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NALTREXONE (low-dose)

aka “LDN,” is available at local compounding pharmacies.
LDN inhibits extremely inflammatory cytokines from microglial cells, a part of the immune system that can sometimes overreact.
There are numerous potential benefits of LDN, including improved sleep, less fatigue, possible prevention or improvements of various neurodegenerative diseases, and weight loss.
In fact, naltrexone is one of the two ingredients in a very expensive weight loss pill called Contrave. Contrave combines Wellbutrin and naltrexone into one pill and has been shown to cause weight loss.
Yahoo sponsors an LDN support group which one can subscribe to for free.

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A very important organ, the thyroid regulates metabolism in every cell of your body. Many of us recognize the obvious symptoms of hypothyroidism, including depression, dry skin, fatigue, hair loss, weight gain, constipation, and cold intolerance, but mild hypothyroidism can easily go undetected.

In order to thoroughly understand a patient’s thyroid function, I recommend a full panel of hormone testing, including TSH, free and total T4, and free and total T3 as well as a complete patient history. If a patient is diagnosed with hypothyroidism, I prefer to treat with T3 (commonly known as Cytomel) rather than T4 (Synthroid), as T4 is the metaphorical line of football players on the sidelines and T3 the players on the field, winning the game. Likewise, the nation’s leading psychiatrists prefer T3 over T4 in the treatment of depression. Often, a combination of the two hormones is most effective.

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Anxiety is a prevalent and sometimes debilitating problem with patients. How to cut your risk for developing symptoms of anxiety? Eat your veggies! Quercetin, curcumin, and hesperidin, abundant in vegetables, help reduce anxiety. Try increasing your consumption of magnesium, white tea, valerian root, B-complex vitamins, and tryptophan while decreasing consumption of aspartame and MSG. These last two toxins are especially harmful to the amygdala, a set of neurons in the brain’s temporal lobe that helps control emotional responses. Reduce your intake of saturated fats and omega-6 fats–e.g., corn, peanut, safflower, sunflower, soybean, and canola oils. Finally, ensure adequate and quality sleep.
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Carnitine is a protein whose main function is to move fatty acids (the fuel the heart prefers) into the mitochondria of heart cells. Mitochondria, as you may recall, are THE energy producers in every cell. Carnitine is so vital to heart function that a deficiency may contribute to heart failure. This protein improves blood flow to coronary arteries, may regulate heart rhythm, and lowers blood pressure. It is also important in the function of the nervous system. In the brain, carnitine stimulates nerve growth factor (leading to repair and growth). In the peripheral nervous system, carnitine may promote healing and regeneration of nerves (helping with nerve damage secondary to diabetic neuropathy and herniated discs).

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MENOPAUSE – can affect women for years, sometimes decades, often causing disabling symptoms. For women with aggravating symptoms, I recommend prescription medications such as gabapentin and those that target serotonin levels (for example, citalopram) and/or clonidine at bedtime. The OTC remedies worth researching are black cohosh, soy phytoestrogens, licorice root, dong quai, melatonin, pycnogenol, and DHEA. I have found that even very low doses of clonidine reduce hot flashes, night sweats, and other symptoms.

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Melatonin is one of the brain’s most powerful and versatile antioxidants. Produced by the pineal gland, melatonin reaches levels greater than 120 in teenagers, but by age 30 the average level is 60. By age 65, melatonin levels are less than five. Autopsies of patients afflicted with Alzheimer’s and Parkinson’s disease reveal very low melatonin levels – much lower levels than expected for the patients’ ages.

Very effective in protecting cells from poisons, melatonin, according to one study, is 60 times more effective than vitamin C in the protection of DNA. Melatonin also aids in mitochondria function (the organelles that produce energy for the body’s cells) and boosts our immune systems by protecting cells from free radical damage. A quick online search offers a much longer list of the benefits of melatonin.

Melatonin is an inexpensive, over-the-counter antioxidant, available at dosages between 5-10mg.

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PTSD (Post-Traumatic Stress Disorder):

As far as medications for this disorder, the focus of treatment should center on patients’ adrenergic over-reactivity, or “adrenaline excess.”. This excess tends to disrupt people’s sleep, among other distressing things. Rather than depend upon drugs that are serotonin stimulants (for example, Lexapro, Paxil, Prozac, Zoloft), patients may benefit from medications that blunt the adrenaline excess. Some of my patients have had good results with medications such as clonidine, prazosin, or terazosin. In addition, gabapentin, baclofen, and Seroquel help some patients. For OTC supplements, consider N-acetyl cysteine (NAC), SAM-e, tyrosine, magnesium, and sublingual B-complex vitamins.

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Ginkgo Biloba

Ginkgo is a powerful antioxidant that protects the adrenal glands, the brain, and the liver by fighting free radical production. It also contains bioflavonoids that improve blood flow to the brain, ears, eyes, heart, and extremities. It may help counteract damage from inflammation and improve memory. It also elevates mood in people with depression.

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Black Rice

Why use black rice? Once served exclusively to royalty in ancient China, black rice provides more nutritional benefits than brown and red rice combined. Black rice is rich in fiber and loaded with antioxidants, vitamin E, protein, and iron, as well as phytochemicals, phytonutrients, and anthocyanins (substances that maintain good health by increasing antioxidant activity and scavenging free radicals). Not only does black rice have a low glycemic index, it also lowers the risk of cancer.

If you compare a spoonful of black rice with a spoonful of blueberries, black rice contains more antioxidants but with less sugar and more fiber and vitamins. Black rice is gluten-free.

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For patients susceptible to kidney stones, I recommend
Urocit K (prescription necessary),
vitamin B6,
Magnesium citrate,
Hydrochlorothiazide (prescription necessary),
Lemon and orange juice,
Adequate fluid intake.

I also recommend restricted salt (sodium) intake and supplementation with benfotiamine (OTC), which helps reduce hippuric acid (thus discouraging stone production).

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If you’ve been my patient for a number of years, you’ve probably heard my lecture on the importance of sugar, oxygen, adrenaline, and pressure (SOAP).  If you have COPD or cardiac disease, you may benefit from oxygen therapy.  Many local durable medical equipment companies offer free overnight oxygen testing.  If your insurance decides that you qualify for oxygen therapy, the benefits are enormous.  In patients with COPD, heart failure, and other cardiovascular diseases, oxygen is one of the few treatments proven to significantly prolong life expectancy and improve quality of life.  If you need more information, please let the receptionist know the next time you make an appointment.
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SAM-e is a molecule formed from the essential acid methionine. Its functions are numerous: it stimulates proteoglycans synthesis in cartilage, reduces inflammatory mediators, increases levels of glutathione, and may maintain DNA methylation.

A meta-analysis of 11 studies concluded that SAM-e is as effective as NSAIDS in reducing pain and improving function in OA! Its onset of action is slower (one month) but SAM-e lacks the adverse effects of NSAIDs.

SAM-e is more effective with adequate intake of vitamin B9 and B12.

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 Taurine is an amino acid that can increase blood flow and promote healing in the brain. Low taurine levels may contribute to memory loss.

Taurine also may improve symptoms of diabetes by triggering insulin release and help relieve heart arrhythmias by countering the effects of excessive glutamate (we hate glutamate). It may also help to reduce the incidence of seizures, prevent thrombosis, and reduce total cholesterol levels. Its antioxidant effects may lower blood pressure.

Taurine becomes even more important as we age, when our taurine levels drop and our organs become vulnerable to autoimmune diseases. Taurine also stimulates mitochondria, key organelles that are the engines of our cells and help to produce energy.

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Found in borage seed oil, evening primrose oil, black currant seeds, and olive oil, GLA enhances the anti-inflammatory effects of omega-3 fatty acids.

GLA is an anti-inflammatory omega-6 fatty acid which improves symptoms of arthritis and boosts levels of the anti-inflammatory prostaglandin E1. High levels of prostaglandin E1 are important because they help suppress another prostaglandin, the inflammatory E2

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Boswellia comes from the resin of the bark of Boswellia trees.

Also known as frankincense oil, Boswellia has been used for centuries to treat symptoms of arthritis by reducing inflammation and suppressing free radical damage. 

Boswellia’s effects are supplemented with the combinations of ginger and ashwagandha.  The most commonly reported side effect is G.I. irritation.  Boswellia is not recommended for use during pregnancy.

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The little avocado contains an important ingredient with a very long name:  avocado-soybean unsaponifiable (ASU).  Available OTC, ASU may encourage collagen synthesis by inhibiting inflammatory agents.

When ASU is combined with EGCG (an important component of tea – see previous blog), this combination may be even more effective by reducing the effects of the inflammatory COX-2.

ASU also inhibits sugar uptake in cancer cells. This compound also reduced pain and stiffness and improves joint function.  Studies are ongoing to determine if ASU may reduce joint degeneration.  

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Ashwagandha is an herb in the tomato family grown in India and parts of northern Africa.  This little gem may help in the treatment of anxiety and depression, fibromyalgia, menstrual disorders, and hypertension.  It may also improve cognitive function.  How?  Through complicated biological actions with complicated terminology, of course.  Specifically, ashwagandha inhibits nFKB activation and gene expression as well as decreasing the inflammatory effects of COX-2.  Its anti-anxiety effects may originate in its ability to bind to GABA receptors, as GABA is a calming agent.

Ashwagandha may cause drowsiness and is not recommended for use during pregnancy.

The usual dose is 500-1000 mg per day.

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Treatments To Consider:

  1. Vitamin C
  2. EGCG (found in green and white teas)
  3. Rosemary tea
  4. Luteolin
  5. Quercetin 
  6. Curcumin
  7. Licorice extract:  DGL (deglycyrrhizinated form)

Quercetin and curcumin help block a toxin released by helicobacter pylori.  It is this toxin that may cause ulcers.

Hesperidin and curcumin increase the protective mucus the stomach creates.

If you bloat excessively, consider being tested for small intestine bacterial overgrowth (SIBO). 

This is done by a simple breath test.  See my previous blogs for more information.

Chew your food slowly, until it is liquefied, so that your stomach does not have to work as hard to process food.

Avoid Rolaids, Tums, and Maalox. 

Also avoid carbonated drinks, large meals, eating right before bedtime, excessive alcohol, hot and spicy food, and peppermint candies.

Finally, sleeping with the head of bed elevated may help alleviate symptoms.

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Found in high concentrations in white and green tea, EGCG offers a number of benefits.

It can protect the brain from stroke, Alzheimer’s, and Parkinson’s by calming the immune cells of the brain and reducing inflammatory chemicals like cytokines and peroxynitrite.

It relaxes arteries, improving blood pressure and blood flow, thus protecting the heart.

It lowers oxalate crystals in urine, helping to reduce the formation of kidney stones.

EGCG powerfully inhibits NFKB and cox-2, a type of protein and enzyme, respectively, which cause inflammation and fuel cancer growth.

Please see my previous blog on tea to read about other healthy chemicals found in various types of teas.

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…is a sedating herb that may reduce anxiety, pain, and blood pressure and improve insomnia and aid in cardiac rhythm abnormalities.  

Take a little time to research the fascinating passiflora.

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Hair Loss

Many patients complain of this common problem. If hair loss affects you, you may have a vitamin or hormone deficiency that can be corrected by supplements or medication. The following laboratory tests should be part of a diagnostic workup:

  • Vitamin D
  • Ferritin
  • Hormone levels (including LH, FSH, estradiol, testosterone, and DHEA)
  • B12
  • A1C
  • Thyroid function exams
  • Cortisol
  • Zinc

Treatments that may help prevent and stop hair loss include biotin, fish oil, antioxidants, and platelet-rich plasma injections.