Narrative Medicine uses a patient’s background and language to assist in clinical practice and research and is an effective and often cathartic approach to individualized healing. When physicians are able to address the personal “stories” that may work in conjunction with physical illness, we can validate the experience of the patient and promote a stronger relationship between patient and physician.
Every day I see patients with varying health challenges, many of whom are additionally metabolically unhealthy. With the risk of COVID-19, poor cardiometabolic health has gained more attention, and some experts are even referring to it as a pandemic within the pandemic. As a preventive integrative physician, I see this as an opportunity for many to focus on metabolic health and, hopefully, make lemonade from lemons.
How could this have been prevented? This is a question I have been asked hundreds of times throughout my training and over the course of my career. As a resident learning about surgical procedure as pertains to obstetrics and gynecology, I clearly recall thinking beyond the surgery to how the need for the surgery may have been prevented. It was during this time that I decided to switch my concentration to family medicine, which would allow me to further focus on prevention.
I recently wrote about the difference between Integrative and Alternative medicines, but you may wonder what exactly is involved in becoming a certified integrative physician?
Over the years I have been approached by patients who seek my care in an effort to bypass conventional medicine. It’s understandable, as many are dissatisfied by the tendency of conventional medicine to focus on high-tech interventions and pharmaceutical management of established disease. There are beneficial aspects of conventional care, most notably acute and surgical care, but I am concerned about those forgoing the preventive aspects of conventional medicine, such as cancer screenings, immunizations and medications that can prevent complications or progression of disease. In addition, I have also seen those declining curative cancer therapy.
After receiving my initial cancer diagnosis, I became acutely aware of making my day-to-day life more manageable, both mentally and tangibly. I feel very grateful for the advice and discoveries that helped to navigate my experience as a cancer patient and to live intentionally.
Alzheimer’s disease (AD) is the most common form of dementia and currently affects more than 5 million Americans and 30 million people worldwide.
Whether it’s an aging parent, a spouse, a coworker, a sibling or a friend, it seems we all know someone who has experienced cognitive decline. And it makes sense, as Alzheimer’s disease (AD) is the most common form of dementia and currently affects more than 5 million Americans and 30 million people worldwide. This devastating disease, along with its precursors, mild cognitive impairment (MCI) and subjective cognitive impairment (SCI), have become the most significant healthcare problems both nationally and globally.
Evidence that shows the symptoms of Alzheimer’s Disease may be partially reversed
Fortunately, progress is being made. Dr. Dale Bredesen, a neurologist who has spent more than 30 years researching Alzheimer’s disease, has created training on its treatment and prevention, known as the Bredesen ReCODE (Reversal of Cognitive Decline) Protocol. Treatments for Alzheimer’s disease and dementia have been largely ineffective thus far because they fail to slow disease progression, but through Dr. Bredesen’s teachings we are seeing evidence that shows the symptoms of Alzheimer’s Disease may be partially reversed, even in advanced cases, and have returned many patients to their pre-diagnosis levels of cognition.
The Bredesen ReCODE Protocol
So, what is the process? By applying key concepts of functional medicine, identifying lifestyle factors, administering tests and designing customized treatments for patients, the Bredesen ReCODE Protocol recognizes some 150 factors that contribute to Alzheimer’s disease. Specific tests are used to measure underlying factors that cause the disease, and a comprehensive plan, personalized for each patient, addresses lifestyle factors such as diet, sleep, stress management and exercise, as well as gut health, hormonal balance, environmental exposures, infectious triggers and more. The relatively simple and often low-cost solutions to treatment and prevention of aging-related mental disorders includes direction on factors such as nutrition, supplements, mental and physical exercise, stress reduction, intermittent fasting. Following this organized, multifactorial protocol, symptoms of mild cognitive impairment and early AD may often be reversed within six months after treatment. Radiologists have reported that MRI tests, which previously showed typical symptoms of Alzheimer’s in the brain, have returned to normal and research has shown patients returning to work, resuming driving and living as they did prior to mental decline.
Following this organized, multifactorial protocol, symptoms of mild cognitive impairment and early AD may often be reversed within six months after treatment.certified ReCODE Provider
Dr. James is a certified ReCODE Provider
Alzheimer’s is something that I am acutely passionate about, having lost my father to the disease and witnessing first hand its devastating path. And so, I am honored and excited to announce that I have completed the Bredesen training and am now a certified ReCODE Provider. As a functional medicine practitioner, studying this method of treatment is a natural next step for me, and I so look forward to sharing my knowledge with those in need and implementing what I have learned to begin the process of bringing hope to Alzheimer’s, SCI and MCI patients. Through this encouraging research and treatment, I am confident that we will continue to make great strides in reversing cognitive decline.
As the children go back to school and parents begin to juggle work, carpools, sports and homework help, it’s easy to become overwhelmed and experience difficulty in maintaining focus. And this applies even more intensely to those dealing with such ailments as ADD, ADHD, mild cognitive impairment and decline, anxiety, past concussions and the like.
But there are ways to combat our failing focus.
A healthy lifestyle that includes plenty of sleep, regular exercise, minimal screen time, ongoing organization and reduced stress, which can be aided by meditation or listening to classical music, are just a few. In addition, focus can be supported by adhering to a diet rich in Omega 3, Zinc, Iron, Vitamin B, and other nutrients.
Below is a list of supplements that may help us manage focus and, ultimately, support good mental health. For those currently receiving treatment for a diagnosis, these may be taken in conjunction with medication. As always, please consult your physician prior to starting a regimen of supplements.
Choline
Choline is a vitamin-like nutrient essential for optimal brain development and it influences cognitive function in later life. Choline is produced in the liver, and the amount that the body naturally synthesizes is not sufficient to meet human needs. While we obtain some choline from our diets, many of us don’t get the amount recommended by the medical profession, which is 550 mg per day for men and 425 mg per day for women. Choline supplements should be taken in the morning to improve attention and cognitive function throughout the day.
Alpha GPC by Jarrow: 300-1200 mg per day. Citicholine by Jarrow: 250-500 mg per day.
L-Theanine
L-Theanine is an amino acid found in green tea that can help with focus, reduce stress, promote relaxation, and is especially helpful for those with anxiety.
L-Theanine by Vital Nutrients: 100-200 mg, 2-3 times per day.
Bacopa
Bacopa is an outstanding herb used in India for the young and old that promotes mental focus and clarity, and has antidepressant and anxiolytic activity for those who experience mental fog, ADHD and learning disabilities.
Bacopa Extract by Planetary Herbals: 1-2 tablets, 2-3 times per day of whole leaf extract.
Kids Daily B Centered
Kids Daily B Centered provides a range of B vitamins, along with zinc, bacopa, lemon balm and L-Theanine. This is ideal not only for those suffering from ADD and difficulty focusing, but it also serves as a calming agent.
Kids Daily B Centered Nutrient Booster Powder by MegaFood: 1 scoop per day.
References:
L-Theanine/ Green Tea https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728665/!
Each year, we hear about new trends in do-it-yourself health care. Some are worthwhile, while some are a waste of time and money, even dangerous. Lately I have noticed that patients are utilizing essential oils, so I thought I’d take a moment to set the record straight on these popular potions, which claim to cure everything from acne to anxiety.
The “essence” of the plants’ fragrance and characteristics.
Essential oils are highly concentrated oils which have been extracted from plants, and are deemed “essential” because they contain the “essence” of the plants’ fragrance and characteristics. Due to their concentrated nature, however, these oils should be used with care and respect, as misuse can potentially cause harm. Here are a few facts to keep in mind prior to dabbling in a potentially slippery slope.
1. Quality.
Currently, there is no independent medically-accepted body that regulates or certifies oil quality, so buyers must beware. There are false claims regarding quality and touting the use of “therapeutic grade,” a meaningless term created and registered by one of the largest distributors of essential oils. For example, 43% of the commercial examples of tea tree oil do not have the appropriate chemical components, and some actually contain contaminants. It is important to purchase from a known distiller who harvests the oils at the correct time, using knowledge of peak growing conditions. Buying organic (but not raw) is important and substitutes are dangerous. A few recommendations to consult prior to purchasing are the National Organic Program (NOP), the USDA or EcoCERT. My rule of thumb: If the price is too good to be true, you are probably purchasing a lesser quality product.
2. Undiluted Oils.
While there are several causes of adverse reactions to essential oils, the most common can be easily avoided: Do not put drops of essential oils into a bath and step into it, as oils do not mix with water and will float on the top, creating a not-so-soothing experience. In addition, contact with water makes oils evaporate less quickly, increasing the body’s absorption of unwanted elements such as parabens. In an effort to avoid health hazards, I highly recommend researching safe ways to dilute essential oils prior to using them.
3. Ingesting.
Unless recommended by a trained practitioner, essential oils should not be ingested. They may be harmful to the body’s microbiome, delicate mucosa of the mouth and gastrointestinal tract.
4. Overuse.
It is not advisable to directly and intensively inhale essential oils for longer than 15 to 20 minutes. The ideal concentration of essential oils should produce a faint scent rather than bombarding the room with bouquet. In addition, constant use of diffusers may harm your pets, as they have sensitive systems that cannot tolerate long periods of inhalation. Remember: Less is more.
5. Misinformation.
Many of the claims and recommendations made regarding essential oils are false and provided by untrained practitioners. For example, patients have asked me recently about Frankincense Essential Oil due to misleading and confusing information on websites and in blogs. At the root of the problem is knowing the difference between Frankincense Essential Oil and Frankincense, which is a resin that contains a promising ingredient, Boswellic acid, that is actually not found at all in the essential oil form. The bottom line is, multi-level marketing companies are selling their products with exaggerated claims and deceptive marketing, so do your homework whenever possible to make sure you’re on the right track.
If you are interested in using essential oils or have already purchased them and are seeking further information, my advice is to use caution when buying, research advice from only trained practitioners and use the oils safely and in moderation. It may be a bit more time consuming, but in the long run it’s best to make sure that what you’re buying and how it’s used is indeed essential to your health.
Resources
Tisserand Institute http://tisserandinstitute.org/grasse-french-aromatherapy/
Every day our bodies experience circadian rhythms, or mental, physical and behavioral changes that are based on our response to the light and darkness in our environments. The best example being sleeping while it’s dark and performing our daily functions while it’s light outside. But these rhythms relate to far more complex brain and body functions, and are suffering in today’s society, as we are living less and less according to the natural cycle of the seasons.
Truth is, our world is light-deprived and we are paying for it with our health.
Our bodies have become accustomed to the dim artificial light provided in our work places, found while running indoor errands, and again at home, when we are relaxing by watching television or sitting in front of our computers. But there’s a bright beam of hope: Researchers are making great strides in understanding the impact of light on our health and wellness, and there is now emphasis on the importance of getting enough of the right kind of light, which is bright light. It is called Light Therapy.
Light therapy recommended for Seasonal Affective Disorder (SAD)
Light therapy, or exposure to bright artificial light that mimics natural outdoor light, has long been recommended for Seasonal Affective Disorder (SAD), a form of depression that occurs mainly in the fall and winter months, causing chemical alterations that result in changes in mood, sleep, even eating habits.
Light therapy is also effective for a number of additional disorders and health issues, such as:
Non-seasonal depression (chronic depression and treatment-resistant depression)
Premenstrual disorders
Pregnancy-related depression
Winter-heightened ADHD
Dementia
Parkinson’s Disease
Jet Lag and Shift Work (exposure to proper light can safely shift our
bodies’ clocks to function effectively under circumstances of fatigue)
Sleep disorders
Low energy and fatigue
Eating disorders
Cancer- and illness-related depression – Chronic Fatigue Syndrome
The benefits of light therapy continue to grow as this treatment is more widely utilized and studied. And while its one-time cost and quick results are an attractive prospect, even more impressive are recent studies and results: Data has shown that light therapy is as effective as antidepressants for depression and other disorders and, when used in addition to medication, accelerates improvement and symptoms.
Guidelines for purchasing a light therapy box
Of course if you are interested in purchasing a light therapy box or lamp, there are guidelines for the best results, such as purchasing a light that provides 10,000 lux of illumination at a comfortable sitting distance, brands that have been tested successfully in clinical trials, a white light rather than a colored light, as “full spectrum” and blue lamps provide no known therapeutic advantage, and more. There are minimal, if any, side effects stemming from light therapy, mainly headaches, eye strain or edginess.
As always, it is best to consult a physician before purchasing or beginning a new therapy. In this instance, the timing of the light is important, and it is not recommended for everyone, especially those with retinal issues or eye disease. I often give light therapy a glowing review and hope you’ll look further into its advantages or contact me for a consultation so we can determine if it might benefit your winter blues.
Resources
Center for Environmental Therapeutics. www.cet.org
Ach Gen Psychiatry, 2011. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/211002
Alzheimer’s is something that I am acutely passionate about, having lost my father to the disease and witnessing first hand its devastating path. And so, I am honored and excited to announce that I have completed the Bredesen training and am now a certified ReCODE Provider. As a functional medicine practitioner, studying this method of treatment is a natural next step for me, and I so look forward to sharing my knowledge with those in need and implementing what I have learned to begin the process of bringing hope to Alzheimer’s, SCI and MCI patients. Through this encouraging research and treatment, I am confident that we will continue to make great strides in reversing cognitive decline.
