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Three Simple Lessons from Sandra

“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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Food is Medicine

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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UltraLite™ Dietary Ketosis Weight Loss Program

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).

b2ap3_thumbnail_blog_jan2_scale.jpg
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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12 Weeks = Amazing Results

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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TESTIMONIAL

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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