Natural Remedies For AllergiesAs I sat down to write this month’s blog on natural remedies for allergies, I thought, “That’s easy. Stay indoors. Move out of St. Louis.” Done. That’s the easiest blog I have ever written. Especially since we got another shot of winter weather this week.

But nothing can be that simple, right?

As always, it is important to understand what is happening on a cellular level before intoxicating it with medicines it may not need.  Medications can interfere with the body’s natural immune response and alter pH balance.

An allergy is defined as a hypersensitive response to anything that enters the body or touches the skin. The allergen could be environmental, food, chemicals, heavy metals, or anything your body deems as foreign.

Once the allergen enters the host, it causes an activation of an immunoglobulin called IgE.  Although everyone has IgE, those prone to allergies produce them in larger quantities. The allergen then binds to the IgE receptors. This binding triggers a “degranulation” of mast cells and basophils. Degranulation causes the mast cells and basophils to break open releasing histamine.  Histamine is responsible for all of those classic allergy symptoms that keep us from feeling our best.

We all know those pesky symptoms and if you live in St. Louis, likely you have experienced a majority of them. So let’s skip over to the important stuff.

Aside from the standard treatments of an antihistamine, eye drops, nasal spray or the ultimate allergy shots, let’s look at some natural ways that may provide relief.

  • Avoidance. While this may seem obvious, there is much more we come in contact with then we realize. Allergies are not all from pollen, grass or mold. With a weakened immune system, one can become sensitive to day to day exposures (i.e. household products, foods, daily use chemicals etc). Assume everything and anything is contributing to your symptoms until proven otherwise. Begin an elimination process by taking out one allergen every 2 weeks.
  • Eat an anti-inflammatory diet. Eating foods that are more alkaline help restore pH balance and thereby strengthening the immune system. Foods such as garlic, lemons, green leafy vegetables, bone broth, coconut milk, almond or almond milk are great sources.
  • Apple Cider Vinegar. ACV has some promising clinical response to decreasing cellular inflammation. Add one tsp in a glass of lemon water first thing in the morning at the onset of symptoms or add one tsp in your Netti pot solution.
  • Netti Pot. There is nothing like clearing out the nasal passages with good ole saline. I like to call the Netti Pot “IV fluid for the nose.” Word of caution: make sure to use distilled water. Tap water is contaminated with chlorine and fluoride that can aggravate the sinus passages.
  • Essential oils. Dr. Axe has provided great tips for use of oils. Oils help by reducing inflammation and improving detoxification of harmful bacteria, parasites, microorganisms and toxins that can trigger an attack. An all time favorite is eucalyptus oil. Add few drops into a Netti pot solution and diffuse it in each room. Or mix with coconut oil for a topical saav. Homemade “Vicks” with the added benefit of smelling minty fresh.
  • Healthy gut. Healthy life. And there it is again! Everything comes back to the lumens of the GI tract. Eliminating gluten, dairy, soy, and sugar goes a long way in controlling those sniffles.

So, next time you long to be one with those peonies, give these tips a try. It is a whole lot easier than moving across the country.

Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

low dose naltrexoneIn 1984 Naltrexone was approved by the FDA in the US for the treatment of opioid addiction, when used at doses of 50mg to 100mg per day. Acting as a pure opioid antagonist, naltrexone in higher doses blocks the effects of endogenous endorphins, that are seen in our own natural endorphins as well as those in drug abuse. Used in opioid overdose and opioid addiction, naltrexone suppresses the “high” experienced with drug use as well as helping minimize withdrawl symptoms in patients going through opioid recovery.

During the peak of the AIDS epidemic, researchers noted that when naltrexone was given in small doses to HIV/AIDS patients, T-cell levels improved! The increase in circulating T-cells helped regulate the immune system and thereby slowing down the disease progression.

It was this discovery that led to further research on understanding exactly how LDN, also known as low dose naltrexone, could be used in clinical practice as one of the greatest treatments for immune support and restoration.

Since LDN works on the deep cellular receptors, it proved difficult to find consistent ways to measure data and therefore not a lot is known on the EXACT mechanism by which LDN works. Due to the limited clinical trials, LDN could only be studied anecdotally by following the patient’s clinical response to treatment. Because of this, LDN never made it to main-stream medicine, until now.

Recent clinical research has shown that LDN, in doses of 0.5mg-4.5mg, although a pure opioid antagonist, does not appear to suppress the endorphins as seen in the higher dose, but in fact, has shown to stimulate the T-cells within our immune system.

According to LDNResearchTrust.org, LDN

  • Causes increased endorphin release
  • Increased endorphins that modulate the immune response
  • Reduced the speed of unwanted cells growing. Dextro-Naltrexone is an antagonist for at least one, if not more immune cells
  • Antagonizes “TLR,” suppressing cytokine modulated immune system
  • Antagonizes TLR-mediated production of NF-kB – reducing inflammation, potentially downregulating oncogenes

Taking Naltrexone in larger doses of 50-300mg seems to negate the immunomodulatory effect by overwhelming the receptors, so for the effect to work, the dose must be in the range of 0.5-10mg, usually maxing at 4.5mg in clinical experience.

Since LDN will only block opioid receptors for three to five hours, the body experiences a rebound effect which greatly increases the production and utilization of endorphins. Once the LDN has fallen off the receptors and excreted, the increased number of endorphins bind to the now more-sensitive and more-plentiful receptors. As a result, these new and improved receptors assist in regulating cell growth, promoting healing, reducing inflammation, and increasing immunity and autophagy.

So what does this mean for you or me?

A few years ago, I began noticing that many of my patients were being treated with LDN for SIBO/Leaky Gut Syndrome by the Gastroenterologist. In the following months, Rheumatologists began prescribing it to help treat Auto-immune conditions.  What I observed was that when LDN was added to their other medications, overall severity of symptoms and relapse rates in health drastically reduced.  I was truly dumbfounded and confused as to how a medication in lower doses that was used to treat opioid addictions was life changing in autoimmune conditions.

I began my research into this potential “miracle” treatment. Given that LDN is not used in mainstream medical practice, it made me a bit leery to begin prescribing it, but it did not stop me from learning everything I could about it.

In March 2020, when the pandemic first began, I was so troubled to see young healthy individuals affected by the virus to a degree that you would not normally expect.  Why would they have this much of a hyper response of their immune system?

The great Dr. Fauci explained it so eloquently. When the virus enters the host (us), it triggers varying responses in our immune system to be able to fight off the virus. This is normal. This is what the body is supposed to do. Some systems may have a small inflammatory response, while others have a massive explosion of their cells.

Think of this analogy: a small fire (the virus) occurs while you are cooking.  Putting the fire out with a glass of water (normal immune response) would take care of it without causing any serious issues (mild symptoms). However,  if the pipes burst and flood the whole kitchen (severe Covid symptoms) in response to such a small fire, then we have bigger problems (ventilator, death, Covid long-hauler syndrome.)

In essence, the immune system is our built-in sprinkler system. It helps put out any fire that occurs in our bodies.

Exercising, adequate sleep, limiting processed foods, minimizing stress, avoiding excess alcohol etc. keep the fire from being created.

However, due to aging, genetics, poor health choices, medical conditions etc, the immune system finds it difficult to handle even small imbalances and begins to over-compensate the response by releasing excessive cytokines and other chemicals that cause a degree of inflammation that is out of proportion to the minor problem that occurred.

The over production of inflammatory components disrupts the natural defense mechanisms and begins signaling to attack our own cells. The body gets confused as to who is the good guy and who is the bad guy, so it attacks anything that comes in its way.  Hence the term AUTO immune.

The vicious cycle of inflammation-attack-inflammation-attack causes cells to mutate and develop into what we know as the disease state. This mutation further weakens our immune system which makes each cycle of inflammation worse than the one before.

So how do we stop this hamster wheel of destruction? That is the million-dollar question. No one has the definitive answer, but LDN has some promising scope.

Months into the pandemic, the science community began to develop some understanding of the nature of Covid’s behavior. However, my attention and worry turned to the potential long-term effects of the attack on our immune system, irrespective of the severity of the symptoms one experienced.

Have you ever wondered why everyone you know suddenly is affected by some form of autoimmune?

Much research is focusing on “Post Infectious Inflammation” as a potential cause of the rise in autoimmune conditions in the last decade.

Remember when you were a kid and were diagnosed with mono or were around your friends who had it?

One theory is that the Epstein-Barr virus, the virus that causes mono, triggered an initial immune response to the virus. Rather than clearing the body of the virus, the EBV remained dormant in the immune system. When there was an external (environmental or lifestyle choices) or internal trigger, it activated the immune system years after the initial infection. Once again, it was our immune mediated hyper-response that led to a decline in our T-cell function.  Similar findings were also discovered in post Ebola and SARS infections. This is the same pattern being seen in Covid long-hauler phenomena.

The decline in T-cell functioning is thought to be the epicenter of where disruption and breakdown of the body system begins affecting every organ and every disease process.

I am extremely terrified of what this virus could be doing to our immune systems 5-10-15 and even 20 years down the road.  The idea is not to live with the worry of ‘what ifs.’ But if we can understand other viruses’ response to our bodies, maybe we can do the same with Covid.

The symptoms we experience on a day to day basis – headache, weight gain, vision changes, joint pain, problems sleeping, GI issues, hormonal imbalances, and the list goes on and on, is thought to be a step from the exaggerated immune response.

Even as we identify the “cause” of those symptoms, why did the “cause” even happen? Let’s say you have been having weight gain and after blood work we identify the weight gain is coming from low thyroid. So we have an answer to the weight gain, but do we have an answer to why is the thyroid not optimally functioning?

That is how deep into the cells we need to go. LDN is helping us find and fix the cause for the causes at the root – where the real healing occurs –  in the immune system. That is where we need to go. We are not just going to the root. We are going to where the seed was first planted.

On January 28, 2021, a double-blinded placebo-controlled study testing LDN 4.5mg in Covid long haul patients began. The study is scheduled to finish August 2021 with preliminary results 12 weeks from the start of the study. Early indications look promising with patients reporting mild improvement in fatigue and muscle aches. That is a start!!

After seeing the results my patients were having with the LDN and after hours, months and even years of LDN research, I felt confidant to begin prescribing it to patients I felt could greatly benefit from the additional immune support.

Since LDN is not commercially available in the lower doses, it must be compounded at an accredited compounding pharmacy.

Doses can start as low as 0.25mg/day, as tolerated and titrated weekly as tolerated until reaching optimal dose of 4.5mg/day.

For some, the optimal dose may not be as high as 4.5mg/day. The body may respond at 1.5mg or 3.35mg. There is no perfect dose. As long as there is clinical improvement, the dose will remain effective for safe long-term use.

LDN is also used for many autoimmune conditions, MS, various cancers and a wide spectrum of other disease processes.

While LDN certainly does not replace the current standards of diagnosing and treating, nor do I believe this is the “one” pill to fix everything, I remain cautiously and excitedly optimistic.

While nothing can ever take the place of our bodies’ own power to heal, it is nice to know that there is something out there that can potentially help take healing beyond the root of the problem and into where the first break occurred.

There is hope!

Stay well. Stay healthy. Stay present. And remember, just breath.

It is all ok! We got this!

 

 

heart healthAccording to the CDC, someone has a heart attack every 40 seconds while one dies every 36 seconds. Coronary artery disease, caused by arterial inflammation and plaque deposits, is the number one cause of heart disease in the United States.

It is so important to take heart health seriously. The greatest risks for coronary artery disease are obesity, significant tobacco and alcohol use, sedentary lifestyle, consuming a diet of processed foods and living in a chronic state of stress. These are the stereotypical images we see in doctor’s offices, magazine covers, pharmaceutical advertisements and even people in our own lives.  We are all at risk and we must work to minimize those chances.

While we can’t prevent everything, we can at least try!

The disease process begins with microscopic cellular damage. We may often have no symptoms or mild symptoms, which we will likely dismiss as a nuance. However, as the damage becomes more intensified, the symptoms become more pronounced until we can no longer ignore it.  Given the great mechanism of the human body’s ability to heal and regenerate, many diseases can be brought under control and even reversed.  But why wait and get to the point of damage control?

February is all about the heart! The heart of Valentine and the heart of YOU!

Making good lifestyle choices has been engrained into our psyche.  It is not enough to know that it is important. We must know WHY it is important. Understanding what is happening on a molecular level will make being disciplined in our day to day living a bit easier.

Let’s talk about some of the ways we can minimize our risks of heart disease.

  1. Physical activity. According to numerous NIH studies, exercising consistently lowered LDL (bad cholesterol) and increased HDL (good cholesterol) levels. Another study showed regular exercise at a moderate intensity decreased platelet aggregation thereby decreasing the risk of clotting. An active lifestyle also aids in vascular remodeling and angiogenesis. This phenomenon allows for greater blood perfusion to all tissues and organs while decreasing the chances of ischemia. Some of the more commonly known benefits to exercising are lower BP, lower glucose levels, better weight control and overall reduction in cortisol. Undeniably, numerous studies and data points show a direct link between sedentary living and increased risks of heart disease.  So, lace up and start moving.

 

  1. Diet. We all know processed foods are not good for us. But what exactly is happening at a cellular level with consumption of high fat foods? There is still much debate on the “perfect” heart healthy diet, and that is in part because of the varying ways crops are grown and harvested in different parts of the world. Let me explain. Our food system was once dominated by local markets with little modification to the crops.  However, our modern food chains, depending on the part of the world, have fallen into the hands of government regulations as a part of a global business endeavor.  This transition has led to changes in processing, packaging, and distribution of our food source. Hence the term GMO has become a household name.  That is not to say that everything we put into our mouths is bad.  We just need to become educated on how our food crops are grown.  According to an NIH article, “a large Danish prospective cohort study of the impact of replacing saturated fats with high-GI carbohydrates found that when high-GI carbohydrates replace saturated fat, myocardial infarction (MI) risk increases 33%.”  Refined carbohydrates, saturated fats, excessive sugar intake, low protein and fiber diet have been shown to increase blood sugars that can lead to diabetes.  Excessive glucose in the blood stream increases the likelihood of platelet aggregation and thrombosis.  While we do not need to deprive ourselves of our favorites, we must understand that daily indulgences can increase the risks. So rather than worrying about which diet is the right one, focus more on taking out the processed foods. Remember, shop local and know your crops.

 

  1. Minimize supplements. The jury is out on this one. I believe ‘less is always more’. Many ads convince us by taking multitude of ‘natural’ supplements we can ‘prevent’ diseases from occurring. Since most supplements have not been FDA approved, we do not really know how ‘pure’ the ingredients are. And what’s not to say that some of the fillers used to bind the supplements, couldn’t in some way increase our risk to the heart. I see so many patients come in with bottles and bottles and bottles of supplements in hopes of maintaining optimal health. Wouldn’t it be fantastic if that were the case?  But the secret to longevity is not by putting more things into our body, it is taking things OUT. Our bodies are equipped with everything it needs to heal and reset and knows exactly what to do. Why jam the process by adding ‘extras’?  Vitamin D, Magnesium, Omegas, Aspirin all have their place and do provide some protection. My concern with supplements is while it may claim to help now, what happens in five or ten or fifteen years? What if it is later proven that they do more harm than good? We do not know that. It is a calculated risk. But if we give our bodies a chance to restore and protect with its own natural mechanisms, it won’t let us down. We just need to do our part by making the right lifestyle choices.  Exercise, eat clean, sleep, sleep, sleep, hydrate and decrease stress levels.

 

  1. Calm the mind. This one will take lots of practice and conscious effort. Stress causes our bodies to mount a defense against the oncoming attack. This defense triggers inflammatory chemicals to be released into the system. While these components play a vital role in protecting the immune system, it comes at a price.  The cost, cellular inflammation, and DNA mutation. Translation? The start of a disease process before even a single symptom is felt! We all know what those stressors look like – not getting enough sleep, becoming physically over exerted, staying in constant states of worrying, holding onto to things that are not for us to carry.   But all is not lost. Take a step back and ask yourself, ‘how did I get here’? Here – to this place of scurry, hurry and worry. Was it worth it? IS it worth it? Did it get me to where I thought I wanted to go? Or have I dug myself in deeper? My guess is the latter. It is awesome when we become aware of what we have been carrying and even more powerful when we choose to set down that burden. The inflammatory effects of stress are real people! Just because we can’t see it, doesn’t mean it won’t jump out of the closet one day. But we can lower this fury. How? By literally taking a deep breath. Begin to spend time in activities that will help lower the anger of the adrenal glands.  It only takes five-seven minutes a day to do this.  Try this: 

    —As soon as you wake up, instead of checking your social media posts, sit up in bed for few minutes with your eyes closed and envision your cells happy and joyous. Create how you want your day to look.

    —Another way is when you are brushing your teeth or in the shower, choose a mantra and repeat it until you finish that activity. Some of the mantras I have created for myself, “My body is the vehicle that helps me live my dream. And I need to honor that purpose.”
    “My health is important because it is through my body that I can serve others in ways they deserve.”
    “When I invest in my health, I invest in living my life’s purpose.”
    “Healthy living doesn’t have to be hard if I choose to live in simplicity.”

    You get the point. These are just some I play around with. Some days, affirmations occur on the spot. Just go with it. We must not underestimate the power of the spoken word and its effects on the cells which will rise up and match those healing intentions.

    —Meditation, Tai-Chi, Yoga, Pranayama, Essential Oils are some simple resources that can be utilized.  However you choose to focus on you, just choose wisely and lovingly.

 

Writing this blog was a bit of a challenge because I wanted to include just enough data to convince you and me why we should be doing a better job of taking care of our health without sounding like a medical journal regurgitating volumes of stats and case studies.

With every article I write, I always learn something new. But this month was different. This month, I was inspired.

Reading the extensive NIH studies and the concluding data, I was utterly astonished as to just HOW much our simple choices can make a profound difference, good and bad. I have become inspired to be a bit more conscious of my choices and not take for granted every heartbeat.

While we can’t prevent everything, we can at least try.

Happy Heart Month to you all!

Physical vs Mental HealthOh boy. Where to even start with this one? I don’t think even Steven Spielberg could have scripted something as wild as the reality of 2020!

While my goal for the monthly newsletters/blog has always been to try and bring some level of awareness that can be used for the betterment of health, this month I wanted to take the opportunity to reflect on what can only be described as the “bizarreness of 2020”.

There is nothing more I can say that hasn’t already been discussed, felt, expressed or lived.

So if you will allow me, I want to share some of my most heartfelt experiences of 2020.

With nine months of living this altered reality, and a vaccine within reach, the body has endured and persevered through days and nights of uncertainty, clinging to the belief that the morning would bring new hope and new healing to the planet.

No one would argue that it has been a relay of stress between the mind and the body, both hoping to cross the finish line just as strongly as it had started. There were those days when the physical body could no longer withstand the pressures . But, in order to keep going, it had to rely on the power of the mind and its affirmational thoughts. Then there were days when our thoughts plummeted, taking the body down with it.  As the mental and physical fatigue began to wane on our spirits, all we could do was hold onto the belief and the resilience of the healing power of the mind-body-spirit.

No doubt, our physical, mental, emotional and spiritual well-beings were tested under the pressures of uncertainties and unimaginable grief. The unforeseen force of the pandemic has led to cracks in the pillars of our foundational existence.

But it was THIS  break that helped open us up into a space that has been untouched, unseen and rarely spoken about.

That place of which I speak, is the space where healing, growing and living happens! That place where we are completely whole and perfect just as we are. It cannot be seen or understood. It can only be experienced in the flow of stillness. That place is the gift of the PRESENT MOMENT.

Our world and the life we have created has become a hamster wheel of unrealistic perfections. Yet, we jump in, with the hopes that happiness can be found in the spinning fury of life.

As tragic, heartbreaking, and devastating as 2020 has been, I wanted to go into that place of stillness and reflection to see what it was all about. I wanted to open the door I rarely even, if ever, place a hand on because I haven’t slowed down enough to even know that it exists, let alone turn the handle. So how did I do this? I consciously slowed my pace of living. I halted the unrelenting rapid fire negativity of thoughts. I told myself that breathing was good and to stop holding my breath.  I welcomed the deafening silence. I embraced the anxious feelings of the unknown. And I worked to release the ideals of perfection that I felt I had to rise up against to be deemed worthy of anything. I didn’t do this to prove something. I did it so I could know what real unconditional healing looked like. I wanted to see what was behind that door.  A door I often walked past because I was always in a hurry to get to the places where I thought joy, healing, and happiness was waiting for me in the future.

But what I had not realized was that I had already arrived at that place. It was a part of me, always has been and always will be. We live it and breathe it every second. We just didn’t realize how perfect that MOMENT in the PRESENT was.

When I could no longer keep up with the pace of unrealistic expectations, mine and others, I had no choice but to slow down, look within and open my eyes to the vastness of how beautifully the mind and body could co-exist. No competition. No hierarchy of being better than the other. The body in all of its imperfections and the mind with all of its doubts existed as one’s ying to the other’s yang.

This is exactly how life, health and happiness should be!!!

I was able to immerse myself into these profound discoveries because the Great Pandemic of 2020 allowed me the grace of time to search for another way of healing that didn’t involve yet another prescription or yet another detrimental side effect.  There had to be another way to health!

When I finally took my body and mind off of autopilot and became more present with myself, I began to truly understand that our immune systems are beautifully integrated into a circuit designed to succeed.

But when we put things into our body that “clog” the pipes – processed foods, poor sleep habits, excessive worry, lack of exercise – the system breaks down.

The answer to a balanced body and peaceful mind is not to add “more” medications, pills, diets or fads. We must clear the pipes that caused the dysfunction in the first place.

Covid has given us an opportunity to slow down life so that we can choose to spend time with ourselves and enjoy our company. We can get excited about increasing our physical activity or learning healthy cooking because we know its rewards are 1000x-fold. We can begin to understand the importance of breath control and how synonymous oxygen is with the quality of living. We can give ourselves permission to rest our bodies without feeling guilty, but still maintain good sleep hygiene. We can finally learn how to eliminate the word “unworthiness” from our vocabulary, and begin living consciously in the present with the little things so that we may once again find the joy in doing nothing.

Healing!

I have been practicing medicine for over 20 years and in that time I have seen a collage of illnesses and its cures. But never have I seen as much inward healing as I have in the last nine months.

I have had patients who have had a rough physical and emotional year, but never before has our approach to treatment been so different as it has been in 2020. We cherished the extra time we got to talk about the role of meditation in healing or the use of essential oils or how less is more when it comes to everything.

The stories they shared, the worries they faced, the discoveries they made allowed us to work together to heal whatever issues were plaguing them at the time.  I understood their fears, because I was living them too.

2020 has helped slowed down the hamster wheel just long enough for us to jump off and take a tour of the places within ourselves we never even knew existed.

No doubt we are missing the softness of the human hug or craving the string of selfies instead of having to settle for screenshots of our gallery of friends. Absolutely, we can’t wait for the day when we can take the trips that were planned back in 2019 that have been put on hold or rejoicing in the celebrations of New Year’s, Valentines, St. Patrick’s Day, Easter, Mother’s Day, Memorial Day, Father’s Day, Children’s Day, Grandchildren’s Day, 4th of July, Labor Day, Halloween, Thanksgiving, Christmas and all those other days in between that we once took for granted. It will happen! But until that day comes, let’s spend it in the presence of our own company.

Unfortunately it took a pandemic for us to feel that we are worthy enough to spend time with ourselves.

Self-reflection is not about seeing our flaws. It is about accepting the perfect connection between our mind-body-spirit.

Positive thoughts lead to eradicating diseases. Healthy body leads to a purified mind.

I just hope when the world opens up and the wheel begins to churn again, that we will choose differently. That we will choose stillness!

Wishing you and your families a safe, healthy, happy and prosperous 2021!

Natural Ways To Raise And Maintain Your Immune SystemEight months into 2020, Covid has become a household name. However we cannot forget the other virus that visits us every winter, Influenza A & B.

Public health officials have been warning us since March that this winter will be the year of the double virus whammy, but what does this mean for us and how can we keep ourselves safe and healthy?

Strong theories suggest because of increased compliance with mask wearing, social distancing and aggressive hand washing, this flu season could be one of the lowest infectious years. It makes sense, but we shouldn’t take anything for granted.

As most of you who know me know, I believe in minimizing supplements and medications and would rather allow the body’s natural defenses to protect us.

So, let’s talk about some natural ways we can raise and maintain our immune system this winter season.

  1. Eliminate processed foods. Excessive intake of sugar and other processed foods triggers inflammatory chemicals, such as cytokines and IL-1, Tumor Necrosis Factor. Overtime, this signals a sense of false-alarm in the body and lowers the body’s response to be able to launch a defense against infections. Processed foods also cause a decrease in the white blood cells needed for optimal immune system. Studies have also shown that a diet high in sugar and salt can cause vaccines to be less effective. This is why maintaining a fresh, clean and whole diet is imperative.
  2. Hydration. Our immune system is highly dependent on nutrients in our blood stream and water is the most important nutrient. Staying well hydrated is also very important for detoxification pathways, increasing lymphatic drainage and clearing out any foreign invaders. Dehydration can contribute to muscle tension, headaches, low serotonin production and digestive issues. I recommend drinking ½-1 oz/ pound body weight. Increased and more strenuous activities will require a higher intake. For example, someone weighing 150lb requires a minimum of 75 oz/day. If plain water is not your jive, try sprucing it up with fresh fruits, lemon, ginger, mint or your choice of flavorings. If the day gets away from you and you find it difficult to get in your quota, try setting an alarm every 20-30minutes as a reminder.  It will make a big difference for your immune system.
  3. Sleep. Our immune system releases proteins called cytokines. These cytokines are needed to help keep us healthy. Sleep deprivation causes a decrease in the release of cytokines as well as a decrease in infection fighting antibodies.  I cannot emphasize how crucial sleep is for our overall well-being. Sleep requires discipline.  Make an effort to shut down all electronic devices one hour before bedtime. Wind down with soothing instrumental music and maybe a warm cup of decaf tea or your favorite non-alcoholic beverage. Take five minutes to write in your gratitude journal or just close your eyes and enjoy the flow of your breath. As simple as all of these may seem, they are the most powerful tools we have. And we each have it in abundance.
  4. Don’t worry. Be happy. Life is a canvas of stress. That won’t change. But how we react to can. Acute or chronic stress raises cortisol levels which decreases our abilities to fight off foreign antigens. Stress also inhibits the body to mount an immune response by decreasing the production of lymphocytes. Of course there are things in life that require our constant attention and can lead us into a path of uncertainty and fear.  Remaining on this path will only takes us into a pit of disease and poor quality of life. Best way to neutralize the effects of stress is to identify which coping mechanisms help you BEFORE stressors arise.  Do you feel happy after a five mile run? Do you forget your troubles after laughing to your favorite sitcom or movie? Does reaching out to your BFF put a smile on your face at the end of the conversation? Or can sitting in silence bring you the peace and calm that is needed? Go on the offense before needing to get defensive.
  5. Essential oils. Health care providers are beginning to incorporate more holistic options into the treatment plan. While much research is still needed and ongoing, the NIH in December 2019 stated, “Certain plants possess immunomodulatory properties exerting effects on various parts of the immune system on both cellular and molecular levels: T cells and other immune effector cells, cytokine, and antibody production.” There are of course many variables that need to be factored in when choosing the correct oils. We must understand the quality control and extraction process of the company.  The plant from which the oils are extracted must be from a reliable healthy source. Understanding the compression process of the oils must retain its natural concentration and properties.  Preliminary studies show certain plants target certain parts of the immune system. Although essential oils shouldn’t be a replacement for medical care, it can be a topic of conversation with your physician.  Many of you may know, I am recovering from Covid.  Not knowing what to expect, I spent two weeks in isolation waiting to see what the day would bring. In May of this year, my daughter got me to try Essential Oils for various conditions, just to see what the hype was all about. During my two weeks with Covid, I thought this would be a good time to test out how effective these oils can really be. I used them in various ways (diffused, topically applied, drops in my water, etc.) and much to my surprise, it offered symptomatic relief for each of my symptoms. I only needed to take Tylenol one time in the entire 14 days. Essential oils may not be for everyone and they are not to be used as a substitution for your prescription medications unless discussed at length with your physician, but I do believe this is another resource to natural holistic support.

Whether you follow one or all of these tips, remember WE WILL get through this. We must be diligent, alert, patient and considerate. We are not only protecting our own health, but also the health of every single person.

Please stay safe. Please stay healthy – and know all will be ok.

There are so many articles out there about an improperly functioning thyroid, it is hard to know where to begin! Let’s start at the top. How many of these symptoms describe you?Improperly Functioning Thyroid

  • Extreme fatigue
  • Weight gain
  • Irritability
  • Muscle aches
  • Depression
  • Rapid hair graying
  • Decreased libido
  • And too many other “little issues attributed to aging”

These little issues could be caused by a small gland with some big responsibilities. That gland is your thyroid.

The thyroid gland produces and stores hormones through an integral and complex pathway that is directly linked to your hormones and adrenals. The thyroid plays a part in EVERYTHING AND EVERY CELL IN YOUR BODY. It is butterfly-shaped and is found in the lower part of the neck, wrapped around the trachea.

Hypothyroidism: A Common Condition, But Frequently Misdiagnosed

Hypothyroidism is a condition where the body, for various reasons, doesn’t produce enough thyroid hormone or is unable to utilize the thyroid at a cellular level. No matter what the cause, this diagnosis has debilitating and frustrating consequences.

Being diagnosed with hypothyroid myself in 2002, I have spent the last 13 years researching, studying,
and understanding the complexity of this “little gland.”

According to the U.S. Department of Health and Human Services, about 4.6 percent of the U.S. population (approximately 18 million people) age 12 and older has hypothyroidism. As prevalent as hypothyroidism is, most people are not correctly diagnosed when they first present symptoms to their doctors because there is not a standard interpretation criteria for screening tests—meaning that one doctor may think a slight dip below the normal range is acceptable while others would argue otherwise.

Your thyroid can be affected if your adrenals are not balanced or if your hormones are constantly fluctuating. Due to the minute-to-minute variability of ALL the hormones in your body, patients are often under-diagnosed.

A single thyroid level test is insufficient to make the determination of hypothyroidism.

Many other thyroid levels also need to be checked. These could include TSH, Free T4, Free T3, Thyroid Peroxidase Antibody, Thyroglobulin Antibody, Magnesium, Iron, Zinc, Vitamin D, Hormones and Cortisol.

A patient who self-educates and self-advocates is in the best position to work collaboratively with his or her doctor to determine the best course of treatment for the symptoms and diagnosis of hypothyroidism. Self-advocacy is much easier when you choose a doctor who has experience in recognizing the symptoms of hypothyroidism as well as other hormonal conditions such as diabetes and adrenal gland issues.

Treatment of Hypothyroidism

Once hypothyroidism is diagnosed, there are many treatment options that need to be considered. Synthetic thyroid (Synthroid or Levoxyl) medication is not the only option. There are T3-only medications such as Cytomel or combination of T4 and T3 medications such as Armour Thyroid or Nature Thyroid. Patients even have the option of having their thyroid medication compounded with an accredited compounding pharmacy.

Hypothyroidism is not a cookie-cutter diagnosis and neither should be the treatment.

It is extremely important to work closely with your physician to monitor symptoms and continue to regularly check your thyroid levels.

The discussion of thyroid disease is more extensive than I can capture in a single blog post. In my 15 years of practicing primary care, I have diagnosed and corrected misdiagnoses of many patients with hypothyroidism. I understand and have experienced every symptom you may be having. I know the frustrations, I understand the suffering and I continue to live with this diagnosis everyday.

If you are suffering from any symptoms that are interfering with your life, Please contact our office today to schedule an appointment.

Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

concierge medicineIt feels like every week the world becomes a little more upside-down and inside out. What do we believe? Who do we believe? How do we make the simple day to day decisions that once took mere seconds have now extended into days? When will the vaccine be ready? Will a vaccine be ready? Where do I go to get tested? Can I have my antibody levels checked? What do I do about sending my kids to school in the fall when I am scared to let them out of my sight? And the list goes on and on……

The truth is, I don’t know that any of us have the answers –  it is okay not to know. It is perfectly okay to be feeling everything you are feeling. Don’t dismiss it. Don’t justify it. Don’t talk yourself out of it. Accept that everything you are feeling is legit and valid.

I have spent a great deal of time during these last four months in meditation and introspection.  My intention for these monthly articles is to always in some small way inspire each of you. But what do I write about that isn’t already out there? How can we have a conversation that doesn’t include a left or right or an up or a down? How can I translate my thoughts into words and hope it will inspire a wave of health and healing?

The only way I know how to do that is to be myself. Raw and authentic.

I thought I would share the story of how I came to practice with the principles and beliefs that I hold.

There was a time in my early years of practice when my patient schedule would be bookmarked with 20+ patients, all spaced in increments of 15 minutes.  I barely had time to say ‘Hi’ to them and next thing I knew, I was walking out the door. There was no time to ask them how they were doing or how the family, kids, or work life was going. We had time to address only one problem at each visit, leaving the rest for a future appointment.

I will never forget the day that I decided I needed to make a change. It was March 2011, and as usual my schedule was double booked with no breaks in sight. As a person who is time conscious, I make it a point to stay on time, but one small set back in the day would put me behind by at least an hour. The day started like any other. I was feeling good that I was on schedule and the stars were aligning.  By late morning, a quick 5 minute break opened. I felt like I hit the jackpot.  I walked into to see my next patient before that break, only to find out her beloved husband had suddenly died.  How could I leave her in the middle of her anguished tears just because the timer on the 15 minutes was ticking down? I couldn’t! So I stayed there to be with her.

I was very well aware of the angry patients that began to line up after her. They also had places to go, things to do, people to see. However, I couldn’t bring myself to tell her that our time was finished. I wanted to give her the respect of my time as she began telling me about the special love she shared with her soulmate for over 50 years.

I also knew it was not fair to the others who were waiting after her because their time was just as important and valuable.

The internal tug-o-war was too much for me to handle. Both pulled at my heart strings and I didn’t know what the right thing to do was. Stay and comfort or politely excuse myself?

It was in that moment I knew I couldn’t do this anymore.  How was I to take care of somebody in 15 minutes when they were placing so much trust in me to help them?

I went home that night 2 hours behind schedule only to collapse into a pool of defeat.

When I graduated from medical school, I took the oath “First Do No Harm,”  NOT  “First Do No Harm but only for 15 minutes!”

This realization left me with no choice except to make the decision to change to Concierge Medicine.

In September 2011, I began my new practice. There was an exponential learning curve during those initial days.  I had to give myself permission to take my time. I had to get used to the fact that there was no reason for me to rush. What a feeling of freedom and joy I had!!  Nine years later, my patients have become like family. I cherish hearing their stories. I relish in their experiences, and I rejoice in their healing.

Concierge medicine has allowed me to scale down my patient volume from having a panel of 3000 patients to a panel of 300 patients.  This gave me the opportunity to take care of patients in a way I never thought possible. The concept of Concierge Medicine has only come to the forefront in recent years. As more focus is directed towards preventative medicine, concierge practices will soon become mainstream medicine. The last nine years have offered me the opportunity to engage in full dialogue with each one of you. I no longer feel a sense of urgency to stop the appointments in mid-sentence in an effort to stay on time. For me, the most profound experience has been the process of learning together with my patients. I always say I don’t have all the answers, but why not find out together? To engage in dialogue that brings about mutual growth and discovery is the best platform I know how to offer.

The time gives me the chance to earn your trust and I hope it allows you to feel heard.

We don’t always get it right – but we always have something to work towards.

Why I am writing about this now is because everything around us, outside of us and inside of us, is chaos and confusion.  When equal trust spans between physician-patient, you know you have an anchor to always hold onto.

Practicing Concierge Medicine is the reason my bond with each of you allows me the space to say “You know what? I don’t know what is going to happen.  I don’t know when things are going to be okay, but together we will figure it out.”

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health,  CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on FacebookTwitterLinkedIn and Pinterest.

5 reasons to spend more time outsideAs the sun glares over the horizon, the warmth of its rays welcomes us to come be present with nature in the great outdoors.

After nearly 10 weeks of doing what is best for our nation and the people of it, we began to sense the door was cracking just enough to raise our excitement.

However, this doesn’t mean it is business as usual. I caution you not to fall into the patterns of previous behaviors. We are not even close to being out of the woods.

But with what we have learnt about the Coronavirus, making smart and safe decisions can ensure we keep ourselves and others safe while being able to enjoy the summer days ahead.

We are still in the nucleus of a pandemic – and unless safe guidelines are in place, even outdoor fun can put us in a major setback.

When I intended to write on this topic a couple of weeks ago, it looked very different in my mind than it does now.

How can we ignore what is happening in our streets, in every corner of our world and within every community that surrounds our lives. All of this while a virus, known as Covid, continues to silently tear through leaving a painful path of its presence.

How are we to make sense of any of what is happening while continuing to live our day to day lives? I don’t know that we can.

But getting outdoors maybe the best possible thing we can do right now.

Here are just some ideas on how to spend more time outside this summer to get you started while still staying safe.

  1. Family picnics. Go back to the good ole days with a blanket on the ground, homemade sandwiches and the lingering scent of bug spray. After a satisfying meal, just lay back and look at the massive painting of stars, each one waiting for you to make a wish.  Such simplicity.
  2. Ice cream stroll. How fun! Load up the family, after all who can’t be bribed with ice cream, and visit your local ice cream parlor. Make it a to-go order and enjoy the savory summer treats while strolling the streets of your community.  What a wonderful way to support local business, get to know your neighbors and be out in nature. Everyone wins.
  3. Family tag. Ok. You may have a little trouble getting the older ones off their screen for this one, but it may be worth a try. Do you remember the game of freeze tag? The game goes like this, if you are tagged, you have to freeze and cannot move until someone untags you? Oh boy, do I remember.  We played this all the time and I would constantly pull pranks on my friends. Right before we would begin to play, I would tell my friends that the only coolest kid was able to drink five glasses of water in 2 minutes. And I double dared them to do it. And they did. By the time the game started, they all were running around with a full bladder.  When they were tagged, they would lose right away because they were unable to stand still because they had to pee so bad! So, I won most of the time, until they caught on to my ploy. It is a blast. You should try it with the family minus the water prank, unless you are competitive like me and really want to win. It is hilarious to watch and keeps everyone hydrated.
  4. Backyard camping. How much lower maintenance camping can you get than this? Pitch a tent or roll out the sleeping back in the privacy of your own back yard. Take in the cool night breeze and reflect on how the last 10+ weeks have brought us all back to the way life is supposed to be lived.
  5. Car roof chats. If it is just a night with the two of you or you are in need of some alone time, why not climb to the rooftop of the car and enjoy conversations with each other or yourself from a different vantage point? It is amazing how a change in location can bring clarity to thoughts and feelings. It is worth finding out, right?

My friends, this was a challenging task to write this blog.  I wanted to find a way to write on a topic that was light but in no way take away from the reality of the darkness that surrounds us.

I DO NOT want to diminish the magnitude of healing that still awaits us. Our hearts are heavy and our spirits are weary. But if we don’t find ways to take care ourselves, how can we hold up our brothers and sisters?

In the few minutes you spend reading this blog, my hope is you place down all the burdens being carried upon you and remind yourself that the world is good and it will once again become our home.

As we are caught in between the splintered worlds of the unknowns, the only thing I know how to do is extend my hand.

I hope being in the embrace of nature allows you to find the solace within the inertia of more questions and not enough answers.

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health,  CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on FacebookTwitterLinkedIn and Pinterest.

working out at homeSix weeks have passed since ringing in the New Year with all of those promising resolutions to get healthy. We set our intentions and march forward to sign up for those “unbeatable” gym specials. However, Old Man Winter can get in the way of leaving the house so we can keep up with those promising resolutions.

Whatever the reason that kept you from using that newly minted membership card, look no further. Here are my suggestions on ways to stay active without having to leave your home.

The benefits of incorporating resistance training far surpasses hours on a cardio machine.  Resistance bands have become one of my absolute favorite tools to have.  The versatility as well as the safety and ease of use are suitable to almost all fitness levels.

Bands are available online or at any retail store. Depending on the brand, prices can range from $5-$30+, a very worthwhile investment.

If you have any medical concerns that may preclude you from exercising, be sure to discuss it with your physician before beginning any exercise regimen.

My Band Resistant Workout: Recommend 3x/week

Warm-up: 7 minutes

Block 1: Repeat 2x rounds.  Tie band around a sturdy structure so that both ends are available to hold. (ie a wall pillar, couch leg, a tree etc)

  1. Band squats. Extend arms straight holding on to end of the band, squat, one sec pause at the bottom and then stand. Repeat 15x reps.
  2. Alternating lunges. Extend arms straight holding on to end of band, alternate reverse lunges

Repeat 15x reps each side.

  1. Squat jack. Extend arms straight holding on to end of the band, sit low in a squat and begin jumping jacks. Repeat 30x low squat jack.

Cardio:  2 minutes high knees

Block 2: Repeat 2x rounds. Free up band from structure.

  1. Lateral pulldown. Hold band in the center with approximately 12 inches between each hand, then raise band overhead and while pulling down to chest, pull the bands apart. Stop mid chest and slowly extend back overhead. Repeat 15x reps.
  2. Bicep curls. With hands in same position as 1st exercise, rest the hands on the thighs palms facing up. Next, create tension on the band by pulling it apart in opposite direction as you flex the elbows to the foreheard. Lower back down slowly. Repeat 15x reps.
  3. Chest pull aparts. Keeping band at chest level, begin pulling the band in opposite directions to outside of chest, 3 sec pause, slowly return to center. Repeat 15x reps.

Cardio: 2 minutes run in place

Cool down/Stretch: 7 minutes.

This format is only a starting point to get you motivated to stay focused on your health. There are any number of resources (online videos, books or magazines, personal trainers) that maybe utilized to take these few exercises and transform them into a consistent way of life, no matter what the outside circumstance maybe.

Be greater than your excuses!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health,  CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on FacebookTwitterLinkedIn and Pinterest.

hair skin & NailsThe quest for great hair, skin and nails seems a lot more difficult to achieve in the winter months. Dry itchy skin, brittle fly-away whispys, chipped nails – sound familiar? The tell tale signs of winter are in the air! Understanding why colder temps affect our skin can go a long way to help remedy the problem areas, but it is important to understand the role a balanced endocrine system plays as well.

Inflammation is the single most important contributor that affects our skin, hair and nails due to the stimulation of free radicals, which accelerates aging by attaching to and damaging cells. In addition, studies have shown that there is a connection between sugar and inflammation in the body.

The main hormones that play a direct role in contributing to the decline from inflammation include:

  1. Estrogen
  2. Progesterone
  3. Testosterone
  4. Thyroid
  5. Cortisol

I have written in the past about how these hormones become imbalanced, which leads to external changes we see. But for this month, I would like to focus specifically on how colder temperatures become a factor.

As we have understood, the fundamental rudimentary cause for the external changes we see is due to hormonal imbalances. The same carries true during winter months.

The longer, darker days lowers our Vitamin D levels. The waxing and waning of the temperatures directly impacts our thyroid levels. Estrogen, Progesterone and Testosterone levels ebb and flow to try and keep the body in balance. This endless cycle causes a rise in cortisol, therefore triggering an inflammatory response which leads to cellular inflammation, disruption and malfunction.

Other contributing factors include:

  1. Drier air from vents
  2. Poor hydration
  3. Increase in consumption of comfort foods (mainly sugar)
  4. Lack of exercise
  5. Prolonged hot showers/baths
  6. Irregular sleep patterns

Until Spring can shine upon us, here are some simple tips to help :

  1. Increase hydration. It is vital to keep the body hydrated with at least 90 oz/water/day. Without the essence of water, cellular healing cannot begin.
  2. Humidifier. Worth the investment. Having one by the bedside and in rooms that are frequently occupied helps prevent skin dry out.
  3. Limit hot showers/baths. Skin that is immersed for prolonged periods of time in hot water strips the natural oils causing hair and skin to become dry. It does feel great to stay for extended time in that warmth, but that causes more harm that good. Limit showers to 7 minutes at most.
  4. Coconut oil/butter. Nothing like solid saturated fats to hydrate the skin. Apply to hair and skin and allow it to soak for 45 minutes to an hour and shower afterwards. Or leave it on overnight for better absorption.
  5. Limit sugar intake. This is not specific to winter only! Refined sugar causes insulin levels to spike thereby leading to inflammation. Be mindful of this hidden culprit.

These are very simple, yet effective means to help control and possibly prevent winter skin ailments.

As the saying goes, we can’t stop the clock. Spring will be here before we know it as soon as we get through the craziness of St. Louis winter swings!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health,  CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on FacebookTwitterLinkedIn and Pinterest.