes and cardboard for recycling outside of the home, only transfer into the home what you need
  • wipe all items being brought into the home with a disinfectant
  • for more information, check out this article

 

GROCERIES
Similar to packages assume all grocery surfaces are contaminated with the coronavirus and develop a plan for disinfecting. Here is the plan we’ve implemented at our house:

  • only one family member does the grocery shopping (my husband)
  • we leave any grocery items that do not need to be placed in the refrigerator or freezer in the garage to wait, usually 5-6 days.
  • items heading to the refrigerator or freezer are thoroughly disinfected first (I use a diluted bleach solution)
  • produce is washed for 20+ seconds with soap and water
  • Check out this video by my former teacher and colleague Dr. Jeff VanWingen. 

Here is one last link with answers to frequently asked questions.

That’s it for today. Stay home, stay safe, and stay well.



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. I continue to see both new and returning patients using our secure, easy video visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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Stay Home & Eat Well with these Recipe Resources

As the COVID-19 pandemic continues to evolve, I remain committed to providing my patients and followers with useful and accurate information. I encourage you to use these resources to help in making informed decisions on how to go about your daily activities in a safe and healthy way. Please share it with friends!

 
I routinely post relevant articles and information on my Facebook page. Not a Facebook member? I have made my Facebook posts available on the homepage of my website as well.
 
Today I’m highlighting four recipe resources that are especially useful for today's Stay Home - Stay Safe environment.
 
Having a stocked pantry is as important now as it has ever been. One of my favorite go-to recipe sites Eating Bird Food has compiled a list of helpful tips to stock your healthy pantry. 
 
Another one of my favorite sites, Well Plated by Erin,  has made available a page of healthy pantry & freezer-friendly recipes.
 
Dr. Kara Fitzgerald’s nutrition staff has assembled a website full of healthy recipes. Why am I obsessed with this site? First, most of the recipes are easily modified to accommodate personal diet plans. Second, the variety of recipes has a broad range, including everything from bone broth to dessert. In addition, the recipes are designed with nutrient density in mind, seeking to optimize nutrient content for optimal immune support. For those of you science geeks (like me) interested in Functional Medicine, Dr. Kara also has an excellent podcast.
 
Ready to incorporate more plant-based options into your diet? The Physicians Committee for Responsible Medicine has the tools you need to get started in the relaunched 21-Day Vegan Kickstart online program and mobile app. The free program features hundreds of healthy recipes, meal plans, grocery lists, expert nutrition advice, cooking demonstrations, and more.
You don’t have to commit to being a strict vegan to learn from this program. We can all benefit by incorporating more plant-based principles into our diet.
  
That’s it for today. Stay home, stay safe, and stay well.
 


Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. During our Stay home - stay safe period I continue to see both new and returning clients via our secure video visit format.  If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585. 

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Integrative Therapies & Nutritional Supplements - Expert Recommendations during COVID-19 Crisis

Amidst the chaos of the emerging COVID-19 crisis, it is more important than ever to have access to well-sourced,  evidence-based information when making decisions regarding your health and wellbeing.

Over the past week, I have been receiving many questions regarding the use of Integrative therapies and nutritional supplements to support the immune system. To answer such questions, I turned to my own trusted sources in an attempt to provide the most accurate information possible.

Thankfully, the team at the Andrew Weil Center for Integrative Medicine at the University of Arizona has developed a set of strategies to be considered for immune system support. These strategies are designed to reduce the severity or the duration of a viral infection, and include measures to reduce risk, as well as supplements to avoid should you become ill.  The recommendations are based upon available evidence, however, it is important to note that Integrative measures have not been validated in human trials of COVID-19.

Andrew Weil Center for Integrative Medicine recommendations

REDUCING YOUR RISK:

  • Adequate sleep: Shorter sleep duration increases the risk of infectious illness. Adequate sleep also ensures the secretion of melatonin, a molecule that may play a role in reducing coronavirus virulence (see Melatonin below).
  • Stress management: Psychological stress disrupts immune regulation. Various mindfulness techniques such as meditation, breathing exercises, and guided imagery reduce stress. Zinc: Coronaviruses appear to be susceptible to the viral inhibitory actions of zinc. Zinc may prevent coronavirus entry into cells and appears to reduce coronavirus virulence. The typical daily dosing of zinc is 15mg – 30mg daily with lozenges potentially providing direct protective effects in the upper respiratory tract.
  • Vegetables and Fruits: Vegetables and fruits provide a repository of flavonoids that are considered a cornerstone of an anti-inflammatory diet. At least 5–7 servings of vegetables and 2– 3 servings of fruits are recommended daily. Some of these foods and/or dietary supplements include tomatoes, apples, onions, oranges, nuts, parsley, celery, berries, licorice, and Chinese skullcap.
  • Vitamin C: Clinical trials have found that vitamin C shortens the frequency, duration, and severity of the common cold and the incidence of pneumonia. The typical daily dosing of vitamin C ranges from 500mg to 3000mg daily with even higher doses utilized during times of acute infection.
  • Melatonin: Melatonin has been shown to be anti-inflammatory. It also reduces oxidative lung injury and inflammatory cell recruitment during viral infections.
  • Curcumin: Curcumin, a key component of turmeric, has anti-inflammatory actions and antiviral effects against a variety of similar viruses.

 

IF YOU HAVE SYMPTOMS OF INFECTION OR HAVE BEEN DIAGNOSED WITH CORONAVIRUS:
To Avoid: In the absence of human clinical data, caution is warranted with the following immune-activating agents due to their possible stimulation of inflammatory response:

  • Sambucus nigra (Elderberry)
  • Polysaccharide extracts from medicinal mushrooms
  • Echinacea angustifolia and E. purpurea
  • Larch arabinogalactan
  • Vitamin D

 

LIKELY SAFE
There are other commonly used natural immune-stimulating and antiviral agents, several of which may work to restore immune balance [homeostasis]. These are, therefore, likely safe to use both prior to, and during COVID-19 virus infection. Whether these agents mitigate the symptoms or severity of COVID-19 is unknown and, therefore, the benefit of these agents during COVID-19 infection is unknown.

Recommendations include:

  • Allium sativum (garlic)
  • Quercetin
  • Astragalus
  • Zinc
  • Vitamin A
  • Vitamin C
  • Full mycelium mushroom extracts
  • Mentha piperita (peppermint)
  • Andrographis paniculata

 

ADDITIONAL INFORMATION
Regardless of how you may choose to incorporate the above recommendations, please continue to be vigilant:

  • Regular hand washing (minimum 20 seconds of scrubbing with soap and water)
  • Social distancing (6 feet, ideally staying home when possible)
  • Stop non-essential travel

If you are considering nutritional supplementation, I have provided additional information and resources on dosing, potential drug interactions, and most common side effects:

ZINC

  • Zinc plays a vital role in helping our immune system fight off bacteria and viruses.
  • Dosing: (as stated above) 15-30mg daily (you may already be taking this amount in your daily multivitamin/multimineral). Do not exceed 40mg daily. Long-term supplementation with high-dose zinc is not recommended.
  • While zinc supplementation is generally recognized as safe for most adults, potential interactions may occur with certain antibiotics. For more information CLICK HERE.

VITAMIN C

  • Dosing: As listed above, Vitamin C dosing ranges from 500-3000mg.
  • The most common side effects are diarrhea and gastrointestinal upset, which are more common at higher doses.
  • For more information about Vitamin C, CLICK HERE.

TURMERIC/CURCUMIN

  • Turmeric is a very powerful natural anti-inflammatory agent and also has beneficial antioxidant properties. The responsible constituents are curcuminoids, of which curcumin is most prominent.
  • Dosing:  While many patients take 300-500mg of turmeric/curcumin daily for general health, I often recommend increasing this to three times daily (approximately 1500mg in divided doses) for immune support.
  • You should avoid supplementation with turmeric/curcumin if you have a history of gallstones, are receiving chemotherapy, or are on blood thinners (like warfarin).
  • Supplementation can slow the elimination of some prescription drugs, including phenytoin (Dilantin), propranolol (Inderal), and theophylline. CLICK HERE for more information.

QUERCETIN

  • While Quercetin is most commonly known for it's anti-histamine and anti-allergy properties, it is also a potent anti-viral.
  • Dosing: 500mg 2-3 times daily.  Quercetin is generally well-tolerated with few side effects.
  • Quercetin is available in many foods, to learn more CLICK HERE.

VITAMIN A 

  • Dosing: Vitamin A is a fat-soluble vitamin.  This means that levels of Vitamin A can build up in your body, rather than being excreted in your urine like most other water-soluble vitamins.
  • For appropriate patients, I generally recommend 3000-5000 IU of Vitamin A (which you may be getting in your multivitamin/multimineral). 
  • Do not exceed doses of 10000 IU daily.
  • Possible side effects of Vitamin A supplementation include nausea and vomiting, headache, blurred vision, muscular weakness, elevated liver function tests, liver toxicity
  • Those who regularly consume alcohol or are taking Coumadin/warfarin or a retinoid-based medication should avoid supplementing with Vitamin A. 
  • For more information CLICK HERE.

VITAMIN D

  • The immune-supporting properties of Vitamin D are well established. There have been a number of studies looking at vitamin D levels and rates of influenza, upper respiratory infections, as well as other infections. All have reported an association of lower vitamin D levels and increased rates of infection.
  • CLICK HERE for additional information
  • Like Vitamin A, Vitamin D is a fat-soluble vitamin, which increases its potential for toxicity.  I generally recommend that my patients maintain a serum level of 25, OH Vitamin D3 at 60-70 ng/ml. 
  • Supplementation of 2000 IU Vitamin D3 daily is generally recognized as safe.  Many of my patients are taking 5000 IU Vitamin D3 daily, with regular monitoring of blood levels.

ASTRAGALUS

  • Dosing: Astragalus root can be found in many different forms. Supplements are available as capsules and liquid extracts. The root may also be ground into a powder, which can be brewed into teas. Follow dosage directions on product labels.
  • Potential interactions: Those who are immunodeficient, have hormone-sensitive cancer, are on anticoagulants, diuretic or antihypertensive medications should use caution or avoid use. 
  • CLICK HERE for additional information.
     

SOURCES:
Andrew Weil Center for Integrative Medicine, University of Arizona
Memorial Sloan Kettering Cancer Center
National Center for Complementary and Integrative Health
Linus Pauling Institute, Oregon State University

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. If choosing to incorporate nutritional supplements, this decision should be discussed with and approved by your healthcare provider.  IF YOU ARE PREGNANT OR BREASTFEEDING YOU SHOULD AVOID ALL NUTRITIONAL SUPPLEMENTATION UNLESS UNDER THE RECOMMENDATION AND SUPERVISION OF YOUR HEALTHCARE PROVIDER.



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585. We are continuing to see new and returning clients during the COVID-19 crisis using our easy, secure video format.

  697 Hits

Non-toxic Skincare. The Why, What and How. Part Two

Non-toxic Skincare.  The Why, What and How. Part Two
Non-toxic Skincare - The Why, What and How.  
Part two:  The WHAT

This month we are highlighting healthy skin, including skincare basics, healthy skin care products, food and skin and more. This is part two of a three-part series going in-depth on the topic of toxic skincare products, including why it’s important to choose healthy skincare products, ingredients to be aware of, and resources to help you choose safe, healthy skin care products for you and your family.


PART TWO: THE WHAT

As explained in my previous blog, your skin absorbs up to 60% of what you apply to it, and serves in some cases as a direct route to your blood. Chemicals in skin care products can bioaccumulate, or store and accumulate in your body over time, potentially causing hormone disruption, inflammation, weight gain and increased cancer risk. Unfortunately, the FDA does not require proof of safety before cosmetics and other skincare products reach the market, so you need to be your own advocate to protect yourself and your family!

There are so many potentially toxic ingredients in skin care products that I had trouble choosing which ones to feature! I’ve chosen three of the most pervasive, and potentially most dangerous chemicals for today’s blog, and I provide links to articles I used in my research with more extensive information should you choose to read more!


b2ap3_thumbnail_natural-shampoo-label.jpgPARABENS

Parabens serve as preservatives in a wide variety of skincare products. Parabens are everywhere, and it’s likely that most of us have been exposed to Parabens through a number of different products throughout our lifetime. Some researchers have estimated that some 90 percent of typical grocery items contain measurable amounts of parabens. Scary!

The main concern with Parabens is that they have hormone-mimicking and estrogenic properties. This means that they can act like estrogen in the body, competing with naturally-produced estrogen and binding to estrogen receptors on cells. This can potentially create an “estrogen overload” effect in the body, which may increase the risk of hormonally-driven cancers like Breast Cancer and fuel other hormone-mediated conditions such as endometriosis.

Ingredient Keywords: methylparaben, ethylparaben, propylparaben, butylparaben, and isobutylparaben


b2ap3_thumbnail_makeup__large.jpgPHTHALATES 

Phthalates serve as plasticizers They are used to make skincare products flexible and better able to hold color and scent.

The concern with Phthalates is that they belong to a group of chemicals referred to as endocrine disrupters, which means they have the potential to disrupt your hormones. Phthalates have been shown to reduce fertility in both men and women, reduce testosterone production in men, reduce egg quality and quantity in women, and are associated with endometriosis.

How to find them? You can look for phthalates on labels, but unfortunately, you won't always find them. The FDA does not require manufacturers to list every ingredient in proprietary fragrances, so they may be hidden in the term ‘fragrance/parfum’.


b2ap3_thumbnail_Triclosan.jpgTRICLOSAN

Triclosan is added to a variety of skin care products to reduce or prevent bacterial contamination. Exposure to Triclosan is so pervasive that the U.S. Centers for Disease Control and Prevention reports that it can be found in the urine of 75 percent of all U.S. residents, as well as in plasma and breast milk.

There are a variety of concerns with Triclosan. Not only does it function as an endocrine disruptor (like phthalates), it also promotes antibiotic resistance, has been shown to be a skin irritant, and is considered to be carcinogenic, increasing the risk of certain cancers. In addition, Triclosan has been shown to have a negative environmental impact, most notably in aquatic ecosystems.

While the FDA banned the use of Triclosan in over-the-counter antiseptic soaps, gels and wipes ion 2016, it is still in widespread use in personal care products like toothpastes, shampoos, and deodorants.

Look for “Triclosan” directly on your label.

Looking for more information? Check out these resources:

Sara Gottfried, MD: Ten Toxic Ingredients That Might Be in Your Skin Care (And What to Use Instead).

MindBodyGreen: 12 Toxic Ingredients to AVOID in Cosmetics & Skin Care Products

Andrew Weil, MD: What's Wrong With Triclosan?

Scientific American: Should People be Concerned about Parabens in Beauty Products?



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, as well as general wellness and healthy aging. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances, and provide treatment options that go beyond the prescription pad. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  597 Hits

Skin Care Basics - The Benefits of Alpha-hydroxy Acids (AHAs)

Skin Care Basics - The Benefits of Alpha-hydroxy Acids (AHAs)
Alpha-hydroxyl Acids (AHAs)


HOW AHAs WORK

Our skin has a natural ability to exfoliate dead skin cells and does so daily. Unfortunately, this process slows down with age, which can lead to an accumulation of dead skin cells, leaving skin appearing dull and uneven.

AHAs dissolve the upper layer of skin cells by weakening the cellular “glue” that holds dead skin cells together, encouraging exfoliation and triggering skin repair.


HOW AHAs IMPROVE YOUR SKIN.

AHAs have a number of proven skin benefits.

AHAs remove dead skin cells, revealing healthy, younger skin cells, resulting in a brighter complexion and more even skin tone. This increase in cell turnover is also effective in treating sun-damaged skin, hyperpigmentation, and melasma.

AHAs trigger collagen regeneration, thickening the outer skin layers. This works to firm and tighten skin. minimize fine lines/wrinkles, and fade blotches. (When combined with a retinol, these results can be even more dramatic, but we’ll save that for another blog...)


AHAs AND DRY OR SENSITIVE SKIN.  

Many of my clients with dry or sensitive skin get nervous when they hear the word “acid“. Have no fear! Even those with dry or sensitive skin can benefit from regular use of a quality AHA product with proper pH balance.

AHAs may actually be a better choice to exfoliate sensitive skin because they are less likely to irritate then manual exfoliation. AHAs are gently applied to the skin, no need to scrub. AHAs can also be effective for dry skin. By removing the outer layer of dead skin cells, healthy skin cells become more receptive to the skin care products you apply. Regular AHA use, combined with appropriate product, can significantly increase your skin’s moisture factor.


GETTING STARTED WITH AHAs. 
While there are a number of AHAs, the two most commonly used in skin care are Glycolic Acid and Lactic Acid. Glycolic Acid is considered to be the most powerful because it has the smallest molecular size of all AHAs. The smaller the molecule, the deeper it is able to penetrate skin layers.

When beginning an AHA regimen, it is important to “start low and go slow”.
Start low - choose a product with a lower concentration of acid to start. Over time, and under the supervision of your skin care provider, you can gradually increase the concentration of your product for added benefits.

Go slow - don’t overdo it! Start your AHA routine only 1-2 times per week, giving your skin plenty of time in between treatments to rest and repair. You can gradually work up two more frequent use. I typically recommend an every other day regimen for my patients, using AHAs twice daily on “active“ days, with “rest“ days in between.

You can add an AHA right into your regular skincare routine. Apply your AHA after cleansing, and follow with serum and/or moisturizer. Don’t forget sun protection! Use of AHAs can make your skin more susceptible to sun damage, so don’t forget your daily sunblock!

b2ap3_thumbnail_BL_Sanitas3.jpg

RECOMMENDED PRODUCTS FROM OUR SANITAS SKINCARE LINE:   

Glycosolution 5% 
The perfect starting point. Removes spent skin cells and helps stimulate skin renewal. An amino acid complex, blended with glycolic acid, helps smooth the appearance of wrinkles, boost moisture retention and brighten dark spots. (also included in all Sanitas System Kits)

Brightening Peel Pads 
Instant results! These pads contain a triple acid blend to brighten, tone and reveal clear, radiant skin. Follow with 3 drops of Vita C Serum for an instant glow.

Solar Block 
A natural, non-toxic broad-spectrum sunscreen for daily use. Contains a blend of zinc oxide and antioxidants. Absorbs quickly and will not clog pores.

All Sanitas products are cruelty-free and contain no parabens, phthalates, dyes, harsh preservatives or gluten.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, as well as general wellness and healthy aging. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances, and providing treatment options that go beyond the prescription pad. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  576 Hits

Non-toxic Skincare. The Why, What and How. Part One

Non-toxic Skincare.  The Why, What and How. Part One
Non-Toxic Skincare - The Why, What and How
Part One:  The WHY

This month we are highlighting healthy skin, including skincare basics, healthy skin care products, food and skin, and more. This is part one in a series of three blogs going in-depth on the topic of toxic skincare products, including why it’s important to choose healthy skincare products, ingredients to be aware of, and resources to help you choose safe, healthy skin care products for you and your family.

PART ONE: THE WHY

Our skin is our largest organ! The average adult has about 8 pounds, or 22 square feet of skin. That is a lot of surface! Not only is that a large area that requires care and protection, but it’s also like a big sponge. What we put on our skin can be absorbed by the body and enter our blood. In fact, we absorb up to 60 percent of what we put on our skin, even more through delicate areas such as the face and armpits.
b2ap3_thumbnail_SKIN2.jpg

So WHY care about the safety of your skincare products? Because what you put on your skin can go directly into your blood.

Toxic ingredients in your skincare products can be sneaky. While you generally won’t notice a problem right away, many toxic ingredients bioaccumulate in the body, meaning they store in the body and build up over time. When it comes to toxic skincare chemicals, this can lead, over time, to hormone disruption, inflammation, weight gain and increased risk of certain cancers.

Bioaccumulation = The accumulation of a substance, such as a toxic chemical, in various tissues of a living organism.

“The FDA protects me from potentially harmful chemicals, right?”

Absolutely not! The FDA does not require proof of safety before cosmetics and other skincare products reach the market. In addition, there is no skincare industry standard for claims like “natural,” “organic,” “green,” “clean”, or “non-toxic.” Buyer beware! You have to do your own research and be your own advocate.

The FDA is not protecting you against potentially harmful chemicals in your skincare products.

Stay tuned…next up we’ll be reviewing a few of the toxic chemicals that you need to be aware of in your skincare products.




Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, as well as general wellness and healthy aging. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances, and going beyond the prescription pad for true health and wellness. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  579 Hits

FOOD SENSITIVITY TESTING & The Next Generation FIT Test

FOOD SENSITIVITY TESTING and
The FIT Test by KBMO Diagnostics


In my medical practice, we look for root causes of symptoms and chronic disease, rather than focusing on simply treating symptoms with prescriptions. This is what sets Integrative and Functional Medicine apart from traditional Western Medicine. 

b2ap3_thumbnail_inflammation.jpg Inflammation is one of the main root causes of nearly everything I see wrong with my patients.  Food is a primary trigger for inflammation and should be considered as playing a large role in most symptoms, chronic disease, and autoimmune disease.  Like I often say to my patients:

Every time that you eat, you are making a decision to either
increase or decrease inflammation in your body.


FOOD SENSITIVITIES & SYMPTOMS
First things first, we are not talking about food allergies.  Food allergies are mediated by an IgE immune system reaction, which produces immediate and often serious or life-threatening symptoms that require immediate medical attention.  In contrast, food sensitivities (also referred to as food intolerances) are mediated by an IgG immune system reaction that is more delayed and generally less serious. Reactions may take up to 3 days to develop, and the IgG antibodies can remain in your body for up to three weeks.
Click here to read more about Food Allergy vs. Food Sensitivity

With food being a primary driver of inflammation, and inflammation underlying most symptoms, the argument could be made that food may be a trigger of nearly any symptom in the body!  The most common symptoms that I see in my practice that have a strong association with food include:

  • b2ap3_thumbnail_Abdominal-Pain-Is-It-Appendicitis_article_main.jpgRashes, Acne, Eczema and other Skin Conditions
  • Joint Pain
  • Digestive Issues, including IBS
  • Headaches
  • Fatigue/Energy and "Brain Fog"
  • Autoimmunity of any kind
  • Hormone Imbalance
  • Weight Gain
  • Mood Disorders, including Depression, Anxiety and more

 

DETERMINING FOOD SENSITIVITIES
Traditionally, the Comprehensive Elimination Diet has been considered the “gold standard” for determining food sensitivities. The Comprehensive Elimination Diet involves removing the food, drink, and additives that are most commonly associated with inflammation and symptoms, including:

  • b2ap3_thumbnail_Donuts.jpgGluten/Wheat
  • Dairy
  • Sugar
  • Eggs
  • Soy 
  • Corn
  • Peanuts
  • Nightshade Vegetables
  • Citrus Fruits
  • Caffeine 
  • Alcohol

The Comprehensive Elimination Diet needs to be done for at least three weeks (if you recall from above, the IgG antibodies associated with food sensitivities can remain in the body for three weeks, this allows time for them to "flush out").  After this time foods may be re-introduced one at a time while monitoring for an increase in symptoms.  For those patients who are able to complete a Comprehensive Elimination Diet, the process can be life-changing.  In my patients who complete this process, I frequently see a dramatic reduction in symptoms, improved energy and mental clarity, and better sleep. However, for many others, this process can be difficult or nearly impossible.


FOOD SENSITIVITY TESTING and the FIT TEST
One of the most common Food Sensitivity laboratory tests (and the one I have previously used) involves measuring IgG antibodies in the blood to a variety of foods.  The presence of these IgG antibodies indicates an immune system reaction to that food.  While the information on an IgG food sensitivity test can be useful, I have found several problems associated with this testing:

  • Some patients have so many IgG food reactions that they could not possibly remove these many foods from their diet.
  • We cannot always correlate a positive IgG food reaction directly to inflammation or a patient's symptoms.
  • These tests can be expensive!

FIT = FOOD AND INFLAMMATION TEST
b2ap3_thumbnail_KBMO.jpgThe FIT Test by KBMO Diagnostics is, in my opinion, the next generation in Food Sensitivity Testing.  Rather than simply measuring IgG antibody reactions, the FIT Test measures IgG and Complement-mediated Immune Complexes.  Translation = by adding the measurement of immune complexes the FIT test may more accurately identify the foods that are actually causing inflammation in the body.  

Other benefits of the FIT Test:
  • The FIT Test measures sensitivities to up to 132 different foods,  as well as coloring and additives.
  • The FIT Test can diagnose increased intestinal permeability, or "Leaky Gut", through the identification of a positive Candida immune-complex response.
  • There are less positive reactions to work with, allowing patients to more easily remove inflammation and symptom-triggering foods.
  • In addition to the 132 item option (currently $275), the FIT Test offers a more-affordable 22 item option which includes the most commonly identified food and antigen triggers (currently $100).*
Click here to learn more about the FIT test, see a list of the foods tested, and view a sample report.

Are you interested in the FIT Food Sensitivity Testing?  Do you have questions?  Feel free to send me an email at This email address is being protected from spambots. You need JavaScript enabled to view it. or contact our office 231-638-5585.

*I do not make any profit of the FIT Test, or any other laboratory test offered in my practice. Any costs associated with laboratory testing are related to the laboratories themselves.



Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

 
 
  1874 Hits

Female Hormone Testing 101

FEMALE HORMONE TESTING 101

Which test is right for you?


Achieving Hormone Balance in women starts with evaluating your hormone levels. While symptoms can often suggest hormonal patterns, I use laboratory data to confirm these patterns, and also to evaluate the safety and effectiveness of prescribed hormones, supplements and lifestyle recommendations.


WHICH HORMONES DO WE TEST?
The term “hormone balance” refers to the interaction and balance of a variety of hormones in the body, therefore when evaluating hormones we need to do so BY keeping all of these interactions in mind. While there are many hormones we are able to test, the hormones I most routinely test in my patients include:
  • Adrenal (stress hormones) - cortisol, DHEA-S
  • Sex-steroid hormones- estrogen, progesterone, testosterone, DHEA
  • Thyroid - TSH and free thyroid hormone levels
  • Other - insulin (think blood sugar regulation), pregnenolone (a hormone precursor often referred to as “the mother of all hormones”)
b2ap3_thumbnail_TESTTUBES.pngThere is no perfect hormone test for everyone.

Hormone levels can be measured in blood, urine or saliva. There are many factors taken into consideration when choosing which test is appropriate for each patient, including:
  • patient age
  • type of hormone(s) being measured
  • the number of samples needed to test
  • pre-, peri- or post-menopausal
  • whether the patient is currently on hormone therapy
  • cost of test

So which test is right for you?

Below I’ve broken down the pros and cons of each test and provided information on the tests I most often order in my practice.


HORMONE TESTING 101

BLOOD
Pros: Blood testing is simple and cost-effective (covered by most commercial insurance policies as well as Medicare and Medicaid).

I routinely use blood testing for thyroid hormones and fasting insulin regardless of age. Blood testing of DHEA and pregnenolone is useful for both baseline levels and to monitor when supplementing these hormone precursors. For sex-steroid hormones (estrogen, progesterone, testosterone), blood testing can be useful in the following situations:
  • Pre-menopause - an early-cycle draw (around day 5) can help evaluate for PCOS (polycystic ovarian syndrome).
  • Peri-menopause - a luteal phase draw (day 22-24) helps to evaluate PMS imbalances and estrogen: progesterone balance.
  • Post-menopause - blood hormone levels can be used to confirm menopause and also to monitor hormone levels while on hormone therapy.
Cons: Blood hormone testing gives us information on one moment in time. It is not practical to use blood for multiple-day specimens, or for several samples in one day. Blood measurements are also limited in their ability to provide information on hormone metabolites. Hormone metabolites give valuable insight info which “pathways” hormones take in your body, some of which are healthier than others, and can help stratify risk for hormone-related cancers.

Click HERE to read my previous blog on estrogen metabolite testing.


SALIVA
Pros: Saliva tests can be performed and shipped from anywhere, bypassing a trip to the laboratory. Saliva tests are convenient when multiple specimens are needed and can be kept in your freezer if testing over a month cycle.
I routinely use saliva hormone testing to test adrenal hormones. I also use saliva sex-steroid hormone testing in pre- or peri-menopause to look at cyclical trends and hormone fluctuations, testing anywhere from 5-28 day periods.

Cons: While Medicare covers saliva hormone testing, most commercial insurance companies do not. Saliva hormone testing does not provide hormone metabolite information. While saliva testing can be useful for adrenal and sex-steroid hormones, it is not used to measure thyroid hormones or insulin. Some patients have trouble producing enough saliva for testing, especially if they have chronic dry mouth or are on medications that reduce saliva production.

MY MOST ORDERED SALIVA HORMONE TESTS BY GENOVA DIAGNOSTICS:

URINE

Pros: Urine hormone testing can be done and shipped from home, bypassing a trip to the laboratory. One of the biggest benefits of urine hormone testing is the ability to get an abundance of information on hormone metabolites (see above and my prior blog). Hormone metabolites are especially useful in stratifying risk for hormone-related cancers and also in evaluating the efficacy and safety of hormone replacement therapy.

Cons: Most commercial insurance companies do not cover the cost of urine hormone testing. Some urine hormone tests in postmenopausal women require a 24-hour urine collection, which can be cumbersome for patients. While I use urine hormone testing to measure adrenal and sex-steroid hormones, I do not use urine to measure thyroid hormone or insulin.


b2ap3_thumbnail_DUTCHwheel.pngMY MOST ORDERED URINE HORMONE TEST BY GENOVA DIAGNOSTICS:
Complete Hormones (either 24-hour or first-morning urine, depending upon patient age)

MY NEW FAVORITE TEST BY PRECISION ANALYTICAL INC. COMBINES BOTH SALIVA AND URINE:
DUTCH Complete and DUTCH Plus testing




Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone imbalance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  896 Hits

Advanced Laboratory Spotlight: The NutrEval Plasma® Test

ADVANCED LABORATORY SPOTLIGHT:

THE NutraEval PLASMA ® TEST

A Comprehensive Test for Identifying Nutritional Deficiencies, Toxicities, Gut Imbalances, and More

by Genova Diagnostics


b2ap3_thumbnail_nutreval-fm-nutritional-test-blood-urine-small-1.pngThe NutrEval® laboratory test by Genova Diagnostics is one of the most commonly ordered specialty laboratory tests in my practice. This test serves as an excellent starting point for evaluating nutritional status and investigating the root causes of chronic illness, as well as a useful follow-up tool to measure how well lifestyle changes and supplement regimens are working.


OVERVIEW

The NutrEval® test is an advanced nutritional analysis designed to reveal nutritional imbalances or inadequacies. NutrEval Plasma® evaluates the functional need for antioxidants, B-vitamins, minerals, essential fatty acids, amino acids, digestive support, and other select nutrients. The test also provides insight into gut health, heavy metal toxicity, mitochondrial function and more.


YOUR REPORT INCLUDES:

Metabolic Analysis (urine organic acids)
Urine organic acids are not something I learned about in Medical School. This analysis, often utilized by Naturopathic Physicians, measures metabolites in the urine that reflect processes going on in your body. This analysis provides insight into:
  • Digestion
  • Bacteria and/or Fungal Overgrowth in the Gut
  • Mitochondrial Function (cellular energy production/Krebs Cycle)
  • Neurotransmitter Balance (stress/mood)
  • Functional B-vitamin Need (not measured values in your body but rather a measurement of how your body is utilizing these vitamins)
  • Need for Detoxification Support
Plasma Amino Acid Analysis (essential and non-essential amino acids, plus intermediary metabolites)
The Amino Acid Analysis represents a 21-day “window” into your protein intake and amino acid balance. I use this section most often to:
  • Evaluate protein intake, digestion and absorption.
  • Evaluate amino acid balance in relationship to mood disorders.

Essential and Metabolic Fatty Acids (red blood cell essential and non-essential fatty acids, including Omega-3 and Omega-6 fatty acids) The Fatty Acid Analysis is a red blood cell measurement, representing approximately 100-120 days prior to testing. When interpreting these results with patients, I am able to accurately identify what type of diet they are following, which types of oils they are cooking with, and whether or not they are supplementing with fatty acids. This section can provide valuable insight insight for diet and supplement recommendations for:
  • General Wellness
  • Inflammatory Disorders
  • Cardiovascular Risk
  • Mood and Brain Disorders

Oxidative Stress Analysis (blood and urine biomarkers indicative of oxidative stress) Oxidative Stress represents the balance of antioxidants and free radical damage in the body. When describing Oxidative Stress to patients, I often describe it as “rusting” on your cells and DNA. This analysis measures markers of this “rusting”, as well as levels of Glutathione, a powerful antioxidant that plays key roles in healthy aging and detoxification (learn more here). Our levels of Glutathione are determined by both our genes and our lifestyle, so if low levels are detected, we can implement protocols for improvement.

Learn more about Glutathione HERE.

Elemental Markers (both mineral nutrients and toxic metals in red blood cells or plasma) This section provides direct measurements of minerals and heavy metals. Mineral results can be used to identify mineral deficiencies or excess. Heavy Metal results can be a useful screening tool, if elevated levels are identified, provoked urine heavy metal testing is often recommended. Analyses measured include:
  • Copper
  • Lead
  • Magnesium
  • Mercury
  • Manganese
  • Antimony
  • Potassium
  • Arsenic
  • Selenium
  • Cadmium
  • Zinc
  • Tin
  • Mood and Brain Disorders
b2ap3_thumbnail_LabTesting.jpg


SPECIMENS:

First-morning urine and a blood draw at a participating laboratory.

COST:
  • Varies per insurance.
  • Covered completely by many Medicare plans.
  • Commercial plans require and out-of-pocket co-pay of $200-300.
  • Not covered by Medicaid.

Note: I do not profit off of ordering this (or any other) laboratory test. Any co-pay goes directly to Genova Diagnostics.

Visit the Genova Diagnostics Website and view a Sample Report HERE.  



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like advanced laboratory testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  805 Hits

Five Mindful Ways to Enjoy Your Holiday Season

Five Mindful Ways to Enjoy Your Holiday Season
The holiday season can be full of excitement, family, friends, and...busy-ness. Before your season becomes a blur of things to do and places to go, take some time to create intentional practices to help you slow down and appreciate the inspiration of the season. Here are five ideas to get you started.


1. CHOOSE AN INTENTION
Use a word, image, or memory to guide your holiday season. Take some time to think about what you truly want from your experience this year, then allow that idea to become a touchstone for your time and energy. For example, if your guiding word this year is gratitude, think about how you can enliven that word in your life, perhaps through journaling, writing a holiday letter of thanks to your friends and family, or finding opportunities to express gratitude within your community.


2. GO OUTSIDE
Getting outside, away from technology, is one of the best ways to slow down and appreciate the here and now. Being in nature calms the body, mind, and spirit, and beneficially affects the nervous system and immune system. Take time to walk in the woods. While you're there, stop to take notice of what you see, hear, and smell. Feel the ground beneath your feet. Plant yourself firmly and remind yourself that you, too, are part of the natural world.


3. BREATHE!
When we become busy and stressed, we change our breathing patterns, taking shorter breaths out of the chest rather than the relaxed, deep breaths that help us feel calm and balanced. Breath awareness techniques can help your mind and body establish a state of relaxation in which you can operate from a state of intentional response rather than stressful reaction. Here's a quick breath awareness tool you might try when you notice yourself feeling rushed and stressed:
  • Close your eyes if you can.
  • Breathe in and feel a touch of cool air at the tip of your nose.
  • Breathe out and feel a touch of warm air.
  • Notice how in each moment of breath awareness you are just here, just now, in the present moment.

4. CREATE AND ENJOY A HOMEMADE MEAL

In our focus on "getting it all done," we can forget to nourish ourselves. Whole, minimally processed food can reduce our stress levels, provide the energy we need to stay balanced, and remind us of the comfort of a good, healthy meal. Choose colorful veggies and fruits, savor the smells and sights of your meal, and enjoy it mindfully, one bite at a time.


5. BECOME DELIBERATE WITH YOUR BEDTIME
Nothing can take away from enjoying the season like sleep deprivation. Sleep is the time when our bodies rest, restore, and gather the resources necessary to wake up focused and ready for an intentional day. Especially during the busy holiday season, your body needs this time to reset. Adequate sleep helps the body to recover from stress, fight off illnesses, balance hormone levels associated with appetite and food cravings, and improve mood, just to name a few of the benefits of healthy sleep. If you are not waking up feeling rested, consider changing your bedtime routine to help you establish a calm state before bed. A few ideas include creating a consistent bedtime, turning off all technology at least one hour before bed, and avoiding substances that interfere with sleep (alcohol, sugar, caffeine, etc.). Treat yourself to a relaxing warm bath or cup of herbal tea and notice how your body can begin to relax and become calm before you get into bed.

Give yourself and those around you the gift of mindful presence this holiday season. Slow down and create a season of intention. Notice that you can find a moment of peace and joy, and take the time to absorb and extend that sensation.


Many Blessings to you all this holiday season,
Katie Winnell RN, BSN, NC-BC



b2ap3_thumbnail_katiewinnell_thumbnail.jpgKatie Winnell is a Registered Nurse and Board Certified Nurse Coach with Credentialing in Clinical Meditation and Imagery and Health Education. She helps clients reveal and activate a lifestyle of wellness though Integrative Nurse Coaching and Clinical Meditation, Mindfulness and Imagery techniques. Katie is now seeing clients through the Integrative Medicine Office of Dr. Carin Nielsen.

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Book Review: FOOD: WHAT THE HECK SHOULD I EAT?

Book Review

FOOD: WHAT THE HECK SHOULD I EAT? 
Dr. Mark Hyman

b2ap3_thumbnail_MARKHYMAN.jpgFROM THE PUBLISHER: When it comes to diet, there's so much changing and conflicting information flying around that it's impossible to know where to look for sound advice. Decades of misguided "common sense," food-industry lobbying, bad science, and corrupt food policies and guidelines have only deepened our crisis of nutritional confusion, leaving us overwhelmed and anxious when we head to the grocery store.

Bestselling author Dr. Mark Hyman is here to set the record straight. In Food: What the Heck Should I Eat? -- his most comprehensive book yet -- he takes a close look at every food group and explains what we've gotten wrong, revealing which foods nurture our health and which pose a threat. From grains to legumes, meat to dairy, fats to artificial sweeteners, and beyond, Dr. Hyman debunks misconceptions and breaks down the fascinating science in his signature accessible style. He also explains food's role as powerful medicine capable of reversing chronic disease and shows how our food system and policies impact the environment, the economy, social justice, and personal health, painting a holistic picture of growing, cooking, and eating food in ways that nourish our bodies and the earth while creating a healthy society.

With myth-busting insights, easy-to-understand science, and delicious, wholesome recipes, Food: What the Heck Should I Eat? is a no-nonsense guide to achieving optimal weight and lifelong health.

MY THOUGHTS: This book is a MUST READ, and will forever change the way you think about food. When I began reading this book I set aside a notebook, thinking that I would take brief notes of information “pearls” to share with my patients - I stopped after 2 chapters because there was so much relevant and useful information on EVERY PAGE I couldn’t possibly write it all down!

In this book, Dr. Mark Hyman acknowledges that there is no one “perfect” diet for everybody, instead of focusing on basic dietary principles that simply make sense. He breaks down macronutrients (carbohydrates, proteins, and fats), providing education on each group’s benefits, as well as information on how to make safe, quality food choices. For example, not only will you learn more about why protein is important for our health, but also which sources of protein provide the most benefit and the “dos and don’ts” of choosing quality sources of protein for you and your family.

The book is packed with information, yet easy to read, and each recommendation is backed by sound research, not simply opinion. I found this book to be eye-opening, thought-compelling, and forever life-changing when it comes to thinking about the food that we eat. Consider adding this book to your Summer reading list!

Carin Nielsen, MD



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, and using a "Food First" approach is a common theme in our office. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  1031 Hits

Summer Supplement Swap

b2ap3_thumbnail_SupplementSwap3.jpgIf you take nutritional supplements, the changing of seasons is a great time to clean and organize your supplement cupboard and re-think your routine. The demands on your mind and body vary with the seasons, and adjusting your supplements to meet seasonal needs can help you to look and feel your best all year long!

Check out these “Summer Supplement Swaps” from my personal routine to help you get started:

SWAP OUT IMMUNE SUPPORT FOR ANTIOXIDANTS

During Winter months I take Vira-Resist herbal immune support daily to fight off coughs, colds, and flu. In the Summer months, I take a break from my immune support and tighten the cap and store the bottle in a cool, dark cupboard.

Summer months bring the potential for increased oxidative stress from sun exposure, summer cocktails and restaurant meals. To fight the effects of oxidative stress I increase my antioxidant routine, adding extra Antioxidant Support Formula, which contains the powerful antioxidants Selenium, Alpha-Lipoic Acid, and N-Acetyl Cysteine, as well as Milk Thistle, which helps to protect my liver from potentially damaging effects of summer cocktails. I also add extra antioxidant-rich Vitamin C in the form of Buffered Vitamin C (which is more gentle on the stomach) to help protect my skin from sun damage and boost collagen synthesis.

ADD EXTRA MINERALS

Summer = Sweat. Combining the increased perspiration of summer with regular infrared sauna use puts me at risk for excess mineral loss, so I add extra Zinc and Magnesium to my routine to replenish losses. In addition, I am liberal with my use of sea salt to replenish minerals and stay hydrated.

KEEP YOUR VITAMIN D DOSE IN CHECK

For myself and many of my patients, a hefty dose of Vitamin D is recommended during Fall and Winter months. During Summer months, with increased sun exposure, this may not be necessary. I check my 25, OH Vitamin D levels and adjust my dose of Vitamin D3 as necessary. Why is this important? You can overdose on Vitamin D! Vitamin D is one of four fat-soluble vitamins (along with Vitamins A, E, and K), so levels can build up in your system and become toxic. It’s important to know your number!

Here’s to a happy, healthy Summer!

Carin Nielsen, MD


Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  1243 Hits

Can Journaling Help You Exercise Smarter?

CAN JOURNALING HELP YOU EXERCISE SMARTER?

b2ap3_thumbnail_beach-1853921_640.jpg

Spring has sprung in Northern Michigan, finally! More sun and warmer temps beckon us outdoors and inspire us to get out and move. Spring is a great time to enter into or return to your exercise routine*. But just like any other healthy habit, it can be hard to find the motivation to stay committed to moving our bodies. 

Instead of plodding through an exercise routine using highly over-rated willpower to push through motivation obstacles, how about taking a step back to look honestly at those obstacles, as well as your hopes and goals? Observing our strengths and struggles nonjudgmentally allows us to view and explore them without falling into sabotaging self-criticism. Once we are clear on where we are, strengths, struggles, and all, then we can plan the path forward with a clear vision based in reality and inspiration.


So, try taking a step inward to notice the story you may be telling yourself about exercising, a story which may color and shape your motivation and commitment to this healthy habit.  Journaling is a great way to begin this practice. Here are 3 journaling prompts to help you get started:

1) Get clear on where you are right now. Why do you want to exercise? It seems like an easy question, but we exercise for different reasons, some for specific health-related outcomes, some to meet athletic goals, and others to get out and feel better emotionally. Knowing why you want to exercise can help you choose a routine and set goals that will be effective and enjoyable. It can also help you remain realistic about your exercise routine, which helps you to set specific, achievable goals that honor your motivation and path, not someone else's. 

2) Take a peek at your future self. Close your eyes, take a deep breath, imagine walking a path. Ahead you see yourself 3 months from now. What do you see from a whole, integrated perspective? Not just your physical self, but what do hope for in terms of your emotional, spiritual, and relational self? Now, what strengths do you hold that can get you further along your path? Perseverance? Positive attitude? Enjoyment of the outdoors? And what obstacles might get in your way? Lack of social support? Time limitations? Self-criticism? How can you problem solve those obstacles now, so when they pop up, you have a plan to overcome them? Keep this picture (make sure it is realistic!) close, and revisit and revise when it's helpful. 

3) Maximize the benefits. Take a moment at the end of each exercise session to journal about how you feel, physically, emotionally, and spiritually. Our human brains spend lots of time ruminating on the negative aspects of new habits (no, it’s not just you, we all do it!), and it is more difficult to hard-wire in the positive. So take a minute to revel in your accomplishment and the state you are in after you exercise. What do you feel? Name how your body feels. Name the emotions you experienced while exercising and post-exercise...joy, positivity, pride? Revisit this positive physical and emotional state when you are low in motivation, remind yourself of what is to come (no worries if you aren't feeling those good vibes, journal about the obstacles you noticed and spend a minute problem solving those struggles).  

Journaling can be an effective awareness practice to help you uncover the stories that either limit you or motivate you. Give it a try, you might surprise and inspire yourself! Most of all, use exercise journaling as a method to explore, not critique. Everything you uncover is more information, neither good nor bad, just more self-knowledge to work with to fine tune your motivation. 

So, explore, journal, and MOVE!

*As always, if you have a specific health condition or are new to exercise, have a conversation with your health care provider regarding your exercise routine. 

Katie Winnell, Board Certified Nurse Coach, Health Educator, and Clinical Mediation and Imagery Specialist, can help you with your wellness plan using coaching, behavioral change, and self-awareness tools. You can make an appointment by calling 231.638.5585.


b2ap3_thumbnail_katiewinnell_thumbnail.jpgKatie Winnell, Board Certified Nurse Coach, Health Educator, and Clinical Mediation and Imagery Specialist, can help you with your wellness plan using coaching, behavioral change, and self-awareness tools. You can make an appointment by calling 231.638.5585.

  838 Hits

Treating Crohn’s Disease - A Functional Medicine Approach

BACKGROUND
b2ap3_thumbnail_Abdominal-Pain-Is-It-Appendicitis_article_main.jpgI first met Todd* with his wife in October 2016. He had been diagnosed with Crohn's disease (an autoimmune inflammatory bowel disorder) three years prior.  His symptoms included abdominal pain and loose stools with blood and mucous.

During our first visit, I learned that during the time his symptoms began Todd had been under increased stress with an upcoming wedding, a change in employment, and home renovations.

He had originally been treated with sulfasalazine, a common prescription medication for Crohn's, however, the medication made him nauseated and his symptoms were not well controlled. He had been unable to increase the dose as recommended due to side effects.

Todd continued to have frequent loose bowel movements within 15 minutes of eating, often associated with mucus and blood. He was experiencing sharp localized abdominal pain with activity, and the pain was limiting his ability to perform his physically strenuous job as an electrical lineman.

Prior to our first visit, Todd and his wife had already explored holistic options for his treatment. He had tried digestive enzymes, probiotics, and homeopathic remedies without relief. He had also completed a two month trial of a gluten-free diet but was unsure if that made any difference.


INITIAL WORK UP
At our first visit, I ordered a comprehensive laboratory evaluation to screen for:
  • Inflammation
  • Nutritional deficiencies
  • Anemia
  • Hormone balance
  • Candida/Yeast
  • Celiac disease
I also ordered Functional Stool Testing.

While waiting for results, I recommended that Todd begin a four-week Comprehensive Elimination Diet, and provided educational materials and book recommendations for support with this.

Blood testing revealed low levels of zinc, and significant vitamin D deficiency, but was otherwise normal. Functional stool testing indicated significant intestinal inflammation and low levels of "good" gut bacteria.

Recommendations were customized for Todd based on his laboratory results (no more “guessing game” when it comes to supplements):
  • Vitamin D (which supports the immune system response)
  • Zinc carnosine (a key factor in the health of the intestinal lining)
  • Fish Oil (a natural anti-inflammatory)
  • Immunoglobulin powder (derived from colostrum)
  • VSL#3 - A high-dose prescription-grade probiotic (this brand has solid evidence supporting its use in the treatment of Crohn’s)
I also prescribed Low-Dose Naltrexone (LDN), an opioid antagonist that has an outstanding safety profile and has shown promise in the treatment of Crohn’s in both adults and children with minimal side effects.


TWO MONTHS LATER–IMPROVEMENT!
Two months after initiating diet changes, LDN and targeted supplementation, Todd reported his pain improved by at least 50% with some pain-free days and improved energy. While still experiencing blood in his stools, he described it as much less than before.

I recommended he add a glutamine/aloe combination to promote further healing of the intestinal lining.


SIX MONTHS LATER–MORE IMPROVEMENT!
b2ap3_thumbnail_intestines.jpgAt six months Todd reported that he continued to experience significant improvement and was very pleased with his progress. He described his pain as minimal, with only minor flares "nothing like it was before”. He had good energy and stamina and was no longer having any work pain. He had become a “believer” in his regimen of supplements and LDN, having forgotten them on two nights, each time with a symptom flare.

While bowel movements had earlier been improved, he had since noticed increased blood and mucus in his stools, so a low dose of Sulfasalazine had been restarted.

He continued to cautiously experiment with his diet, determining his “trigger foods”.


ONE YEAR LATER
This past fall I was able to meet with Todd and his wife for his one-year follow-up. He reported great energy and stamina, no work pain, and no blood in his stools.

While still on the low dose of Sulfasalazine, it was a dose that did not give him side effects and his symptoms as a whole were nearly resolved. Follow up laboratory testing showed normalized levels of iron, zinc and Vitamin D.

I ordered comprehensive nutritional testing at this visit, which allowed us to customize Todd’s diet and supplement needs. His testing showed a need for B-vitamins, as well as magnesium and enhanced antioxidant support to reduce oxidative stress in the intestinal lining. Based on this testing, I also recommended he begin to reduce the amount of animal protein in his diet, transitioning to plant-based proteins.

In just one year, Todd was able to get much better control of his Crohn’s disease through changes in diet, targeted supplementation, and lower-doses of prescription medications without side effects. He had normalized bowel movements, no blood in his stool, minimal pain and improved energy. I look forward to continuing to work with Todd and his wife to optimize his nutrition, simplify his regimen as he continues to heal, and achieve further success!

*Patient names are changed to protect privacy

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many autoimmune conditions. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  978 Hits

THREE REASONS TO CHOOSE SANITAS SKIN CARE

b2ap3_thumbnail_sanitasgeneral2.jpg

THREE REASONS TO CHOOSE SANITAS:


1. MAKE YOUR SKIN WORK FOR YOU
Sanitas products give skin everything it needs to do what it already does best: repair and strengthen itself.

The human skin has miraculous built-in mechanisms for constant repair and renewal of its surface. Unfortunately, the combined assaults of lifestyle, environment and time can compromise the body’s ability to keep up – which is why every technology, ingredient, and dosage in every Sanitas product is selected to foster and improve your skin’s own natural processes to regenerate and protect itself.


2. “EXERCISE & REST” - YOUR NEW SKINCARE ROUTINE
The heart of Sanitas’ tested and proven skincare routines lies in the concept of “exercise and rest.”

A resting phase and strengthening phase are both necessary to build continuous skin strength. “Exercising” products utilize alpha hydroxy acids to encourage skin renewal and strengthen the skin’s barrier. On resting days, exercising products are eliminated and only pH neutral products are used to keep the skin’s barrier intact. Limiting the use of exercising products to three to four days per week allows the skin to recover and regenerate.


3. CLEAN, SAFE INGREDIENTS
All Sanitas products are cruelty-free and contain no parabens, phthalates, dyes, harsh preservatives or gluten.

Sanitas Skincare pharmaceutical-grade ingredients are obtained from fair trade, earth conscious, sustainable suppliers. All Sanitas facial care products that remain on the skin are completely fragrance-free and only essential oils that are medicinal in purpose are used.

Want to learn more? Stop by our Downtown Petoskey office to sample or browse products online.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  914 Hits

SANITAS SKIN CARE - PROGRESSIVE SKIN HEALTH

Your skin has the amazing ability to repair and regenerate itself, especially when you treat it with the right balance of stimulation and nourishment. This simple truth is the foundation of the Sanitas Skin Care line.

I have been using products from this Boulder, Colorado based company for years and am excited to share them with my clients.  All Sanitas products are cruelty free and contain no parabens, phthalates, dyes, harsh preservatives or gluten.


b2ap3_thumbnail_SAN_CURRENT-PHOTO-groupsm.jpgPROGENERATE • ACTIVATE • OPTIMIZE

AN OVERVIEW OF THE SANITAS SKIN CARE SYSTEM
 

PROGENERATE
The foundation for healthy skin starts here.
Start with daily essentials: Cleanser - Serum - Moisturizer

Looking to change up your skin care routine? This is the place to start. This collection features customized, daily essentials that are specially formulated for various skin types. A simple daily regimen of cleanser, serum, and moisturizer will help strengthen and prepare your skin to progress to the Activate and Optimize categories for rapid results.  Formulas available for all skin types.
Dr. Nielsen's favorites: The Lemon Cream Cleanser is addictive - one smell and you will be hooked! I alternate between the Vita Rich Serum (very hydrating and packed with antioxidants) and the Weightless Serum (more of a matte finish) depending on the time of year.

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ACTIVATE
Looking to take your skin care routine up a notch?
Integrate one or more of the Active skin care products into your routine. 

Designed to activate skin rejuvenation levels and elevate results, this collection of products integrates powerful technologies for progressing the health of the skin. Activate products include alpha-hydroxy acids, retinols, high-potency topical Vitamin C and more. Product concentrations may increase over time to prevent your progress from plateauing.
Dr. Nielsen's favorites: I'm obsessed with the Vitamin C Lactic cleanser (used 2-3 days per week).  I use the Vita C Serum at night - this high-potency Vitamin C serum is rich in antioxidants and essential fatty acids.  

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OPTIMIZE
Have a specific need?
Try these targeted, therapeutic products.

Whether you are looking to reduce blemishes, brighten, hydrate, or reverse the effects of aging, this collection of targeted, therapeutic products is designed to help rehabilitate challenged skin. When combined with the proper Progenerate and Activate programs, the correct selection of Optimize products will advance skin to its most healthy, optimal state.
Dr. Nielsen's favorites: I LOVE the Brightening Peel Pads - these pads can be used 2-3 times per week for an instant glow. The Hyaluronic Concentrate is combined with your usual moisturizer to boost hydration and reduce the appearance of fine lines - instant results!

Want to learn more? Stop by our Downtown Petoskey office to sample or browse products online.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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Meditation…One Size Fits All?

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In our fast-paced, on-the-go culture, a meditation practice can offer moments of calm amidst the chaos, moments which can grow into a lifestyle of greater attention, awareness, and peacefulness. As stressful lives have led to an increase in stress-related illness, the healthcare industry has gravitated toward integrating contemplative practices such as meditation into care plans for those with new or chronic illness. This occurrence is supported by years of research into the effectiveness of using meditation as a tool for stress reduction, chronic illness risk reduction, and for balanced emotional and spiritual health. As western medicine becomes better at understanding the gifts of meditation, it is clear that meditation is an effective adjunct therapy for many physical, emotional, and spiritual illness states. 

In using meditation as an aspect of integrated medical care, however, we must be careful to match the meditation style to both the personality and the symptom set of the client. Though meditation skills, in general, are appropriate for almost all populations, using meditation clinically involves more than a one-size-fits-all approach. Using an evidence-based scientific approach to meditation has taught us that meditation changes the neurophysiology of the brain, changes the parts of the brain that are "on-line" and functioning, and changes brain wave activity in the brain. These changes, of course, are reflected in the body. So, how these practices are taught and applied, among other factors, can determine the outcome. This is important in setting where a particular outcome is desired, where others may not be. Different goals require different techniques. 

Fortunately, we know a lot about how different meditation techniques affect the body and the brain. And we know a lot about how different symptoms and illnesses present in the body and the brain. With the combination of clinician experience, medical history, and the client's own wisdom, specific meditation techniques can be matched to best meet the needs and goals of the client. Mindfulness Meditation may be the right fit for one client, Focused Awareness Meditation more effective for another, while Open Heart Meditation best matches the needs of yet a different client.

Research does indeed suggest that even relatively brief and general meditation training can have an impact, but this same research indicates that the popular impression that "meditation" or "mindfulness" is good for everything or everyone is a bit of a fallacy, especially when used in clinical settings. Clinically, meditation should not be guesswork. Rather, it should be used with specificity regarding the client's own goals, their physiology, and how different meditative techniques impact the brain and body. When meditation training is matched to the individual client, it has the potential to reduce stress, reduce chronic illness symptoms, and open the door to experiences of joy, wonder, curiosity, and peace.



b2ap3_thumbnail_katiewinnell_thumbnail.jpgIf you are interested in learning about how meditation can be effective for your life and health goals, you can make an appointment to begin your journey with Katie Winnell RN, BSN, NC. Katie is a licensed RN, Nurse-Coach and Health Educator with credentials in Clinical Meditation and Imagery. The upcoming Spring 2018 Foundations of Meditation Session, an introductory 4-week class which sets the foundations for your meditation practice, begins April 17th at 6:30 pm at Dr. Nielsen’s office, 413 Waukazoo Ave., in Petoskey. Call 231.638.5585 to pre-register or schedule an appointment.

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