That Gut Feeling is more than You Think

 “What does your gut tell you?”  Hmmm… “I’ve got a gut feeling” this is going to be a great article.  Do you get “butterflies in your stomach” when you are nervous or upset?  Then you’d better “go with your gut” and read on!  These colloquialisms are truer than simple literary comments imply.  The connection between the gut and the mind is very real and very much influences the way we think and feel. 

Gut - Brain Connections

From the earliest stages of development the gut and the brain share a common source.  As a developing 4-week-old embryo we are about the size of a walnut and shaped like a little Frisbee with a mohawk.  The mohawk is the “neural crest” which is the earliest formation of our nervous system.  At a later point in development the neural crest literally divides into separate pieces, with one part becoming the brain and spinal cord while the other joins the gut, henceforth being called the “enteric nervous system” or the second brain.

These two “brains” are forever linked by the vagus nerve with most of the information traveling from the gut toward the brain.  The gut has 100 million neurons - more than are found in the spinal column or the entire peripheral nervous system.  As much of 95% of the “feel good” brain chemical called serotonin and about 30 other neurotransmitters are produced in the gut.  How the gut “feels” has a direct impact on the brain and a healthy, happy gut leads to a healthy, happy mind. 

The gut-associated lymph tissue (GALT) surrounds the gut and produces most of our infection fighting white blood cells called lymphocytes.  Everything that passes through the gut wall immediately encounters the GALT, which is vital in keeping toxins and microbial invaders from passing undetected out of the gut into the general circulation.  If gut absorption and processing is not running smoothly then the immune system is excessively triggered, causing the release of inflammatory chemicals, which have far reaching effects throughout the body, including the brain.

There are several known conditions in which an unhealthy gut will provoke the GALT.  “Leaky gut” refers to a damaged gut lining, with literal gaps in the gut wall.  An imbalance or deficiency of the beneficial gut bacteria is known as “dysbiosis”.  Both leaky gut and dysbiosis can lead to inappropriate triggering of the GALT.  Delayed food allergies are also common, affecting most of us to some degree, with certain foods provoking an immune reaction 12 to 72 hours after eating.  Even healthy foods such as whole wheat can be stoking the immune system causing decades of “simmering” inflammation.

Science is recognizing the profound impact that inflammatory chemicals have on brain function, detailing the minute connections that link inflammation and mood disorders.  Inflammation changes brain chemistry, and perhaps most symptoms of brain neurotransmitter imbalance, such as depression, anxiety and attention-deficit are ultimately linked to underlying immune dysfunction, which is so often triggered from the gut. 

We routinely find impaired gut function as the “root cause” of cognitive and mood disorders.  Symptoms such as difficulty concentrating, irritability, impatience, or being easily distracted are often linked to gut dysfunction or delayed food allergies.  I routinely see healing the gut and elimination of food allergens lead to resolution of depression, anxiety and attention deficit disorders.  Even autism and schizophrenia have documented connections to impaired gut health.

Great Gut Health

Insuring gut health starts with a healthy diet.  Our ancestors evolved over generations while eating a Paleolithic diet of fresh fruits, veggies, nuts, seeds, and wild game.  We inherit our family “culture” of beneficial gut bacteria and the specific balances of good and bad bacteria that inhabit our gut depend upon our diet. 

Modern diet changes that include sugar, grains and inflammatory fats wreak havoc on our native gut bacteria.  The plethora of food additives and chemicals in our food and water has an impact on gut ecology.  Medications and antibiotics can destroy the good bacteria that help keep our gut healthy.  All these impacts on gut health can indeed lead to changes in how we think and feel.

Taking a broad-spectrum probiotic is a simple measure that supports gut health.  An amino acid called L-glutamine can help heal an inflamed leaky gut.  My favorite is a special formulation from Douglas Labs call “Intestamine” that provides L-glutamine and other nutrients necessary for gut health.  Numerous plant-derived supplements such as aloe, mallow, olive leaf extract and slippery elm are soothing to the gut. 

Testing for delayed food allergies involves getting a simple blood test – but be wary of the results depending upon the lab used for testing!  I’ve used 12 different labs in as many years and found that not all labs do food allergy testing well.  We get consistent reproducible results and great patient outcomes from Immunolabs and it is the only lab I trust for food allergy testing.  A stool test called “comprehensive digestive stool analysis” from Genova Diagnostics is another great test that provides information about good and bad bacteria, pathogens, enzymes, inflammation and chemical processing in the gut.

Sign up for the “American Gut” project and for $99 you can get an analysis of your own gut bacteria while contributing to research that is mapping the gut ecology of millions of Americans.  Go to humanfoodproject.com for details.

Hippocrates said over 2000 years ago “All disease begins in the gut” and modern science is just starting to realize how very correct he was.  Gut health is a foundation for overall health and I believe we’ll see the restoration of beneficial gut flora and the repair of leaky gut as paramount achievements in mental health as well as medicine in general.

FREE SEMINARS

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Monday, October 7^th, 6pm

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Wednesday, October 16^th, 6pm

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Monday, October 21^st, 6pm

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Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (imcwc.com) and Bellezza Laser Aesthetics (bellezzalaser.com).  Call (970) 245-6911 for an appointment or more information. 

Cleanse & Detox

If you want to do something to improve your overall health, consider a simple cleanse and detox program.

Each of us has a continual onslaught of toxic chemicals that build up in the body and especially wreak havoc with our DNA, immune, endocrine and neurologic systems. With thousands of chemicals released every year into the consumer goods market, we are all exposed to and full of toxins. A cleanse is a great way to help our body to eliminate these toxic chemical invaders.

The results of toxin build-up may be symptoms such as fatigue, weakness, muscle or joint aches, brain fog or emotional ups and downs, irritable bowel syndrome or weight gain. Diseases such as cancer, dementia, heart disease, autoimmune disease and hormone imbalances are linked to various chemicals found in our food, air, water and consumer products.

One study showed that the average American has about 100 various chemicals directly measurable in the fat tissue where most toxins like to accumulate. These toxins include normal metabolic end-products, bacteria, both over the counter and prescription drugs, alcohol, insecticides, pesticides, pollutants, contaminants and food additives. 

NATURAL DETOXIFICATION

Our body comes with a marvelous system for eliminating toxins, most of which enter our body through the gut, skin or lungs. The liver is the first and foremost detox organ in the body. All the blood from the stomach and small intestine flows directly to the liver where the various bacteria and toxins are filtered out. The toxins are “deactivated” and made soluble in water so they can be eliminated via the kidneys, skin or gut.

The natural detox system has three main phases that must work in concert to get the job done. Phases one and two occur in the liver and like a “one-two punch” they need to work together to succeed. Phase three is the final “packaging” that allows toxins to be sent on their way out the body.

The first phase of detox involves the “cytochrome P450” enzyme system, in which toxins are transformed into chemical intermediates that are even more toxic and must be immediately acted upon by the phase two system. During phase one detox, adding or removing an electrical charge from toxins creates the dangerous “free radicals” that can cause so much harm in the body. This is one area where anti-oxidants play a key role in health by keeping control of these free radicals.

Phase two detox is called “conjugation” and it picks up where phase one left off, immediately going to work neutralizing the toxic intermediates by attacking various chemical groups. This is where naturally-occurring enzymes such as glutathione, catalase, and super-oxide dismutase rule.

When everything works well, our body does a fine job of taking care of these toxins so that they don't harm the body. However, there are numerous reasons that our detox system fails.

First, the system can only do so much. Our exposure to hundreds of chemical toxins is not part of the evolutionary plan and we are overloading our capacity to detox. Second, the detox systems rely on abundant nutrients to function, which our standard American diet is woefully short on supplying. Third, impaired gut health is common and causes many toxins to build up while impairing phase two detox pathways upstream. Last, we have discovered only in recent years many genetic mutations that cause some people to have a dysfunctional detox system. 

HOW TO CLEANSE AND DETOX

When I say “cleanse” what I'm referring to is cleaning out the stagnant, built up accumulation of toxins and sludge that interfere with a healthy detox. The first stage focuses on the gut by eliminating foods that cause inflammation, while increasing foods that help bind toxins and stimulate bowel motility. Various supplements are usually added to facilitate this process. This stage is done to “prepare” the rest of the system for detox.

The second stage of a cleanse and detox program is the actual detox portion. Foods and nutrients that support the liver are emphasized. Plenty of water helps the kidneys and skin excrete toxins through the final phase three pathways.

There are dozens of diets to cleanse and detox. A loosely structured detox diet simply eliminates sugar, grains, red meat, dairy, and processed or packaged foods, while emphasizing raw, organic fruits and veggies. Most detox diets also eliminate caffeine and alcohol. Fasting is often done to facilitate the cleansing of the gut. We like the “Fast Track Detox Diet” by Ann Louise Gittleman, PhD, CNS, because it is simple and effective.

The third stage of most detox plans involves healing the gut, replenishing the nutrients lost in the aggressive detox, and restoring the beneficial bacteria in the gut. Again, this is usually done through diet and supplements.

Foods that support the liver detox systems include crucifers such as broccoli and cabbage, green leafy veggies and herbs such as kale and parsley, citrus fruits such as lemon and lime, sulfur-rich foods such as garlic and onions, and foods that heal the liver such as artichoke, asparagus and celery. Cleaning out the colon is done with foods high in fiber, including carrots, apples and berries, and supplements such as psyllium or flaxseeds.

There are probably more supplement programs for detox than there are diet plans. I routinely use and highly recommend two products from Douglas Labs. The “metabolic rejuvenation pack” is a 4-week program designed to prepare, detox and repair. The “metabolic cleanse” is a powdered protein drink designed to add extra nutrients and gut-healing compounds into the plan. 

DETOX FOR HEALTH

If you have any significant health problems, it is wise to consult with your doctor and/or a professional that is well versed in detox programs. All medications are processed through the liver detox systems and a detox program may affect the metabolism of drugs. This is usually helpful in the long run by helping the liver process and eliminate drugs; however, it can also change blood levels of drugs such that it could cause problems.

We routinely perform the DetoxiGenomic® Profile from Genova Diagnostics, which evaluates genetic mutations called single nucleotide polymorphisms (SNPs) that are associated with increased risk of impaired detoxification capacity especially when exposed to environmental toxins. It also identifies individuals potentially susceptible to adverse drug reactions.

Doing a cleanse and detox is a simple process that can reap big health rewards. No matter what method you choose, be careful to avoid gimmick detox programs. Be sure the program is founded in good nutrition, quality supplements and overseen by a qualified professional.

For more detailed information, join us for our free “Cleanse and Detox for Great Health” seminar. Nutritionist and colleague Monica Cullinane and I will review the science on cleanses and detox programs. She follows our seminar with a cooking class geared toward detox foods and then a 10-day detox program. Call 970-245-6911 if you are interested in consulting with Monica to plan your own detox program.

Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call 970-245-6911 for appointments or more information. 

Dietary Confusion Part 1: Making Sense of Different Diets

With titles from A to Z, there are hundreds of diet plans and the media headlines are full of tips on “this diet” or “that diet”.  The medical literature banters back and forth about the benefits and risks of “low carb” versus “low fat” versus “high protein” as we hyper-analyze measurements such as good cholesterol, bad cholesterol, insulin, glucose, weight and blood pressure.  But which diets really work, what do they have in common, and which ones promote good health? 

On my bookshelf sit about 30 books on various diets which I have read over the years, including The Atkins, HCG, Hormone, Jenny-Craig, Mediterranean, NutriSystem, Paleo, Ornish, Pritikin, South Beach, Weight-Watchers, and Zone diets, just to name a few….  Each diet has it’s own “claim to fame”, and there are some common-sense threads that they all share, with a few of them making recent medical news.

Well Known Diets

The Atkins diet promotes weight loss by severely limiting carbohydrates, which are the “ready to burn” food source that converts quickly to glucose, and any glucose that is not burned for energy gets stored as fat.  By eliminating carbohydrates from the diet, the body naturally breaks down stored fat into chemicals called “ketones” which are burned for energy.  Ketones suppress appetite, which also leads to less calorie intake.  In the short term, the Atkins diet usually works for weight loss, but there is much controversy over the long-term health effects.

The South-Beach Diet is a “heart-friendly” version similar to the Atkins diet, but it makes a distinction between good and bad carbohydrates, and between good and bad fats.  Similar to Atkins, reducing carbs is key, but mostly the high-glycemic carbs that so quickly breakdown to glucose.  Unlike the Atkins plan, only healthy fats are allowed.

The Pritikin and the Ornish diets are both centered on a low-fat diet.  As with the South-Beach diet there is a distinction between good and bad carbs or fats.  The Ornish program in particular emphasizes the diet as part of a bigger program including exercise, stress relief, and healthy social connections.  Dr. Ornish has published numerous articles on the success of his program in reversing heart disease, and has succeeded in getting insurances such as Medicare to actually pay for qualifying patients to go through his “intensive cardiac rehabilitation” program.

The Paleo diet, also known as the “caveman” diet, is based on the idea of eating similar to our distant Paleolithic hunter-gatherer ancestors, focusing on a diet that includes wild game, fish, nuts, roots, fruits and vegetables.  Excluded are foods that came into our diet after the age of agriculture and domestication of animals – namely grains, legumes, and dairy.   Loren Cordain, PhD, Colorado State University professor and author of “The Paleo Diet” says even though grains and dairy seem healthful, our "genome has not really adapted to these foods, which can cause inflammation at the cellular level and promote disease.”

The Mediterranean Diet... even the name inspires a vision of warm breezes, crystal blue waters, and fresh healthy foods.  Rich in plant foods and healthy fats the diet has shown some of the best health benefits of any in numerous studies.  The focus is on locally available and fresh seasonal foods, relying heavily on unprocessed, whole plant foods such as fruits and vegetables, beans, whole grains, nuts, olives, and olive oil along with some cheese, yogurt, fish, poultry, eggs, and wine.

Several diet plans emphasize the role of hormones in proper metabolism.   I enjoyed The Hormone Diet as a great review of how many hormones, such as thyroid, cortisol, and the sex hormones, impact metabolism.  This plan emphasizes low-allergenic natural foods, and takes readers through a 3-step program that starts with a detox diet, all the while pointing out that balancing hormones is key to good metabolism and weight loss.

The Zone diet is geared toward eating a balance of foods that lower inflammation and lower insulin levels.  Author, Dr. Sears, recommends lower carbohydrate intake and some protein at every meal in order to blunt the fat storage hormone called insulin, and encourage more of the fat breakdown hormone called glucagon.  The focus is that we think of food not as "a source of calories but as a control system for hormones."

Calorie Control Programs

The Jenny Craig diet has been around since the 1980s and centers on calorie control with pre-packaged meals being the focus during the initial phases of the diet.  Exercise and lifestyle are also emphasized in the formal programs.  About the only limitation in food type is limiting high-glycemic carbs. 

NutriSystems goes back to the 1970s and provides a pre-packaged food system that takes convenience to a new level by shipping complete microwavable meal plans for a month.  Again, calorie control is the focus, and the food ingredients are generally healthy, being low in salt, mostly low-glycemic good carbs, low fat, healthy protein, and high-fiber. 

Starting in the 1960s, one of the oldest and most well known diets is Weight Watchers.  As stated on their website it was based on the idea of “changing habits and getting support and encouragement from people who cared” and “the belief that the best way to control weight is to change bad eating habits”.  The program allows most any food and focuses on calorie control using a point system that gives certain foods certain points with a limit on how many points one can eat in a given day, thus leading to an overall method of encouraging the choice of more of the healthier low calorie low point foods.

The HCG diet has been wildly popular in recent years although it has been around since the 1950s.  It is an aggressive weight loss program that centers on using the HCG hormone, normally made during pregnancy, to help the body readily breakdown stubborn fat deposits.  Not a long-term plan, this diet is more about shedding pounds.  Eating a very restricted calorie diet of normal meats, fruits and vegetables, while injecting the HCG hormone, dieters don’t get hungry and usually lose up to a pound per day.  This diet should be done with medical supervision.

With the above overview of some of the most well-known diet plans you may be better informed, but still a bit confused about which one to follow.  In “Dietary Confusion, part two” I will condense the lot of these into what I consider the most successful plan that will help you lose weight, promote good health and feel your best.

FREE SEMINARS

“Supplements:  Why You Need Them and How to Choose Them”

Monday, April 1^st at 6pm, at the IMC

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Monday, April 15^th, at 6pm, at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call 245-6911 for an appointment or more information.

Adventure Medical Kits

  

What if your routine cross-country ski jaunt on the Mesa turned emergent and you were stranded - would you be able to spend a night out on the Mesa this time of year?  Or how about an incapacitating sprained ankle or illness during the backpacking trip – how would you deal with that?  Having the right medical gear is simple and might just save a life.  Here are some tips on where to start preparing or updating your kit.

General Considerations

Preparing a medical kit requires addressing a few general issues first.  What is the purpose of the kit?  The contents are determined by the nature of the trip, and the specific injuries or illnesses most often encountered.  My day kit is mostly a survival kit with fire starters, rescue mirror, emergency blanket, compass, knife, cordage, etc.  The kit I taking rafting or camping is my standard adventure medical kit, with the survival kit included and now adding more medical supplies.  The kit in my car has contents that would be appropriate if we got stranded or came upon an accident.

The level of medical training of the party is another issue.  Obviously the people using the kit need to know how to use its contents appropriately.  A license or degree does not guarantee adequate knowledge of wilderness medical skills.  I might have IV fluids and injection medications while everyone could have wound care and basic medications.  Knowledge of what to do is sometimes more important than the contents of the kit.

The destination of a trip has a big impact on kit contents.  Consider climate, terrain, altitude, and unavoidable dangers of certain areas.  For example, desert hiking requires different items than winter mountaineering.  When backcountry skiing I add a metal cup to melt snow, a Nuwick 120 hour candle, and small lightweight snow-shovel.  Consider endemic diseases.  A kit for use in America is different than a trip to another country where malaria or other diseases are endemic.

The length of trip determines how much to bring.  I don’t need a week supply of different medications in my day pack, but for a two week camping trip I need to prepare for a complete course of medications should they be needed.  Consider high use items such as blister pads versus rarely needed items such as epinephrine and stock accordingly.

The size of the party is a similar variable as length of trip, and again requires stocking more high use items.  Even as a kid on adventures with my buddies, I was generally the “go-to” person whenever there was trouble.  So I’ve learned to prepare for myself and family, but also recognize that I might be treating others as well.

Exposure is the amount of time until outside help can be reached and may greatly influence the level of care needed and thus the supplies.  From the Grand Mesa I might walk downhill to a highway in a day, or call a medical helicopter to fly in, while on a remote river or backpacking trip you might be days away from help.

Bulk, weight and cost are variables.  Include items with multi-purposes and take a modular approach to packaging that allows changing kits without completely repacking.  I’ve prepared small, light kits for as little as $25 and also spent thousands for huge kits used by commercial companies caring for employees spending months in remote parts of foreign countries.

Containers and Equipment

Think maximal protection and maximal accessibility.  Use containers that are easily located and allow you to rapidly identify the contents using labels or visible colors.  Divide "mini kits" among party members to avoid loss of the entire kit.

The materials included reflect the needed functions.  A fundamental need is to stop bleeding.  One can use direct pressure with bare hand, clothing, or pressure bandages.  I keep a complete wound kit for convenience with minor wounds, but for anything life-threatening or large plan to use cotton clothing or other material and not try to stock huge amounts of pressure bandages. 

Treating and closing wounds can be done with butterfly bandages, steri-strips or sutures with surgical equipment.  Duct tape can be cut into a very effective butterfly bandage.  Cleansers and disinfectants, local anesthetics, bandaging materials and blister treatment fall into this category.  In the wilderness, you should boil or purify water for cleansing a wound just like you would to prepare for safe drinking. 

Splinting is a common need for a sprain or fracture.  Prefabricated splints are widely available and I always carry a light-weight SAM splint.  Improvisation is the key as most anything can be splinted with a stick and duct tape.  Coban, or “vet wrap”, makes a great compression dressing and soft splint.

Monitoring vital signs is important and a watch is helpful for checking pulse rate.  A thermometer can be useful.  A blood pressure cuff is rarely needed.  Special equipment is needed for administering medication by injections or IV fluids.  Usually in wilderness settings more serious life support equipment is not realistic, such as artificial airways, chest tubes, electroshock, etc. 

I recommend purchasing an empty specialty bag such as a first aid kit, toiletry bag or camp kitchen bag then filling it with materials.  Prepackaged kits are costly and not usually complete to my specifications anyway.  Most supplies can be purchased at a pharmacy or through your doctor.  I simply drop my organized bag into an ammo can for water protection.

Medications

Here is a comprehensive list of different medication categories to consider:  antibiotics, analgesics (pain killers), anaphylaxis, anti-histamines, anti-pyretic (for fever), anti-emetic (for nausea and vomiting), anti-diarrhea, anti-fungal, anti-parasitic, anti-tussive (for cough), cardiovascular, decongestant, dental, dermatologic, diabetes, diuretic, hemorrhoidal, iv fluids, laxatives, local anesthetic, muscle relaxant, ophthalmic, otic, rehydration, sedative, snake bite and vaginal. 

About half the medications can be found over the counter without a prescription.  I recommend speaking with your physician about prescription medications.  I generally meet with a patient for a short office visit to discuss the various medications that are indicated and simply write them a prescription.  I’m careful to include “first aid kit – for expedition use only” on the prescription and emphasize the medications are for the patient or family use only.  Giving the medications to other people is discouraged due to issues such as allergies or medication interactions, and patients have to use their discretion and accept responsibility if sharing medication with others.

Remember the old saying, “proper prior preparation prevents poor performance” and once packed and ready to go I don’t give it another thought because I’m prepared.  Most wilderness medical emergencies can be handled with a good adventure medical kit, a little first aid knowledge, and the determination to succeed with grit, spit and a whole lot of duct tape!

FREE Seminars

“Bioidentical Hormone Replacement for WOMEN”

Monday, February 4^th, 6pm at the IMC            

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Monday, February 18^th, 6pm at the IMC

OPEN HOUSE Bellezza Laser Aesthetics

Wednesday, February 27^th, 6pm at the IMC

Giveaways, wine and appetizers!

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Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call 245-6911 for an appointment or more information.

Why am I So Tired-Could it be Low Thyroid?

Thyroid hormone controls your energy, growth and metabolism.  If you are low on thyroid you might notice fatigue, sluggishness, intolerance of cold or cold body temperature, brittle thinning hair, or dry skin.  You might have uncontrollable weight gain, trouble losing weight, constipation or indigestion.  You might even be depressed, apathetic, have “brain fog” or low sex drive.  Abnormal menstural cycles or trouble getting pregnant can be due to low thyroid.

What is Thyroid?

The thyroid gland sits in the front part of the neck and makes thyroid hormone from iodine and an amino-acid called tyrosine.  80% of thyroid output is tyrosine with 4 iodine molecules attached, called T4, but this is not the active thyroid hormone.  Out in the body, in the muscle, liver, kidney and brain, T4 must have one of its iodine molecules removed to form the active thyroid hormone, called T3, which is the form that gets into the cells to do its work.  Thyroid binds to nuclear receptors and commands a whole array of energetic and building processes, from growth, to metabolism, to energy production and detoxification.

Control of thyroid production is overseen by the pituitary gland, a small pea sized gland that resides in the lower central portion of the brain.  The nearby brain area called the hypothalamus determines if there is enough thyroid hormone in the body, and if not, sends a signal to the pituitary to increase thyroid production.  The pituitary then releases thyroid stimulating hormone (TSH) which urges the thyroid to ramp up production of thyroid hormones.

Low thyroid is called hypothyroidism and “primary” hypothyroidism is when the thyroid gland is impaired and quits making thyroid hormone.  “Secondary” hypothyroidism is when the thyroid gland is fine but the pituitary is damaged and does not send the proper TSH signal, or the thyroid gland does not get the signal.

The most common textbook form of primary hypothyroidism is called Hashimoto’s, in which the body makes antibodies that attack the thyroid and turn off thyroid production.  We find this most commonly in women, age 30-50, often after pregnancies or around menopause.  In recent years we have learned that this condition, like other autoimmune diseases, can be cured if we can find and remove the “trigger” that upset the immune system’s regulating cells.

Some people have low thyroid due to iodine deficiency.  There is debate as to whether the iodine in our table salt supply is really enough for optimal health.  We recommend testing for iodine levels and supplementing only if indicated.

Secondary hypothyroidism can be due to anything that damages the pituitary or interferes with the ability of TSH to work properly.  Inflammation and the stress hormone cortisol both interfere with pituitary output, causing a low grade impairment of TSH production from the pituitary.  Head injuries are a common cause of subtle pituitary damage.

I have hundreds of patients with low thyroid that are “under-converters”.  For various reasons some people do not convert their T4 to T3, and as a result are low on thyroid.  The lack of conversion can be due to aging, stress, prolonged illness, toxic metal or chemical exposures, other hormone imbalances, nutrient deficiencies and medications, amongst others.

Beware of “Normal” Thyroid Tests

The standard blood test for diagnosing and monitoring thyroid conditions is thyroid stimulating hormone (TSH) from the pituitary gland.  TSH goes up to promote thyroid production, so if TSH is high, it suggests low thyroid, and visa-versa.  There is conflicting opinion about how well this test can be trusted and in my opinion it is not at all sufficient to monitor thyroid status.  I recommend patients also get a free T4 and free T3 blood test, as well as two tests for antibodies to the thyroid, TPO and thyroglobulin antibody.

Sometimes even the better blood tests are not accurate in determining thyroid status.  The blood level of thyroid hormone may not reflect the level that actually gets into the cells or the cells may be resistant to thyroid hormone.  There are numerous reasons that TSH may not accurately reflect thyroid status.  In practice there is much controversy over this concept, yet there are dozens of studies from the endocrinology research that confirm these phenomena.

Not every low thyroid condition requires thyroid hormone.  We strive to correct other imbalances that have led to low thyroid production or resistance to thyroid hormone action.  Often Hashimoto’s is curable.  Controlling high stress and cortisol can improve thyroid function.  Eliminating sugar and high glycemic foods from the diet will improve all hormone functions.  Supplying nutrients for thyroid production, eliminating exposures to thyroid-toxic chemicals or chelating heavy metals out of the system can help improve thyroid function.

Most physicians use T4 only thyroid hormone for replacement, such as Levothyroid or brand name Synthroid.  This is just fine as long as people convert the T4 to the active T3.  Some patients do markedly better on forms of thyroid hormone that contain both T4 and T3, such as brand name Armour thyroid.  And still other patients will only feel normal by taking a T3 only type of thyroid replacement.

Aside from feeling poorly, low thyroid will increase the risk of diseases such as obesity, diabetes or heart disease.  Low thyroid also causes problems with the function of other hormones causing them to work poorly.  For example, women need thyroid hormone to ovulate and make enough progesterone which is required for a normal menstrual cycle or pregnancy.  Men and women need enough thyroid hormone to allow the sex hormones to promote a healthy sex drive.  As you can see, thyroid is a critical player in the symphony of hormones.

If you have symptoms of low thyroid and they don’t seem to relate to anything else, then you are very likely low on thyroid hormone.  The routine blood tests might be “normal” even if your thyroid function is NOT!

So, know the symptoms of low thyroid.  If you are suspicious that you have a problem, ask your physician to check the blood tests suggested above.  This will give you a starting point for treatment.  If the blood levels are within the normal range, but you still have symptoms of low thyroid, you may need to consider some of the conditions mentioned above in order to have your thyroid “normal” for you.

At last count I have 12 paperbacks and 2 textbooks on my shelf specific to the thyroid.  I recommend several as resources, including “Stop the Thyroid Madness” by Janie Bowthorpe, and  “Why Do I Still Have Thyroid Symptoms?  When My Lab Tests are Normal” by Datis Kharrazian.

FREE Seminars

“Low Thyroid:  Misunderstood, Misdiagnosed, Missed”

Monday, January 21^st, 6pm at the IMC            

“LIGHTWAVE and Laser Skin Care Essentials”

Wednesday, January 30^th, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call 245-6911 for an appointment or more information.

HCG Boost for New Years Weight Loss

If you want to "kick start" your New Year's weight loss efforts then consider getting a boost with the HCG diet.  Although it has been around for about 50 years the diet is getting more attention than ever and for good reason.  Losing up to a pound per day for 20 days is evidence enough that it works.  HCG is no miracle but it does come close! 

HCG is "human chorionic gonadotropin", a hormone that women produce in pregnancy, which amongst other things helps to mobilize fat stores to ensure sufficient energy for mom and baby.  The HCG diet involves taking a daily dose of the HCG hormone while eating a limited calorie diet.

In my experience, the HCG diet is a good starting point for long-term healthy nutrition as it eliminates all sugar and junk food, allows for lean proteins, veggies and fruits, while helping us to see that our current portion sizes are way out of control.  Another thing I like about the HCG diet is that it gets people away from so much dairy and gluten, which are common food allergens.  These are further reasons most people feel highly energized throughout the program - usually way better than they did before they started.

One of the first questions people ask is "will I get hungry?" on the diet.  No, since the HCG increases the body's ability to access energy stored in stubborn fat reserves, patients on the HCG diet will break down enough fat for needed energy.  As a result they don't feel hungry.

A second question is how overweight does one need to be in order to consider the HCG diet?  There is no certain weight to qualify...  We have had several patients lose over 100 pounds, while most lose 20-40 pounds, and some have needed help losing the last stubborn 10 pounds.

Another big concern is whether the weight will stay off.  After a 20 day cycle of the HCG diet, there follows a critical three-week stabilization period of eating higher calories combined with low sugar and low fat.  This teaches the body to burn fat readily, and after that, so long as reasonably healthy patterns are maintained, there is no rapid rebound weight gain.

What about safety of HCG?  Women make as much as 1 million units of HCG daily while pregnant.  HCG is used in conventional medicine to induce ovulation in girls and promote puberty in boys with delayed puberty, in doses of about 10,000 units daily.  The HCG diet uses doses of 125 units per day and I've neither witnessed nor heard of any complications with HCG.

But wouldn't any restricted calorie diet cause weight gain?  Yes and no...  Without HCG people on restricted calorie diets get very hungry, feel poorly and lose muscle along with fat.  We don't observe that with HCG so it clearly makes a difference.

I first came across the HCG diet over 10 years ago.  As there is not much published literature on the diet I was initially reluctant to implement it into clinical practice.  Over the years I met other doctors, both allopathic and naturopathic, that prescribe the HCG diet in their practices with great success, which encouraged me to proceed.  Now, after 4 years of prescribing HCG with hundreds of patients I continue to be impressed by the success of HCG for weight loss. 

Keeping Weight Off Holistically

The HCG may be the "catalyst" that people need to get the weight off but it is critical to address all the underlying reasons that people have excess weight to begin with.  In order to maintain healthy weight we need to take a holistic approach that addresses both the body and the mind.  A medical weight-loss program should consider social, psychological, hormone, digestive and immune systems. 

Hormonal imbalances or deficiencies, such as low thyroid, high cortisol, estrogen dominance or low sex hormones after menopause, all contribute to impaired metabolism and abnormal fat storage.  Low testosterone leads directly to less muscle building and more fat storage.  Undiagnosed or under-treated hormone imbalances are present to some degree in about half of the patients we treat!

Digestive health is truly a foundation of good overall health.  Many people who struggle with weight have impaired gut function due to a lack of the beneficial bacteria that do so much to promote health, including production of important metabolic B vitamins, activation of thyroid hormone, metabolism of excess estrogens, and more. 

"Leaky gut" may be allowing toxins and undigested food particles through the gut wall which causes the immune system to be constantly agitated leading to chronic elevations of inflammatory chemicals, the stress hormone cortisol, blood sugar and insulin - all of which leads to weight gain, especially around the middle.

Delayed food allergies are another major cause of impaired digestive health and weight gain.  As with "leaky gut" a food allergy can stoke the immune system for years leading to the same cortisol-insulin resistance issues.  Unlike the "immediate" allergies involving histamine (e.g. hives, hay fever) the "delayed" allergies take 12-72 hours to get going thus making it hard to correlate a food with an allergic reaction.  Patients are therefore unaware that certain foods they are eating everyday are causing weight gain. 

HCG Success Story

A new patient consulted with me to "get to the root of the problem instead of adding another medication".  He had tried numerous weight loss diets without success.  He weighed 260 pounds and was on eight medications for arthritis, diabetes and high blood pressure.  After the first week on HCG he had already lost 10 pounds and stated "I've not felt this good in years". 

After two rounds of HCG he was 50 pounds lighter and off all medications except one blood pressure pill.  His low back pain is gone.  His diabetes is gone.  Correcting his hormone deficiencies, restoring gut health, eliminating food allergens, and adopting good health habits with diet and exercise were an important part of his overall metabolic health.  A year later he has not only maintained the weight loss, but also actually dropped more weight on his own.

Under the right conditions the HCG diet will lead to weight loss give people a better chance of maintaining ideal weight.  A great weight-loss program involves a medical doctor, registered nurses, medical assistants, health coaches and more.  In depth medical evaluation, nutrition and exercise education, and psychological support all combine to ensure success.

Of course, maintaining a healthy weight involves great nutrition, regular exercise, healthy sleep and management of stress.  The HCG diet isn't a magic cure... but it is a dynamite catalyst toward long-term healthy nutrition and weight management.

FREE Seminars

"HCG Weight Loss"

Wednesday, January 16^th, 6pm at the IMC

"Low Thyroid:  Misunderstood, Misdiagnosed, Missed"

Monday, January 21^st, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com).  Call 245-6911 for an appointment or more information.

My Christmas Music Perscription

  If laughter is the best medicine, then I’d like to think music is a close second.  Not having the opportunity to study music as a child, I discovered around the age of 18 that I actually play music by ear, which is a blessing and a curse.  I must confess that my love for music, specifically playing the piano, borders on problematic.  Most days if I’m running behind I can blame it on the irresistible gravitational pull of that glorious black and white keyed beast that lives in our living room.  When the evening workout is skipped, again the piano is impugned.  If the jazz bars would have me and I could pay the bills, I’m afraid medicine might become my hobby.

Listening to music is equally appealing.  Mozart helps the infant brain grow and the college student score higher in math.  Whether it’s Beatles or Stones, Rock or Country, Jazz or Classical, music can lift the spirit, infuse the soul and send us flying.  Have you ever seen someone singing in the car, smiling, oblivious to the hubbub around them?  Or, how about after your first breakup, when somehow every song on the radio seemed perplexingly written just for you. 

The Christmas season brings with it some of our favorite music, and to my wife’s delight, my children and I start practicing around September.  Not that we need the practice, but it’s a good excuse to cover up our sentiment.  The classics, so jazzy and light, so uplifting and spiritual – aaah, there’s a reason they are classics.  Being a music buff, I’d like to share some little known history of a few Holiday favorites.

Austrian Catholic priest Joseph Mohr penned one of the most beloved and well-known songs, ‘Silent Night’, in 1818.  The church pipe organ had broken and Franz Gruber hastily composed the music for a tenor, a bass and two guitars.  That same night it was heard for the first time at Midnight Mass.  The song quickly became a favorite around Austria, then the world, and it was the 1850s before the anonymous composers knew of its success.

“Gloria in Excelsis Deo” was called from peak to peak on Christmas Eve by shepherds in the south of France, announcing the birth of Christ.  The song, “Angels We Have Heard on High” was first published in a carol collection that dates 1855.

“Joy to the World”, penned in 1719 by English hymnist and cleric Isaac Watts was based on Psalm 98 in the Old Testament.  The “Carol of the Bells” was originally a Ukrainian folk song intended to be sung a-capella, celebrating the joyous bounty of the season. 

           

“Adeste Fideles” was written in France around 1750 by British exile John Francis Wade, and a century later British clergyman Frederick Oakeley turned out the English version, “O Come, All Ye Faithful”.  He translated the song because he felt if congregations had good literary texts to sing, they would sing well.

Modern day composers, such as Johny Marks who wrote “Rockin’ Around the Christmas Tree”, “A Holly Jolly Christmas” and “Rudolph the Red-Nosed Reindeer”, provided the songs for legendary singers like Nat King Cole and Bing Crosby, who made the Christmas songs into classics.  Judy Garland made “Have Yourself a Merry Little Christmas” famous in the 1944 film Meet Me in St Louis.  Gene Autry wrote “Here Comes Santa Claus” and his singing made “Frosty the Snowman” a huge hit in 1951. 

           

Even the great geniuses of American musical theater, Rodgers and Hammerstein, gave us some great Christmas tunes with “My Favorite Things”, from the 1959 Sound of Music.  In the stage version, Maria sings a duet with her Mother Superior in the covenant, listing the many things in her life she could not give up as a nun – whiskers on kittens, brown paper packages tied up with string….

           

When it comes to Christmas recordings, here are some of our family favorites:  A Very Special Acoustic Christmas by assorted artists, My Kind of Christmas by Christina Aguliera, Go Tell it on the Mountain by The Blind Boys of Alabama, When My Heart Finds Christmas by Harry Connick, Jr, Yule B’ Swingin’ by assorted artists, and of course the timeless classic of all classics, The Christmas Song by Nat King Cole.

           

George Frideric Handel composed the oratorio, “Messiah” in 1741, and the “Hallelujah” chorus is perhaps one of the most celebrated works of the Christmas season.  There is a story told about this chorus... that Handel's assistant walked in to Handel's room after shouting to him for several minutes with no response.  The assistant reportedly found him in tears, and when asked what was wrong, Handel held up the score to this movement and said, "I thought I saw the face of God."

           

My prescription for the holiday season is to ‘eat, drink, and be merry’ – eat rich but healthy, drink in moderation, and merrily enjoy the simple beauty of the songs that celebrate the reason for the season.

FREE Seminars

“HCG Weight Loss”

Wednesday, January 16^th, 6pm at the IMC

“Low Thyroid:  Misunderstood, Misdiagnosed, Missed”

Monday, January 21^st, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com).  Call 245-6911 for an appointment or more information.

In the Mood for Hunger Control