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There are a number of reasons why starting your day with a protein shake or smoothie is a great idea.
Here are my top 3 reasons to get you thinking about what your breakfast has to offer!

1. It gives you energy and keeps you full.

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Sugary cereals and donuts and gluten-filled bagels 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! 


2. It's healthy and quick to make!

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Toss your ingredients in the blender and you have a healthy, delicious breakfast in minutes.

If you are really pressed for time, use a shaker bottle to mix your shake on the go.

 

3. It's an easy way to pack more greens and super foods into your day.

blender_bottle.jpgb2ap3_thumbnail_smoothiegreen.jpgA shake or smoothie is a great way to add extra servings of the foods your body needs to stay healthy and strong! You can add handfuls of greens such as spinach or kale. Blend in 1/2 cup of dark berries for added flavor and antioxidants. A tablespoon of ground flax seed can increase fiber and improve detoxification. Use up what is left in the fridge and pack the nutrients in!

I don't just encourage my patients to start their day with a breakfast rich in protein, fiber and micronutrients - I do so myself! Most mornings I begin my day with a nutrient-packed Vegan Protein Shake. While I always start with a high-quality protein-powder base, I customize the ingredients to match my needs each day. Here are a few of my favorite tips:

  • I like to make my smoothie with 1/2 water and 1/2 unsweetened coconut or almond milk. This keeps the sugars low but allows for a creamer texture and more full flavor.
  • If I know my day will be jam-packed with patients or meetings, I make a double batch in my blender and save a second shake for mid afternoon. This allows me to maintain consistent energy during they day, and by the time I get home I can make a nice dinner without feeling like I have to raid all of my cupboards!
  • I often freeze my greens, such as organic spinach and throw 1-2 large handfuls in my blender in the morning. This prevents my greens from spoiling and adds a nice texture to my shake (my mom likes to use Watercress).
  • For patients who are often constipated, I recommend 1-2 TBSP ground chia seed for added fiber and promotion of regular bowel movements.


b2ap3_thumbnail_ProteinShakePhoto.jpgClick here for more information on my physician-approved Balanced Vegan Protein Shake mix. It's 100% vegan, 100% non-GMO, packed with fiber and micronutrients, and is a great value!

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..


Yours in Health,

Carin Nielsen, MD

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2089

Meet Diane*

b2ap3_thumbnail_blog_foodismed_hands.jpgWhen we first met this past September, Diane was looking for both weight loss and an Integrative/Functional Medicine approach to her Rheumatoid Arthritis. She had been diagnosed with Rheumatoid Arthritis about 6 years earlier, and she had nodules and joint pain and stiffness in both her hands and her feet. Her pain had been worsening to the point where walking was very painful and she had become more sedentary. Her rheumatologist had recently recommended she move to an expensive intravenous/infusion medication to treat her joint pain pain and avoid further joint destruction. Diane was frightened by the thought of starting these infusions, worried about potential long-term side effects. She told me that she was in the process of scheduling her first infusion but felt was doing so while "kicking and screaming".

I asked Diane to postpone her first injection and give me two weeks to guide her to results both with weight loss and reduction of join pain. Diane agreed and started a Functional Medicine approach to her care, based on the concept of using Food as Medicine.
  • After 2 weeks Diane had lost 8 pounds and was pain free in her feet. Most of the pain was gone from her hands with the exception of some mild pain in her left wrist.
  • At 5 weeks she had lost over 12 pounds and had no pain with increased movement and activity.
How did Diane achieve such amazing results in such a short period of time? She did it by changing the information she was giving her cells, removing the foods that were promoting inflammation and activating her immune system to work against her. Diane did this simply by changing her diet through the use of a comprehensive elimination diet.

Food is Medicine

b2ap3_thumbnail_blog_jan2_salad.jpgOur bodies are made up of trillions of tiny cells. These cells work together to form all of our organs, our blood vessels, our nerves, our muscles and everything else that makes us, well us!

Each cell in your body contains your complete genetic code. Depending on where the cell is in the body, the cell will read a different part of the genetic code to do it's job (muscle cells read the muscle part of the code, skin cells read the part of the code that codes for skin, etc.).

Your cells will also activate different parts of the code depending upon the information that is presented to them.

Food is information

The food that you eat provides information to the cells of your body that tells the cells what to do! Food actually does this job as well if not better than prescription medication can! The type of food information presented to your cells can change the way the cells works by activating different parts of the cell's genetic code. For example, sugar activates the genes in our cells that promote the production of inflammation.

b2ap3_thumbnail_blog_jan6_cell.jpgIs this starting to make sense? The food that you eat can either activate or "quiet down" your immune system. And, like the example above, the food that you eat can activate pathways that increase inflammation, or activate other pathways from your genetic code that reduce inflammation.

You might ask, why is it that certain foods negatively affect some people more than others? This is because we are all working off a different genetic code, or what I like to call our genetic "blueprint". This is also the reason why certain medications affect some people differently than others. Because we are all working off of a different "blueprint" (which makes us biochemically unique), we don't all respond to food in the same way. This concept is the basis for Nutrigenomics. a growing area of research that is focused on the effects of food on gene expression. We use the concepts of Nutrigenomics in my office every day when prescribing elimination diets for patients to treat various medical conditions.

The Elimination Diet
learning how foods affect your gene expression

In my office, we do not believe that there is one optimal diet that works best for everyone, because we know that based on our different genetic blueprints, we will all have different nutritional needs. We work with our patients to help them determine their own optimal diet for optimal health and vitality. An elimination diet can be an effective tool in doing so.

An elimination diet can allow you to determine how food is affecting your gene expression. More simply put, it allows you to figure out how different foods make you feel. By removing certain foods from your diet for a period of time, then re-introducing them, you can experience which foods are "working for you" and which are "working against you". Based on your symptoms or medical condition, the list of foods that will be recommended for you to remove may vary. Foods are generally removed for a period of at least 3 weeks, and then they are reintroduced one at a time, allowing 3-4 days before reintroducing another food in order to assess for delayed reactions in the body.

In Diane's case, her list of foods to remove from her diet included:
  • gluten
  • dairy
  • sugar
  • soy
  • corn
  • eggs
  • peanuts
  • nightshade vegetables
  • citrus fruits
You might look at this list and ask "well what could she eat then"? That's easy! We asked her to focus on:
  • lots of vegetables and fruits
  • clean, lean proteins
  • nuts and seeds
  • healthy fats
  • gluten-free, high-fiber starches and grains (like rice, quinoa, sweet potatoes and beans/lentils)

b2ap3_thumbnail_blog_foodismed_feet.jpgBecause Diane was also interested in weight loss, she limited her starches and grains to not more than 2 servings per day. She also utilized a vegan protein meal replacement in the morning for breakfast (meal replacement can be very helpful with the elimination diet because it takes some of the "work" out of meal preparation and provides essential amino acids).

We use elimination diets frequently in the treatment of autoimmune disease as well as a number of other conditions including irritable bowel syndrome, fatigue, brain fog, chronic headaches and weight gain.

At this point, Diane is 12 weeks into her journey. She is 15 pounds lighter. She no longer needs to consider the infusion therapy and she is still pain-free. We will be spending the next 12 weeks continuing her weight loss efforts, attempting some food reintroduction, and assessing for other underlying imbalances that may be contributing to her autoimmune disease such as the health of her digestive tract and the possibility of heavy metal toxicity. Stay tuned!

Yours in Health,
Carin Nielsen, MD

*while this represents a true story, the patient name has been changed to protect his/her identity and privacy

Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including autoimmune disorders like Rheumatoid Arthritis. Treating autoimmune 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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Turn on your body's fat-burning switch!

Meet Karen*, age 65

This past fall, Karen was looking to lose 10 pounds.
She lost even more than that in just 4 weeks with Ultra Lite™!

Integrative Medicine Weight Loss UltraLiteAt age 65, Karen was healthy and energetic. She took very little medication and had few concerns about her health. There was one thing that was nagging at her - her waistline. Since menopause, Karen had slowly put on about 10 pounds, and it wouldn't come off! Her Body Mass Index (BMI) was still considered in the "normal" range, but her clothes weren't fitting well and she just didn't' feel comfortable in her own body. With the Holidays approaching she was looking for a program that would produce results - fast!

Karen started the Ultra Lite™ to jump-start her weight loss. After one week she had lost 7.6 pounds, and after four weeks she was down 12.6 pounds. She lost 4.5 inches off her waist and 3.4 inches off her hips. Best of all, she felt full of energy!



What is Ultra Lite™?

Ultra Lite™ is a dietary ketosis weight loss program. It is designed to reduce hunger and cravings, increase mood and energy and maintain muscle mass while burning fat.  Ultra Lite™ is a great program for those who are motivated and ready for fast weight loss results or are looking to "jump-start" their weight loss/


How does Ultra Lite™ work?

The Ultra Lite™ program combines a balance of lean protein and limited high-quality 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. 


What is dietary ketosis?

The cells of your body typically use glucose, or blood sugar, as their primary source of fuel (I discussed this recently in my post about insulin resistance). When the amount of carbohydrates in your diet are restricted below a certain level, the cells of your body change their fuel!  They go from burning sugar for fuel to burning fat.  When you begin to burn fat as your primary fuel, your body produces ketone bodies which are circulated in your bloodstream.  The circulating ketone bodies have the benefit of reducing hunger and increasing energy and mental clarity.  You can measure the levels of ketone bodies in your urine to stay in maximal fat mode.  (Nationally known Functional Medicine neurologist Dr. David Pearlmutter makes an argument for lifelong dietary ketosis in his best-selling book "Grain Brain")


Is Ultra Lite™ a high-protein diet?

No! As a matter of fact, 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).

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How is Karen doing?

Well, 2 weeks after transitioning out of dietary ketosis and into a normal, balanced diet, Karen was doing fantastic!  She had lost nearly 3 more pounds and her energy was still soaring high.

Are you interested in the Ultra Lite™ weight loss program? This is just one tool of many that I use with clients to customize weight loss and lifestyle change programs for their needs. Learn more about my approach to weight loss by visiting our website www.MyOptimalDiet.com.  

Yours in Health,

Carin Nielsen, MD

www.CarinNielsenMD.com

*while this represents a true story, the patient name has been changed to protect his/her identity and privacy.



Carin Nielsen, MD Integrative MedicineI 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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What causes problems with your gut... and what to do about it.

We have a recurring theme this month. It's about our cells and the information we present to them.

Integrative Medicine Leaky GutRemember, our bodies are made up of trillions of cells, and each cell contains a complete copy of our genetic blueprint, which makes us unique. Different parts of our blueprint will be activated in different cell types (muscle cells vs. skin cells).  The parts of the blueprint activated will also change depending upon the information presented to the cell. Food is information.  Many people do not realize that the information our food gives the cells in our body is as powerful, if not more so, than the information provided by prescription medicine.  Let's take this one step further - do you know how one medication may cause side effects in one person but not another?  That is because of our different genetic blueprints.  The same thing happens with the food that we eat.  Depending on our blueprint, the food that we eat will affect us differently.

Recently, I wrote about the gastrointestinal (GI) tract, or gut, and the huge role it plays in our immune system, nervous system, mood and more. I explained how a properly-functioning digestive system works, and also what can go wrong and cause gut imbalance and "leaky gut" - leaking food particles and proteins into your bloodstream that the cells of your immune system don't recognize, activating inflammatory pathways which can lead to many medical problems, including autoimmune disease, eczema, fatigue and more. Today we'll explore the causes behind "leaky gut" and how to repair and rebalance your GI tract.

Causes of "Leaky Gut"

There are many factors that can contribute to your GI tract becoming out of balance, including:
  • Chronic stress and use of over-the-counter pain medications, antacids or PPIs (proton pump inhibitors like Prilosec or Nexium) reduce your stomach acid. Other medications can reduce saliva production.
  • If your gallbladder has been removed you lack the "control switch" on your bile salts. 
  • High intake of sugar, alcohol or genetically modified (GMO) food can break down the protective mucus barrier that lines your intestines.
  • Loss of "good bacteria" from low fiber intake and use of antibiotics may impair digestion and breakdown of food particles and increase growth of "bad bacteria", which along with toxins and irritants can attack and break down both the mucus barrier and the intestinal wall.

Healing your leaky gut.

Identifying and healing your core gut imbalances is one of the most important first steps you can take to promote health and well-being. Originally pioneered by naturopathic physicians, the "4Rs" program of gut repair is used routinely by Functional Medicine physicians to restore health and balance to the GI tract.

The "4Rs" Program

REMOVE - Get rid of what might be irritating your system! Start an elimination diet to remove commonly offending foods. Consider testing for food sensitivities with IgG antibody testing. Identify any abnormal bacteria, yeast or parasites with functional stool testing (I use the "GI Effects" test from Genova Diagnostics) and take appropriate measures to remove them!

REPLACE - Replace any missing factors needed for proper digestion. Working with a functional medicine practitioner can be useful to identify which enzymes or acids are missing. Betaine HCL can be used to replace low stomach acid, digestive enzymes can replace low pancreatic enzymes, and bile salts can be added if needed. The idea is not to remove acid, but rather to support your digestion with the acids and enzymes it needs, giving your gut less work to do!

REINOCULATE - Add back "good bacteria" with a high-quality probiotic blend and promote growth of good bacteria by increasing your intake of fiber and fermented foods.

REPAIR - Promote healing of the GI tract lining by supplying needed nutrients, such as zinc, antioxidants, fish oil, and glutamine.

In my experience, patients generally see positive results in as little as 10 days of this process, with less pain, bloating and stiffness, clear skin, improved energy and mental clarity.


Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com



Carin Nielsen, MD Integrative MedicineI 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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The Functional Medicine TreeMy traditional family practice has evolved into an Integrative/Functional Medicine practice, and my approach to health and healing has changed in many ways. Digestive health and wellness is one of the biggest changes.

Every day, I sit across the table from my clients and talk about the gut. The "gut" we speak of is referring to the gastrointestinal (GI) tract, which is a long tube that starts at your mouth and ends "where the poop comes out" (I have twin 10-year-old sons, so in my house we have many terms for this area).

As a Functional Medicine physician, I often look to the gut first when encountering any chronic medical condition. Why? Because your gut has everything to do with your health. I'm not just talking about symptoms like abdominal pain, bloating or abnormal bowel movements - there are many more symptoms and conditions that occur outside of your gut, yet may be closely linked to GI tract imbalance, including:
  • chronic headaches
  • weight gain
  • eczema/skin rashes
  • asthma
  • depression
  • fatigue/low energy and "brain fog"
  • autoimmune disease (such as rheumatoid arthritis and lupus)
  • chronic sinus problems
  • joint and muscle pain
  • mood swings

Read more about Functional Medicine


Why is the gut so important?

Integrative Medicine GI TractYour GI tract contains the first line of defense in your body. 70% of your immune system lies in your gut! Every day, when you eat, drink and breathe, you bring various toxins and infectious "bugs" into your body through your mouth and nose. Your gut provides one of the most important and difficult balancing acts of your immune system, seeking out and destroying these foreign invaders (toxins, viruses, bacteria) while ensuring that proper nutrition and micronutrients can be absorbed and assimilated from the foods that you eat.


Your gut is a key factor in regulating your emotional health and nervous system. There is an enormous amount of communication that occurs between your GI tract and your nervous system (which consists of your nerves and brain). The connection between your gut and your nervous system is so strong that scientists have referred to your gut as your "second brain"! Your gut balance can directly affect your mood - 95% of your serotonin (a key neurotransmitter involved in depression and mood) is in your GI tract, and serotonin regulation is a key factor in depression, anxiety, and other mood disorders.

"Leaky Gut"
How GI tract imbalance can affect your entire body

If you used the term "leaky gut" with me 10 years ago, I may have looked at you like you were crazy! As a matter of fact, if you use this term with many of my traditional Western medicine colleagues, they will probably do the same. That is because this is a concept that is not familiar to traditional Western medicine. This is part of Functional Medicine, which involves "getting under the surface" to determine the underlying cause of your symptoms, rather than just treating your symptoms with a medication.

Let me describe "leaky gut" to you the way I described it to my patients in the office. 

A healthy, properly functioning GI tract looks something like this: 
  • Saliva and chewing break the food in your mouth
  • Stomach acid breaks down food particles further, while muscles and nerves work together to keep everything "moving forward" in your intestines.
  • Digestive enzymes and bile salts (from your pancreas and liver) break down your proteins, fats, and starches.
  • Food particles then enter the small intestine. The small intestine has a very important job! 

This is where all of the nutrients and proteins in the food that you eat are absorbed into your bloodstream, while at the same time preventing toxins and infections from being absorbed. In order for everything to work as it should in the small intestine, several things need to be in working order:
  • First, the small intestine has a thick mucus lining that provides protection against toxins, infections, and other irritants.
  • Second, the small intestine contains adequate amounts of "good bacteria". These bacteria work to digest your food and also maintain a balance that prevents overgrowth of "bad bacteria" or other infections.
  • Third, the wall of the small intestine is tight and strong. This wall is what separates the food particles from your bloodstream. If the wall of your small intestine remains healthy and intact, only well-digested small food particles and proteins are let through into your bloodstream. 
So, when everything is functioning properly, your food is digested well, infections and irritants are kept from getting out of control, and small nutrient particles and proteins are entered into your bloodstream where they can find and enter your cells to provide them the nutrition and energy they need.

What happens when the gut becomes leaky?

Integrative Medicine Leaky GutIf your food is not broken down properly, the size and structure of the nutrient particles and proteins presented in your small intestine may be larger and shaped differently. If the integrity of your small intestinal wall is compromised, these larger, different nutrient particles and proteins may be let into your bloodstream.

As we have discussed before, food is information! The food you eat provides information that interacts with the genetic code that resides in each and every cell in your body. By changing the structure and size of these food particles and proteins, you are changing the information presented to your cells, which may activate pathways that promote inflammation.

The cells of your body's immune system are particularly sensitive to this. High inflammatory foods, such as sugar, along with increased "bad bacteria" or toxins in the gut may send a signal to your immune system to be "on alert" for problems. This is followed by the altered food particles and proteins entering the blood stream, causing your immune system to feel under attack! The cells of the immune system activate pathways that increase inflammation. Depending upon your genetic code (or "blueprint", as I like to call it), certain cells may be affected more than others. That is why leaky gut may present with a rash in one person, fatigue and headaches in another, and autoimmune disorders like rheumatoid arthritis in yet another person. Your genetic blueprint determines your susceptibilities.

Common signs of "leaky gut" include:

  • rashes/eczema
  • headaches
  • fatigue and "brain fog"
  • muscle and joint pain
  • weight gain and water retention
The good news - identifying and healing your core gut imbalances is one of the most important first steps you can take to promote health and well-being. We've covered the basics of digestive health and where problems can arise, stay tuned to learn more about the causes of "leaky gut" and what to do about it!

Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com



Carin Nielsen, MD Integrative MedicineI 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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Recently I wrote about Insulin Resistance, a common disorder I see in my practice. This post highlights my recent experience with Beverly*, who lost nearly 30 pounds and dramatically increased her energy in just 12 weeks - simply by identifying where her imbalances were and making a few simple changes that improved her insulin sensitivity.


Meet Beverly*, Age 60

When Bev first sat across the table from me this past August, she said "I feel off balance". She couldn't pin-point it, but something just didn't feel right. She felt more and more fatigue, especially mid-afternoon when she had her energy "slumps". She was gaining weight steadily and was feeling "old".

During our discussion I learned more about Bev. She had her thyroid removed a few years ago due to a large goiter. While her temperature fluctuations and heart palpitations had improved, her energy levels had not. She had also described high levels of stress during the past few years. She had made progress with her stress management but in general felt "worn down".

Bev's medication list included thyroid replacement, and two medications for high blood pressure. On examining her I noted that her weight gain was primarily around her abdomen. I also noted an elevated heart rate and increased reflexes.

We then obtained some data with a blood draw, and Bev's laboratory results confirmed my suspicions. Now remember - I am a Functional Medicine physician - so I often order labs that other doctors may not order. I also interpret the lab results differently, looking for patterns and clues that relate to the individual and their symptoms, and desiring "optimal" results, not "normal" results. Bev's blood sugars were normal, but she had significantly elevated morning insulin (normal less than 10, hers was greater than 50. While her thyroid tests were "within normal range", they showed her thyroid was functioning on the high-end of normal, which explained her elevated heart rate and hyper-reflexes.

Now it was time to get to work. Bev had insulin resistance! This had likely been creeping up over many years, and was made worse the past 3 years by elevated cortisol as a result of the stress she had been experiencing. To make matters worse, one of the two blood pressure medications she was on was known to worsen insulin resistance. My Functional/Integrative approach to Bev's care was simple and straightforward, focusing on:
  1. Correcting her underlying hormone imbalance
  2. Removing the foods that were working against her by limiting the refined carbohydrates and sugar from her diet
  3. Using targeted supplementation to treat her insulin resistance


Hormone balance

While getting to work on treating her insulin resistance, we also had to balance Bev's thyroid. I lowered her dose of thyroid medication and within a week she felt a difference. Her heart rate came down and she began to feel more "at ease". This is an important point because so many women want to add more thyroid medication - but more isn't always better! An overactive thyroid can also contribute to fatigue. It's all about balance!


Removing offending foods

I presented Bev with a meal plan that included real, clean food. Her plan involved 2 prepared meals, two meal replacement shakes, and healthy snack options. Her two prepared meals each included lean, clean protein, lots of vegetables and healthy fat. We limited her starches and grains and had her choose from gluten-free, high-fiber varieties. The timing of her meals was also important! She was not to go more than 3-4 hours without eating (to balance her blood sugars). We used meal replacement to provide adequate protein and help her with meal structure (meal replacement can often help take some of the "work" out of diet change.

Targeted supplementation

Bev's supplementation recommendations were designed to help correct her insulin resistance, and included chromium, ALA, Fish Oil and PGX.

Chromium - helps insulin to do it's job! Chromium helps insulin transport blood sugar into cells more efficiently, providing cells with much-needed energy.

Alpha-lipoic Acid (ALA) - enhances the insulin receptor on the cell's surface, allowing insulin to enter the cells more easily (there is actually a direct binding site for ALA on the insulin receptor). ALA also acts as an antioxidant, reducing cell damage.

Fish Oil - contains two key substances - EPA and DHA - which help form and strengthen cell membranes, keeps them from getting stiff. This improves cellular communication and helps insulin receptors work properly.

PGX - a novel fiber blend, PGX is taken with a glass of water about 15-20 minutes prior to meals. The flavorless granules can also be sprinkled over food or taken as capsules. The PGX fiber expands into a gelatinous "blob" in your stomach. This helps you to:
  • feel full after eating less food
  • release any glucose from your meal into your blood stream more slowly
  • reduce insulin and blood sugar spikes
  • reduce hunger and sugar cravings.



Within 2 weeks Bev had lost over 7 pounds and reported less brain fog and more consistent energy.
At the end of 12 weeks she had lost 29.6 pounds, 5.5 inches off her waist, and 3 inches off her hips!

She felt great and was no longer getting a dip in her energy levels in the middle of the day. Repeat blood testing showed that her fasting insulin level was cut by more than half. She was completely off one blood pressure medication (the one that was making her insulin resistance worse) and was down to a fraction of a dose of her other blood pressure medication. She had lost so much weight that we had to lower her thyroid dose even further!

The best part? She kept saying over and over "I really just can't wrap my head around it, this has been so easy". The changes Bev made were simple and straightforward. She continued to live her life and did not have to remove herself from society in order to make the necessary changes (she even traveled, ate at restaurants and hosted parties). In just 12 weeks, Bev not only changed her life, she created a plan for lasting change.

Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com

*while this represents a true story, the patient name has been changed to protect his/her identity and privacy

Carin Nielsen, MD Integrative MedicineI 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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Proper insulin and blood sugar balance can be a key factor in optimizing hormone balance and improving energy, mood and weight.

Integrative Medicine Insulin ResistanceBelly fat and low energy?

Is it getting more difficult to button your pants due to belly fat? Does your energy plummet at different times during the day, especially around 3pm? These are both clues that your body is not maintaining normal blood sugar levels. If insulin and blood sugar aren't working together properly not only will you see your waistline get larger, but you may also feel more tired or even depressed.

Insulin and Blood Sugar - the Basics

Integrative Medicine Insulin ResistanceOur body is made up of trillions of tiny cells. These cells work together to form all of our organs, our blood vessels, our nerves,muscles and everything else that makes us, well us!
In order for our bodies to work, our cells need energy.

This energy comes primarily in the form of blood glucose, also called blood sugar. Blood sugar cannot just enter into cells to provide energy - the blood sugar has to be carried into the cells - this is the job of insulin.

Insulin is a hormone that is made in the pancreas.
Your pancreas makes insulin in response to the normal increase in blood sugar that occurs after you eat.

The insulin binds to blood sugar in the bloodstream, and transports the blood sugar into your cells through an insulin receptor on the cell's surface. This provides the cells with the energy they need to stay alive and function optimally.

Think of insulin like a gas pump -
it gets the gas into the car for energy!

Insulin Resistance

When you have insulin resistance, your cells don't allow insulin to transport blood sugar into your cells so easily. It's like the nozzle of the gas pump no longer fits and your cells become "resistant" to the action of insulin. To compensate, your pancreas has to make more and more insulin to get enough fuel into your cells.


Integrative MedicineInsulin Resistance = Higher Insulin Levels = Higher Blood Sugar Levels = Low Energy

Why is insulin resistance a problem? For many reasons. Both high insulin and sugar levels contribute to inflammation in the body. Excess insulin also causes changes in energy levels, especially feeling tired after a meal, and increases hunger and sugar cravings. The higher blood sugar levels cause more of your blood sugar to be stored as fat, promoting weight gain, especially in your abdomen. When cells aren't getting the energy they need, your body doesn't operate efficiently, and you experience more fatigue, brain fog, and low stamina. Insulin resistance contributes to infertility, and if not corrected, insulin resistance is likely to turn into Type 2 Diabetes and elevated risk of heart and vascular disease.


Are you at risk for insulin resistance?

You may want to discuss testing for insulin resistance with your physician or booking an appointment in my office for a consultation if you have one or more of the following:
  • you struggle with weight gain, especially in your abdomen
  • you experience energy "slumps" after eating, especially mid-afternoon
  • you have a family history of Type 2 Diabetes
  • you have a personal history of gestational diabetes (diabetes in pregnancy)
  • your diet is high in "fast carbs" like sugar and white flour
  • you experience chronic stress
  • you have dark patches of skin on the back of your neck, elbows, knees, or armpits
  • you have a lot of skin tags, especially around your neck and armpits

Can insulin resistance be reversed?

YES - insulin resistance can be reversed! As a matter of fact, we help walk people through this process frequently in my office. Insulin levels can be normalized fairly quickly if the problem is caught early enough and the right action is taken. Treating insulin resistance makes weight loss easier, improves energy and mood, and reduces hunger and sugar cravings. The mainstays of treating insulin resistance in my office involves the following:
  • Changing the types of foods in your diet. Removing "fast carbs" like sugar and white flour, and incorporating more "slow carbs" that are high in fiber and micronutrients
  • Learning how to read a food label to look for hidden sugars, fiber content, and more.
  • Stress management to avoid cortisol and blood sugar spikes
  • Supportive supplementation to correct underlying deficiencies, reduce inflammation, and make your cells more responsive to insulin
  • Prescription medication is sometimes used in advanced cases as one part of the treatment plan
Are you or a loved one interested in testing and treatment of insulin resistance? Feel free to send an email my way, or contact our office to schedule an appointment, 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
www.CarinNielsenMD.com



Carin Nielsen, MD Integrative MedicineI 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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Five ways our approach to healthcare can help you find your balance in the New Year.

Integrative Medicine Petoskey Balance Hormones

#1 - Balance your Hormones and Neurotransmitters!

Looking for more stable mood and energy? Balanced hormones and neurotransmitters are the key! We can help you:
  • Evaluate your Thyroid using the right tests, and look for optimal levels, not the "normal range"
  • Examine the effects of stress on your Adrenals, which can be rebalanced with customized herbal blends
  • Learn about both hormonal and non-hormonal options for peri-menopause and menopause
  • Serotonin is a key factor in depression and anxiety, you can boost your levels by improving digestive health and providing key nutrients for serotonin production, not just with anti-depressants
Visit our website for more information about our approach to Emotional Health.

#2 - Figure out which Foods are working for you, and which are working against you.

Food sensitivities and intolerances are underlying factors in a number of chronic medical conditions, including:
  • chronic headaches
  • weight gain
  • eczema/skin rashes
  • asthma
  • depression
  • fatigue/low energy and "brain fog"
  • autoimmune disease (such as rheumatoid arthritis and lupus)
  • chronic sinus problems
  • joint and muscle pain
  • mood swings
We have the tools and experience to help you determine your optimal diet, including food sensitivity testing, customized elimination diets, and evaluation for "leaky gut".

Integrative Medicine Weight Loss Petoskey

#3 - Shed Pounds and Gain Energy with a Customized Diet Plan

We offer everything from a 10-day detox/cleanse to a 12-week weight loss and lifestyle change program to help you look and and feel your best. All programs are customized to your individual needs. No fad diets and no "one size fits all" program.

Visit our website for more information about our My Optimal Diet program.

#4 - Learn more about what is going on "under the surface" with Functional Laboratory Testing.

Assess the micronutrient status in your body. How well is your liver working? How balanced are the microorganisms in your gut? Our laboratory testing options go beyond "standard values". Examples include:
  • micronutrient testing
  • adrenal saliva testing
  • screening for heavy metals
  • advanced lipid testing
  • food sensitivity testing
  • hormone testing for men and women
  • assessment of cellular energy production
  • functional stool analysis

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#5 - Customize your Nutritional Supplements to meet Your Needs

Every cell in our body contains a copy of our genetic code, or "blueprint". The nutrients we obtain from our food and vitamins/nutritional supplements will provide us with varying benefits, depending on our blueprint. Your genetics, your medical history, and your current state of health should all be taken into account when choosing nutritional supplements. Dr. Nielsen can provide you with sound evidence-based recommendations to meet your needs. Micronutrient testing is also available.

Visit our website for more information about Customized Vitamins/Supplements.


Yours in Health,

Carin Nielsen, MD
www.CarinNielsenMD.com



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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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I am a Functional Medicine physician. I use Functional Medicine every day to optimize the health and well-being of my clients, yet many of my clients aren't familiar with the term "Functional Medicine". It's time to change that!

Functional Medicine practitioners promote wellness by focusing on the fundamental underlying factors that influence every patient’s experience of health and disease. 

Modern Western medicine does a really good job with medical emergencies. If you've sustained an injury, suffered a heart attack or stroke, or have a serious infection, modern medicine has the tools, technology and ongoing research to take care of your immediate need.

In my opinion, modern Western medicine falls short with it's current approach to chronic disease. With the emphasis on technology and promotion of pharmaceutical therapies, modern Western medicine has lost "the basics". The system is so focused on pills to treat your symptoms that it no longer asks the most basic question:


Funtional Medicine Carin Nielsen MD
"What are the root causes of your symptoms?"

Functional Medicine asks this question and more.
  • What is going on under the surface?
  • What happened "upstream" to cause this "downstream" effect?
  • Where is the underlying imbalance?

Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among each patient's genetic, environmental, and lifestyle factors that can influence their long-term health and development of chronic disease.  Functional Medicine recognizes that the factors underlying disease are unique from person to person, and that optimal health and well-being can only be achieved by examining the person as a whole, rather than just treating a symptom.


Functional Medicine is Integrative Medicine

Functional Medicine integrates traditional Western medical practices with what are sometimes considered “alternative” or “complementary” therapies. The focus is not on diagnoses/labels but on prevention, wellness and balance. Some of the tools I use every day in my office include:
  • personalized nutrition, diet, and exercise recommendations
  • state-of-the art laboratory testing and other diagnostic techniques
  • prescription medication and/or botanical medicines
  • evidence-based supplements and therapeutic diets
  • detoxification programs
  • stress-management techniques 

Do you feel your healthcare needs are not being met?  Do you have unanswered questions?  Are you looking for healthcare that involves more than a prescription pad?  Are you looking for tools to help you achieve optimal health and well-being?


Functional Medicine may be just what you are looking for.

For more information please visit my website www.CarinNielsenMD.com or send me an email at This email address is being protected from spambots. You need JavaScript enabled to view it.. You can also learn more by visiting the Institute for Functional Medicine's website https://www.functionalmedicine.org.

Carin Nielsen, MD



b2ap3_thumbnail_blog_carin3.jpg
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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It has been a busy week in the medical press with opinions abound on the new guidelines published Tuesday by two of the nation’s leading heart organizations. The American Heart Association and  The American College of Cardiology.  The first new such guidelines in a decade, they serve to outline specific clinical strategies for the lowering of blood cholesterol to lower the risk of heart attack and stroke.

It is widely accepted that the new guidelines represent a dramatic shift from the current accepted "norm" of cholesterol treatment, and that adherence to these guidelines will double the number of adult Americans who are prescribed a statin medication (such as Lipitor, Crestor or Zocor) to lower cholesterol.  This is expected to increase the number of U.S. adults on statin drugs to approximately 1/3.  In addition, those taking statin drugs to lower cholesterol will no longer be monitored to reach specific target levels of LDL cholesterol, but rather simply taking a recommended dose of the medication is considered sufficient.

The new guidelines divide people needing statin treatment into two broad risk categories:
 
HIGH RISK - those with diabetes or very high levels of LDL cholesterol or those who have had a previous heart attack.  These patients are recommended to be prescribed high-dose statins regardless of other risk factors or cholesterol levels.  
 
LOW RISK -  Those not considered high risk (everyone else) should be considered for a statin if they have a calculated 10 year risk of a heart attack or stroke of at least 7.5 percent.  Doctors are advised to use a new risk calculator that factors age, sex, race, blood pressure, diabetes and total cholesterol to calculate risk.
 
So what's my take?  While the new guidelines do address lifestyle changes in the prevention and treatment of heart attach and stroke, the message is lacking, and difficult to find, buried underneath the message to focus on increased statin drug therapy.
 
Dr. Stephen Devries, an Integrative Cardiologist with the Gaples Institute for Integrative Cardiology at Northwestern University offered insightful "pros and cons" of the new guidelines in a blog post earlier this week.  To summarize:
 
Pros
 -The guidelines do a good job of clearly defining the 4 highest risk groups most likely to benefit from statins and should be helpful in addressing the current under treatment of high-risk populations - those with known vascular disease, middle age diabetics, people with exceptionally high LDL, and those with multiple risk factors. 
 
Cons
-The guidelines give a comprehensive overview of the benefits of long-term use of statins in high-risk people, but not the risks!  As I see quite commonly in my office, significant side-effects are common, especially muscle pain - experienced by up to 10% of those on statins-and more common with high doses.  In 2012, the Food and Drug Administration updated labeling on statins to include warnings about the potential for muscle weakness, confusion and memory loss, and elevated risk of developing Type 2 diabetes.
-Another concern is that recommending long term high dose statins for vascular disease regardless of cholesterol levels may reduce the incentive for patients to make lifestyle changes.  The new guidelines call for using the same high dose of statin regardless of changes in diet, exercise, or weight. Dr. Devries makes an excellent point that an accompanying guideline on Lifestyle Management to Reduce Cardiovascular Risk”  emphasizes improving cholesterol and blood pressure, rather than focusing on diet changes to impact overall risk to heart health. There’s an important difference. For example, a  Mediterranean diet in the Lyon study succeeded in reducing the risk of a serious heart problem by 72%, yet didn’t change cholesterol at all.
 
The bottom line.
According to the World Health Organization, 80 percent of cardiovascular disease is caused by smoking, lack of exercise, an unhealthy diet, and other lifestyle factors.  These new guidelines offer new tools to calculate risk of both heart attack and stroke, and offer specific, evidence-based drug treatment protocols for those at the highest risk.  Companion guidelines on modifying lifestyle and treatment of overweight and obesity in adults are a step in the right direction, but their message is lost behind the strong emphasis on statin drug therapy.

While I am not opposed to statin therapy in high-risk populations, I will not allow the message of lifestyle modification to be lost with my clients.  My approach involves digging deeper with specialized testing to evaluate risk, "thinking outside the box" to treat all risk factors, and treating each client with a personalized approach.  If you want to learn more about your risk, or how these guidelines affect you or someone you love, consider an Integrative Medicine consultation.  www.CarinNielsenMD.com.
 
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Hormone balance is a common theme in my office.  Today it was a theme of nearly every patient!  Often, patients present to me complaining of fatigue, weight gain, depressed mood, and low stamina, questioning whether an imbalance in hormones is the cause.  They often ask about their thyroid.  Some are interested in Bio-identical Hormone Replacement therapy.  While thyroid hormone and estrogen balance are important factors to consider - it might surprise you to learn that my first step in evaluating hormone balance is always the adrenal glands.
 
The adrenal glands are walnut-sized glands that sit on top of your kidneys.  The main purpose of your adrenals is to enable your body to respond to stressfrom every possible source. This includes physical stress such as from injury or illness, as well as psychological or emotionsl stress.
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In medical school, I learned about the adrenal glands by studying Addison's disease. This is an uncommon disorder, often autoimmune, in which the adrenals lose their ability to function. Those affected by Addison's disease require lifelong daily medication for survival.
 
Now, I discuss more subtle changes adrenal function with patients every day.  Even more mild changes and adrenal function can have a significant impact on vitality, energy and quality-of-life.  
 
In addition to regulating sodium and potassium balance in the body,  the adrenal glands create and secrete hormones in response to stress.  When something startles you, adrenaline is released, which creates a "fight or flight" response. You feel suddenly super-charged and ready for quick response.  Cortisol, one of the primary hormones secreted by the adrenals, is important to maintain blood pressure and blood sugar. When you experience injury or inflammation, elevated cortisol secretion protects the body by supplying adequate levels of blood glucose and maintaining blood pressure for healing.
 
If the adrenals are exposed to chronic inflammation, such as that from chronic illness, poor diet, or prolonged emotional stress, they can have a prolonged output of cortisol and adrenaline. This can cause anxiety, irritability, chronically elevated blood pressure and blood sugars, elevated heart disease risk, increased fat production (especially abdominal fat), and weight gain
 
Over time, over-active adrenal glands can become exhausted and under-active.  If this happens, you may experience symptoms such as fatigue (especially in the morning), feeling rundown or overwhelmed, craving salty and sweet food, low stamina, difficulties recovering from illness or injury, low blood pressure, or "brain fog".  Adrenal exhaustion may also be associated with the development of auto-immune disease or illness.
 
Testing adrenal function can be done through blood or saliva.  My test of choice is a saliva test that tests adrenal hormones at four points throughout the day.  It is done at home and shipped directly to the lab company.  I receive results in about 10 days.  This information can then be used to direct therapy to balance adrenal function.  A combination of nutraceuticals, herbs and/or prescription medication can be used to restore under-active adrenal function or calm over-active adrenals.
 
In addition to adrenal testing and therapy, we offer Mindfulness training (both group and individual) to help control and change response and reaction to stress.  Learning how to better manage and respond to stress is essential to maintain healthy adrenal function and hormone balance.
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If you or someone you love is experiencing any of the symptoms above, or if you would like more information, 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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October is Breast Cancer Awareness Month, and like most of you, I have many patients, friends and loved ones who have been affected by Breast Cancer.  It's hard to imagine in this day and age that there is someone out there who hasn't been affected by Breast Cancer.  According to the National Institutes of Health, it is estimated that about one out of every eight women born today will be diagnosed with breast cancer at some time during her life.

Breast Cancer advocacy groups have done a remarkable job of increasing Breast Cancer awareness, educating the public on risk factors, raising money for research and encouraging screening for early detection (and therefore higher cure rates).  It is really fantastic to see Breast Cancer research support at such a national level, especially in October when the nation is practically painted in pink ribbons.
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But in my opinion, there is one risk factor that we just aren't talking about enough - and that is the link between environmental exposures and development of Breast Cancer.

Endocrine Disrupting Chemicals, or EDCs, are chemicals that can mimic or disrupt our natural hormone balance.  There is a growing body of scientific research that exposure to environmental chemicals containing EDCs is associated with developing Breast Cancer, as well as early puberty, endometriosis, male and female infertility, and prostate cancer.  Many of the most harmful EDCs are xenoestrogens - compounds that can mimic the effect of estrogen in the body.  Excess estrogen is everywhere!  Dangerous amounts of both natural and synthetic estrogens are being found in our public water supply.  Male fish containing female sex organs are popping up in our nation's rivers.  Girls in general are starting their first menstrual period several years earlier than they were twenty years ago (early onset of first menstrual period is a known risk factor for breast cancer), and those with higher levels of exposure to common household chemicals have been found to have their first menstrual period even earlier (seven months earlier than girls with lower exposures).  

EDCs are all around you!  They are in your jeans (2/3 of jeans made in China, your mattress, your canned goods, your upholstery, and your PLASTIC!  They are in your perfume, your lotion, your shampoo and your cosmetics.
 
In honor of Breast Cancer Awareness Month, I encourage you to educate yourself on Endocrine Disrupters and examine your home and environment to reduce exposure (I know I will).  There are a number of simple things individuals, families, and communities can do reduce exposure to environmental chemicals that could pose risk for breast cancer:
    • Avoid plastic water bottles and Styrofoam containers;
    • Never microwave food in plastic or Styrofoam; 
    • Eat fresh or frozen foods, not canned, unless can is lined with BPA-free plastic;
    • Go fragrance free in both personal care products and household cleaning products;
    • Remove plastic bags and air out garments that have been dry-cleaned before either wearing them or putting them in closets or drawers;
    • Choose products that have detailed ingredient labels and don't contain known EDCs (e.g., parabens, phthalates, BPA). Contact companies for information if you have concerns about their ingredients;
    • Minimize the use of pesticides and herbicides, especially when using them for mainly cosmetic landscaping purposes, to avoid personal exposure and especially for young children in your neighborhood.
    • Seek out reputable information to help you make safer choices and decrease your exposure to environmental risks, such as The Environmental Working Group

I offer advanced laboratory testing in my office to assess for toxic exposure, as well as relative levels of "good" and "bad" estrogens.
Want to learn more?  This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585
 
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Last week I had a follow-up visit with a male patient in his early 40s who had come to see me for muscle aches and decreased muscle stamina with exercise. He was having soreness on a daily basis, particularly in his upper thighs.  Laboratory workup had revealed significant Vitamin D deficiency. He reported at his follow up visit that after only 3-5 days of high-dose Vitamin D supplementation, his muscle symptoms were noticeably improved.

He was surprised to hear that I see this quite frequently, both Vitamin D deficiency and other patients with similar symptoms of muscle aches that improve when Vitamin D intake is increased. My medical practice is in Northern Michigan, and Vitamin D deficiency is quite common. I have been checking Vitamin D levels routinely on my patients for many years, and I rarely find an "optimal" level, let alone a level that isn’t deficient!

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Why is your Vitamin D level important?

Did you know that Vitamin D is actually a fat-soluble hormone?  Your body produces Vitamin D in your skin when exposed to sunshine or ultraviolet light. Knowing that, it’s not surprising that north of the 45th parallel Vitamin D deficiency is quite common!

Vitamin D is necessary to absorb calcium, it helps to regulate the levels of calcium and phosphorus in the body, and together with these minerals works to maintain bone strength and integrity. The benefits of Vitamin D intake on bone health and reduction of osteoporosis is well documented by randomized controlled trials and evidence has also linked Vitamin D intake to reduced falls in the elderly.

A growing body of research suggests that Vitamin D intake may be linked to reduced risk of cancer (specifically breast, prostate and colon cancer), depression, autoimmune disease, and heart disease, although further studies are needed to verify these results.  Vitamin D deficiency has been linked to chronic muscle aches and pains, and (as described above) I have observed numerous patients with chronic diffuse muscle pain (especially in the thighs and forearms) get relief when restoring their Vitamin D levels to normal.

Do you know your Vitamin D level?

When testing your Vitamin D level, it is important to order the correct test. There are two tests for Vitamin D – 1,25(OH) Vitamin D or 25(OH) Vitamin D. 25(OH) Vitamin D is the best test as it is the best marker of overall Vitamin D status. 

A level below 30 ng/dl is considered deficient. In my practice we first look to raise levels above 30 into the “normal range”, and then look to get levels in the “optimal range” (those of you who are clients of mine know that this is a frequent topic of conversation, what is normal for one person may not be normal for another, and therefore when interpreting test results we strive for the optimal level for best health). Opinions vary as to “optimal” Vitamin D levels.  I strive to get levels to at least 48 ng/dl, as a comprehensive review of evidence from various studies found this level to be optimal for cancer prevention.

How do you raise your Vitamin D levels?

There are two types of Vitamin D: Vitamin D3 (cholecalciferol – which is the type of Vitamin D synthesized in your skin when exposed to sunlight), and Vitamin D2 (ergocalciferol – found in Vitamin D fortified foods and synthesized by plants).

Vitamin D3 is better utilized by the body than D2, and is the preferred source for supplementing. Vitamin D3 is found in eggs, organ meats, animal fat, cod liver oil, and fish.  It is also available in both liquid and capsule supplements.  If you are considering supplementing with Vitamin D speak with your physician about what dose is most appropriate for you.

Can I get too much Vitamin D?

Yes!  While Vitamin D toxicity is rare, it can happen if you over-supplement. Unlike many water-soluble vitamins, Vitamin D is fat-soluble and excess intake will store in your fatty tissues. Excess Vitamin D intake has also been linked to kidney stone formation.

For more information, or if you are interested in having your Vitamin D levels tested, contact our office at 231-638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it..

 

 

 

 

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Weight is never something women want to talk about but it is a common thread that ties us all together – namely our never ending struggle to lose weight and achieve a healthy lifestyle. Struggles with my weight have been consistent throughout my life. To make matters worse, I suffer from hypothyroidism and am now in my 40s – a lethal combination that accounts for an achingly slow metabolism. At the turn of my most recent birthday I knew that my life was spiraling out of balance and that something had to change. That’s when I sought the help of Dr. Nielsen. In addition to creating a customized weight loss plan that worked for me (I am a vegetarian), Dr. Nielsen addressed other issues that had plagued my ability to lose weight. She adjusted my thyroid, got me on a regular schedule of proteins that work for me and most significantly, took a comprehensive blood panel to make sure we weren’t missing anything. In four months, I lost more than 20 pounds. Even better, I no longer suffer from nightmares – nightly nightmares that have troubled me for years. I am sleeping better, my energy level is consistent throughout the day, I am losing weight and I am feeling better about myself. My journey is not done yet (I still want to lose 20 more pounds) but I know that I can do it thanks to Dr. Nielsen and the program she created specifically for me. I also know that I can trust her for guidance when I get frustrated and to celebrate my successes even if they are just one pound lost per week. I could not have gotten as far as I have without Dr. Nielsen’s support and expertise – something I will forever be grateful for. Thank you Dr. Nielsen for helping me find a weight loss program that works for me and for helping me find the balance I was so desperately seeking!
Marci, age 41
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Last week, I ran into a patient of mine as she was leaving the office after her third acupuncture treatment with Price DiGiulio, MS, LAc. I had recommended acupuncture a few weeks prior as an adjunctive treatment for her depression. She had been struggling with low motivation and energy, decreased appetite and weight loss as part of a mixed depression/grief reaction over the past year. Despite taking two anti-depressants she was not getting adequate relief of her symptoms.

Before speaking a word it was obvious that the acupuncture was working well for her. There was a brightness in her eyes and facial expression that was not there before.  She appeared more awake, alert and calm. When I asked her how her treatments were going she said “Very well, I’m feeling much better, but what really struck me is that after my last treatment I went home and was starving! I was so hungry I couldn’t get enough to eat. I can’t remember the last time I experienced hunger like that.”

My face turned into one big smile - this is the part where my job gets really cool. What this patient didn’t know is that Price and I had discussed her case prior to her last appointment (she had signed a release for us to do so). We compared our assessments and discussed her care plan – this is Integrative Medicine at it’s best.  I mentioned to Price that her weight loss and lack of appetite were becoming more concerning and were the symptoms that seemed the most difficult to treat with prescription medication. He said he would try specific points to stimulate her appetite. Obviously it worked.

How does acupuncture work?

This is how I explain Acupuncture to my patients:

Acupuncture is a form of Traditional Chinese Medicine. It is based on the concept of Qi (pronounced chee).  Qi is thought of as life energy flowing through the body along channels known as meridians. According to Traditional Chinese medical theory, illness arises when the flow of Qi in the meridians becomes unbalanced or blocked. Through acupuncture, specific points on the body are stimulated to “unblock” or balance the flow of Qi through the meridians.

Looking for a more scientific explanation? When needles are inserted (they are not inserted very deep), they stimulate nerve receptors that transmit impulses to the brain. Depending upon where the needles are inserted, different receptors and areas of the brain can be influenced. Choosing specific points can stimulate the release and balance of various chemicals, neurotransmitters and hormones from the brain that regulate various processes in the body, including digestion, mood, perception of pain, energy, well-being, sleep, inflammation and more.

It is thought that acupuncture works for the treatment of chronic pain by stimulating the area of the brain that releases endorphins, natural pain-killing hormones (I have read that endorphins are 200 times more potent than morphine). For treatment of depression, acupuncture is thought to stimulate the release of neurotransmitters that regulate serotonin (a major mood-affecting chemical). 

Acupuncture is prescribed in our office for a variety of symptoms and conditions. As a bonus - when your physician and acupuncturist are working together you are able to get the "best of both worlds".  To learn more about acupuncture or inquire about an appointment contact us at 231-638-5585 or visit our website http://www.carinnielsenmd.com/integrative-therapies/acupuncture.

 

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Today we finalized and published our fall Mindfulness class schedule and I am really excited about it.

What is Mindfulness?

Here is a textbook definition:  Mindfulness is the practice of paying attention to our thoughts and feelings purposely, in order to become more present within our own lives.

Need more clarification? Here is how I explain the concept of Mindfulness to my patients:  Mindfulness is a tool to create some distance between yourself and your “brain chatter”.

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There will always be stress. Often in life it seems we finish dealing with one stressor, and there is another waiting around the corner. We can't change that. What we can change is our reaction to stress. We don't have control over the presence of stress in our lives, what we do have control over is our response.

When you start to think of stress in these terms, the concept of stress itself becomes external. You can put a little distance between yourself and the stress. By doing so, the effects of stress are less likely to "take over" your mind and body.

If you feel chronically “stressed”, it is likely that you have a good amount of what I like to call “brain chatter”. As a Type-A busy working mom, I am very familiar with this concept.  “Brain chatter” is all of that stuff that is spinning around in your brain.  It is the to-do lists, the thoughts about what happened at dinner last night, about where the kids need to be picked up later, about your worries about your job, about that kitchen faucet that still needs to be fixed, and everything else.  It is all of those thoughts that are spinning around in your brain while you go about your day.

With a brain so full of chatter – it’s difficult to concentrate on anything else.  You go about your day almost on “auto pilot”. You could get yourself ready in the morning, eat breakfast, and drive to work and yet be totally unaware of your actions because you are so distracted by your “brain chatter”.  If that chatter is full of worries and negativity, it can cause you to be irritable and snap at others for no apparent reason. You react quickly, perhaps in a negative way, because you are not focused and present within moment, your brain is focusing instead on negative chatter. The chatter escalates and spreads throughout your body, causing you the physical symptoms of stress (muscle tension, headaches, and heart palpitations to name a few).

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It is called Mindfulness practice for a reason. You can read about the concept all day long, but it is putting it into action that gives you results. It isn't easy! It takes time to retrain your brain to become more aware and less reactive. With patients I often use the analogy of running a marathon. You wouldn't just wake up one day and run a marathon. You would spend months, oftentimes up to a year, to train. It is similar when training your brain. When learning Mindfulness meditation, you start with a few minutes here and there, and gradually work your way up to longer meditations.

S.T.O.P. 

"STOP" is a quick and easy way to start incorporating Mindfulness into your daily routine as a means of reducing the effects of stress. It takes about 30 seconds. I often do this routine in between seeing patients.

S = Stop what you are doing

T = Take a deep breath.  A " belly breath", Relax your abdominal muscles and breathe deep as though you are filling your belly with air.

O = Observe. How is your body feeling? Where are your thoughts right now? If your mind is spinning with "brain chatter", acknowledge this chatter and then set it aside. Put a little bit of space in between you and your "brain chatter"

P = Proceed. Go on about your day with a mind that is slightly more clear and a body that is slightly more relaxed.

Have I sparked your interest? I’ll discuss the science and research of Mindfulness in future posts, but if you are interested in getting started this fall we will offer everything from one-night workshops to a six-week course to teach the principles and practices of Mindfulness.

Chris Frasz, MSW

Back by popular demand, we will be offering our six-week introductory course "An Introduction to Mindfulness for Stress Reduction". This course is facilitated by Chris Frasz, MSW who has facilitated several courses for us in the past and gets many rave reviews and requests for additional classes. Chris recently completed a week-long Mindfulness intensive under the direction of Jon Kabat –Zinn, the founding and executive director of the Center for Mindfulness in Medicine, Healthcare, and Society at the University of Massachusetts Medical School. Learn more about this class and Chris Frasz by clicking here, www.carinnielsenmd.com/stress-reduction.

Kelly Daunter, PsyD, LLPIn addition to the six-week introductory course, clinical psychologist Dr. Kelly Daunter will be offering three one-night Mindfulness Workshops - Mindful Eating, Mindful Parenting, and Mindfulness for Stress Reduction During the Holidays. These workshops are a great way to “get your feet wet” and see what Mindfulness Practice is all about, while applying the concept to everyday life stressors. If you’ve ever mindlessly ate a bag of potato chips, snapped at your kids and regretted it, or felt run-down by Holiday stress, one of these workshops might be for you!  www.carinnielsenmd.com/events

Workshops will be held at Integrative Medicine | Carin Nielsen, MD in Downtown Petoskey. Space is limited and advanced registration is required. Please contact us to reserve your spot (231) 638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it." target="_blank" style="color: #f05329; line-height: 1.5;">This email address is being protected from spambots. You need JavaScript enabled to view it.

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