The Staggering Costs of HEALTHCARE

The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease”—Thomas A. Edison (1847-1931)”

 

Yet pharmaceuticals have grown excessively from 2010-2018. 35% to be exact. In fact, in 2019 spending on prescription drugs did US$500 billion.

 

The Administrative burden costs too much

It was estimated that in the year 2019 the administrative cost of healthcare to the US GDP was $265 billion. The statistic is staggering, but there is more. In 2015 the American Academy of Family Physicians did a study. They found that there was a 90% increase in healthcare jobs. Yet those jobs were for administrative personnel. In the 4 years prior to the study, 95% of all hires were administrative personnel. They reported that the average administrative burden of any office was 3:1. That is 3 administrative personnel to every 1 medical provider. 

 

From the 2019 Research the costs were further looked at in terms of waste. That waste is part of the administrative burden. It was reported that the average employee spends 5.5 minutes on the phone per day with clients explaining the EOB from the insurance company. It accounts for a loss of $21.6 billion dollars. 

 

With these calls followed up with calls to the insurance company from the provider office, the burden of cost is $95 billion. And then there is the burden overall. It is reported that the more time that someone works in the healthcare field, the less productivity they have. It is typically reduced on average by 1% per year after the 3rd year of employment. 

 

People who regularly engage with the Insurance companies via phone or written correspondence report 10% less satisfaction and are 14% less likely to engage in the healthcare system. This can actually significantly delay care for more specific diseases like cancer, heart disease and diabetes.  

 

Overall Cost of Healthcare: $3 trillion annually or 28% of the total GDP

To keep that in perspective, only $50 million is spent on Physical Therapy each year. 

 

When Social Security and Medicare started in 1930, the average life expectancy was 58 for Males, 62 females. Currently the average life expectancy is 75 for males, 76 females. The age of retirement is 65 years of age, but many companies are offering retirement earlier as ways to age out more established people who have a higher salary burden to the company.

The cost of Medicare Benefits currently is $709.5 billion dollars and covers 58 million people. 

References:

https://careers.iconplc.com/blog/how-has-the-pharmaceuticals-industry-changed-in-the-last-decade–blog-01142312301
https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019?gclid=Cj0KCQjw4cOEBhDMARIsAA3XDRgMlO9jpLc29krIJlv5syhuvP-VbwS-_nKmu0t7BNP5Q1bXKghA7qoaArggEALw_wcB

Thyroid Dysfunction: Overall Health Part 2

Thyroid and Hair Loss

Many people start to suffer what is called hormonal alopecia. It is the systemic loss of hair from all over the body with the loss, or gain, of certain hormones. The most common type of hair loss for women is due to thyroid dysfunction. The areas that we typically notice is the thickness of mane hair, or a shrinking ponytail. But, eye lashes coming out and or thinning of the brows, particularly the outer 2/3’s is fairly significant and should be noted. It IS A REASON to have you thyroid tested.

In Many cases, thinning brows, or a slimmer ponytail might be your only true indicator that the thyroid is struggling. This is because the sleep issues in the current day and age are rampant. Devices, job and school requirements and stimulant intake disrupts what we consider “normal sleep”. Since most think 1 bowel movement every 2 days is normal, this may also be missed. (See Previous Blog). Weight fluctuates for many college students and athletes as they exit high school and collegiate sports as well, so that might not be a great indicator.

Why Is my Hair Thinning a symptom?

Because the hair grows sin 4-6 week cycles, If you are not able to maintain growth due to poor thyroid function, you will start to see global sparseness in the hair. The patterns is across the entire scalp, not just the top or the front. It is related because the thyroid controls the ongoing functions that support the system as a whole to remain WHOLE. If you are lacking in nutrients required, you will start seeing hair loss sooner than diagnosis. This is because “Sub-Optimal” levels of thyroid can lead to long term damage.

What Can I do about Hair Loss and Hormones? (1)

  1. Take a Quality Muti Vitamin 
  2. Take Extra Vitamin D and Know your levels (25OH-VitD should be between 50-80, 30 is considered normal)
  3. Get 15 Veggies and 5 fruits Daily
  4. Get Enough Protein (1.9kg/pound females; 2.4g/pound males)
  5. Get some Protein from collagen
  6. Sleep 8-10 hours daily
  7. Eat iodized salt
  8. Eat crustaceans (selenium, iodine and zinc all support thyroid).
  9. Eat Brazil Nuts (4/day for selenium requirements)
  10. Get tested Early and Often.
  11. As young as 18 but before age 24. (normally recommended at age 32)
  12. Run a FULL Thyroid panel (most run TSH and Total Thyroid)(2)

 

  1. 1. https://www.endocrineweb.com/news/thyroid-diseases/thyroid-conditions-hair-loss-help#:~:text=What%20does%20thyroid%20hair%20loss,hair%2C%20and%20eyelashes%2C%20too.
  2. https://thyroidpharmacist.com/articles/need-know-thyroid-disease/

Thyroid Dysfunction: How does over all health affect this?

Thyroid. Weight Gain. Hair Loss

All of these terms fall together when we think about thyroid dysfunction, but there are a lot of reasons why each symptoms is important. There are also many ways to support the thyroid without medicating it first.

The Blogs of the last few weeks had focused on weight management and goals around weight. This can be considered an extension, but for different reasons. The thyroid is the endocrine gland primarily responsible for metabolism. Many don’t know this, but the thyroid gland can control heart rate, sleep cycles, hunger cycles, sweet tooth, salty cravings, and kidney and bladder function. Your thyroid also can have an impact on mental clarity, focus, memory and mood. (1)

HPA-axis: Health in balance

The thyroid, anterior pituitary gland and hypothalamus create that HPA axis in conjunction with the adrenal glands and are a self regulatory system for maintenance of glandular function and hormone production in the body. The HPA axis is stimulated primary by signals released from the liver. When given the right stimulus, with all the available nutrients in surplus, the system is flawless. IF there is a lack of nutrients, or there is toxic load increase in the liver, the system hits some bumps. Those bumps can cause major health issues.

Hypo- Low Thyroid:

This condition occurs for many reasons. There is a subclinical hypothyroidism that many times goes undiagnosed until a problem arises, but is often still last to be treated. People with hypothyroid often suffer feeling cold all the time. They have cold hands and feet, even if it is 100 degrees outside. Bradycardia, or a rather slow heart rate at rest is also a symptom. Now many athletes have bradycardia, but most don’t also feel cold all the time. slow heart rate at rest is looking at someone who drops often into high 40s or low 50s after being at rest lying down for 10 minutes. Weight gain is a symptoms of low thyroid. Constipation. This, as discussed in the last blog, is a huge factor. Many think not voiding fecal matter for 1-2 days is normal. IT. IS. NOT. People also often feel tired, lack of desire, lack of motivation.

Hyper- Fast or high Thyroid

Some might think this is what they want. I can introduce you to a few people who can tell you that if this persists longer than a month, you want it to stop. Tachycardia. The opposite of Bradycardia. You can see resting heart rates above 120. Now, if your not sure what that feels like, go for a run walk for 30 minutes where you run for 1 min walk 1 min. And try and cary on a conversation. It’s HARD. It’s EXHAUSTING. And let’s say you are a nurse who must wear scrubs, lab coat, Procedure covering gear, shoe covers, hair covering, face covering, and talk through discharge instructions with each patient. Are you sweating yet? Imagine this daily. Usually, the doctors will ask for you not to exercise until it is regulated as well. That would be awful for many who use exercise as a mental health boost. These people also often have muscle weakness, intolerance to heat, tremors, and diarrhea.

How do you Support Thyroid Naturally?

  1. Eat a healthy well balanced diet with a lot of fruits and vegetables. (15 vegetable, 5 fruit/day0
  2. Get enough protein (males 2.4 g/kg body weight per/day; females 1.9g/kg body weight/day)
  3. Have some protein come from collagen.
  4. Set a sleep schedule
  5. Use a Good Quality Vitamin.
  6. Each iodized salt
  7. Eat crustaceans (selenium, iodine and zinc all support thyroid).
  8. Eat Brazil Nuts (4/day for selenium requirements)
  9. Get tested Early and Often.
    1. As young as 18 but before age 24. (normally recommended at age 32)
    2. Run a FULL Thyroid panel (most run TSH and Total Thyroid)(2)
      1. TSH

        Optimal versus Normal Thyroid Lab Values
        Comparison of Optimal versus Regular values
      2. TPOa
      3. T3
      4. Reverse T3
      5. T4 Total
      6. Free T4
      7. FTI
      8. Resin F3 Uptake
      9. TGB
1.https://www.ncbi.nlm.nih.gov/books/NBK500006/
2. https://thyroidpharmacist.com/articles/need-know-thyroid-disease/

Weight Loss: Tried and Failed Goals Part 3

Poop

How does Pooping affect my weight?

In the last blog on the 25th of February, You may have noticed that I mentioned regular bowel movements as a way to loose weight. Or that not having 3 bowel movements a day can cause weight gain. So Why is this?

Constipation is the Devil when it comes to Detoxification

Constipation occurs when our food bolus byproducts move through the intestines too slowly. This can be caused by a bunch of different factors, so let’s go over a few.

  1. Dehydration:

    1. Your Body needs between 80-120 ounces of non-caffeinated Fluids a day, mostly from water.  You can have 4-6 ounces of juice or lemonade. Even the occasional Sprite or decaf root beer. But mainly, it should be water
    2. water helps bulk up stools so they can pass easier through the intestines
    3. Sticky materials move slower, so hydration makes them less sticky.
    4. Hydration is key daily throughout the, not all in one day or all at one time. I’ve heard many people say they drink 90% of their water before lunch, yet they still eat dinner. That meal has trouble making it through because less water is still available to move it.
  2. Poor Gut Microbiome:

    1. If your gut flora is out of balance you will crave more calorie dense, nutrient deficient foods
    2. The poor ability to have balance in the gut doesn’t allow certain types of foods to be broken down properly, thus poor nutrient absorption
    3. Poor nutrient absorption leads to Whole Food Pieces being present in the stool, making it stickier
    4. Can lead to IBS

How does Pooping decrease my weight

  1. Toxic Load is no longer High

    1. the number one reason you can not loose weight is that your body is storing toxins as fat.
    2. The environment, Food, Stress daily causes toxins to increase.
    3. Bowel movements, along with perspiration (Sweating) and Urination are the number one ways to eliminate Toxins
  2. You stop STORING that weight of your Poop.

    1. Some individuals carry up to 20 pounds of poop inside them
    2. Gas is not longer trapped, causing you to weight less, because the poop is exiting as well.
  3. Decreased Inflammation

    1. If you get rid of the toxins in your poo multiple times a day, there is less to cause inflammation
    2. You dont strain to go to the bathroom, decreasing the risk of inflammation, hemorrhoids and fissures in the colon/anus.

What other things cause constipation?

A variety of things can cause more constipation that the list above. Some of those include viruses. In June of 2016, the Yale Daily News reported finding that herpes type viruses, including shingles, epstein-barr and chicken pox, could cause constipation.

The Westchester Health Blog indicated that parasites are often linked with constipation. Bloating and gas as well as 8 other symptoms could indicate that you have a parasite.

A slow gallbladder can also cause constipation.

What should my Bowel movement look like?

Remember too that constipation can look a variety of ways. Difficulty going, not going enough, rabbit like pellets, stools that have lines, cracks or fissures.

Your Stool should be somewhere between the texture of a ripe banana to soft serve ice cream. It should take you less than 10 minutes to complete a bowel movement. You should not have to “bear down”, grunt or hold your breathe. And it should occur no less than 3 times a day, but optimally 4 times daily.

If you are interested in improving your Gut health and Poop Health, Schedule a Discovery Visit

Weight Loss: Tried and Failed Goals Part 2

What are other factors that affect weight Gain?

How many of you have tried a “detox”, “Cleanse” or a “reset”?

How many of you gained weight during that time?

I did. Every February for a decade, I did a 4 week detox and reset. I focused on getting 15 servings of vegetables, 3 servings of fruit, and 3 6ounce servings of Protein a day. I skipped the caffeine, cut out sugar and had NO PROCESSED FOODS.  The last two years that I did that cleanse I gained 12-14 pounds of fat in 28 days.

How do I know it was fat?

None of my pants fit. which meant it was abdominal weight gain. That weight gain is ALWAYS fat around the organs. It is also the most dangerous type of fat. Because it causes metabolic disorders like: Heart Disease, PCOS, Diabetes, Infertility, Menopause, Kidney dysfunction, Fatty Liver syndrome, etc.

So Why did it happen?

If you remember from last summer, I wrote a blog about Lemon water and detoxification. That Blog is important because it contains information about why we gain weight.

“The solution to pollution is dilution”

Your body only knows one way to “dilute” toxins. Toxins come from all over the place. The air, the food that we eat, The Body products we loose, The STRESS we don’t manage. IF your body can not get rid of the toxins, it will store it. The place it stores best, because it is the most binding area, is FAT CELLS. If your toxic load is too high, you will store in the fat cells.

If you are unsure what Toxic load is, Please read this blog 

What other things make you hold onto your fat, instead of burning it?

  • NOT Pooping 3 times a day

    • Failure to defecate a few times a day causes the toxins to be re-absorbed into the blood stream.
  • Hormone imbalance.

  • If your hormones are out of balance, particularly if you are estrogen dominant, No Nutrition Plan will work. IT is important to get hormone testing done each year after the age of 30, First Pregnancy, or infertility issues. So what hormones?
    1. Estrone (E1)
    2. Estrodial (E2)
    3. Estriol (E3)
    4. Testosterone Total and Free
    5. TSH
    6. T3 Free and Total, reverse
    7. T4 Free and Total
    8. TG Antibodies
    9. TPO antibodies
    10. DHEA-s
  • Vitamin D Insufficiency.

  • In 2011-2012, it was estimated that 82% of the poulation had vitamin-d deficiency. Why so prevalent? Insurance companies don’t cover the testing, but it should be done yearly starting at age 20 according to this study
    1. Vitamin D deficiency was labeled as having 25(OH)D3 less than 50nmol/L.
    2. In Functional medicine, we would like to see this number closer to 70nmol/L;
    3. but most physicians say that 33nmol/L is adequate because it falls in “normal range”.
    4. VitD is the number one vitamin used to repair ALL tissues and is the Backbone for every hormone produced in the body, including thyroid.
  • Thyroid dysfunction that is Misdiagnosed.

    1. Most physicians don’t order a TPO antibody test. This test can indicate AUTOIMMUNE thyroid, which requires a different medication than Synthroid
    2. Many people on Thyroid meds still suffer from poor sleep, foggy brain/memory, thinning hair and eye brows.
    3. Thyroid isn’t tested regularly, even with a family history, until age 32. If you have family history, start asking for it to be tested annually at age 20 or if you have irregular or heavy menstruation; Difficulty loosing weight, fatigue that seems excessive.
    4. Don’t settle for Normal ranges. The Clinical Range is too wide. The optimal range is much narrower:
      1. TSH 0.5-2.0 uIU/L (clinical 0.2-5.5)
      2. Free T4 15-23 pmol/L (clinical 9-23)
      3. Free T3 5-7 pmol/L (Clinical 3-7)
      4. Reverse T3 11-13 ng/L (clinical 11-21)
      5. TPO antibodies <20 IU/L (clinical <35)
      6. TG Antibodies <2 IU (clinical <35 IU)
  • GENETICS.

  • Your genetics can cause obesity for a variety of reasons. In this blog I cover some of the reasons. What is the most important thing to know? Only 5% of the world actually has a FAT gene. But, other genetic factors can lend to increased weight/mass on the body.
    1. Oxidative stress: In the world outside our bodies that looks like rust. On us it looks like dry, dull skin, wrinkles, inflammation and weight gain
    2. Inability to Methylate: your body uses B vitamins to produce and recycle some hormones so that your body has less stress. It also uses B vitamins as a methyl donor for Glutathione. This is the most important antioxidant that you can use in the body for tissue repair.
    3. Poor Detoxification Methods: Sometimes we are genetically set up to fail in Detoxification through the liver. This organ does 87% of detox in the body, so it’s important to support these pathways.
    4. Poor Lipid metabolism: some of us are predisposed to have the ability to burn fat and eliminate cholesterol. The only way to manage this is with a LOW FAT diet and exercise. These people DON’T respond to cholesterol medications.
  • Parasites, Mold, Heavy Metals

  • When most of us do a cleanse, we focus only on foods, but we forget things like metal fillings in our mouth. We forget that Parasites can come from ANYWHERE and can pass undetected until they cause a health crisis. Mold creates so much dysfunction in the body that it can not work on healing, it can only focus on fighting.
    1. It takes a different type of cleanse to get rid of these types of infections
    2. Lyme disease can be included here
    3. epstein-barr can be cleared through this type of cleanse.

If you have more questions about doing an in-depth cleanse, Let’s Talk. Set up a Discovery Visit Here.

Weight Loss: Tried and Failed Goals

Today, I want to talk about weight loss and health goals.

3/4 people set a goal of weight loss each January

According to consumer reports, 75% of Americans want to loose weight each year. 68% of them report they will use cardio to do it. But, as we should all well know by now, running on the treadmill won’t get the results you want.

Why Cardiovascular activity isn’t enough:

Let say that in a day, you take in 1800-2500 calories. Those calories start with a 480 calorie drink from Starbucks and some egg bites or an egg sandwich. Near 10 am, you have s light craving so you wander to the break room (read kitchen currently in this pandemic) and look at what’s available. You choose the one donut that is left.  At lunch time you think you’ll eat a bit healthier, so you grab a salad with a hardboiled egg, some bacon and avocado. Then you put on the ranch or blue cheese dressing that comes in the package. You also have a cookie at the end of lunch, because, hey, you ate healthy. you can cheat, Right? Then for dinner you have chicken and rice.

You calorie intake: closer to 2900; Fat intake: 108 grams; Carb intake: 178 grams; Sugar intake: 98 grams (15 is daily requirement); Proteins intake: 81 grams

This is the standard American diet (SAD for future reference).

“You can’t out run a bad diet”

This statement is more than true, but what is a good diet? How do I make adjustments? What Diets are not fads?

  • KETO: According to Wikipedia, the diet is high fat, adequate proteins,  low carb diet used in medicine to treat epilepsy. The diet brings the body into ketosis by having the liver convert fatty acids into ketone bodies that cross the blood brain barrier. Ketosis occurs in the absence of carbohydrates transitioning into glucose. The diet originated in the 1920s.
    • This brings up the question: what is adequate protein? Answer: 1 gram of protein for every pound body weight at a healthy weight. Avg female is 115g-145g/day Avg male 145g-190g/day. Keep in mind the body only absorbs between 28-40 grams at a time. And that can be based on activity level. After a strenuous workout your body will use more.
    • What is low carb: 75-100 grams.
    • Calories: 1 gram of fat = 9 calories; 1 gram of carb or protein = 4 calories.
    • Who should NOT do this diet: people that already have ketones in their urine due to diabetes, or other metabolic disorders. People with Kidney dysfunction, kidney stones, or kidney and bladder infections. People who lack a gallbladder, have high cholesterol or have pain after 30 minutes to 2 hours after eating.
    • When and how long might i do this diet: 6-8 weeks maximum to train to the body to burn fat for fuel. Then switch to High Protein Nutrition plans.
  • Calorie restrictive: 1200kcal
    • This diet again should be maintained for short periods of time because it can have health benefits, but also detriments.
    • You must focus on hitting your protein goal daily and not eating processed foods so that you can eat plenty of vegetables and 3 servings of fruit per day.
    • This Type of eating should be “Cycled” in a fashion of 6 weeks on 6 weeks off or 12 weeks on 12 weeks off, depending on how much weight you have to loose.
    • Daily goals: Protein 125, Carb 100 or less, fat 35-45 depending on carb intake.
  • Paleo: goal of 1800-3500kcal per day depending on fitness, age, sex
    • Originally posited as a healthier way to eat in 1890; Made famous in 2002 with the book “The Paleo Diet”
      • 5 Previous books also exist.
    • Goal is to eat absolutely No Processed foods, No Dairy, No Alcohol, No Salt, No Processed Oils, No Coffee, No Grains, No Sugar and No Legumes.
    • You can eat Honey and Pure maple Syrup when In Season only (think spring/summer.)
    • Fairly similar to the Mediterranean diet when looked at overall. Think 15 servings of veggies and fruit, 6 oz protein each meal. Almost no processed food. (although does allow alcohol and 2-3 oz espresso daily).
  • Mediterranean Diet: Goal of 1600-3500kcal daily based on activity levels and Weight loss goals.
    • Consume 6-8 oz of vegetables 3-4 oz of fruit 1-2 ounces of yogurt or cheese and 4-6 oz of fish, lamb, or bird (Chicken, Turkey, pheasant, quail, etc) each meal.
    • Snacks are fruit or vegetables, including olives and nuts
    • You can have 6 oz wine daily. 2-3 oz of espresso, without sugar and milk, daily
    • 1 serving of grains (unrefined) per day or 1/2 cup
    • Started as research in the 1960s regarding why Americans have more health concerns like heart disease, obesity, diabetes than Mediterranean European Counter parts.
    • Also shown to reduce risk of Depression, Alzheimer’s, Seizures, Cognitive decline.
    • Contact

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  • Intermittent Fasting: around since 1915, there are a variety of options: Calorie goals should still be 1600kcal-3500kcal on the feeding times based on activity levels, weight loss goals, age and sex.
    • 8:16: you limit eating to an 8 hour window and fast for 16. Many recommend starting to eat later in the day as dinners out are more likely social events than breakfast. You should still stop eating 3 hours prior to bed time, or 7pm; which ever comes first. So daily you would eat between 11am-7pm.
    • 5:2 You Pick 2 days out of the week to fast, not back to back in the beginning, and then eat in a 10 hour window on the other 5 days. (See Proposed Schedule below)
      • Sunday eat between 10am-6pm
      • Monday Fast
      • Tuesday Eat between 10am – 6pm
      • Wednesday Eat between 10am-6pm
      • Thursday FAST
      • Friday Eat between 10am-6pm
      • Saturday Eat between 10am-6pm
    • 6:1 This way has you fasting for 14 hours, eating for 10 hours for 6 days, complete fasting for 1 day.
      • Sunday eat between 10am-6pm
      • Monday Fast
      • Tuesday Eat between 10am – 6pm
      • Wednesday Eat between 10am-6pm
      • Thursday eat between 10am-6pm
      • Friday Eat between 10am-6pm
      • Saturday Eat between 10am-6pm
    • 2019 study showed reduced risk of
      • Obesity
      • Heart disease
      • Insulin resistance
      • Diabetes
      • High Cholesterol
      • High Blood Pressure and
      • inflammation.
    • Important things to note:
      • If you have a sweet tooth, don’t keep sweets in the house. You will pop those in your mouth first after a fast and undo the good you did by fasting.
      • Diabetics should always consult physician and monitor numbers regularly (every 2 hours) until the body adjusts to the schedule
      • Exercise will likely be impacted

Strength training is the best way to loose FAT

I am sure you have heard the saying “Muscle weighs more than fat”. Well, that is inaccurate. The truth is muscle takes up less room that fat of the same weight. By almost half. So if you want to loose fat and be healthier, you have to build muscles.

Another misnomer is that strength training makes women bulky. NOT TRUE. Strength training, when done correctly, can actually trim you down at the waist, bicep, thigh and calf. Instead of focusing on a lot of weight, spend 6 days a week doing weights with 4/6 2-3 sets of 15-20 reps. You will get great tone, no bulk and improved strength. I can attest to this. I’ve been lifting heavy 3 days a week for the last 18 months. My thighs have lost 1/2″, but I have gained strength in my squat, Hamstring curl and dead lift. The other 3 days I focus on lots of reps with very little rest. I also do no less than 20 min cardio to warm up each session. Did you see that? 20 Minutes. Then, on day 7 I do a recovery cardio day.

Recovery includes family bike rides, hikes, walks. A light easy swim, Walk on a treadmill if the weather is bad, Rowing machine. All of it at “conversational pace”. Meaning I could sing the national anthem while still doing the activity without much effort.

One TRUTH that you need to hear: Muscle takes energy to maintain. That means that even at rest, the more muscle you have, the more calories you burn.

Where Do I start with strength Training then?

I use an app where a coach guides me through a series of questions to determine the right programming. The app allows me to take pictures, Measurements, Weigh in, Track food, Track Reps and sets with weights of each activity prescribed. I can also write notes about sleep, how I felt, what stressors were present, etc.

There are a bunch of these fitness apps. Mine is $50/year. If you want the link, email me

YouTUBE. There is so much stuff out there. You can find a workout with sheets as the resistance. No other equipment required.

Ask a friend who already works out

Search fitness on instagram or FB

What about the TIME it takes?

If you can not carve our 40 minutes a day for yourself, look at your priorities. I own a business, work 50 hours a week, run an online business, have twin boys in separate sports, cook a family dinner EVERY night and I still exercise EVERYDAY. I don’t do much social media and I don’t watch TV. I am an avid reader (2-3 225 page books/week).

Health is My Priority. What is yours?

 

 

 

Tainted Oils? How do I know what is good quality?

The Business of Essential Oils is Controversial

Many of you know that since January of 2020, I have incorporated Essential Oils in my practice. I use these oils to help with Air Purification, Calming, Relaxation and support of certain systems of the body. This decision did not come lightly. You see, I was introduced to dōTERRA back in 2011 when a friend of mine asked to borrow the clinic to host a class. I willingly gave her the space to use for free, but was not interested in joining her team. Over the years, many have approached me about different MLM Oil companies and asked me if they could simply use oils from Sprouts and Whole Foods.

After doing some research, I would tell people that they should not ingest the oils unless they could get independent testing results. It turns out, most of those companies won’t release all their testing results and they do it in house. Even as a medical professional, they would not release oil testing results to me. One particular company even goes so far as to say in a letter to its Sales Associates that they don’t need to give the results. The people should just believe what they are told.

As a Consumer, How do you know what to buy and use or not use?

This one is hard. You see, the incorporation of essential oils into my practice came after i received my Functional Medicine Certificate. I was on a web class discussing hormone pathways and support for those pathways and they kept mentioning things like Peppermint Oil, Grapefruit Oil, Majoram, Fennel, Frankincense and Cinnamon and Clove Oils. This company that was doing the education only provides one service: Urine and saliva testing of metabolized hormones.

They don’t sell oils.

They didn’t recommend a brand

They didn’t say internal or external use.

So I did more research…

This is why I USE and Recommend dōTERRA Oils.

  1. Yes they are an MLM, but you can ask my up-line, I have no builders, just customers. In fact, I probably should have signed up to just be a retail seller as it would make more sense currently, but retail purchase is expensive for a minimum order and I wanted to try them first.
  2. 86% of all of the company sales are customers, not SELLERS
  3. they have a 68% return purchase rate for multiple years of re-purchase
  4. They are the only one I could find at the time that really backed what they said in ALL aspects.

Many Don’t Believe me

Yep, Every oil company will tell you the ethically source. They will tell you that they don’t adulterated or alter their product. they will tell you its organic. They will even tell you that they get their oils the same place dōTERRA does.

Don’t believe it. In Many independent studies, not just one, dōTERRA comes out above its competitors.

Not sure you believe it? https://www.consumersadvocate.org/essential-oils Read this Review of 11 companies.

Of the 10 who’s reviews stay up, Améo Oils and dōTERRA are the only that make the cut.

Brands hat you find at area stores like NOW and Aura Cacia are tainted. Brands that you order online that claim to source from dōTERRA sources are tainted like RockyMountain Oils and Plant Therapies.

 

This Letter https://tinyurl.com/y44glwtu show legal action taken against Revive Oils for its misrepresentation and it references another oil company. You can look up that long standing feud as well, and how a Judge with independent labs said no, that product is adulterate.

 

 

Synthetics Cause Harm

As a Medical Provider and Functional Medicine Specialist, My job is to first o no harm. Turns out, 90% of side effects could be eliminated through a few tests and removal of synthetics from our food, diet, and drugs.

Have you noticed the drug commercials with the lists of side effects at the end that are as long as the product information?

Genetic testing like the DNAMedCheck can indicate if you should try a certain type of drug to help with your particular health concern. the DNAHealth Test can also indicate if your genetics are even likely to benefit from the type of therapy recommended. For instance, My body does not process lipids well. Turns out I also am not likely to benefit genetically from statins to control cholesterol. The best recommendation: Diet of low fat and Exercise. Not a Statin drug for cholesterol.

Plant based Therapies have been around for years. There are independent studies done that show that specific essential oils in combination with antibiotics boost effectiveness in drug resistant bacteria and viruses. Notice is said in combination. Here is one Example

This Example shows the immune boosting properties of some oils to support the body’s natural processes.

If we can recommend plant therapies in conjunction with drugs with harmful side effects, why would we not? Could we lower the need for the medications with harmful side effects by supporting the body rather than fighting it? In studies on Cinnamon and Diabetes, it turns out that a lot of blood markers improved. Cholesterol, Glucose, triglycerides.

The hard part is leading the horse to DRINK. Most, if not all, Chronic illness in the United States are caused by the Standard American Diet and our lack of Exercise. So just like anything else, Oils are NOT A CURE for anything. But neither are drugs. Both are meant to support a system to obtain better health and then remove it until a time when it is again necessary.

Problem: High rates of fast food, poor quality high carbohydrate processed foods, lack of regular exercise that includes both resistance and cardiovascular training, Poor Hydration to move things through our digestive tract and high intake of sugary drinks.

Solution: Exercise 6 days a week for 30 min of cardio vascular, 30 min of resistance training. You can not our run a bad diet though. So 2-3 Meals a day focused on 6 oz of LEAN Protein, 1 cup of veggies that are green and 1/2 cup of Fruit, legume or grain (oatmeal, rice, corn, quinoa, Millet). Calorie goals should be 1500-2200kcal/day. with 50% – 60% coming from protein. Water intake minimum should be 80 oz. With exercise and a dry climate, 100-130 oz.

Supplementation: with essential oils to promote immune health, detoxification and help with seasonal threats. With Omega 3s to assists in brain health, cardiovascular health and joint lubrication. Vitamin D for tissue and hormone repair. B vitamins for the nervous system.

If you are interested in essential oils click here

Interested in Pharmacy grade Supplements click Here

 

 

Can you be Healthy at Every Size

This is a blog I have struggled with.

I started writing it the first week of July 2020. I struggle with it because I know people who struggle with Body Acceptance. I Know people who Body shame others. I know people with significant Body Dysmorphia and Eating disorders. 

One of my goals as a Functional Medicine Wellness Coach is to Empower People to Health. So I feel obligated to write this particular article. But also, obligated to be vulnerable with you and caring in what I write. There is a Movement called Health at Every Size, or HAES for short. It wants people to recognize that a person who is Morbidly Obese can be as healthy as a person of “Normal” size. (20-25% body fat in the pictures below).

 

Body Fat Percentages
20-25% is considered healthy for Females, 12-20% for Males

HAES challenges some of the key assumptions of traditional approaches to weight management. These include

  1. that adiposity poses significant morbidity and mortality risk,
  2. that weight loss will prolong life,
  3. that anyone who is determined can lose weight and keep it off through appropriate diet and exercise,
  4. that the pursuit of weight loss is a practical and positive goal,
  5. that the only way for people living with obesity to improve health is to lose weight, and
  6. that obesity-related costs place a large burden on the economic and health system, and this can be corrected by focused attention to obesity treatment and prevention

Principles of HAES:

  1. Intuitive eating
  2. Body acceptance
  3. Movement for health not weight loss or performance

So What does the research say?

HAES says that not every approach works the same on each individual and a 2015 Study in the American Journal of Public Health denounced HAES research stating that While the exact proportion of obese people who are metabolically healthy varies depending on what criteria are used to define both obesity and health, it is smaller than the proportion of obese people who are not metabolically healthy. As it is currently not possible to predict which people will remain metabolically healthy despite excessive weight gain, it may be dangerous to make blanket community statements that people can have health at every size. 

Interpreted: We are unsure who is really healthy and stays that way according to cardiac and lung function, Diabetes as well as Cholesterol levels. This also includes things like Sleep Apnea. 

Study published in the Journal of American Diet Association in 2005  Showed that persons of obese nature improved metabolic fitness in cardio, lipid profiles, social behavior, depression and self esteem. But Intuitive eating not without risks: Food is calorie dense and nutrition deficient, which allows for people who lack satiety gene to over eat, as they don’t feel full, Causes those with sweet tooth gene to eat more sugars which lead to further obesity and then other health concerns. Cost of Nutrient poor versus nutrient rich foods is significantly different and has a significant impact on Socio-economic habits and allowances. Then the environment which someone grows up in with genetic predisposition for obesity or thinness.

Body Acceptance:

On top of all of this, body acceptance is lacking world wide in the female population. The Number of women who berate themselves daily about weight, acne, size of hips or thighs is remarkable. It shows how we look at the world as a society and what society believes is attractive versus what’s healthy is out of balance. There is also research that has been published on the difference, particularly in women, on how providers see and treat women. It showed that if a woman was obese, no matter the reason for her visit, she was more likely to be lectured about weight ad diet. A woman who was put together with good clothing, hair, makeup was less likely to be taken seriously regarding pain. Also, a woman who was dressed in sweats, hair in a bun and no make-up was looked on as drug seeking if there was a complaint of pain. As providers of Healthcare it means that we need to be aware of the bias we come to the table with and try to think of the person in front of us. Try and connect more intimately with the complaint they have in front of us and try and treat equally, regardless of size. 

 

Here is some startling information: If you use the calculator found here:Calculate BMI and HERE: Calculate Body Fat You can get a sense of where you fall according to Normals. I have a BMI of 25.1, putting me at obese. My Body Fat with this crude calculation is 36.5%, placing me also in the obese category. 

Moving for health, Not Fitness

Movement for health is a great tipping point many have difficulty overcoming, Particularly in the Endurance category and Body Building Category. The ability to just go for a walk to walk and enjoy the outdoors is lost on many. The use of E-bikes has improved the number of persons in a specific socioeconomic class enjoying trains throughout the cities in the US recently. The other portion of this coin is Movement sometimes takes an inner motivation that people don’t possess and therefore need a significant amount of goals or push to get the exercise in. 

The Skeletal system:

Whether or not a person with excess weight develops metabolic diseases such as diabetes or cardiovascular disease, sooner or later the mechanical effects of excess weight and the resultant gait abnormalities, combined with systemic inflammation, are likely to take a toll. As one example, adults who are overweight have a 2.2-fold greater chance of developing knee osteoarthritis than those with a BMI under 25 kg/m2, and this increases to a 2.6-fold greater risk for adults with a BMI of 30 kg/m2 or more. Moreover, every increment in BMI contributes to escalating difficulties in performing activities of everyday life, such as walking, getting out of a chair and climbing stairs.

How do we know that inflammation happens overtime with obesity? Studies of adipose tissue show that they have their own homeostasis in relation to Hormone secretion and cytokine production. The Adipose or Fat tissue actually makes its own estrogen and Cytokines. In the current environment with COVID-19 showing a Cytokine storm as the leading cause of Intubation in ventilator use, we know that an Obese person is more likely to suffer this fate. Intubation comes with a host of problems later down the road such as poor lung function. Poor lung function leads to decreased ability for the Cardio-respiratory system to keep up with the body’s needs. 

In addition to this, Cytokines can actually cause destruction of small Blood vessels in the capillary beds.  

After this time, carrying excess weight may become ‘hard wired’ into the parts of the brain that regulate body weight, and it may be almost impossible to make any changes at all. In normal animals, exposure to an energy dense diet that is high in fat, or high in fat and sugar – similar to the default diet of modern societies – initially leads to physiological changes that would tend to counteract weight gain, as recently reviewed

The study by Sainsbury showed that animals originally will stop eating or eat lighter meals when exposed to high sugar and high fat diets in order to regulate body fat. This is done by the hypothalamus supporting release of Leptin. What happened over time though was that the animals became leptin resistant in a period of 9-12 months and then developed higher body fat and lost the ability to feel satiety. They never felt full, so kept over eating. 

Studies in 2006 and 2007 showed that Obese Rats that were continually fed the same diet developed a leptin resistance. In the 2007 study, Rats were able to “reset” Their Leptin resistance and become a healthier weight again with dietary changes. However, the 2006 study showed that the rats actually reached a “Set Point” that was higher than the original point at which the body thought it was healthy. This is why some people say things like “I have to starve myself to get below X and maintain it.” This is where the Genetics come into play. If you are predisposed to weight gain and have a difficult time taking it off, using Lipids circulating in your blood as energy or converting stored fat to energy, you may develop a higher “set point” This is the Definition of epigenetic. The effect the environment, including nutrition, has on the genes you were born with. The really dangerous part of that: IT leads to future generations of obesity due to the fact that the DNA is changed. 

The HAES movement says wait until it is convenient to do something about the weight. Epigenetics says you can not waste that time. By Age 50, it may be too late. If you have a family history of obesity and you want to see positive changes for your future generations, it should start prior to pregnancy and certainly through your lifetime and the child’s lifetime. That does not mean Body Shaming. It means education about healthy choices and responsibility. It will take 3 generations to DAMAGE the DNA and 5 generations to REVERSE the Damage.

 

 

Studies:

Vincent HK, Heywood K, Connelly J, Hurley RW: Obesity and weight loss in the treatment and prevention of osteoarthritis. PM & R. 2012, 4 (5 Suppl): S59-S67.

Blagojevic M, Jinks C, Jeffery A, Jordan KP: Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis and cartilage / OARS. 2010, 18: 24-33. 10.1016/j.joca.2009.08.010.

Enriori PJ, Evans AE, Sinnayah P, Jobst EE, Tonelli-Lemos L, Billes SK, Glavas MM, Grayson BE, Perello M, Nillni EA, Grove KL, Cowley MA: Diet-induced obesity causes severe but reversible leptin resistance in arcuate melanocortin neurons. Cell Metab. 2007, 5: 181-194. 10.1016/j.cmet.2007.02.004.

MacLean PS, Higgins JA, Jackman MR, Johnson GC, Fleming-Elder BK, Wyatt HR, Melanson EL, Hill JO: Peripheral metabolic responses to prolonged weight reduction that promote rapid, efficient regain in obesity-prone rats. Am J Physiol Regul Integr Comp Physiol. 2006, 290: 1577-1588. 10.1152/ajpregu.00810.2005.

Milagro FI, Campion J, Garcia-Diaz DF, Goyenechea E, Paternain L, Martinez JA: High fat diet-induced obesity modifies the methylation pattern of leptin promoter in rats. J Physiol Biochem. 2009, 65: 1-9. 10.1007/BF03165964.

Zhang FF, Morabia A, Carroll J, Gonzalez K, Fulda K, Kaur M, Vishwanatha JK, Santella RM, Cardarelli R: Dietary patterns are associated with levels of global genomic DNA methylation in a cancer-free population. J Nutrition. 2011, 141: 1165-1171. 10.3945/jn.110.134536.

Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J: Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011, 365: 1597-1604. 10.1056/NEJMoa1105816.

Size acceptance and intuitive eating improve health for obese, female chronic dieters.

Bacon L, Stern JS, Van Loan MD, Keim NL, J Am Diet Assoc. 2005 Jun; 105(6):929-3

Am J Public Health. 2015 May; 105(5): e38–e42.

Published online 2015 May. doi: 10.2105/AJPH.2015.302552The Health at Every Size Paradigm and Obesity: Missing Empirical Evidence May Help Push the Reframing Obesity Debate Forward, Tarra L. Penney, BSc, MA and Sara F. L. Kirk, PhD

Velho S, Paccaud F, Waeber G, Vollenweider P, Marques-Vidal P: Metabolically healthy obesity: different prevalences using different criteria. Eur J Clin Nutrition. 2010, 64: 1043-1051. 10.1038/ejcn.2010.114.

Sainsbury A: The Biology of Weight Control. A modern epidemic – expert perspectives on obesity and diabetes. Edited by: Baur L, Twigg S, Magnusson R. 2012, Sydney, Australia: Sydney University Press

 

 

 

 

 

Genetics and Health

Nutrition and Supplements for GENETICS and HEALTH, avoiding drugs

Can I tell you a story and see if it seems familiar? Picture this:

You see someone that claims to love and support you after 3-6 months. That person is either a friend or a family member. Maybe a FAN on social media. In that time, you have changed your body composition so that your waist is trimmer, you have more muscle and less fat. Your skin looks healthier and you hold your head higher. They say something like: "Wow, you look really good, Are you Starving yourself?" or "Why'd you lose weight, you were fine before." then there is the "I've seen your posts, what are you trying to prove?".

We've all had it, right? It makes us feel bad. I mean shoot, look what was said about Adele's Decision to Get Healthy.

What we know about Obesity:

Obesity is the number one cause of almost ALL CHRONIC disease. It causes joint degeneration, heart disease, diabetes, cancer of all types. It is one of the leading COSTS in the healthcare system. So why are people Health Shaming you? They feel Guilty. Or, they think you should feel guilty for improving because you are now supposedly Fat-Shaming them by losing the unhealthy habits.

What Role Does Genetics Play in ALL of this?

Back in April, I did a Blog on Genetics and Pharmacology. (you can reference that here)

Is Pharmacology Necessary?

What I would like to tell you today, is that that while sometimes pharmaceutical intervention is necessary; Pharmacology can also do harm in more than just the side effects. You see, Most drugs are meant to alleviate symptoms short term and then time out. We want to adjust and treat the cause of the symptom, not just override it or mask it with a drug. Most drugs come with side effects that lead to the need for another drug. If we can look to the genetics and the NEEDS of the PERSON, we can decrease our dependency on pharmaceuticals by 3 fold in this Country

Now, there are times when you need to be on a specific drug for a longer amount of time, but you should also know those nutrient deficiencies are created with those drugs or combination of drugs.

So When might you need to be on a drug longer than 90 days? Severe, chronic disease states like diabetes, COPD, Hypertension that is Hereditary, Thyroid medication after thyroid removal; Hormone replacement therapy after menopause or in cases of severe low-T. The list is not endless though.

When should you talk about Health Management vs. Pharmaceutical Management?

Let's say you are someone who has High Blood Pressure or Hypertension, has a BMI greater than 23 (Calculate Here)With Extra weight around your midsection and When you measure your waist it is greater than the measurement of your Hips. Your medication should only be given in conjunction with a Nutrition and Exercise Plan. Notice I Did NOT use the word DIEt. That's right, to DIET is to DIE. Think in terms of Nutrition. What helps my Body GAIN what it NEEDS?

That Plan should be Monitored and carried out to work towards lowering or removing the medication altogether. This plan would take 90 days to 18 months and appropriate supplements would be added to ensure nutrient depletion did not occur.

For MOST individuals, Physical Activity alone is not enough. We need to CHANGE Nutrients being put in. Genetics play a role in the AMOUNT of food needed, the TYPE of food needed, the ability to tell if you are FULL or HUNGRY and the AMOUNT and TYPE of physical activity required.

Feel Better - Find Nutrients Depleted b...ent Depletion Calculator - Mytavin.com

This is an example of someone taking Lipitor, Aldactizone and Metformin. The LIST is all of the deficiencies created. These deficiencies can also play a role on the GENETIC Expression of some markers for EACH INDIVIDUAL.

When did Being a Proper weight and size become a Negative?

I Don't Know about YOU, But I'd Rather have the TOP of this Picture than the Bottom. So many times, even in my own life, I have had people ask me why I am exercising or why I am skipping desert. Or My favorite, "You've lost so much weight, You should Eat". My goal is to CHANGE HEALTH in this country, one person at a time. I want to restore people's ability to believe in themselves. To tell that person trying to sabotage them, "HEY! Back off. Its about and for ME, not you." Because really, that person is jealous that you had the Guts to change your health. I want to teach people To Fight for their HEALTH, and to know when they can say NOT TODAY to a drug or surgery. I want to bring AMERICA BACK TO RIGHT through education, Nutrition Exercise and Supplements, not Drugs.

To schedule a Consult to see if we are a right fit to correct your health, Click Here

~Dr. Marci

References:

  1. https://dnalife.academy/dna-health/
  2. Recent developments in genetic/genomic medicine, Rachel H. Horton and Anneke M. Lucassen, Clin Sci (Lond). 2019 Mar 15; 133(5): 697–708.Published online 2019 Mar 5. Prepublished online 2019 Feb 27. doi: 10.1042/CS20180436
  3. Pharmacogenomics in the treatment of mood disorders: Strategies and Opportunities for personalized psychiatry; Azmeraw T. Amare,1 Klaus Oliver Schubert,1,2 and Bernhard T. Baune1; EPMA J. 2017 Sep; 8(3): 211–227.Published online 2017 Sep 5. doi: 10.1007/s13167-017-0112-8
  4. Future Trends in the Pharmacogenomics of Brain Disorders and Dementia: Influence of APOE and CYP2D6 Variants; Ramón Cacabelos,1,2,* Lucía Fernández-Novoa,1,2 Rocío Martínez-Bouza,1,2 Adam McKay,1,2 Juan C. Carril,1,2 Valter Lombardi,1,2 Lola Corzo,1,2 Iván Carrera,1,2 Iván Tellado,1,2 Laura Nebril,1,2 Margarita Alcaraz,1,2 Susana Rodríguez,1,2 Ángela Casas,1,2 Verónica Couceiro,1,2 and Antón Álvarez1,2Pharmaceuticals (Basel). 2010 Oct; 3(10): 3040–3100.Published online 2010 Sep 29. doi: 10.3390/ph3103040
  5. Some observations on the role of environment and genetics in behaviour of wild and domestic forms of Sus scrofa (European wild boars and domestic pigs)S Robert, J Dancosse, A Dallaire – Applied Animal Behaviour Science, 1987 – Elsevier
  6. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
  7. https://mytavin.com/results/medications/612-83-1100

Lemon Water: The Good, The Bad and The Ugly

What are the benefits and Negatives of Drinking Lemon Water daily?

 

 

Research suggests that the average female needs 91 oz of water while the average male needs 125oz of water daily,  But it’s so bland. So how do you get it in? What about flavored water or water with something added to it? 

 

The most common fruit placed in water is Lemon, and with good reason. The question is, is it for your betterment or does it cause harm. Well, just like anything, too much of a good thing is too much. Use best Judgement and guidance from multiple providers, including your dentist. 

 

So what is Lemon Water Used For? 

Ayurvedic medicine has long stated that lemon in the water plays a role in detoxification, hydration, weight loss, digestion, improved skin quality, prevention of kidney stones, and it’s a good source of Vitamin-C.  But which of those hold water?

Turmeric powder,Turmeric in Mortar Grinder drugs and ingredient herbs on wooden background

It turns out that most of it is correct. In a study published in 2016, they looked at the benefits of using lemon water with honey in it to decrease lipid profiles. 50 people participated and the results were conclusive. The Fat weight of the person decreased, Triglyceride levels went down and Free Fatty Mass decreased. The questions for the researchers that I have is in part around the fasting and in part around subject numbers. Intermittent fasting is also shown to improve Free Fat Mass and triglycerides, so is it a side effect of just that, or is it actually the lemon in the water? 

 

If i was not convinced that it had to do with the lemon in the water, a 1014 study with 100 participants showed similar results. They added daily walking for 20 minutes as a component of their study though, and took out fasting. 

 

The most conclusive results that I could find were in a 2019 study looking at changes in the gut microbiome and longevity. That study showed that microbial activity of bacteria that help the body break down and digest food was increased by 10% -30% depending on the individual’s microbiome at the start of the study. They showed that the persons had more energy and then they also were looked at over a period of ten years. They tested at younger ages via blood work, mental cognitive tests and agility than same aged peers. 

 

So why do some think it is harmful to drink lemon water? The answers might surprise you. 

Most of the time, we don’t think about washing fruits that we peel, but they can be a significant host for things like e.coli, staph and MRSA. One study of 20 restaurants across the US showed that almost all of the oranges and lemons contained at minimum E. Coli on the skin. You don’t want to stick that in your water (or beer).When it comes to restaurant lemons and oranges, Squeeze them into the drink, but leave the fruit on the plate please. 

 

Lemons are acidic in nature, so they can irritate the skin, gums and cold sores or canker sores. The American Dental association recommends that you stay away from them in those instances. Also, if you have weak tooth enamel or start to notice your teeth feel rough when you run your tongue over them, re-consider your flavor of water. That acidity may also play a role in GERD. While some people get a benefit for their heartburn from lemon water, others can suffer because the pH balance in the stomach is upset by trying to balance out the acidity of the lemons. 

The last thing you may want to consider is about migraines. If you are unsure of your triggers, check citrus fruits specifically when you know you have some down time. Getting a migraine at work because you drink lemon water is not a good plan.

 

That’s all for now, Check back later for more health news!

 

Effects of Lifelong Intake of Leon Polyphenols on aging and intestinal microbiome; Shimizu et al. sci rep. (2019)9;3671
Effects on 8P of Daily Lemon intake and Walking. Y.Kato et al. J. Nutr. Metab. (2014)2014:912684
Does Short Term Lemon Honey Fasting Have Effect on Lipid Profile and Body composition. J. Ayurveda Integ Med (2016)Mar; 7(11-13).