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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.
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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.
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CAN JOURNALING HELP YOU EXERCISE SMARTER?

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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.This email address is being protected from spambots. You need JavaScript enabled to view it.">

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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.
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SEASONAL ALLERGY ALTERNATIVES

b2ap3_thumbnail_Depositphotos_2734528_l-2015.jpgAccording to the Asthma and Allergy Foundation of America, at least 50 million people in the US suffer from symptoms of nasal llergies, and that number is on the rise.  If you suffer from allergies, you likely know the symptoms well - nasal congestion, runny nose, sneezing, itchy and watery eyes. as well as fatigue and “brain fog”.  In today’s blog, I present alternatives to the standard prescription and over-the-counter antihistamines commonly used to treat seasonal allergies - calling on the advice and recommendations of Dr. Andrew Weil. world-renowned leader and pioneer in the field of Integrative Medicine, and Director of the Arizona Center for Integrative Medicine at the University of Arizona



QUERCETIN

b2ap3_thumbnail_blueberries.jpgQuercetin is a bioflavonoid found in a variety of foods, and can also be taken in supplement form.  Dr. Weil states that in the lab, Quercetin stabilizes mast cells that release histamine, the principal mediator of reactions to pollen and other allergies, making it a natural antihistamine. It is used to treat symptoms of hay fever (when taken regularly for at least six to eight weeks), such as runny nose, watery eyes, and itching, as well as other forms of allergy and hives.
Food sources of Quercetin: buckwheat, apples, onions, kale, tomatoes, broccoli, asparagus, berries, red wine, and tea.

STINGING NETTLE
b2ap3_thumbnail_nettle.jpgStinging Nettle is a perennial flowering plant that has been used medicinally for ages. dating back to ancient Greece.  Dr. Weil states that Stinging Nettle, while often used to treat conditions such as osteoarthritis, eczema and gout, may also affect the sneezing and itching of hay fever, perhaps because the herb can reduce the amount of histamine the body releases from mast cells in response to an allergen.
Stinging Nettle grows all over the world and blooms June through September, with pink and yellow flowers.


ACUPUNCTURE

b2ap3_thumbnail_acupuncture.jpgAcupuncture for allergies?  While you may be skeptical, Traditional Chinese Medicine specialists frequently use Acupuncture to lessen the signs and symptoms of seasonal allergies.  In a study published in the journal Annals of Internal Medicine, researchers examined 422 people who tested positive for pollen allergies and had allergic nasal symptoms. The participants who received real acupuncture treatments with their antihistamines showed a greater improvement in their allergy symptoms and less use of antihistamines compared to the other groups.  While the conclusion had it’s limitations (those participants receiving “sham” acupuncture also showed some benefit, suggesting a placebo effect), Dr. Weil states the study’s outcome suggests that acupuncture may help relieve the symptoms of seasonal allergies and is worth further investigation.
To read more about this research article and Dr. Weil’s views on acupuncture for allergies click here.


THE GUT-ALLERGY CONNECTION

b2ap3_thumbnail_tarmar.jpgDid you really think that I could blog without mentioning the gut?  Dr. Weil also acknowledges that deleterious changes in the microbiome may underlie the increased incidence of allergy, as they are also felt to be linked to other conditions, including gluten sensitivity, autoimmunity, and autism.  In a study published in 2011 in the Journal of Allergy and Clinical Immunology, Danish researchers showed that the risk of allergies is higher than normal in children with a less diverse microbiome. If you suffer from allergies, consider working with a Functional Medicine specialist to evaluate and optimize your gut microbiome.
Do the bugs in your belly cause allergies?  Read Dr. Weil’s article here.

 



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.

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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.
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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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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.This email address is being protected from spambots. You need JavaScript enabled to view it.">

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b2ap3_thumbnail_HealingArthritis.jpgIn Healing Arthritis, Dr. Susan Blum, author of the bestselling The Immune System Recovery Plan shares her science-based, drug-free treatment plan for the almost fifty million people who suffer from arthritis.

FROM THE PUBLISHER:
Arthritis is the most common cause of disability in the world—greater than both back pain and heart disease. One example, Rheumatoid Arthritis (RA), is the most common autoimmune disease, affecting 1% of the US population, and almost 68 million people worldwide. Conventional medicine tends to treat arthritis with strong, gut-damaging, immune-suppressing pain medications, temporarily relieving the symptoms of the disease without addressing its root causes. Now, in her groundbreaking new book, Dr. Susan Blum, a leading expert in functional medicine, offers a better approach to healing arthritis permanently.

MY THOUGHTS:
This book is a must-read for anyone suffering from joint pain or arthritis. While I’ve been recommending Dr. Blum’s first book The Immune System Recovery Plan to my patients for years, I find Healing Arthritis easier to read and more user-friendly for my patients to navigate. The book provides an overview of the root causes of inflammation/arthritis, focusing on:
  • inflammatory foods
  • gut health
  • the role of stress/trauma
Dr. Blum includes a straightforward two-week plan to quickly reduce pain through anti-inflammatory foods and supplements; followed by an intensive gut repair program. Once through this initial phase, her plan addresses the emotional issues that contribute to inflammation and outlines a simple, Mediterranean inspired diet to maintain a healthy gut.

I was pleased to see that the diet and supplement recommendations are given are the same available to patients in my office! This book will serve as a useful companion for patients navigating the world of Functional Medicine in treating arthritis and controlling inflammation.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including arthritis. 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. When treating arthritis and autoimmune disease, my approach involves treating root causes such as toxicity, food allergy/sensitivity, stress/trauma and underlying infection. 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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In one year, this 10-year-old has made significant behavioral improvements, has stopped two of three medications, is no longer experiencing insomnia or constipation, and is thriving at school.  Read today's blog to hear his story!

BACKGROUND

I first met nine-year-old Luke* and his mother in late 2016. Luke had been diagnosed with a variety of psychological and neurological disorders, including ADHD, PDD-NOS (pervasive developmental disorder-not otherwise specified), Anxiety, OCD (obsessive-compulsive disorder), ODD (oppositional defiant disorder), and a sensory processing disorder.

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Since the age of five, Luke had been evaluated and treated by a variety of psychologists, psychiatrists, neuropsychologists, and pediatricians, as well as a number of occupational and physical therapists. By age nine he was on three different prescription medications for mood and attention.

At that first visit, Luke’s mom described him as "consistently inconsistent". She illustrated a child who on one day would appear happy, calm and content, while the next day appeared ”tormented" by irritability, anger, hyperactivity, impulsiveness, and anxiety.

I also learned that Luke had suffered from both chronic interrupted sleep and lifelong constipation. At times he would go 5–7 days without a bowel movement, and his mother would notice worsening behavior during these times. Complicating matters, his multiple psychiatric medications only seemed to worsen both his sleep and constipation.

INITIAL WORKUP AND RECOMMENDATIONS 
After hearing Luke’s story and performing an examination, a comprehensive laboratory evaluation was ordered which included testing for:
  • nutritional deficiencies
  • inflammation
  • blood levels of heavy metals
  • thyroid function
  • food allergies and sensitivities
  • micronutrient testing
  • functional stool testing
Prior to our first visit, Luke's parents had already implemented changes to his diet by eliminating additives and preservatives, most processed foods, sugar, soy, and conventional dairy products. I asked them to expand upon this and completely remove gluten from his diet.

FOLLOW UP AND PLAN 
I met again with Luke and his mother in early March 2017 to review the results of his testing. With the exception of low Vitamin D, Luke’s blood lab results were overwhelmingly normal. His stool testing, however, was not.

Luke’s functional stool testing revealed several abnormalities, including:
  • poor digestion, with evidence of high levels of protein and fat in his stool
  • bacterial dysbiosis, an overgrowth of “bad” bacteria in the gut
  • low microbial diversity
I recommended they add both fish oil and vitamin D with specific dosing recommendations given. We also initiated a protocol to rebalance his gut which included:
  • continued food restriction, avoiding gluten and other inflammatory foods
  • chewable digestive enzymes with meals
  • pharmaceutical-grade probiotics
  • an herbal blend to reduce the overgrowth of “bad” gut bacteria while still promoting the growth of “good” gut bacteria
TWO MONTHS LATER - PROGRESS! 
Off one medication and behavior improved!

Luke’s mother and I followed up via email in May after completing the herbal gut protocol. I was thrilled to learn of the progress that Luke had made! He had been off of Concerta (a medicine for hyperactivity and attention) for 2 months and was experiencing less behavioral problems. I advised them to continue the probiotics, enzymes, fish oil and vitamin D, and we added magnesium.

A FEW MORE MONTHS - MORE PROGRESS!
Off two medications, sleeping well and regular bowel movements!

b2ap3_thumbnail_GUT.jpgBy August 2017 Luke was down from three to only one medication. His mother reported that he was sleeping well and was having daily well-formed bowel movements! While Luke was still often impulsive and defiant, overall significant behavior improvement had continued since his initial visit.

In November Luke’s mother and I touched base after he had been back in school. She reported that he was “loving school” and was excited to report that he had not had any behavioral or academic problems. His anxiety and impulsiveness had improved. and his mother commented that “he looks really healthy”.

ONE YEAR LATER 
To follow up our gut protocol, we repeated Luke’s Functional Stool Testing, as well as a Urine Organic Acid Panel (which can give us a wealth of information without another blood draw). His stool testing had significantly improved, with better microbial diversity however he continued to show signs of poor digestion and bacterial levels, while much better, were still trending toward imbalance.

Using this follow up information we were able to “tweak” his current program, adding back digestive enzymes (which had been phased out), and repeating a one-month herbal program to further balance gut bacteria. We also added back L-glutamine to further heal and strengthen his small intestinal lining.

His diet restrictions have loosened slightly, but key concepts remain in place, including a whole food diet, and keeping sugar and processed foods to a minimum. They have identified significant gluten intolerance with increased anxiety and agitation, as well as a slightly less pronounced sugar intolerance.

Through the use of a thorough history, appropriate laboratory testing, and evidence-based Functional Medicine protocols, Luke has made significant behavioral improvements, has stopped two of three medications, is sleeping well, having regular bowel movements and thriving at school. I look forward to seeing his progress continue over the years to come!

*patient name has been changed to protect privacy

Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including both adult and childhood mood and behavior disorders. Rather than focusing solely on the use of prescription medication, consider addressing potential "root causes" of you or your loved one's symptoms, such as nutrition, gut health, toxicities/impaired detoxification, hormone imbalance, deficiencies and more. 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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What is the best way to keep your New Year’s resolution for better health?

Make it something easy and enjoyable that you actually want to do.

A key part of weight management, healthy blood pressure, hormone balance, and overall better health is stress reduction.

Exercise and acupuncture are both excellent ways to reduce stress. In a research article on acupuncture’s physiologic effects on the body, researchers in Stockholm Sweden stated “Both exercise and acupuncture . . . cause the release of endogenous opioids and oxytocin essential to the induction of functional changes in different organ systems. Beta-endorphin levels, important in pain control, . . . have been observed to rise in the brain tissue of animals after both acupuncture and strong exercise.”

The release of these ‘feel good’ substances helps us to feel less stress (and less pain). Evidence also shows that the elevated levels of endorphins and oxytocin after acupuncture can remain long after the acupuncture treatment has ended.

The exercise part of the equation is up to you, but monthly, bi-monthly, or even seasonal acupuncture treatments can do wonders for your health. And, if you have pain issues or a lack of energy, acupuncture can help with those too.

Resolving to improve your health could be the best choice you will ever make, but only if you actually follow through on it. Why not make it easy on yourself? A relaxing hour, or half hour, break in your day for an acupuncture treatment could make the difference.



b2ap3_thumbnail_katiewinslow_thumbnail.jpgRegardless of your health history and physical background, almost anyone is a candidate for acupuncture. If you have an ailment, acupuncture can help relieve it. If you feel well, acupuncture can help you maintain wellness, boost immunity, and manage stress. At Integrative Medicine, practitioners provide acupuncture in collaboration with Dr. Nielsen’s recommendations. Patients very often see greater improvement in their condition when treated by both an MD and an acupuncturist. If you are interested in a consultation or appointment, contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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b2ap3_thumbnail_Shop_17FiberCapsules.jpgGlucomannan is a “Super Fiber” that has been shown to reduce appetite, aid in weight loss, lower cholesterol and blood sugars, and relieve constipation.*

Glucomannan is an ancient fiber that comes from the Asian elephant yam, also known as Amorphophallus konjac. This soluble fiber is one of the most viscous dietary fibers known - it can absorb up to 50 times its weight in water.

APPETITE AND WEIGHT LOSS

When combined with water, glucomannan forms a viscous gel-like substance that slows digestion, delays the emptying of food from the stomach into the small intestine, slows down the influx of carbohydrates and fats into the bloodstream, binds to bile acids, and impedes dietary fat absorption.* [1,2]  Studies suggest that glucomannan supplementation significantly reduces weight at doses of 3 g/d to 4 g/d when compared to placebo. [1-7]

Bottom line: When combined with water, Glucomannan expands in your stomach, helping to reduce hunger and promote weight loss.*

GLUCOSE AND LIPID METABOLISM

Soluble fiber slows the absorption of carbohydrates, which influences the release of insulin and the rate of fat storage. Glucomannan studies have not only demonstrated a positive impact on postprandial glucose handling and glucose metabolism but also on cholesterol metabolism.* [1-4,7-9]

Bottom line: When combined with food, studies show that Glucommanan can lower blood sugars and cholesterol.*

HEALTHY BOWEL FUNCTION, PREBIOTIC

Glucomannan not only allows more water to remain in the stool, thereby making waste softer, larger, and easier to pass through the intestines, but it is also an excellent prebiotic. In a placebo-controlled, randomized, parallel, double-blind, crossover trial, doses of 3 g/d and 4 g/d of glucomannan had a positive impact on bowel regularity when compared to placebo. [10] Glucomannan has also been shown to increased the fecal concentration of lactobacilli as well as the daily output of bifidobacteria, lactobacilli, and total bacteria. In addition, fermentation of glucomannan resulted in greater fecal concentrations of short-chain fatty acids and lower fecal pH.*[11]

Bottom line: Glucomannan promotes regular bowel movements and the growth of more "good bacteria" in your gut.*


FIBER LEAN

b2ap3_thumbnail_Shop_17FiberLean.jpgFIBER LEAN
features Shimizu Propol® A propolmannan - a konjac-derived glucomannan using proprietary processing techniques that allow the fiber to maintain high viscosity yet remain stable through the digestive tract.
  • Supports Appetite and Weight Control* 
  • Supports Glucose and Cholesterol Metabolism* 
  • Supports Healthy Bowel Movements* 
  • Serves as a Prebiotic for Intestinal Bacteria* 
When taken with adequate amounts of water, Fiber Lean expands in the stomach, creating a viscous “gel-like” substance which promotes a sense of fullness, slows the rate at which food enters your bloodstream and increases the speed at which food exits the body through the digestive tract (pushing more calories out through the colon, rather than letting them be absorbed). Fiber Lean binds and quickly eliminates toxins from the gut.*
  • Take 30-60 minutes before a meal to feel full with reduced portion sizes*
  • Take prior to heading out to a party/event to reduce cravings and temptation*

Fiber Lean comes in both powder and capsule form.  
Visit our Downtown Petoskey office for a free Fiber Lean sample, 

or visit our online store to buy online.


1. Walsh DE, Yaghoubian V, Behforooz A. Effect of glucomannan on obese patients: a clinical study. Int J Obes. 1984;8(4):289-93. [PMID: 6096282]
2. Doi K, Nakamura T, Aoyama N, et al. Metabolic and nutritional effects of long- term use of glucomannan in the treatment of obese diabetics. In: Oomura Y, Tarue S, Inoue S, Shimazu T, eds. Progress in Obesity Research 1990. London: John Libbey; 1991:507-14. [on file]
3. Kaats GR, Bagchi D, Preuss HG. Konjac glucomannan dietary supplementation causes significant fat loss in compliant overweight adults. J Am Coll Nutr. 2015 Oct 22:1-7. [PMID: 26492494] 4. Biancardi G, Palmiero L, Ghirardi PE. Glucomannan in the treatment of overweight patients with osteoarthritis. Curr Ther Res. 1989;46:908-12. [on file]
5. Reffo GC, Ghirardi PE, Foranttini C. Glucomannan in hypertensive outpatients: pilot clinical trial. Curr Ther Res. 1988;44(1):22-27. [on file]
6. Salvatoni A, Bosetti G, Gambarini G. Lipid pro le and excess body weight in obese children: effect of a dietary drug supplement (glucomannan vs detastranum). Ped Oggi. 1991;11:243-45. [on file]
7. Kraemer WJ, Vingren JL, Silvestre R, et al. Effect of adding exercise to a diet containing glucomannan. Metabolism. 2007 Aug; 56(8):1149-58. [PMID: 17618964]
8. Hopman WP, Houben PG, Speth PA, et al. Glucomannan prevents postprandial hypoglycaemia in patients with previous gastric surgery. Gut. 1988;29(7):930- 34. [PMID: 2840365]
9. Vita PM, Restelli A, Caspani P, et al. Chronic use of glucomannan in the dietary treatment of severe obesity [in Italian]. Minerva Med. 1992 Mar;83(3):135-39. [PMID: 1313163]
10. Marsicano LJ, Berrizbeitia ML, Mondelo A. Use of glucomannan dietary ber in changes in intestinal habit [in Spanish]. G E N. 1995 Jan-Mar;49(1):7-14. [PMID: 8566676]
11. Chen HL, Cheng HC, Wu WT, et al. Supplementation of konjac glucomannan into a low- ber Chinese diet promoted bowel movement and improved colonic ecology in constipated adults: a placebo-controlled, diet-controlled trial. J Am Coll Nutr. 2008 Feb;27(1):102-08. [PMID: 18460488]

Consult your healthcare practitioner prior to use. Individuals taking medication, especially hypoglycemic agents, should discuss potential interactions with their healthcare practitioner. Do not take Fiber Lean at the same time as medication as it may reduce medication absorption.

*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.

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 eating habits and lifestyle patterns 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” 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.
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b2ap3_thumbnail_lotus-2436937_1920.jpgRegardless of who you are, where you live, or what you do, chances are you’ve experienced the stress and anxiety life can bring. The fact of the matter is, we live in uncertain times. As a human species, we always have. Intellectually we know there are no guarantees that come with being alive. Our evolutionary development demands that we stay alert to threats and potential danger so that we can stay alive. While we no longer find ourselves on the look-out for the proverbial lion outside the cave door, potential threats and turmoil abound, for some of us more than others. This can leave us feeling stressed, anxious, uncertain, and vulnerable.

Every day we absorb, integrate, and react to countless stressful stimuli from our external environment as well as the emotions and thoughts that these stimuli bring up within ourselves. Our brains have literally been designed to scan for these stimuli and attach emotion and memory to them (termed the negativity bias) (1). In this sometimes constant state of vigilance, we may find ourselves further and further away from a state of calm, a state of peace. This distancing from inner peace can lead to increased chronic stress and multiple stress related illnesses (2). Now we have added another layer of dis-ease to our uncertain lives.

And yet, amidst all of this turmoil, we live, we trust, we love, we look forward to tomorrow. How is it that we hold these two dichotomies within the same brain, the same heart, the same spirit? This is the essence of being human. It is in human vulnerability that we often locate both our desire for and our capacity to experience the state of peace which allows us to trust, to love, to find the meaning and purpose that see us through to tomorrow. And these potentials exist within each and every one of us. They are not mysterious or magical, they are the result of the intermingling and reorganization of the myriad functions of the human brain (3). This physiological fact, however, does not diminish the beauty and freedom experienced with unlocking these potentials. We all have access to these resources, sometimes we just need the guidance and support of others to nudge open the door within ourselves behind which they are waiting.

So how do we nudge this door within ourselves open? One inch at a time. The field of neuroplasticity has shown us we can “turn down” the negativity bias wired into our brains through evolution and “turn up” our capacity to scan and experience beauty, contentment, and peace (1). Doing this, however, takes a dedicated practice which guides us to a state of inner awareness, then gently turns this inner awareness to a more active state of focused attention to the experience of peace. This quite literally changes the activity of the brain biochemically and energetically, priming us to absorb and experience calm peacefulness. From this state we can access our own wisdom, our purpose in life, softening the vulnerability of uncertainty (4).

We can exist in peace, even in the tumultuous world in which we live. But this is a practice. And as in any practice, we need guidance and support. Join me at Dr. Nielsen’s office for one or both of these offerings as we explore the human potentials of peace, wisdom, purpose, and oneness through the practice of Clinical Meditation and Imagery.


FOUNDATIONS OF MEDITATION
Four-week session: When: Monday evenings November 6th, 13th, 20th, 27th, 2017, 6:30pm.
$140. Pre-registration required.


EXPLORATIONS IN MEDITATION AND IMAGERY
Drop-In sessions: When: first and third Tuesdays of each month** starting September 5th 2017, 6:30pm.
$15 drop-in fee. No registration required.
**please note: October 2017 offerings will be the first and fourth Tuesday, Oct. 3rd and 24th, 2017**

Sources:
1. Hanson, Rick. Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence. Harmony Books, NY, New York.
2. Sapolsky, R. (2004). Why Zebras Don’t Get Ulcers. Sapolosky, NY, New York.
3. Schaub, Bonnie, and Schaub, Richard. (2014). Dante’s Path: Vulnerability and the Spiritual Journey. Florence Press, NY, New York.
4. Austin, James. (2000). Zen and the Brain. First MIT Press, Cambridge, Massachusetts.



b2ap3_thumbnail_katiewinnell_thumbnail.jpgIf you are interested in learning how I can help you manage chronic illness risk factors and access your own unique lifestyle of wellness through wellness management, health education, health coaching, workshops, and clinical meditation instruction or if you would like to schedule a consultation, please contact the office of Integrative Medicine - Carin Nielsen, MD at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

 
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THE THREE BOOKS I MOST OFTEN RECOMMEND TO PATIENTS

Summer is a great time to relax in the hammock or on the beach with a good book.  Below are three books I frequently recommend to patients.  Each is the type of book that you can come back to over time, re-reading chapters and absorbing more information.  Happy reading!


b2ap3_thumbnail_ImmuneSystemRecovery.jpg THE IMMUNE SYSTEM RECOVERY PLAN: A DOCTOR'S 4-STEP PROGRAM TO TREAT AUTOIMMUNE DISEASE

By Susan Blum, MD, MPH

A must-read for anyone seeking a Functional Medicine approach to Autoimmune Disease, and a great companion to my office protocols.

This book provides:

 -A basic science “primer” of the immune system and its dysfunction in Autoimmune Disease (you can skip ahead if it’s too much).
- An overview of a Functional Medicine approach to Autoimmune Disease.
- Sep-by-step protocols for managing stress, cleaning up the gut and optimizing detoxification.


b2ap3_thumbnail_HormoneCure.jpg THE HORMONE CURE:
RECLAIM BALANCE, SLEEP, AND SEX DRIVE; LOSE WEIGHT; FEEL FOCUSED, VITAL, AND ENERGIZED NATURALLY WITH THE GOTTFRIED PROTOCOL

by Sara Gottfried, MD

If you are a female between the ages of 35-65, you should read this book!

Harvard-trained physician Dr. Sara Gottfried provides an easy-to-read, well-organized summary of a Functional Medicine approach to hormone balance, including:
  • - Adrenal dysfunction
  • - Thyroid disorders
  • - Peri-menopause and Menopause
Dr. Gottfried explains how stress impacts hormones at many levels and provides evidence-based protocols to get you started on the path to hormone balance.


b2ap3_thumbnail_GrainBrain.jpg GRAIN BRAIN:
THE SURPRISING TRUTH ABOUT WHEAT, CARBS, AND SUGAR--YOUR BRAIN'S SILENT KILLERS

by David Perlmutter, MD

Looking to learn more about gluten and its potentially damaging effects on the body? Considering a more “Paleo” diet? This best-selling book by board-certified Neurologist David Perlmutter is thought-provocative and research-oriented, and will certainly cause you to pause before you put that bagel in your mouth! Included is a practical four-week plan to get you started on a grain-free lifestyle, including gluten-free recipes.

Want to learn more? Consider a few of Dr. Perlmutter’s other books:
  • “The Grain Brain Cookbook” and “The Grain Brain Whole Life Plan” offer even more practical, day-to-day applications.
  • “Brain Maker” a compelling read that describes the relationship between gut health and brain function.
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b2ap3_thumbnail_Scale.jpg
The National Weight Control Registry (NWCR) is an ongoing research study established in 1994 that includes over 10,000 adults who have lost at least 30 pounds of weight and kept it off for at least one year.

Members complete annual questionnaires about their current weight, diet, exercise habits and behavioral strategies for weight loss maintenance.

The NWCR was developed to identify and investigate the characteristics of individuals who have succeeded at long-term weight loss.


HOW DID NWCR MEMBERS LOSE THE WEIGHT?
  • 98% of NWCR participants report that they modified their food intake in some way to lose weight.
  • 94% increased their physical activity, with the most frequently reported form of activity being walking.
  • Over half of participants lost weight with the help of some type of program.

HOW HAVE NWCR MEMBERS KEPT THEIR WEIGHT OFF? HERE ARE SOME LIFESTYLE HABITS THEY HAVE IN COMMON:
  • 78% eat breakfast every day.
  • 75% weigh themselves at least once a week.
  • 62% watch less than 10 hours of TV per week.
  • 90% exercise, on average, about 1 hour per day.
Like I frequently discuss with clients. this is not rocket science! These people (over 10,000) lost weight simply by changing their eating patterns in some way and moving more!


WANT TO LEARN MORE?

Visit the NWCR website www.nwcr.ws




Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including weight gain and obesity. 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.
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b2ap3_thumbnail_Alpha-lipoic-acid.jpgWHAT IS ALPHA-LIPOIC ACID?

Alpha-lipoic acid (sometimes referred to as ALA) is a co-enzyme found in every cell of the body, and is used to turn glucose into energy. Alpha-lipoic acid also functions as a powerful antioxidant, attacking "free radicals". Free radicals are produced in the body as a byproduct of energy production, and cause harmful chemical reactions that can damage cells, organs and tissues, and make it harder for the body to fight off infections.

Alpha-lipoic acid is the only antioxidant that is both water and fat-soluble, which means it has access too all parts of our body to attack free radicals and prevent oxidative damage. Alpha-lipoic acid also helps to regenerate other powerful antioxidants and make them active again.

WHAT IS ALPHA-LIPOIC ACID USED FOR?
  • Diabetes, Pre-Diabetes and Insulin Resistance
  • Peripheral Neuropathy
  • Heavy Metal clearance
  • General Antioxidant Support
Researchers believe Alpha-lipoic acid helps improve insulin sensitivity. More simply put, Alpha-lipoic acid may make it easier for your body to use blood sugar for fuel. Alpha-lipoic acid is also used to treat the symptoms and delay progression of diabetic and alcoholic peripheral neuropathy. Studies show Alpha-lipoic acid binds with toxic metals, such as mercury, arsenic, iron, and other metals that act as free radicals. Because alpha-lipoic acid can pass easily into the brain, it may help protect the brain and nerve tissue, researchers are investigating it as a potential treatment for stroke and other brain problems involving free radical damage, such as dementia.

HOW TO SUPPLEMENT: ADULTS
  • General antioxidant support: 50-400 mg per day
  • Diabetes and diabetic neuropathy: 600-800 mg per day

PRECAUTIONS/POSSIBLE INTERACTIONS


Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a health care provider. Side effects are generally rare and may include insomnia, fatigue, diarrhea, and skin rash.

Alpha-lipoic acid has not been studied in children, pregnant or breastfeeding women and is therefore not recommended for use in these populations.

Caution:
  • If you are diabetic or have low blood sugar, as Alpha-lipoic acid many lower blood sugars further.
  • If you are an alcoholic, or have Vitamin B1 (Thiamine) deficiency, as animal studies have shown that Alpha-lipoic acid may lower Vitamin B1 levels.
  • If you are on thyroid medication, monitor thyroid levels as Alpha-lipoic acid may reduce thyroid hormone levels.
  • If you are on chemotherapy, you should check with your oncologist prior to using Alpha-lipoic acid.
SOURCES:
  • University of Wisconsin Integrative Medicine - Supplement Samplers
  • University of Maryland Medical Center - Complementary and Alternative Medicine Guide
  • Oregon State University, Linus Pauling Institute - Micronutrient Information Center



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 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.
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Interested in learning more about our 12-week Weight Loss/Lifestyle Change programs?

Wondering how a program might work for you?


TODAY'S BLOG COMES FROM A PATIENT'S OWN WORDS AFTER HER RECENT
“12-WEEK TRANSFORMATION”.


b2ap3_thumbnail_Apple.jpg

“The program was personalized to fit my needs, concerns. Once I learned how and what to eat I have been able to continue almost automatically. It works because it changes how you see food and gives you a healthy change, instead of yo-yo diets or a fad diet that you won't be able to do long-term.

It is a lifestyle change, one that my body needed. I am able to pinpoint which foods make me feel sick and which ones add weight, and eliminate them.”  EL, Age 36.

In just 12 weeks, she lost:

28 POUNDS
7 INCHES OFF HER WAIST 
4.5 INCHES OFF HER HIPS
3.75 INCHES OFF HER CHEST
3.25 INCHES OFF HER ARM

 And she even took a three-week vacation during her program!  


Are you ready to get started?


Call 231-638-5585 to book your appointment today, or feel free to email me with questions at This email address is being protected from spambots. You need JavaScript enabled to view it.



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.
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b2ap3_thumbnail_breathawareness.jpg

In the busy-ness of our everyday lives, we often forget one of the most powerful tools we have to create physical, emotional, and spiritual wellness. Breathing. It seems so simple, yet so many of us breathe in ways that actually cause an increase in physiologic and emotional stress. The adage “breath is life” is finding ground in the medical community, with an increasing number of evidence-based studies showing the link between breath awareness practices and improved health. Indeed, these practices have the ability to positively impact multiple symptomologies, from test anxiety to high blood pressure, the common cold to chronic pain. Further, because breath awareness techniques have the ability to alter brain functions such as brain wave patterns and how parts of the brain “talk” to each other, breathing techniques can set the stage for new understandings, emotional integration, and spiritual development.

The link between specific breathing techniques and health outcomes lies in our innate ability to affect our nervous system function by simply breathing. Just taking a moment to be aware of the sensation of your breath as it moves in and out begins to switch your body out of stress and into relaxation. This happens because calm, focused breathing both mechanically and biochemically stimulates the parasympathetic nervous system. This is the branch of your autonomic nervous system sometimes called the “rest and digest,” or “tend and befriend” nervous system. Its activation has been linked to positive health benefits such as decreased heart rate, lower blood pressure, decreased pain, and increased immune response.

The polar opposite of this state of relaxation occurs with the activation of the other branch of the autonomic nervous system, the sympathetic or “fight or flight” nervous system. Chronic activation of this part of the nervous system can contribute to multiple health problems such as cardiovascular disease, GERD, weight gain, and anxiety. Given the hectic, busy nature of our lives, we spend a large amount of time in “fight or flight,” and not nearly enough in “rest and digest.” Subsequently, our culture is seeing a precipitous rise in stress related chronic illness. Many of these states of illness, however, can be positively affected by practicing breath awareness as a stress management tool, effectively altering the nervous system balance between “rest and digest” and “fight or flight.”

In the upcoming workshop, Breath Awareness for Stress Reduction, we will explore and experience three powerful breath awareness techniques: Simple Breath Awareness, Diaphragmatic Breathing, and Extended Exhalation. These evidence-based techniques, when practiced over time, can truly lower your physiologic stress levels, allow you to access your “rest and digest” nervous system, and decrease chronic illness indicators. Moreover, they set the stage for more in depth explorations of meditation as a tool for health and wellness. Whether used independently or as an introduction to meditative practices, breath awareness can be an effective tool to reach your wellness goals. So, go ahead, Just Breathe.

References:
1. Bergland, C. (2013 Feb.). The Neurobiology of Grace Under Pressure. Retrieved from: https://www.psychologytoday.com/blog/the-athletes-way/201302/the-neurobiology-grace-under-pressure, accessed 03/22/17.
2. Med Sci Monit. 2013; 19: 61–66. Published online 2013 Jan 21. doi:  10.12659/MSM.883743
3. N.A., (n.d.), Stress. Retrieved from: http://umm.edu/health/medical/reports/articles/stress, accessed 03/22/17
4. Neurol Sci. 2017 Mar;38(3):451-458. doi: 10.1007/s10072-016-2790-8. Epub 2016 Dec 19
5. Pain Med. 2012 Feb;13(2):215-28. doi: 10.1111/j.1526-4637.2011.01243.x. Epub 2011 Sep 21




Carin Nielsen, MD Integrative MedicineIf you are interested in learning how I can help you manage chronic illness risk factors and access your own unique lifestyle of wellness through wellness management, health education, health coaching, workshops, and clinical meditation instruction or if you would like to schedule a consultation, please contact the office of Integrative Medicine - Carin Nielsen, MD at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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b2ap3_thumbnail_20130805165357_weightLoss1.pngMany people are familiar with the use of acupuncture for pain relief, alleviation of nausea, or its use in conjunction with IVF. Not as well known is that acupuncture is an excellent complement to a healthy weight loss program. It is by no means a quick fix, but, it can be an important piece of the puzzle for people struggling with weight issues.

Acupuncture is a major part of Traditional Chinese Medicine (TCM). TCM views excess weight as a symptom of a deeper underlying imbalance in the body. This imbalance can have a physical or psycho-emotional basis (or both). Until the underlying health issue is resolved, lasting weight loss is difficult, even with the most restrictive of diets.

TCM considers stress to be one of the most common causes of excess weight (or in underweight individuals, the inability to gain weight). Acupuncture can help to relieve stress and address other deeply rooted issues contributing to weight problems, allowing the body to naturally and easily shed unwanted pounds.

RESEARCH HAS SHOWN ACUPUNCTURE TO:

  • Reduce appetite1 2
  • Reduce food cravings3
  • Modulate gut bacteria4
  • Modulate hormones (specifically hormones that play important roles in metabolism, appetite regulation, and fat accumulation)5
  • Modulate neurotransmitters that promote a feeling of well-being, and reduce the effects of stress on the body.6
  • Reduce inflammation
  • Enhance motivation

FURTHERMORE, ACUPUNCTURE INDIRECTLY AIDS IN WEIGHT LOSS BY:

  • Improving sleep quality
  • Raising immunity
  • Increasing energy
  • Relieving pain that restricts a more active lifestyle.

b2ap3_thumbnail_Ac.jpgFor maximum benefit, I recommend starting with a series of six sessions. Although people frequently notice some changes after one treatment, the effects of acupuncture are cumulative and the response is much stronger if treatments are done regularly for a period of time. Acupuncture is not a magic bullet. For significant weight loss it must be combined with healthy diet and lifestyle changes. But with little to no negative side effects, and so much benefit, why not give it a try?

1Yao H1, Chen JX, Zhang ZQ et al. Effect of acupuncture therapy on appetite of obesity patients. 2012 Dec;37(6):497-501 Available from http://www.ncbi.nlm.nih.gov/pubmed/23383461

2Aust Fam Physician, Richards D, Marley J. Stimulation of auricular acupuncture points in weight loss. 1998 Jul;27 Suppl 2:S73-7 Available from http://www.ncbi.nlm.nih.gov/pubmed/9679359

3Kang OS, Kim SY, Jahng GH, et al. Neural substrates of acupuncture in the modulation of cravings induced by smoking-related visual cues: an fMRI study. Epub 2013 Feb 28. Available from http://www.ncbi.nlm.nih.gov/pubmed/23455593

4Xu Z, Li R, Zhu C, Li M. Effect of acupuncture treatment for weight loss on gut flora in patients with simple obesity. Epub 2012 Sep 8. Available from http://www.ncbi.nlm.nih.gov/pubmed/22961606

5Güçel F1, Bahar B, Demirtas C. Influence of acupuncture on leptin, ghrelin, insulin and cholecystokinin in obese women: a randomised, sham-controlled preliminary trial. Epub 2012 Jun 22. Available from http://www.ncbi.nlm.nih.gov/pubmed/22729015

6Sheng-Xing M. Neurobiology of Acupuncture: Toward CAM. 2004 Jun; 1(1): 41–47 Available at https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC442119/



b2ap3_thumbnail_katiewinslow_thumbnail.jpgRegardless of your health history and physical background, almost anyone is a candidate for acupuncture. If you have an ailment, acupuncture can help relieve it. If you feel well, acupuncture can help you maintain wellness, boost immunity, and manage stress. At Integrative Medicine, practitioners provide acupuncture in collaboration with Dr. Nielsen’s recommendations. Patients very often see greater improvement in their condition when treated by both an MD and an acupuncturist. If you are interested in a consultation or appointment, contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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Have you or a loved one been diagnosed with high cholesterol? Have you been prescribed a statin medication? Functional Medicine provides a framework to determine why you have high cholesterol, assess other cardiovascular risk factors, and outline a treatment plan that is cu
stomized for your individual needs.

1. FUNCTIONAL MEDICINE ASKS THE QUESTION- WHY DO YOU HAVE HIGH CHOLESTEROL?

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As Functional Medicine physician and best-selling author Dr. Mark Hyman likes to say, “High Cholesterol is not a Lipitor deficiency”.

Before jumping to a prescription, Functional Medicine asks the question why? By addressing the root cause of your elevated cholesterol you may be able to avoid medication and lessen cardiovascular risk.

Obviously, diet can play a big role in elevated cholesterol, but there are other factors that may be contributing to or causing high cholesterol that a Functional Medicine doctor considers, including:

  • Genetics
  • Hormone Imbalance (especially thyroid and insulin/blood sugar)
  • Hidden Infections
  • Toxicity (especially heavy metals)


2. FUNCTIONAL MEDICINE GOES BEYOND THE STANDARD LIPID PANEL WITH ADVANCED LABORATORY TESTING.

Why do we even care about high cholesterol? Because of risk for heart and vascular disease! Yet many physicians base risk and treatment decisions on a standard lipid panel alone.

Functional Medicine uses Advanced Laboratory Testing to get a more accurate assessment of risk and to develop individualized treatment plans that are not simply focused on statin medication.

b2ap3_thumbnail_ExampleLipidPanel_Click.jpgLDL cholesterol is typically referred to as “bad cholesterol”, but not all LDL cholesterol is created equal!

Advanced Laboratory Testing measures the size and number of your LDL particles - which is a better predictor of heart and vascular disease risk. If you have small, dense “sticky” LDL particles, these are much more concerning than large, buoyant “beach ball”-like particles, which carry less risk. In addition to measuring the size of your LDL particles, Advanced Laboratory Testing measures another type of lipid protein called lipoprotein(a). Lipoprotein(a) is a highly atherogenic “troublemaker” that has a strong genetic component and does not readily decrease with diet change or statin drugs. Knowing your lipoprotein(a) levels can help to direct a more individualized treatment plan.

What is LDL?
LDL is a “carrier protein”. Its job is to “carry” cholesterol particles around the body.

LDL isn't always "bad" because your body needs cholesterol!

Cholesterol is an important component of cell membranes and has an antioxidant effect on the brain. Cholesterol is also an important “building block” from which we make our hormones and Vitamin D.

LDL cholesterol itself isn't necessarily a bad thing, yet when LDL cholesterol is in an inflamed environment, your risk of heart and vascular disease increases.

Advanced Laboratory Testing measures the factors that make your LDL cholesterol more of a problem:

  • Inflammation (think of as “fire” in your arteries) measured with hsCRP and fibrinogen
  • Oxidation (think of as “rusting” in your arteries) measured by myeloperoxidase or oxidized LDL
  • Glycation ( think of as “sugar coating” LDL and making it stickier) measured with fasting glucose, insulin, and HbA1c

Advanced testing can also look for signs of plaque formation in the arteries - measured with LP-PLA2 activity laboratory testing, or imaging studies such as carotid artery ultrasound or coronary calcium CT scoring.


3. FUNCTIONAL MEDICINE OFFERS TREATMENT FOR HIGH CHOLESTEROL THAT GOES BEYOND STATIN DRUGS.

b2ap3_thumbnail_Blog_vegetables.jpgDon’t get me wrong, a Functional Medicine doctor may prescribe statin medications if indicated, but not as first-line therapy. These days it seems almost a “knee-jerk” reaction for doctors to prescribe statin medications at the first sign of elevated cholesterol. In fact, statin drugs are one of the most frequently prescribed classes of medication worldwide and account for hundreds of billions of dollars in revenue for pharmaceutical companies.

Once you’ve determined why your cholesterol is elevated, and what other risk factors are present, Functional Medicine then outlines a treatment plan that is individual for each patient, based on this information.

Food First!

Diet is first and foremost in the treatment of high cholesterol and the discussion of heart and vascular disease risk. This doesn’t have to be difficult! The principles of a heart-healthy diet can be broken down to a few simple goals:

  • reduce the “white stuff” (sugar and processed and refined carbohydrates)
  • avoid unhealthy fats
  • eat more plants
  • choose high-quality protein sources

Functional Medicine does not believe in a “one-size-fits-all” diet approach. Based upon a person’s genetics, testing results, and the current state of health, various diet plans may be recommended, including:

  • A low glycemic load diet, such as “The Blood Sugar Solution” by Dr. Mark Hyman
  • A modified Mediterranean Diet such as the Institute for Functional Medicine’s Cardiometabolic Food Plan
  • A plant-based diet such as Rip Esselstyn’s Engine 2 Diet
  • A “paleo” diet such as Chris Kresser’s “Your Personal Paleo Code”

Laboratory studies are re-checked about three months after making diet change to assess the impact on disease risk.

Beyond Diet

Moving “beyond diet”, a Functional Medicine treatment plan for high cholesterol will focus on the underlying causes listed above, and the results of Advanced Laboratory Testing, and may include:

  • Treatment of low thyroid to achieve optimal thyroid levels (not simply “normal range”)
  • Stress-reduction and mind-body tools to lower cortisol output
  • Weight reduction to lower blood pressure and reduce sleep apnea
  • Treating insulin resistance and lowering blood sugars
  • Treating infections in the gut and restoring gut balance
  • Antioxidant support to reduce oxidation stress
  • Detoxification/chelation of heavy metals
  • A regular exercise program to increase cardiovascular fitness


Carin Nielsen, MD Integrative MedicineDo you have questions about a Functional Medicine approach to High Cholesterol or Cardiovascular disease risk? Are you ready to get your own evaluation started? 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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