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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”.


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“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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“Detox Jump-Start” - Five Tips for Success



1. GIVE YOURSELF TIME TO PREPARE.

Take time to look the kit over and become familiar with the diet plan. Make a shopping list and stock your kitchen for success!

2. IF YOU ARE CONSTIPATED, START THE COLON-X AND DRAINAGE PRODUCTS FOUR DAYS PRIOR TO THE DETOX START, RATHER THAN TWO.

You should never detox if you are constipated, you need to be able to “take the garbage out”! Ensure adequate bowel movements prior to starting.

3. IF YOU DRINK COFFEE, CUT BACK SLOWLY.

Stopping coffee “cold turkey” can cause headaches! Cut back slowly, down to 1/2-1 cup in the AM. If you desire, eventually stop completely or switch to decaf.

4. KEEP IN MIND - YOU MIGHT NOT FEEL WELL THE FIRST FEW DAYS OF THE DETOX PROGRAM. 

This is common. As your body begins to detox, you may experience symptoms such as headaches, fatigue, mental fog or irritability. Don’t worry! After a day or two these symptoms should subside. Drink plenty of water and get plenty of rest.

5. PLAN FOR LONGER THAN SIX DAYS!

While the kit says “6-Day Detox”, you will get more benefits if you extend your program. We ask clients to try to commit to a minimum of two weeks. With the exception of OptiCleanse GHI, all products in the kit contain a 30 day supply! As you wrap up your program, make note of how you are feeling, and consider re-introducing food groups one at a time. Allow about three days before re-introducing new foods, and monitor how you feel for 1-3 days after reintroduction. This will allow you to identify food sensitivities you may not have been aware of.

If you have any questions or concerns, don't hesitate to contact me at This email address is being protected from spambots. You need JavaScript enabled to view it.

Carin Nielsen, MD
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NUTRITIONAL WELLNESS:
USING MINDFUL AWARENESS TO EAT HEALTHIER IN THE NEW YEAR

Eating healthier is a common New Year’s Resolution, and for good reasons. Institutions such as Harvard Health1 and The World Health Organization2 report that a quality diet focusing on whole grains, healthy fats, high-quality protein, and colorful vegetable choices can positively affect our quality of life and decrease the risk of many chronic diseases. So if your resolution is to get healthy through changing your diet, good for you! Now, how to make that happen…

Sticking to resolutions and lofty goals can be tricky. How about starting with “simple awareness?” Learning to become aware of the emotional, physical, and nutritional triggers that alter our food choices is a great start to engaging in healthier eating patterns. Stress reduction3 and mindful eating practices4 can begin the process of becoming aware of why, what, and how you are eating. Additionally, over the long-term these techniques may have the potential to assist in changing your internal hormonal balance5, optimize the function of your gastrointestinal tract6, and help you meet your health, nutrition, and weight goals. Bringing awareness to our bodies and minds is the first step in helping us notice, understand, and change the “habit behavior” that can sometimes lead to poor diet choices and wreak havoc on our nutrition and weight goals. Over time, awareness followed by behavioral change can produce healthier eating patterns that last a lifetime.

Join Nina Fearon, RDN,and me, Katie Winnell RN, BSN, HEd., for a discussion on Nutritional Wellness. Together we can bring “simple awareness” to your 2017 New Year’s nutrition resolution.


Course Details

Tuesday January 24, 10am-12pm or 6pm-8pm
$40 per participant, advanced registration required

For more information or to pre-register: (231) 638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it.

View Mindful Eating Workshop Details.

References:
1. N.A. (N.D.). What Should I Eat? Retrieved from: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/.
2. N.A. (N.D.). Diet, nutrition and the prevention of chronic diseases. Retrieved from: http://www.who.int/dietphysicalactivity/publications/trs916/summary/en/.
3. Norris, (2011). Stress Reduction and Mindful Eating Curb Weight Gain Among Overweight Women. Retrieved from: https://www.ucsf.edu/news/2011/12/11091/stress-reduction-and-mindful-eating-curb-weight-gain-among-overweight-women.
4. N.A. (N.D.). Mindful Eating. Retrieved from: http://www.health.harvard.edu/staying-healthy/mindful-eating.
5. Bergland, C. (2015). Cortisol: Why “The Stress Hormone” Is Public Enemy No. 1. Retrieved from: https://www.psychologytoday.com/blog/the-athletes-way/201301/cortisol-why-the-stress-hormone-is-public-enemy-no-1.
6. Suarez K, et al. Psychological Stress and Self-Reported Functional Gastrointestinal Disorders. The Journal of Nervous and Mental Disease (March 2010): Vol. 198, No. 3, pp. 226–29.




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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“My health was continuing in a negative pattern, other programs weren’t working…I knew if I didn’t make changes now it would have dire consequences.”
-Sandra, age 63

Sandra was referred to our office by her family physician in August 2016 for help with weight loss. At 63 years old, her weight had been hovering between 190-200 pounds for the past 20 years. Despite regular exercise, including CrossFit, she had not been able to achieve lasting weight loss on her own.

LESSON #1 - YOU CAN'T EXERCISE YOUR WAY OUT OF A POOR DIET.

Sandra’s “weakness” was sugar. She loved to bake and her sweet tooth often took over, especially in the evening. She also had a fairly high-starch diet, with bread or muffin in the morning, and snacking on chips or popcorn later in the day.

LESSON #2 - WHITE FLOUR IS PROCESSED IN THE BODY JUST LIKE SUGAR.

Sandra’s plan was simple -
Rather than focusing on what she shouldn’t have, we focused on “stacking the deck”, a term we use to describe getting the right foods in earlier in the day to avoid over-eating later in the day. It’s more positive to think about the good foods you should be eating, rather than the foods you should be avoiding.

LESSON #3 - IF YOU DON'T GIVE YOUR BODY WHAT IT NEEDS DURING THE DAY, YOUR BODY WILL SEEK OUT WHAT IT DOESN'T NEED IN THE EVENING!

By focusing on protein, fiber, and healthy fat at key points during the day, Sandra was able to curb her nighttime snacking, and within a couple of weeks her sweet tooth had subsided.

12 weeks later:
  • Sandra had lost 18 pounds.
  • Her body mass index was no longer in the “obese” range. 
  • She took 4.5” off her waist, 2.25” off her chest, and 1.5” off her hips.
  • Her thyroid numbers were optimized.
  • Her blood sugar was no longer in the pre-diabetic range.

The best part? I saw her yesterday at the office, and one month after her program ended, she had maintained her weight loss!

When asked how our program was different from weight loss programs she has tried in the past, Sandra stated, “It was fairly simple in what to have. What to eliminate from eating. Not counting everything and just helping to make better choices…the encouragement from all of you was amazing.”

Are you ready for a change in the New Year?  
Visit www.CarinNielsenMD.com for more information,
or contact our office for an appointment 231-638-5585.



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 for general health and wellness and weight loss. 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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INFRARED SAUNA THERAPY

Frequently Asked Questions


b2ap3_thumbnail_InfraredSaunta.jpgWHAT IS AN INFRARED SAUNA?
An infrared sauna uses infrared light waves to penetrate deep into the body, heating it directly.
Infrared sauna treatments cause reactions in the body, including:
  • increased sweating
  • increased heart rate
  • the same type of clarity-of-mind feelings as moderate exercise
  • relaxation responses triggered by the body’s parasympathetic nervous system

HOW IS AN INFRARED SAUNA DIFFERENT THAN A CONVENTIONAL SAUNA?

An infrared sauna differs from “regular saunas” because their light directly penetrates your skin but does not warm the air around you. The results of a far-infrared sauna are produced at lower temperatures than a conventional sauna.


WHAT ARE THE POTENTIAL BENEFITS OF INFRARED SAUNA?
Potential benefits of infrared sauna may include:
  • Relief of stress
  • Relaxation of muscles
  • Reduction of chronic pain, including pain from arthritis
  • Enhanced detoxification
  • Improved heart function
  • Increased calorie burning
  • Improved skin appearance
  • Lowered side effects in Diabetes
  • Reduction of coughs/colds and Influenza
  • Overall improved well-being

WHO MIGHT BENEFIT FROM INFRARED SAUNA THERAPY?

As sweating is one of the most powerful detoxification tools of the body, anyone may benefit from infrared sauna treatments.

Some studies have shown benefits of infrared sauna therapy for people with:
  • cardiovascular disease
  • diabetes
  • high blood pressure
  • congestive heart failure
  • Improved heart function
  • rheumatoid arthritis
  • chronic muscle and joint pain
  • poor digestion
  • chronic depression and anger

OUR  INFRARED SAUNA THERAPY USES FAR-INFRARED LIGHT,
WHAT DOES THAT MEAN? 

All infrared sauna therapy is not the same!  There are different levels of infrared light: near, middle, and far.  These different levels represent the different sizes in infrared wavelengths and refer to the intensity of the treatment.

While near-infrared light may be helpful for wound healing and may help to warm the body. far-infrared light penetrates deeper in the body producing more sweat.  Potential benefits may include improved circulation, muscle relaxation, and enhanced detoxification.


SHOULD I BE CONCERNED ABOUT EMR (ELECTROMAGNETIC RADIATION) OR ELECTRICAL FIELDS)?

Our Finnleo® far-infrared sauna uses Pure Infra technology, which was developed to take the worry out of unnecessary exposure to EMR and EF. Simply put, no other infrared sauna system minimizes your exposure to EMR and EF better than Pure Infra. The electrical field in a Pure Infra is less than you’d experience from a computer screen or cell phone.




Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions.  Holistic therapies such as Infrared Sauna are just one way that we help patients "think outside the box". 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 MOOD CHANGES?

Time to check in with your Neurotransmitters.


PART ONE – LIGHT THERAPY AND VITAMIN D

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It’s that time of year. The days are getting shorter, the sky is getting darker. If you are one of the many people affected by the changing seasonal light patterns, you may be starting to feel physical symptoms such as:
  • Feeling more tired or feeling a need for more sleep.
  • Feeling “blue”, sad, or even depression.
  • Increased food cravings, especially carbohydrates.
These seasonal physical symptoms are thought to be caused by changes in your neurotransmitters. Neurotransmitters are brain chemicals that communicate information throughout our brain and body. Think of neurotransmitters as “brain hormones”. Proper balance of neurotransmitters is essential to regulate hunger, mood, cravings, energy, motivation, and self-image.

Learn more from my earlier blog “Get to Know Your Neurotransmitters”.

BOOST YOUR NEUROTRANSMITTERS THIS FALL: CONSIDER LIGHT THERAPY

As our daylight dwindles are you getting tired and grumpy?

b2ap3_thumbnail_CarinNielsen_LightTherapy225.jpgReduced exposure to sunlight in the fall and winter can be a major factor contributing to symptoms of seasonal depression, cravings, and fatigue. With light therapy (also called phototherapy), a light device (which is most often a light box but also available as a light visor) emits a full-spectrum light resembling sunlight. Light therapy is felt to work by regulating and improving the production of the neurotransmitters serotonin and dopamine (key chemicals in regulating mood, energy and food cravings).

For best results using light therapy:
  • Your light box or device should emit 10,000 lux (a measurement of light intensity).
  • You should sit with your face near the light, eyes open but not looking directly into the light.
  • Aim for 30 minutes daily, preferably in the morning.
Want to learn more about light therapy? Check out this article by Dr. Andrew Weil.

OPTIMIZE YOUR VITAMIN D LEVELS

b2ap3_thumbnail_CarinNielsen_Sunshine125.jpgVitamin D - the “Sunshine Vitamin”
Vitamin D is often referred to as the “Sunshine Vitamin”, however is not actually a vitamin at all! Vitamin D is a hormone that is produced in the body when your skin is exposed to sunlight. That being said, as the daylight hours lessen, so does your ability to produce Vitamin D. As a physician who has been routinely checking Vitamin D levels in my patients for many years, I can tell you that I rarely see an “optimal” Vitamin D level in the winter months without Vitamin D supplementation.

You may be aware of the numerous well-studied benefits of Vitamin D - including it’s role in bone strength, fracture prevention, healthy immune and nervous system function,and even prevention of certain cancers - but did you know that Vitamin D was also important in regulation of mood? Several studies have suggested that the symptoms of seasonal depression may be due to changing levels of Vitamin D3, which may affect serotonin levels in the brain (a key neurotransmitter in mood and appetite regulation).
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My Vitamin D recommendations:
  • Have your blood levels of 25 OH Vitamin D measured. While a number greater than 30 is considered “normal”, aim for an “optimal” level closer to 60.
  • If supplementing with Vitamin D, choose Vitamin D3, and take with a meal containing fat for best absorption.
  • While supplementing, recheck 25 OH Vitamin D levels approximately every three months.
Want to learn more about Vitamin D? Check out this article by Dr. Mark Hyman.


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.
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2252

How much Fish Oil are you really taking? Read the label!

As an Integrative and Functional medicine physician, I frequently recommend omega-3 fatty acids to my patients for a variety of reasons. Omega-3 fatty acids:
  • have potent anti-inflammatory benefits
  • are important components of cell membranes
  • help to maintain heart, brain and nervous system health

Omega-3 fatty acids are backed by volumes of research indicating their value in preventing conditions such as:
  • heart attack and stroke
  • autoimmune disease such as rheumatoid arthritis
  • certain forms of cancer
I most often recommend fish oil to supplement omega-3 fatty acids, because it is a rich source of the two active and essential omega-3 fatty acids known as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Other omega-3 rich supplements include cod liver oil and krill oil.

All omega-3 fatty acid supplements are not created equal!

WHAT YOU NEED TO KNOW ABOUT FISH OIL: 
  • EPA and DHA are the active omega-3 fatty acids in fish oil
  • When taking fish oil, the amount of EPA and DHA is what is most important, not total omega-3 fatty acids or total fish oil content.
  • The amount of EPA and DHA varies widely in different products.
  • Fish oil labels can be very deceiving.
  • The FDA does not regulate dietary supplements, so you need to know how to read labels!

HOW TO READ YOUR FISH OIL LABEL:

Look at the Serving Size.
How much of your product is considered a serving?
How much EPA and DHA is in each serving?
  • Remember, EPA and DHA are active omega-3 fatty acids, the rest of the omega-3 content is inactive.
  • Calculate how many servings you need to take to get your doctor’s recommended dose of EPA and DHA. 

Take a look at this example:

These two fish oil labels both contain 1000mg of fish oil, yet their EPA and DHA content is very different.

Product #1 contains 330mg of EPA and 250mg of DHA per serving (1 soft gel). Total EPA+DHA 580mg per serving.
b2ap3_thumbnail_MyFishOilLabel.jpg

Product #2 contains 250mg EPA+DHA per serving (1 soft gel). It does not specify amounts of each.
b2ap3_thumbnail_KirklandFishOil2.jpg

If your doctor was recommending 1000mg daily EPA+DHA, you would have to take:
  • 2 tabs of Product #1
  • 4 tabs of Product #2
Even though they both contain 1000mg of fish oil!

Take a look at this label. This product does not even specify EPA and DHA content:
b2ap3_thumbnail_WalMartFishOil2.jpg

IF A PRODUCT DOESN'T SPECIFY EPA AND DHA CONTENT, DON'T BUY IT!

——————————————

Our Balanced Fish Oil (available at my office and online at shop.carinnielsenmd.com) is:
  • High-Potency
  • Ultra-Pure
  • 2 soft gels provide over 1000mg EPA+DHA

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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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1936

Acupuncture is part of Traditional Chinese Medicine and can be traced back for at least 2,500 years.

The general theory of Acupuncture is based on the premise that there are patterns of energy flow through the body that are essential for health. This energy is referred to as Qi (pronounced “chee”). Disruptions of the flow of energy/Qi are believed to be responsible for disease.

Acupuncture works to correct imbalances of energy/Qi flow by stimulating anatomical points on the body. These points are stimulated using very thin, solid metallic needles placed at identifiable points close to the skin. The needles may be manipulated by the practitioner’s hands or by electrical stimulation.

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Three reasons it’s time to consider Acupuncture.

#1 NEARLY EVERYONE CAN BENEFIT FROM ACUPUNCTURE.

Regardless 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.

#2 THE BENEFITS OF AN ACUPUNCTURE APPOINTMENT OFTEN GO FAR BEYOND THE REASON YOU BOOK IT.

While localized pain such as tennis elbow, carpal tunnel syndrome and back pain are common reasons for seeking acupuncture treatments, the treatment itself provides full-body benefits. Many different acupuncture points are stimulated throughout the body. Those who participate in Acupuncture often report an overall feeling of calm, relaxation and well-being after their treatment

#3 ACUPUNCTURE IS A SAFE ALTERNATIVE TO PRESCRIPTION MEDICATION.

While prescription medication may sometimes be necessary, the risk of adverse reactions and potential side effects can be staggering (all you have to do is turn on the television at night to hear the long lists of medication side effects that permeate commercials). Acupuncture can provide a safe and effective alternative with much less risk and few negative side effects. In addition, Acupuncture has been proven to treat the side effects of many chemotherapies, especially nausea and vomiting.

Are you ready to start your trial of Acupuncture? Contact our office or visit our website for more information.

Yours in Health,
Carin Nielsen, MD



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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2434
Thyroid Basics

b2ap3_thumbnail_Thyroid1.jpgYour thyroid gland is part of your hormone system (also referred to as your endocrine system). The thyroid gland is shaped like a butterfly and is located inside your neck over your windpipe.

The thyroid gland plays a major role in regulating metabolism and weight. Thyroid hormone is also involved in many other physiological processes in the body, and it's effects are linked directly to your bowels, skin, muscles, gums, and more.

Balanced thyroid hormone is essential to prevent weight gain, ensure adequate energy and mood, proper internal temperature regulation, normal skin tone and consistency, muscle stamina.

LOW VS HIGH THYROID

It is far more common to have low thyroid than high thyroid levels.
When you have a low functioning thyroid it is called hypothyroidism.
Symptoms of hypothyroidism include:
  • fatigue 
  • dry skin
  • weight gain
  • constipation
A less common condition is hyperthyroidism, when your thyroid is over-active.
Symptoms of hyperthyroidism include:
  • weight loss
  • “bulging” eyes
  • hot flashes
  • rapid or racing heart beat
UNDERSTANDING THYROID TESTING 

b2ap3_thumbnail_Thyroid2.jpgTSH = Thyroid Stimulating Hormone
TSH (Thyroid Stimulating Hormone) is made by your brain, not by your thyroid. Your brain makes TSH when it senses that your body needs more thyroid hormone. The TSH made by the brain sends a signal to the thyroid to make more thyroid hormone. 

When thyroid hormone levels in your body are low, the brain makes TSH to "turn on" your thyroid.
  • TSH high = body needs more thyroid hormone
  • TSH low = body does not need more thyroid hormone
The TSH is only test many doctors will order to evaluate thyroid function, however relying on the TSH alone does not give you a complete picture of thyroid function, and may miss a certain percentage of people with low thyroid hormone.
If you have symptoms of low thyroid and are told your TSH is "normal" - test beyond the TSH!

T4 and T3
Your thyroid makes different types of thyroid hormones. The two most important are T4 and T3.
Here’s what you need to know about T4 and T3:
  • You make much more T4 than T3
  • T4 gets converted in your tissues to T3
  • T3 is far more active than T4
Why does this matter?
If you have a normal TSH, but a low free T3, you will have all of the symptoms of low thyroid (hypothyroid) even though your doctor tells you that your thyroid is “fine”!
b2ap3_thumbnail_Thyroid3.jpg

(the lab tests shown here are taken from a recent patient of mine who had this issue)

BOTTOM LINE:
  • listen to your body
  • test beyond the TSH
  • know your levels of T3 hormone
My standard thyroid laboratory testing always includes:
  • TSH
  • Free T4 hormone 
  • Free T3 hormone
Additional testing often ordered include:
  • Reverse T3 (which “hides” T3 and prevents it from dong it’s work)
  • Thyroid Antibodies (to evaluate underlying autoimmune disease)

Have questions? Feel free to send me an email. Ready to learn more about your thyroid? Contact our office to book an appointment for your thyroid evaluation. 231-638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it..

Yours in Health,
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, 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.
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1975
Three ways we can help you find your balance with diet and lifestyle change this winter.

#1 - DETOX JUMP-START
  • Enhance Detoxification
  • Reduce Inflammation
  • Improve Digestion
Let our staff design a detox schedule to meet your needs.

Using the Xymogen™ 6-Day Detox Kit, combined with a modified elimination diet, we can extend your detox up to 28 days, and modify your program as needed based upon your symptoms and your schedule.

A Detox Jump-Start is a great way to kick-off your weight loss program, break sugar cravings, and refresh your body and mind. Benefits may include:
  • improved energy
  • reduced bloat and body fat
  • decreased joint discomfort
  • improved focus and mental clarity
Click Here for more information about our Detox Jump-Start program, or This email address is being protected from spambots. You need JavaScript enabled to view it. to book your appointment!


#2 - ULTRALITE™ DIETARY KETOSIS WEIGHT LOSS PROGRAM

  • Reduce hunger and cravings
  • Increase mood and energy
  • Fast, visible results
The UltraLite™ dietary ketosis weight loss program is great for those who are motivated and ready for fast weight loss results.

The program combines an elimination diet with a balance of protein and carbohydrate to put your body into a mild state of dietary ketosis. This biochemically sets the body to burn your own fat as fuel for maximal fat loss. People will typically eat less protein than they normally do, but enough to not lose muscle mass (a key issue with weight loss is to protect your muscle mass; as muscle mass is your body's calorie burning engine).

Click Here for more information about the UltraLite™ program, or This email address is being protected from spambots. You need JavaScript enabled to view it. to book your appointment!


#3 - MY OPTIMAL DIET
CUSTOMIZED DIET AND LIFESTYLE CHANGE PROGRAMS


Looking for a program with more flexibility? My Optimal Diet 12-week Diet and Lifestyle Change Programs are physician-supervised, customized for your needs, and provide three months of one-on-one support to help you meet your goals.

Our unique approach to healthy diet and lifestyle change involves more than just counting calories. We explore a variety of factors that can contribute to poor health and weight gain, including:
  • hormone imbalance
  • high levels of stress
  • medication side effects
  • thyroid disorders
  • depression and anxiety
In addition, the types of food you are eating can have a strong impact on your weight gain, not to mention your energy level and mood.
There is no “one-size-fits-all” program in our office! Each 12-week program is designed to meet your needs and may include:
  • testing for hormone imbalance and vitamin deficiencies
  • customized meal schedules and food choices
  • protein-packed meal replacement products
  • prescription weight loss medication when appropriate
  • behavioral therapy to curb binge eating
  • vitamin and supplement support
  • acupuncture, massage, and more!
Click Here for more information about My Optimal Diet, or This email address is being protected from spambots. You need JavaScript enabled to view it. to get started!



Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to help them lose weight and improve their mood and vitality.  A "one size fits all" program where you simply sign up and go through the steps doesn't address the underlying factors that caused 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.

Yours in Health,
Carin Nielsen, MD


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2015
b2ap3_thumbnail_breast-cancer-ribbon2.png
Earlier this week, I introduced the concept of estrogen metabolites, which are formed when estrogens are metabolized through the liver.  Why do I care about estrogen metabolites?  Because certain types of estrogen metabolites are associated with a higher risk of Breast Cancer.  
 
Estrogen metabolite testing can give you an idea of which path estrogen is taking in your body.  
 
If you discover that estrogen is taking an “unhealthy path” in your body, you can take measures to correct this!

 
Three Reasons to Consider Estrogen Metabolite Testing
 

#1 - You are post-menopausal and considering hormone replacement therapy.
 
This is probably the most common reason I perform estrogen metabolite testing.  If unhealthy levels of “bad” estrogen metabolites are found on testing, this should be considered before adding hormone therapy to the mix, and may lead to:
  • consideration of non-hormonal alternatives or use of lower hormone doses
  • lifestyle measures to promote a healthier hormone balance
  • targeted supplementation to reduce risk
 
#2 - You are peri-menopausal and experiencing symptoms of hormone imbalance.
 
Symptoms of an “estrogen overload” pattern in peri-menopause (usually in the mid to late 40s)  include breast swelling and tenderness, weight gain, fluid retention, increased PMS, mood swings, and insomnia.  Identifying hormone imbalance during this time-period may help to direct therapies that alleviate symptoms and reduce breast cancer risk, and may include:
  • adding progesterone or herbal therapies to combat the potential dangers of elevated estrogen
  • focusing more intensely on lifestyle changes such as weight loss and alcohol reduction
  • dietary changes to limit animal fat and increase intake of cruciferous vegetables
 
#3 - You are at an elevated risk for breast cancer, or have a personal history of breast cancer, and you want to look for other potentially modifiable risk factors.
 
If factors that are not in your control (such as family history and genetic patterns) have put you at a significant risk for breast cancer, or if you are a breast cancer survivor, you may be looking to identify every possible risk factor that can be avoided.  Estrogen metabolite testing can be used as part of this process to examine what path the estrogen is taking in your body.  The results may help you to lower your risk of breast and other estrogen-related cancers through:
  • considering prescription medication to reduce risk
  • reducing toxin exposure to prevent formation of harmful estrogen metabolites
  • providing methylation support to inactivate harmful metabolites, and/or antioxidant support to prevent DNA damage if needed

If you are interested in hormone testing or would like to learn more, send me an email!  This email address is being protected from spambots. You need JavaScript enabled to view it.
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Breast Cancer Risk

THE ROLE OF ESTROGEN METABOLITES 

b2ap3_thumbnail_breast-cancer-ribbon2.pngBased on current estimates, 12.4 percent of women born in the United States today will develop breast cancer at some time during their lives. This means, if the current incidence rate stays the same, a woman born today has about a 1 in 8 chance of being diagnosed with breast cancer at some time during her life.

Hormone balance is one of the most common reasons women seek care in my office. As an Integrative and Functional Medicine physician, my role is to provide effective testing and assessment of hormone imbalance, and outline personalized recommendations to reduce my clients’ risks. I use estrogen metabolite testing to evaluate and assess Breast Cancer risk.



BREAST CANCER RISK FACTORS


When examining your potential risk for developing Breast Cancer, a variety of factors should be taken into consideration.
There are some risk factors for Breast Cancer that are out of your control, such as:
  • genetic variants/gene mutations
  • family history
  • reproductive history
  • high-dose radiation exposure to the chest
Other risk factors for Breast Cancer you have more control over and are modifiable:
  • high endogenous estrogen (elevated levels of estrogen in the body)
  • hormone therapy
  • obesity
  • alcohol consumption
Estrogen metabolites are additional factors that can be measured in your urine and considered when evaluating Breast Cancer risk. Estrogen metabolites are formed when estrogen is metabolized through your liver. This process is influenced by a combination of your genetics and environment. The type of estrogen metabolites that you produce in your body may have an impact on your Breast Cancer risk.

ESTROGEN METABOLITES 
Which path does estrogen take in your body?
  • Estrogen metabolites are formed when estrogens are metabolized through your liver.
  • There are different types of estrogen metabolites, and certain types may be associated with a higher risk of Breast Cancer.
  • The types of estrogen metabolites that are produced in your body are impacted both through genetic and lifestyle factors.
Estrogen metabolites are formed when estrogens are processed through your liver.
All estrogen is metabolized in your body through pathways in your liver. It doesn't matter if the estrogen is made in your body (from your ovaries or through conversion in your fatty tissues) or if you are taking estrogen in from the outside (whether intentionally through hormone therapy or birth control pills or unintentionally through xenoestrogens in the environment). It all gets processed, or metabolized, in this way.


There are different types of estrogen metabolites, and certain types may be associated with a higher risk of Breast Cancer.
Think of estrogen being metabolized through the liver like it is traveling along a complicated map route. There are a number of factors that affect the route it takes, and different routes produce different estrogen metabolites. 
b2ap3_thumbnail_complicated_map_route.jpg


The three key estrogen metabolites measured and their relative risk of Breast Cancer include:

Estrogen Metabolite                  Association with Breast Cancer Risk
2-hydroxyestrone (2-OHE1)                          lower risk
16 alpha-hydroxyestrone (16a-OHE1)            higher risk
4-hydroxyestrone (4-OHE1)                          highest risk


2-hydroxyestrone (2-OHE1) binds very weakly to target tissues, and has even been shown to have anti-estrogen properties. In contrast, 16 alpha-hydroxyestrone (16a-OHE1) is a powerful metabolite that stimulates target tissues. High levels of this potent metabolite are linked to increased risk and poorer prognosis in conditions linked to estrogen excess such as breast cancer and lupus. It is desirable to have a higher ratio of 2-OHE1 to 16a-OHE1 metabolites.

4-hydroxyestrone (4-OHE1) is considered a “bad” estrogen metabolite because it can easily convert to compounds that directly damage DNA, potentially increasing risk for initiation of Breast Cancer.

b2ap3_thumbnail_estrogen_metabolite2.jpg

The types of estrogen metabolites that are produced in your body are impacted both through genetic and lifestyle factors.
If you have a genetic variant in one or more of these pathways, this can affect your ratio of estrogen metabolites and impact your risk of Breast Cancer.

Estrogen Metabolite                                Genetic Pathway
2-hydroxyestrone (2-OHE1)                     CYP1A1
16 alpha-hydroxyestrone (16a-OHE1)       CYP3A4
4-hydroxyestrone (4-OHE1)                     CYP1B1


Diet and lifestyle patterns also affect which types of estrogen metabolites are produced in your body. Factors that are known to promote a healthier estrogen metabolite ratio and lower risk of Breast Cancer include:
  • higher intake of cruciferous vegetables, lignans (flax seed) and whole soy
  • reduction of body fat
  • reduction of exposure to pesticides
  • reduced intake of alcohol
  • higher omega-3 fatty acid intake
  • regular exercise

DETERMINING ESTROGEN'S PATH IN YOUR BODY.

In my office, I measure estrogen metabolites primarily through the urine (there is a report example below). In premenopausal women, this is done with a first-morning urine on day 21 of the menstrual cycle. In postmenopausal women, this is done with a 24-hour urine collection. The test can be repeated to follow-up targeted lifestyle therapies and supplement protocols.

b2ap3_thumbnail_estrogen_metabolite.jpg



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.
 
 
 
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2296
No matter where you live, the summer season can quickly turn into one big party! Tuesday night suddenly looks like Friday night, friends and family come out of the woodwork, and the picnics, BBQs and cocktails start becoming daily activities.

Suddenly, healthy eating becomes even more of a challenge.

Challenging, yes - but not impossible! Let me share with you the same advice I give my patients everyday - when it comes to food, don’t focus on what you shouldn’t be eating, instead focus on the foods that you need to eat at key points during the day to maintain energy, boost metabolism, and avoid over-indulging.

CONSIDER THESE THREE SIMPLE STEPS TO PREVENT SUMMER DIET SABOTAGE:

b2ap3_thumbnail_ProteinShakes.jpg1. Start your day with protein and fiber

Cereals, donuts, toast and bagels all cause a rapid rise in blood sugar (and insulin) that is followed by a blood sugar crash within hours. This can cause your energy level to plummet and can spark strong hunger and cravings. Starting your morning with protein and fiber promotes consistent energy by avoiding a blood sugar crash, boosts metabolism to promote weight loss and keep you full, often until lunchtime!

A protein shake/smoothie is an excellent way to start your summer days. Read more about reasons to start your day with a protein shake.


b2ap3_thumbnail_salad.jpg2. “Stack the Deck”
This is a concept that I frequently discuss with my patients. "Stacking the deck" simply refers to giving your body the food that it needs earlier in the day to promote stable mood and energy and reduced food cravings later in the day. If you know you have a party or event later in the evening, the last thing you want to do is starve yourself in anticipation! Not only will this increase cravings and decrease willpower, it can cause rapid mood swings. In addition, not eating during the day makes your body feel as though it is starving, which switches your metabolism to "fat-storing" mode instead of "fat-burning" mode.

3. Fill up on the good stuff first
Have you ever been to a Mexican restaurant? If you have, then you have probably gorged yourself on a basket of chips and salsa - filling yourself up before your meal even comes to the table!
Let's turn this scenario around. What if they brought out the basket of chips after you finished your meal? Would they still be as appealing? No way! Think of this as you plan your eating for your next party. Fill your plate with vegetables first. By filling up first with foods that are high in fiber and low in sugar, you will be less likely to over indulge in unhealthy choices without feeling deprived.

You can visit our online store to learn more about products we have available to help support you this summer, including my physician-formulated Balanced Vegan Protein Shake Mix, Appetite Support Formula, Starch Blocker, and Balanced Liver Support. 

b2ap3_thumbnail_CN_TheEssentialsStore.jpg

I'd love to hear your comments or questions. Feel free to message me directly at This email address is being protected from spambots. You need JavaScript enabled to view it..

Be Well!
Carin Nielsen, MD
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2078

An Introduction to Mindfulness Practice
By CHRIS FRASZ, BS, MSW

Chris Frasz, BS, MSWMindfulness, an eastern meditation practice with a history of over 2,500 years, was established as a foundation for developing a clear and focused mind, allowing one to then analyze in depth various topics for self improvement.

With the gradual introduction of this practice to the west in the 60’s, interest has gradually built, supported by a great deal of research and empirical evidence, clearly showing many mental and physical benefits. Now, the practice of mindfulness is part of our culture, being incorporated extensively throughout the United States, from hospitals to businesses, from schools to professional athletic teams. Most recently, 60 Minutes aired a segment on mindfulness, touting both its efficacy and widespread use.

Mindfulness practitioners learn to better understand and regulate their thoughts, thus taking a more active role in improving their mental well-being. With developed stability and awareness, practitioner’s benefit by viewing and relating to their mental and physical states in a more objective and healthy manner. And, as the medical world builds empirical evidence relating to the connection of one’s mental and physical well-being, the mental growth and improvement has shown significant physical benefits, including:

  • Lower blood pressure
  • Lower heart rate
  • Increase in immune system
  • Stress reduction
  • Growth of grey matter in the brain (Psychiatry Research: Neuroimaging)

Within our upcoming course, Introduction to Mindfulness for Stress Reduction, we review the mindfulness practice in detail, giving participants various ways of engaging in the practice and the rationale behind why and how the practice is effective. Guided, in-class participation, combined with discussion and presentation, enables participants to learn and grow in a supportive and safe environment. Active engagement allows participants to build their own practice and create a foundation for future growth.


Chris Frasz received his B.S. from Michigan Technological University and his Masters Degree in Social Work from the University of Michigan, Ann Arbor. He has many years of experience teaching Mindfulness Meditation at a variety of levels, drawing on his exposure to various meditation techniques from both Western and Eastern meditation teachers, including Jon Kabat-Zinn, Kyabje Gehlek Rimpoche and others. His background in engineering, business, social work, and family life give him a unique perspective in understanding and working with the various stressors related to work, family, and life in general. If you are interested in learning more about the benefits of mindfulness and our Introduction to Mindfulness to Stress Reduction courses, 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 yesterday's blog I gave an overview of Neurotransmitters, brain chemicals that communicate information throughout our brain and body.  These “brain hormones” are essential for optimal mood, energy and weight!  Treating thousands of patients over the last ten years, I have learned that a proper balance of neurotransmitters is a key first step when embarking on a program toward lasting lifestyle change.  Take my short quiz to assess how neurotransmitter imbalance may be affecting your mood as well as your appetite and hunger patterns.  


Take my short quiz to assess your neurotransmitter balance.


CHOOSE 1-2 STATEMENTS FROM EACH GROUP BELOW THAT MOST APPLY TO YOU:
 
1.b2ap3_thumbnail_brain.jpg
A.  I consider myself a low-energy person
B.  I have trouble relaxing
C.  I am easily irritated, I can be quick to “snap"
D.  I am forgetful
 
2.
A.  I have trouble motivating to exercise
B.  I often feel "stressed out”
C.  I have poor self-esteem or poor body-image
D.  My memory is poor
 
3.
A.  I frequently seek out sugar/candy 
B.  I "binge", eating large amounts of food at one time
C.  I crave starchy carbohydrates, like pasta
D.  I crave fatty, fried foods like hamburgers and pizza
 
4.
A.  I consume caffeine throughout the day (coffee, soda)
B.  I am an emotional eater
C.  I have higher food cravings in the evening
D.  I prefer creamy deserts like cheesecake and ice cream
 
 
RESULTS:
 
- If you chose “A” for two or more of these statements, you may have low dopamine levels.  
 
Improving low dopamine levels:
  • ensure adequate intake of foods rich in tyrosine: including most animal products, green leafy veggies, avocado, vegetables, green tea, chocolate, coffee
  • supplement with L-tyrosine, the building block of dopamine, and/or ginkgo billoba*
  • exercise boosts dopamine levels
 
 
B - If you chose “B” for two or more of these statements, you may have low GABA levels.
 
Improving GABA levels:
  • increase intake of shellfish, broccoli, brown rice, bananas
  • start a regular yoga practice
  • consider supplementation with l-theanine, taurine, glutamine, leucine, and/or inositol*
  • learn to meditate
 
 
C - If you chose “C” for two or more of these statements, you may have low serotonin levels.
 
Boosting serotonin levels:
  • ensure  adequate protein intake at key times during the day
  • supplement with 5-HTP, samE, and/or melatonin*
  • increase B-vitamins (especially B6) and magnesium*
  • stress management (elevated cortisol produced with stress breaks down serotonin)
  • heal your gut - 90% of your serotonin is produced in the gut
 
 
D - If you chose “D” for two or more of these statements, you may have low acetylcholine levels.
 
Improving acetylcholine levels:
  • increase intake of eggs, avocado, olives, nuts and seeds
  • increase Vitamin B5 intake*
  • consider supplements such as phosphytidyl serine or choline* 
 
*Each individual is different, and the pattern of neurotransmitter balance may be different for each person.  Nutritional supplements may interfere with each other, or with prescription medication.  Consult with your health care provider, or consider working with an Integrative Medicine Specialist, prior to starting nutritional supplements to treat a medical condition.



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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