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

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

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

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

Omega-3 fatty acids are backed by volumes of research indicating their value in reducing risk of conditions such as:
  • heart attack and stroke
  • autoimmune disease such as rheumatoid arthritis
  • certain forms of cancer
I most often recommend fish oil to supplement omega-3 fatty acids, because it is a rich source of the two active and essential omega-3 fatty acids known as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Other omega-3 rich supplements include cod liver oil and krill oil.
All omega-3 fatty acid supplements are not created equal!

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

HOW TO READ YOUR FISH OIL LABEL:

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

Take a look at this example:

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

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

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

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

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

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

——————————————

Are you getting enough omega-3 fats in your diet?  Could you benefit from more?  We can test your blood omega-3 fats through an essential fatty acid panel.  I also make individual recommendations for fish oil supplementation for patients based upon symptoms and chronic conditions.  Contact our office for more information or to book an appointment!  231-638-5585.






Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. I continue to see both new and returning patients from all over Michigan using my secure, easy video-visit format.  If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  3328 Hits

Book Review: "Healing Arthritis" by Susan Blum, MD, MPH

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

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

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

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

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including arthritis. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. When treating arthritis and autoimmune disease, my approach involves treating root causes such as toxicity, food allergy/sensitivity, stress/trauma and underlying infection. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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Infrared Sauna Therapy

INFRARED SAUNA THERAPY

Frequently Asked Questions


b2ap3_thumbnail_InfraredSaunta.jpgWHAT IS AN INFRARED SAUNA?
An infrared sauna uses infrared light waves to penetrate through the skin barrier, deep into the body, raising the body's core temperature.
Infrared sauna treatments, like traditional saunas, cause increased sweating and heart rate.


HOW IS AN INFRARED SAUNA DIFFERENT THAN A CONVENTIONAL SAUNA?

An infrared sauna differs from traditional saunas because the infrared light waves penetrate through the skin into the body, heating the body directly. Traditional saunas raise body temperature by heating the around you.
Infrared saunas do not heat the air around you, and produce results at lower temperatures than a traditional sauna. In fact, you can comfortably read a book or magazine during your sauna treatment!


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


WHO MIGHT BENEFIT FROM INFRARED SAUNA THERAPY?

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

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

OUR  INFRARED SAUNA THERAPY USES FAR-INFRARED LIGHT,
WHAT DOES THAT MEAN? 
All infrared sauna therapy is not the same!  There are different levels of infrared light: near, middle, and far.  These different levels represent the different sizes in infrared wavelengths and refer to the intensity of the treatment.
While near-infrared light may be helpful for wound healing and may help to warm the body. far-infrared light penetrates deeper in the body producing more sweat.  Potential benefits may include improved circulation, muscle relaxation, and enhanced detoxification.

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

Our Finnleo® far-infrared sauna uses Pure Infra technology, which was developed to take the worry out of unnecessary exposure to EMR and EF. The electrical field in a Pure Infra is less than you’d experience from a computer screen or cell phone.

Are you ready to start infrared sauna therapy?
Give our office a call at 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.  Holistic therapies such as Infrared Sauna are just one way that we help patients "think outside the box". Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  2796 Hits

FOOD SENSITIVITY TESTING & The Next Generation FIT Test

FOOD SENSITIVITY TESTING and
The FIT Test by KBMO Diagnostics


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

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

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


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

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

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

 

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

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

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


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

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

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

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

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

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



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

 
 
  2450 Hits

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

Book Review

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

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

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

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

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

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

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

Carin Nielsen, MD



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, and using a "Food First" approach is a common theme in our office. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office at This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  1575 Hits

Summer Supplement Swap

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

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

SWAP OUT IMMUNE SUPPORT FOR ANTIOXIDANTS

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

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

ADD EXTRA MINERALS

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

KEEP YOUR VITAMIN D DOSE IN CHECK

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

Here’s to a happy, healthy Summer!

Carin Nielsen, MD


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

b2ap3_thumbnail_sanitasgeneral2.jpg

THREE REASONS TO CHOOSE SANITAS:


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

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


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

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


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

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

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

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

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

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


b2ap3_thumbnail_SAN_CURRENT-PHOTO-groupsm.jpgPROGENERATE • ACTIVATE • OPTIMIZE

AN OVERVIEW OF THE SANITAS SKIN CARE SYSTEM
 

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

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

b2ap3_thumbnail_SAN_GlycoSolution-5_sm.jpg
ACTIVATE
Looking to take your skin care routine up a notch?
Integrate one or more of the Active skin care products into your routine. 

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

b2ap3_thumbnail_SAN_BrighteningPeelPads_sm.jpg
OPTIMIZE
Have a specific need?
Try these targeted, therapeutic products.

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

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

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  1544 Hits

Childhood Mood & Behavior Disorders - A Functional Medicine Approach - Luke's Story

In one year, this 10-year-old has made significant behavioral improvements, has stopped two of three medications, is no longer experiencing insomnia or constipation, and is thriving at school.  Read today's blog to hear his story!

BACKGROUND

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

b2ap3_thumbnail_boy-attacked.jpg

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*patient name has been changed to protect privacy

Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including both adult and childhood mood and behavior disorders. Rather than focusing solely on the use of prescription medication, consider addressing potential "root causes" of you or your loved one's symptoms, such as nutrition, gut health, toxicities/impaired detoxification, hormone imbalance, deficiencies and more. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  2584 Hits

12-week Transformation

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

Wondering how a program might work for you?


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


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

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

In just 12 weeks, she lost:

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

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


Are you ready to get started?


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



Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  1902 Hits

Treating Seasonal Mood Changes. Part One - Light Therapy and Vitamin D

SEASONAL MOOD CHANGES?

Time to check in with your Neurotransmitters.


PART ONE – LIGHT THERAPY AND VITAMIN D

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

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

BOOST YOUR NEUROTRANSMITTERS THIS FALL: CONSIDER LIGHT THERAPY

As our daylight dwindles are you getting tired and grumpy?

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

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

OPTIMIZE YOUR VITAMIN D LEVELS

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

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


Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone imbalance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
  2381 Hits

Estrogen Metabolites - Which path does Estrogen take in your body?

Breast Cancer Risk

THE ROLE OF ESTROGEN METABOLITES 

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

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



BREAST CANCER RISK FACTORS


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

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


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

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


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

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

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

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


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

DETERMINING ESTROGEN'S PATH IN YOUR BODY.

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

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Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone imbalance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
 
 
 
  4150 Hits

Three Simple Steps to Prevent Summer Diet Sabotage

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

Suddenly, healthy eating becomes even more of a challenge.

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

CONSIDER THESE THREE SIMPLE STEPS TO PREVENT SUMMER DIET SABOTAGE:

b2ap3_thumbnail_ProteinShakes.jpg1. Start your day with protein and fiber

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

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


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

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

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

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

Be Well!
Carin Nielsen, MD
  3247 Hits

Quiz: Assess your Neurotransmitter Balance

In yesterday's blog I gave an overview of Neurotransmitters, brain chemicals that communicate information throughout our brain and body.  These “brain hormones” are essential for optimal mood, energy and weight!  Treating thousands of patients over the last ten years, I have learned that a proper balance of neurotransmitters is a key first step when embarking on a program toward lasting lifestyle change.  Take my short quiz to assess how neurotransmitter imbalance may be affecting your mood as well as your appetite and hunger patterns.  


Take my short quiz to assess your neurotransmitter balance.


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



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

  11630 Hits

Get to know your Neurotransmitters - “brain hormones” essential for optimal mood, energy, and weight

Neurotransmitters
Balancing these “brain hormones” is essential for optimal mood, energy, and weight.


b2ap3_thumbnail_brain.jpgNeurotransmitters are brain chemicals that communicate information throughout our brain and body. Think of neurotransmitters as “brain hormones”. Proper balance of neurotransmitters is essential to regulate hunger, mood, cravings, energy, motivation, and self-image.

Neurotransmitters are synthesized in the body using amino acids, the building blocks of protein. These amino acids come from the digestion of protein in the foods that we eat. The synthesis of neurotransmitters also requires cofactors, various vitamins and minerals needed to make each type of neurotransmitter.


The four key neurotransmitters -
what they do and how their levels affect your mood, appetite and weight.



SEROTONIN 
What do you see when you look in the mirror?

b2ap3_thumbnail_serotonin.jpgSerotonin is perhaps the most important of all neurotransmitters in maintaining mood and well-being. The primary building block of serotonin is tryptophan, an amino acid found in large amounts in poultry. Tryptophan is converted to 5-HTP which is then converted to serotonin. Serotonin levels regulate:
  • self-image and confidence
  • mood stability
  • happiness/positive attitude
  • hunger and cravings
  • healthy sleep cycles
Low serotonin is associated with:
  • depression, anxiety, PMS and obsessive-compulsive disorder (OCD)
  • negative self-talk and self-image, poor self-esteem
  • sadness, tearfulness
  • short-tempered, an inability to “let things go”
Association of serotonin with hunger and weight:
  • serotonin is temporarily boosted after eating carbohydrates/sugar
  • those with low serotonin will often crave starches like pasta and bread
  • those with low serotonin will often have more hunger/cravings in the evening


DOPAMINE
Have you lost your “spark”?

Dopamine is another key neurotransmitter in mood and well-being. Dopamine is made from the amino acid tyrosine, which converts to L-DOPA, and then to Dopamine. Dopamine helps to regulate:b2ap3_thumbnail_dopamine.jpg
  • motivation
  • energy
  • focus
  • feelings of reward
  • Low dopamine levels may be associated with:
  • fatigue
  • low motivation
  • difficulty with focus/attention
The relationship of dopamine and food/drink:
  • those with low dopamine levels often have cravings throughout the day, especially sugar, candy, and chocolate
  • those with low dopamine levels also tend to seek out caffeine throughout the day

GABA
Are you able to relax?

b2ap3_thumbnail_GABA.jpgGABA is an inhibitory neurotransmitter that is needed to keep the brain from becoming overstimulated. It is our primary “relaxation” neurotransmitter. Low GABA levels are often associated with:
  • anxiety
  • an inability to relax
  • feeling chronically “stressed out"
  • Physical signs of low GABA may include:
  • recurrent headaches
  • heartburn
  • muscle tension
  • irritable bowel syndrome
How GABA levels may affect your eating patterns:
  • those low in GABA tend to be emotional eaters
  • those low in GABA are also more likely to binge eat, although not necessarily just starches

ACETYLCHOLINE  b2ap3_thumbnail_acetylcholine.jpg
Are you forgetful?

Acetylcholine is the neurotransmitter involved in the processing speed of the brain. Acetylcholine levels are associated with:
  • learning
  • memory
  • retention of information
  • low levels of acetylcholine are also seen with Alzheimer's disease.
Acetylcholine levels and food cravings:
  • those low in acetylcholine tend to crave fat, fried foods such as hamburgers and pizza
  • those low in acetylcholine may favor creamy desserts like cheesecake and ice cream

Are you relating to any of the above symptoms?  Many of my patients with neurotransmitter imbalance will relate to more than one of these categories.  Tomorrow I will offer a short quiz to test where your neurotransmitter imbalances may be, and discuss a variety of treatment options.  Stay tuned!

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

  4208 Hits

Highlights from the Annual Nutrition & Health Conference

Earlier this week I attended the 12th Annual Nutrition & Health Conference, presented by the Arizona Center for Integrative Medicine under the direction of Andrew Weil, MD (pictured with me below). Each year, this conference brings together a variety of experts to focus on the central role of nutrition in health and healing, and provide a scientific basis for the integration of nutrition and medicine into practice. It is a medical conference like no other! I was inspired not just by the depth of research presented, but also by the quality and character of both the faculty and the fellow attendees. This is an organization that truly “walks the walk”.

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MY CONFERENCE TOP FIVE HIGHLIGHTS:
 
Thin mice become obese when they receive a fecal transplant from obese mice.  
Without any other change (including no change in diet/exercise), simply transplanting stool from an obese mouse into a thin mouse causes weight gain.  Now you know why I am so obsessed about the role of your gut microflora in your health…
 
Environmental exposures are directly linked to childhood obesity, especially Bisphenol A (BPA). 
Once again, it is not just about calories, there is more to the story.  Chemical exposure contributes to obesity.  On a positive note, research has shown that when children have their diet changed to organic food, the measured levels of pesticides in their urine is substantially lowered in less than a week.
 
When it comes to weight loss and reduction of hunger, it's not total daily protein intake, but rather adequate protein intake at key points during the day that matters. 
This was not news to me - but it was great to see the valid research backing up what I speak with my patients about daily!  For those patients in need of weight loss, food pairing with adequate protein at timed intervals during the day can be very effective in reducing hunger and preventing over-eating, especially curbing nighttime snacking.  
 
Mitochondria make up approximately 10% of your body weight.  
Don’t know what mitochondria are?  It’s time you learned.  Mitochondria are the “energy factories” in all of the cells of our body.  Certain cells have more mitochondria than others, such as heart cells, which need more mitochondria because they need more energy.  Healthy mitochondria are the key to healthy aging, and one of the best things you can do to keep your mitochondria healthy is to EXERCISE.
 
If an item displays a "USDA Certified Organic” label, it is non-GMO. 
I actually did not know this.  While there are separate labels for non-GMO, you do not have to look any further if you see this certified organic label.  No GMOs allowed.  That being said, as larger companies are buying up smaller organic companies, they are getting more seats on the government boards that set these definitions.  The number of allowed chemicals under the "USDA Certified Organic” label is changing yearly.  Something to keep an eye on...

If you have any questions about this conference or the topics above, please feel free to email me directly at This email address is being protected from spambots. You need JavaScript enabled to view it..

Be Well,

Carin Nielsen, MD
 


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

  3045 Hits

Leaky Gut Explained

Leaky Gut = Inflammation, Food Sensitivities, Nutrient Deficiencies and Autoimmune Disease

b2ap3_thumbnail_GutHealing.jpgOur intestinal lining is a very important barrier. When working properly, the lining allows only certain small desirable substances (like nutrients) to pass through, while keeping out larger undesirable particles (like infections, allergens and toxins).

Think of your intestinal lining like a net with very small holes. If the net becomes damaged and the holes of the net become larger, then larger particles are able to pass through the net that ordinarily couldn’t. This damaged intestinal lining is what may lead to increased intestinal permeability, or “leaky gut”.

b2ap3_thumbnail_FineMeshStrainer.jpgIf the intestinal lining is damaged or compromised, undesirable substances such as bacteria, viruses, undigested food particles and toxic waste products can leak from the inside of your intestines through the damaged lining into your bloodstream. Once they get into your bloodstream, these particles are transported throughout your body and can trigger your immune system to react. The end result is inflammation in various parts of your body.


An unhealthy intestinal lining can be a major source of inflammation in your body.

The inflammation in your body caused by a damaged digestive lining can lead to a wide variety of symptoms, including:
  • Bloating and abdominal cramps 
  • Fatigue and “brain fog” 
  • Rashes, Eczema and Acne 
  • Food sensitivities 
  • Weight Gain 
  • Joint pain 
  • Headaches 
  • Depression and Mood Swings 
  • Chronic sinus infections 
  • Allergies 

When your intestinal lining is unhealthy, you are more likely to have food sensitivities.

When you have a leaky gut, certain foods that you eat are likely to make your symptoms worse. This is because large, undigested food particles entering the bloodstream trigger your immune system to react, promoting more inflammation and symptoms such as listed above.


An unhealthy intestinal lining can also lead to nutrient deficiencies.

With leaky gut not only is the intestinal lining more porous (bigger holes in the net) and less selective about what can get in, but normal absorption can also be affected. Intestinal villi are finger-like projections in the wall of the small intestine that are responsible for absorbing nutrients. When these villi become damaged, certain nutrients are not able to be properly absorbed, resulting in nutrient deficiencies. Common deficiencies seen include:
  • Iron 
  • Vitamin B12 
  • Magnesium 
  • Zinc 

An unhealthy intestinal lining over time can lead to autoimmune disorders.

There is a growing consensus that the immune system response triggered by leaky gut may be a primary cause of autoimmune disease. As discussed above, your immune system acts like your own personal army, ready for attack! When larger, undesirable particles get into the bloodstream, the immune system goes on “high alert”, increasing inflammation in preparation of fighting off invaders. The immune system then may begin to produce antibodies to attack and destroy these invaders. Problems result when this antibody response gets out of control, and begins to attack your own tissues. This is self-attack-self, the hallmark of autoimmune disease. This may trigger or worsen conditions such as:
  • Rheumatoid Arthritis 
  • Thyroid disorders 
  • Psoriasis 
  • Celiac disease 
Before you jump to potentially harmful prescription medication - get to the root of the problem! Healing an unhealthy intestinal lining is one of the most important steps in treating a variety of symptoms and conditions, including autoimmune disease.



Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to an unhealthy digestive lining. Treating symptoms simply by prescribing medication as a “band-aid" 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.


  3341 Hits

Have you been tested for Chronic Inflammation?

b2ap3_thumbnail_fire.jpgIt is well established that chronic inflammation is a key factor in most chronic disease, yet many doctors overlook the one simple blood test that can assess your level of inflammation. Often without symptoms, chronic, low-level inflammation may be threatening your health right now without you even knowing it!



Inflammation - the Good and the Bad

Inflammation in your body has a purpose - to treat injury and illness. Without inflammation, wounds would not heal and simple infections could become deadly. The inflammation in your body that treats injury and illness comes from your immune system. Think of your immune system like your own personal army, ready for attack. If you become ill or injured, your immune system activates pathways of inflammation in your body for healing. You can see and feel this inflammation as swelling, pain, warmth and redness at an injury site or warmth from a developing fever. These symptoms are all signs that your immune system is doing it’s job! When your immune system is working properly, the inflammation is temporary, and the inflammatory pathways in your body are turned off as you heal.

b2ap3_thumbnail_injury.jpgWhile temporary, purposeful inflammation is healthy, too much inflammation in the body is not. When inflammation persists or serves no purpose, it damages the body and causes illness. In the brains of Alzheimer’s patients, inflammation destroys nerve cells. Inside arteries, smoldering inflammation damages the arterial lining and helps kick off atherosclerosis (plaque). Inside joints, inflammation eats away at cartilage causing painful arthritis.


It is well-established that chronic inflammation is the root cause of many chronic diseases, including:

  • Heart disease
  • Stroke
  • Obesity
  • Many cancers
  • Arthritis
  • Alzheimer's disease
  • Diabetes

Causes of chronic inflammation:

  • b2ap3_thumbnail_Donuts.jpgStress 
  • Lack of exercise 
  • Genetic predisposition
  • Elevated blood sugars
  • Excessive calorie consumption
  • Excessive body fat (fat cells release inflammatory signals in the body)
  • Exposure to toxins (cigarettes, pesticides, heavy metals, etc.)
  • Periodontal disease
  • Infection and Imbalance in the Digestive Tract
  • Inflammatory foods 


Testing for Inflammation

Knowing your level of underlying inflammation can be a key step in making changes to reduce the development of many chronic diseases and avoid age-related health decline.

hsCRP = high-sensitivity C-reactive protein

There are several tests that can be used to assess your level of inflammation, but the one test you need to start with is the high-sensitivity C-reactive protein, or hsCRP. C-reactive protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. Elevated levels indicate inflammation due to infection or tissue injury. The high-sensitivity type of this test can detect chronic inflammation even at very low levels.

Do you know your hsCRP value and what it means?

hsCRP value of 2.0 or greater is considered high risk

hsCRP value 1.0-1.9 is considered borderline risk

hsCRP value kess than 1.0 is desired


If you are interested in knowing your hsCRP value, you can order a hsCRP laboratory test directly through my website without an appointment!  Follow this link to avoid insurance hassles with affordable testing and get fast results!



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


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Three reasons to start your day with a Protein Shake

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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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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