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.

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.

staying healthy through the holidaysDo the holidays have you jumping for joy or running for the nearest exit? Labeled as “The Most Wonderful Time of the Year,” the holiday season can be stressful and overwhelming for some. If you are in need of a vacation to refuel after all that joy, how about trying something different this year? Staying anchored amidst the peripheral chaos will not only keep you healthy, but also give you a chance to enjoy in the merriment.

Here are some simple things to keep this year’s festivities filled with glee.

  1. Exercise. Moving the body helps to mobilize stagnant energy. Inducing a heart rate response helps delivery of oxygen to those much deprived sedentary tissues. Plus, it keeps the waistline in check. If you are able to maintain your regular schedule of workouts, fantastic! If not, try using resistance bands at home. Ten minutes in the morning and ten minutes before bed provides enough resistance training to keep your muscles from winter atrophy.
  2. Meditation. Studies have shown just three minutes of mind-stillness is enough to lower cellular inflammation significantly. One of my go-to meditation apps is ‘Insight Timer’.  It is a free download that offers 24,000 meditation options ranging from two minutes up to three + hours.  Set your alarm clock five minutes earlier than you would normally get up and head to your favorite spot. Set a timer. Turn on your favorite music or have no music at all and just let your mind get lost. Don’t stop any thoughts, emotions or feelings that arise. Let them come to the surface and just observe. Go deeper into your diaphragmatic breath as each inhale/exhale brings you to a place of calm.  Once the timer goes off, you get to choose if you are done or if you want to continue longer. There is power in stillness.
  3. Increase protein. With so many tempting processed foods surrounding us this time of year, even the most disciplined cave to the pressures of home baked goods. We all know how we get when we eat too much sugar – crabby, anxious, irritable, depressed, fatigue, joint pain, swelling – and this is all before the weight gain even starts. Do yourself a favor. You know what the outcome of a sugar splurge is going to feel like. So don’t go ALL the way there. Yet, you don’t want to deprive yourself of the simple pleasures in life. You can have your cake and eat it too, but in smaller quantities. If you know you are headed towards the dessert table, load up on high protein meals prior to start of the party. High fiber, high protein snacks curb cravings while making you feel fuller. Stock your pantry this season with nourishing snacks like dates, nuts, fruits, cut meats, pre-made protein shakes (my favorite) or anything else you find nourishing and satisfying and eat it thirty minutes before partying it up.
  4. Water. We all know water helps with satiety, but more importantly water’s function is to keep the cells operating fully and completely.  As our body begins to acclimate to the cooler temperatures, it is vital that we become more diligent with water consumption. Regulating our internal thermostat causes dehydration even before the onset of symptoms. All it takes is just a little effort to see how easy drinking water actually is.  To make the process a little easier, use water bottles with clear markings so it takes the guess work out of the equation. For those that don’t enjoy the taste of fresh water, add fresh fruits through an infuser to sweeten the deal.  Recommended intake is ½ oz per body weight in pounds/day.  Set phone reminders. Having an alarm go off every 15 minutes is surely an annoying way to keep anyone on track. Don’t underestimate the importance of staying hydrated.
  5. Relax. I often tell my patients, “Let’s work really hard the first 11 ½ months of the year so when these last two weeks roll around, we can play.”  Come on guys.  Isn’t life stressful enough as it is? Why do we want to make the “Most Wonderful Time of the Year” like all the other stressed out days? Family can be stressful. Cooking can be tedious. Hosting can be exhausting. Sleep can be deprived. Weight can be piled on. House can be random chaos. But soon everything will go back to its organized, fast-paced, hurried, no-time for each other life. Let it go. The pie doesn’t have to be perfect. The decorations don’t have to be like HGTV paid you a visit. Just breathe and remember holidays are of course about celebrating family and the joys in our lives, but it is really about celebrating YOU. It is an opportunity to reflect on who you have become this year and who you are becoming into the next. It is about all that you have learnt and all that you have released. It is about slowing our heart rate and pausing with each breath. Take the pictures. Eat the food.  Enjoy the moment. You know why? Because January 2nd is right around the corner and we will soon be back on this hamster wheel in a game we call ‘life’.

Wishing you and your families a most joyous holiday season. May 2020 be a year of healing, happiness and prosperity!

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.

menopauseMenopause, a women’s worst nightmare or is it? By simply understanding the basic science, we can clear the myths of this dreaded change and make it the most empowering years of a women’s life.

The two predominant hormones are Estrogen and Progesterone. Menopause is nothing more than a mirror image of menarche, or the start of menses.

In the pubertal years, the E2 (Estrogen) and P4 (Progesterone) begin to increase in quantity in preparation of future pregnancies. During this time, there is an imbalance of E2 and P4 which occurs that results in PMS, development of female habitus, acne, mood changes and so on.

During the 20’s and 30’s, E2 and P4 are in prime balance which allows the opportunity for the woman to conceive. When in equilibrium, a woman feels her best.

Around 35 years of age, the body begins to prepare to slow down. This is the time, the change STARTS.

E2 and P4 levels begin to biologically drop. Progesterone declines twice as fast as Estrogen. It is this imbalance between the lower Progesterone in relation to the higher Estrogen that causes menopausal symptoms.

Walking around with higher than needed Estrogen leads to higher risk of breast, uterine, or ovarian cancers, blood clots,  and heart disease. Progesterone is there to keep Estrogen from over stimulating the cells. Progesterone also helps with sleep, balances your mood, acts as a diuretic, and gives an overall sense of calm.

When Progesterone declines in respect to Estrogen, it creates a phenomena known as Progesterone Deficiency or Estrogen Dominance.

This is when women experience acne, mood changes, sleep issues, cravings, slowed metabolism, weight gain around mid-section and hips. In essence, menopause is a mirror reflection of menarche.

The solution? That is the million dollar question. Pre-menopause, Peri-Menopause, Menopause, Post-Menopause-whatever phrase you choose to describe this phase is irrelevant because the concept is the same.

Crossing the turbulent rivers of menopause is much easier and simpler than we think because we now understand why the body is changing the way it is.

So how do we get through these years? Here are few things to remember:

  • Breathe. This is not a permanent! The hormones are trying to find their balance and they eventually will. No one can predict how long this will take. And nothing can be done to speed up the process. The body is only trying to protect you. Allow it to do so. Don’t condemn the changes you are experiencing. The body is your armor, your voice and your friend. Understand what it is trying to tell you when it speaks to you in the form of symptoms.
  • Stop worrying about the weight. The weight is a symptom like anything else. Weight gain occurs due to Estrogen Dominance/Progesterone Deficiency. There are alpha and beta receptors throughout our muscle and adipose layers in the body. Depending on how those receptors are activated in each person, is where the weight change will occur.
  • Watch your diet and move your body. Our foods are coated with Estrogen and other chemicals which worsens Estrogen Dominance. It is imperative to cut out gluten, sugar, dairy. Eat clean and as unprocessed as possible. Additionally, without exercise don’t expect the body to change. Your body will not respond how it did was few years prior. And that’s ok. But it doesn’t mean that it won’t change. This will just become the new norm. One of the places Estrogen is converted is in adipose tissues. So the more fat you carry, the more estrogen it will convert, thereby again, worsening Estrogen Dominance. Striving towards optimal body fat will help keep Estrogen Dominance controlled. Focus on feeling balanced, not skinny.
  • Make sleep a priority. Without sleep the adrenal glands cannot function at their best. The disruption to the cortisol results in further Progesterone depletion. Turn off the devices and sink yourself into restful slumber.
  • Meditate. When the mind is silenced amongst the chaos of life, we are able to center and align to the root of our existence. Take 5-10 minutes a day, close your eyes and go to the places that feel off balance and listen for the guidance given.
  • Use hormones. I am all for using hormones, IF AND WHEN IT IS NEEDED. Treating with hormones during menopause is certainly not mandatory. The fundamental question to ask is, “are my symptoms debilitating enough that it is affecting my quality of life?” If the answer is yes, use the smallest amount needed for optimal results. Hormones are like the waves of the ocean. Anything can affect them – sleep, weight, seasonal changes, stress levels, nutritional habits, exercise commitment. You may need hormones for a while and decide later they are not needed. And depending on what’s going on in life, may need them again. There is no one answer. The correct answer always is what your body tells you it needs. Hormones are not the magic solution to these symptoms. They are only a crutch to lean on while working on lifestyle modifications.
  • Stop comparing. Don’t compare yourself to your past self. Menopause is a beautiful opportunity for growth and experience. Just keep remembering the symptoms we experience is the body protecting us. This cloud WILL pass! Learn to dance in the rain and embrace the glory of being a woman. This is a period of transformation, revitalization and rejuvenation.

Menopause is the process of shedding the layers of struggle. But just be patient my friends because the wings of healing are opening to reveal the vastness of all that is authentically you.

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.

balance hormones naturallyIt seems like just when I have the hormonal pathways figured out I am gently reminded of how much I don’t know. To me, that is the beauty of trying to understand a system that continues to elude us. The learning is endless.

In my previous blogs, I have discussed the varying components to hormones. What are the different hormones? What are the functions of each one? Why do they become imbalanced? How do we check for them? What medications can we use?

This month is all about my two favorite topics: Hormones and anything natural!

The complexity of the hormonal pathways is similar to our highway system. One road may lead to multiple different avenues with multiple different ways to get there. Just so, there is no one correct way to bring things into alignment.

Let’s take a look at how we can naturally keep our hormones balanced and how to naturally bring them back into balance if an imbalance were to occur.

  1. Maintain weight. With a higher body fat percentage, more adipose tissues are available to covert to Estrogen. This conversion results in worsening estrogen dominance, which leads to decreased metabolism, insulin resistance, increased weight gain, and subsequent imbalance.

    Solution:  Strength train 3-4x/wk. Increasing muscle mass helps maintain insulin regulation and metabolism resulting in lower body fat.

  2. Adequate sleep. Without proper quality and quantity of sleep, cortisol levels may fluctuate greatly throughout the day in an effort to support basic daily functioning. When cortisol levels are unable to synchronize with our natural flow, it places the body into “stress mode.”  In anticipation of the stress, insulin, once again, is down-regulated and thyroid functioning slows. This leads to cravings, mental fogginess, slowed reaction times, and decreased metabolism. This can cause an increase in weight and therefore, worsening estrogen dominance.

    Solution: Sleep. Sleep. Sleep. Allow the body to rest in the full capacity it needs. Many people have told me, “Oh, I can function with just 4 hours of sleep.” Sure, maybe in the short-term. But in the long run, the body can’t sustain optimally under constant tension. Just like a car can’t run on empty, neither can you. Fuel up with sleep.

  3. Limit supplements. Why take something if your body doesn’t need it just because some limited research claims it can prevent Disease X or Symptom Y, only to come back in a few years claiming it is not beneficial at all. Overloading with a garland of drugs in a hopeless promise to health is becoming one of the leading causes of imbalances. Supplements stimulate the adrenal glands in ways we don’t yet understand. So what is all of this REALLY doing to us a decade from now. Be picky with what goes in your body.

    Solution: Have an open discussion with your physician regarding any non-prescription medications, even if you think it is not significant. Blood work can be done to check certain vitamin levels. If you are depleted, taking a supplement maybe beneficial. But only after asking the question, why are the levels abnormal in the first place?

  4. Meditate: Google “meditation” and you will find no shortage of studies proving meditation is ONE of the BEST healing therapies available. It doesn’t have to be for a gazillion hours or on top of a mountain. It can be for a few minutes with your feet firmly planted on the ground. Meditation is an ancient remedy that has gotten lost in the confusion of our techno-driven world. As meditation is finding its way back to us, it is worth trying.

    Solution: Take five minutes daily in a quiet uninterrupted place and observe your breath. Observe the chaos leaving and peace entering. Envision your entire system coming into balance working harmoniously so that you can become the best version of yourself.

  5. Self-Love.We have been conditioned to believe that taking time out for ourselves is selfish. When we allow self-criticism, judgement, and negativity to invade our space, our system starts to believe that we are less than. We begin to feel we are not worth the effort it takes into becoming healthy. Before we know it, the downward spiral has begun. This self-destructive process leads to depression, anxiety, poor sleep, and addictive behaviors. These choices once again puts the body into the familiar space of fighting stress.

    Solution: Daily positive affirmations are powerful tools. Every morning before starting the day, choose an affirmation, look yourself in the mirror and repeat it until you believe it. Then walk out the door with your head held high knowing you are worth SO MUCH more than ANYTHING that defines you.

Listening to your body is one of the best ways to ensure never getting lost on the road to healing!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance.

For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.

You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

Gluten-Free LifestyleDoes maintaining a gluten-free lifestyle measure up to the promised hype of feeling better? That’s the million dollar question. Let’s take a look at this more closely and recap what we already know about gluten.

Gluten is a composite of storage proteins found in wheat, barley, rye, and oat. It gives elasticity to dough, helps it rise, keeps its shape and gives food a chewy texture. But here are a few reasons why gluten has earned a bad rap:

Gut Inflammation. The proteins in wheat are gut irritants which dig into the lining of the gut wall, causing amylase trypsin inhibitors to provoke an inflammatory immune response.

Increased Intestinal Permeability. The gut is a patrol system that regulates which nutrients may enter and which may not. Inflammation in the gut caused by gluten halts that process of control. It loosens the junctions between cells in the gut wall so too much stuff can pass through. Hence the name of “leaky gut.” This leak is thought to be the number one contributing factor to developing autoimmune disease.

Vulnerability to Gut Autoimmunity. Gliadin is a component of gluten and once it enters the system, the problems begin. The exposure to gliadin causes one’s body to form antibodies against its own tissue, thereby creating an avalanche of toxins. Gluten-related inflammation may also be a factor in the development of Crohn’s Disease.

Autoimmune Reactions. Studies have found wheat exposure might be causing autoimmune issues even without evidence of celiac disease. With the abundance of GMO’s, there have been an exponential surge of autoimmune disorders thought in part due to the toxic effects of gluten.

Symptoms of gluten sensitivity can vary. Some common ones include:

  • Fatigue
  • Mood changes
  • GI issues
  • Poor sleep
  • Rash (Dermatitis Herpatiformis is specific to gluten)
  • Hormone dysregulation
  • Hair loss
  • Weight changes
  • Joint/muscle pain/swelling

If these are reasons enough to make you want to consider cutting back on gluten, here are steps you can take to make the process a little easier.

  1. Get educated. There is nothing more empowering than understanding exactly why you are choosing this path. When I first began my gluten free journey it was not by choice, but out of necessity. I was one of the few that experienced all 10 of the above symptoms. It was daunting and overwhelming. I simplified the process by reading. A great way to start is with the book “Wheat Belly” by Dr. William Davis. Dr. Davis takes you through the history of how gluten has become toxic to our system. Sit with the information and absorb the rationale of why maintaining a gluten-free diet can be life-saving.
  2. Make a list of the foods your currently eat. Rather than trying to figure out which foods do or do not have gluten, start by streamlining and looking at your own diet. Make a list of all the foods and ingredients you eat on a regular basis. Then begin researching that specific food. Remember –  gluten is not listed as an ingredient. It is a protein! You won’t find it on the label. You will learn over time how gluten is disguised in various forms.
  3. Start slowly. Don’t expect yourself to change overnight. It is not safe for the body, nor is it healthy. Start by decreasing a certain percentage of what you are currently eating. For example, eat only one slice of bread with your sandwich rather than two. This small change can make a significant impact. Remember, gluten is inflammatory. As you decrease your intake of gluten, body inflammation also diminishes. This will result in decreased cravings and an overall decrease in inflammation.
  4. Limit the gluten-free foods. While reaching for gluten-free cookies is nice when you need that sugar fix, gluten-free products are filled with other ingredients and chemicals that are not good for us. In August 2013, the FDA issued a final rule, effective August 2014, that defined the term “gluten-free” for voluntary use in the labeling of foods as meaning that the amount of gluten contained in the food is below 20 parts per million. This means only a small portion of the food needs to be gluten-free to earn that label. It very well could be that the other portion in the food is not. If you wouldn’t eat a regular cookie, then you shouldn’t be eating a gluten-free one. Indulgences are ok as long as they remain on that special occasion.
  5. Clear out expectations. Lose the idea that going gluten-free will be the “IT” weight loss miracle. Because it is not! If you lose weight from removing gluten, it is because you are caliberating your metabolism. While weight loss may be an added benefit, the real reward is overall health. When the body is balanced and brought to its natural homeostasis, everything will be in perfect working order, including the weight. Don’t chase the weight loss. Allow it to present itself to you along with all of the other great benefits!

Gluten-free eating is truly not the next fad. There are many, and more to come, unfolding studies and evidence of benefits to living gluten free. It is not a quick fix. We didn’t get here overnight. So stay the path. Stay focused. Stay determined and above all STAY COMMITTED!

CHANGE IS COMING!

depressionDepression has been labeled “a hush hush” diagnosis. The stigma of being called “depressed” has somehow placed a Scarlet Letter on those affected. Everyone reading this understands at some point what it feels like to be down. Let me tell you, we have ALL been there, continue to be there, or will be there. There is nothing wrong in admitting that we can’t do it all. It doesn’t make us weak. It makes us that much stronger for having the courage to say what everyone else may be thinking. I have talked about the effects of hormonal imbalances in my previous blogs. This month, I would like to focus on breaking through the silent conversations of depression.

While depression is known to have genetic links, it does not mean we are destined to that fate. With the convoluted ways of our world and the minute to minute emotional roller coaster we face from our home life, work place or just by turning on the news, there is no doubt we have all been plagued on some spectrum of depressive symptoms.

So why am I writing on this topic? I am writing because it is time to start having REAL conversations on what is happening within our psyche.

While depression has earned its own DSM code, all depression is not treated equally. Each degree of symptoms is just as important as the other. It must be acknowledged and accepted so that healing may begin.

How does depression affect the physical body beyond the obvious?

“The most frequently occurring endocrine abnormality in depressed subjects is hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Depression also affects the hypothalamic-pituitary-GH (HPGH) and -thyroid (HPT) axes. Alterations in the reproductive system may also play a role in the pathology of depression. In addition, there is increasing evidence that leptin and neurosteroids, such as DHEA, are implicated in mood disorders.” J Endocrinol Invest. 2005 Jan;28(1):89-99.

So what does this mean? Exactly what we think it means. When neurotransmitters are imbalanced or depleted, it drives cortisol into over production to compensate for the deficit. This puts an extra burden on the organ systems leading to the development of diseases we are too often familiar with.

What are causes of depressive symptoms?

  1. Hormonal imbalances
  2. Decreased levels of neurotransmitters
  3. Endocrine disorders (Hypothyroidism,Hyperthyroidism, Diabetes etc)
  4. Autoimmune disease (Thyroid, Rheumatoid Arthritis, Lupus etc)
  5. Food or environmental allergies
  6. Environmental stressors or trauma
  7. Medication side effects

By no means is this a complete list, but it is evident most anything can cause symptoms.

How many of these sound familiar?

  • Physical pain
  • Irritability
  • Sadness
  • Guilt
  • Fatigue
  • Hair loss
  • Decreased concentration
  • Fleeting thoughts
  • Indecisiveness
  • Weight changes
  • GI disturbances
  • Sleep disturbances (too little or too much)
  • Increase in alcohol consumption
  • Spending increased time on social media or online (who would have thought?)
  • Not keeping up with grooming or hygiene

Don’t give up!! There are many ways to treat these symptoms and come out on top!

How can I get well?

  1. Therapists/Healers. They are your BEST and #1 resource. There is nothing like being able to sit in a room for an hour talking about yourself with someone listening to your every word. They are trained to listen and they are trained to help. No, they can’t change the situation, but they do know how to give objective insight and perspective. We all at some point should experience the awesomeness of seeing a therapist.
  1. Breathe. If we block oxygen from entering our cells, then nothing can heal, including our emotions. Pick your favorite breathing technique and start inhaling power and exhaling doubt.
  1. Stay present. Easier said than done, I know! Learn to control your mind from re- visiting the past or jumping to the future. Both are out of your control, so begin accepting the gift of the present.
  1. Mindful eating. YES, everything comes back to the GI tract! When we eat clean, the body stays clean. Don’t hoard toxins that only spin you further out of control. Hydrate – 90 oz water/day. Even if you have to force yourself to get the water down, it is worth it.
  1. Exercise. Moving the body has been proven to release endorphins that stimulate release of neurotransmitters. Higher levels of hormones means happy you. Move, move, move.
  1. Buddy up. Nothing like being in the company of friends whose energy can give you a boost. Relish and cherish the bonds of friendships. BFF’s are the best antidepressant in the world.
  1. Explore your creativity. Color, paint, write, choreograph a dance, compose music, cook, sew….whatever brings out the Martha Stewart in you, do it. Stimulating our creative forces causes increase blood flow to different parts of the brain thereby increasing levels of the neurotransmitters.
  1. Get a pet. Now, I know this maybe a little bit of work so don’t panic on me. Just think of the love, energy, unconditional compassion they bring into the home. That is enough to take away anybody’s down days. Just consider it.
  1. Herbal supplements. I have included this on the list, but I am not a strong advocate of herbs. There is some evidence that certain natural supplements help lift minor depressive symptoms, but it has not been evaluated in long term studies. Be cautious! It is only a temporary solution.
  1. Antidepressants. Let me clear up one thing. Antidepressants are very effective in treatment of depressive symptoms and I am in favor of using them, BUT only in conjunction with other treatment modalities. Think of antidepressants as a crutch to help you walk on this rocky road. It doesn’t mean you are unable to handle the situation without the use of meds. It only means they help protect your physical body from the effects of depression. It doesn’t have to be a permanent treatment, but only to be used only until the storm passes. Whatever your reason may be for resisting them, don’t. They truly can help ease the passage into brighter days.

There are many more advanced treatments, remedies and therapy techniques on the treatment of depression and its associated symptoms.

The courage must lie within you to find the voice of your feelings. Sweeping things under the rug doesn’t make them go away. It only makes the magnitude of the situation seem worse.

We are all human beings. And part of being human is the glory of having feelings. Some feelings make us feel good and others don’t. It is about identifying those that don’t and making things alright. Because at the end of the day, it will be alright!

“People cry not because they are weak. It’s because they have been strong for so long.” — Johnny Depp

You are not alone!!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieveing 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.

sugar addictionSugar addiction is really prevalent in the news right now. Sugar – we can’t live with it, we can’t imagine life without it. Could removing sugar from your diet be that one magic answer to our weight loss battle?

Let’s start at the beginning. Why do we thrive on it? The more we have, the more we want. The answer may be simpler than we once thought.

Ingesting sugar causes a dopamine release in the Nucleus Accumbens. When we consume sugar often and in large quantities, dopamine is released in excess causing a down regulation and blunting of the receptor sites. Therefore, in order to get that “feel-good” response, the body requires even MORE sugar to produce the same response.

“The reviewed evidence supports the theory that, in some circumstances, intermittent access to sugar can lead to behavior and neurochemical changes that resemble the effects of a substance of abuse. According to the evidence in rats, intermittent access to sugar and chow is capable of producing a “dependency”. This was operationally defined by tests for bingeing, withdrawal, craving and cross-sensitization to amphetamine and alcohol. The correspondence to some people with binge eating disorder or bulimia is striking, but whether or not it is a good idea to call this a “food addiction” in people is both a scientific and societal question that has yet to be answered. What this review demonstrates is that rats with intermittent access to food and a sugar solution can show both a constellation of behaviors and parallel brain changes that are characteristic of rats that voluntarily self-administer addictive drugs. In the aggregrate, this is evidence that sugar can be addictive.” Neuroscience & Biobehavioral ReviewsVolume 32, Issue 1, 2008, Pages 20–39

The compelling evidence and research on sugar addiction proves the effects on the brain mimics those of cocaine and heroin abuse. But how do we get away from it when it lurks in the shadows of every ingredient we consume?

How Do I Take The First Step?

We must first accept that this change will be gradual. Don’t expect to have immediate results. Sugar is a “drug.” It will be hard before it gets easy. Taking the first step will be the hardest. We didn’t get here overnight, so don’t expect the body to revert just the same. This is a marathon, not a sprint!!

Unfortunately, there is no quick fix to this. Here are few things that help the process.

  1. LEARN INGREDIENTS. I am not talking about memorizing the chemical makeup of every ingredient you eat. Understand the common names and abbreviations. Ingredients are hidden under different names including high fructose corn syrup, dried cane syrup, invert sugar, molasses, sucrose (or any word ending in “-ose”), brown rice syrup, honey, and maple syrup. There are many lists available. The goal is to become educated. Click here for one such list.

  2. KEEP A FOOD JOURNAL. It’s not so important at this stage to worry about calorie counting. While consuming the correct amount of calories plays a key role, it is more important to really know WHAT types of food you are eating. Chances are, like most of us, you are eating things thinking they are healthy. The food industry has made its way into every aspect of our health. FIGHTING THE GIANTS, MEANS BEING ARMED WITH THE POWER OF KNOWLEDGE.
  1. HYDRATE. I can’t emphasize this enough. DON’T UNDERESTIMATE THE POWER OF WATER. It has always been our ally long before flavored drinks entered the picture. I understand water may not taste good. This is because our palate and taste buds have been conditioned to the sweetness of drinks that claim to give us instant energy. What it has also conditioned us to is the crash that comes with the sugar laden beverages. Flavored waters (8 tsp/bottle), bottled iced teas (>9 tsp/bottle), energy drinks (7 tsp/can), bottled coffee drinks (8 tsp/bottle), and store-bought smoothies (>12 tsp/small) all contain way too much sugar. Strive to consume 90 oz of pure water/day. If you are not a water drinker, you may need to start with only 8 oz and work up slowly. However you do it, WALK AROUND WITH A WATER BOTTLE.
  1. TIME YOUR MEALS. Sugar thrives on messing with not only dopamine, but also insulin. Its very essence is to disrupt our insulin regulation and response. Timing of meals is crucial to stabilizing the insulin surges and decrease sugar cravings, especially in the initial phases of removing sugar from your diet and your life. Increase protein and healthy fats in your diet to help maintain steady release and uptake of glucose. Most important take home message: YOUR EVENING MEAL SHOULD BE FINISHED BY 7:30PM.
  1. KEEP MOVING. Two parts to this: First, move your body-in whatever capacity that can circulate blood. Walk, workout, lift weight, dance, swim, clean…it doesn’t matter. Just move. Don’t worry about how much you move….just move. Second, keep moving forward. Don’t become discouraged because your body is not responding the way you THINK it should. Your body is here to protect you. It won’t always give you what you want. But it will always give you what you need. Changing life long habits is a process. Be kind to it. It was kind to you when you weren’t so nice to it. THE BODY IS ON OUR SIDE.
  1. MAINTAIN HEALTHY GUT. Sugar undoubtedly alters pH throughout the body. The shift in acid base balance triggers more chemical disruptions that worsen the down regulated neurotransmitter receptors. One of the largest target organs is our GI tract. I have talked in extensive detail in previous blogs about the crucial importance of maintaining a healthy GI tract. Studies have shown the desensitization process that happens with sugar consumption also occurs with other foods. In other words, our weakened immune system sets us up for chemical attacks from other food groups (even the healthiest of foods). HEAL THY GUT.
  1. AVOID THE FAKE STUFF. This is worse than consuming the real stuff. Anything that reads “sugar-free” is a blaring warning label. Stay away!! Dangerous chemicals are added to sugar free substitutes that lead to whole other set of problems. According to a review in the 2010 Yale Journal of Biology and Medicine, when you eat something sweet, your body expects calories and nutrition, but artificial sugars don’t give your body those things. That may be why fake sugars are associated with weight gain. According to a meta-analysis in the Journal of Medicinal Food, sprinkling on cinnamon has been shown to naturally regulate blood sugar, which helps control your appetite. DON’T GO FOR THE FAKE STUFF.
  1. RELAX. Just take a deep breath. There is no finish line in this race. This is about a life style change. This is about taking back control of what you lost. This is about being the best version of yourself. Don’t make it about the weight. The weight is only your body’s way of telling you that it is not feeling good. Don’t let the 3 little numbers on the scale define your worth. The body is a glorious vehicle that will take you where you want to go if you nurture and love it the way it is. Make these changes gradually. Cut back slowly and enjoy the process of getting healthy. You will learn so much about what your body has been trying to tell you for years. If you want to enjoy that chocolate cake, by all means, do so. This is about finding the body, mind and soul connection. If you totally give up all of your favorites, your body will fight you with the cravings and then then mind will be consumed with the thought of wanting that cake and the soul will become restless watching these two go at it. Take the bite of the cake when you want to and listen when the body tells you to stop.

Mindful eating is truly becoming an entity of its own in the medical field. The next few years will uncover some of the greatest mysteries of the human body. My thought is that the answer has been with us all along: YOU ARE WHAT YOU EAT!

Let’s all become empowered and walk this journey of discovery together.

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieveing 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.

Hormones can have a major affect on your hair, skin and nails. Skin, the single largest organ in the human body readily tells the story of what is really going on beneath those layers.

hormones hair skin nails

Do any of these symptoms sound familiar?

 

  • Hair loss in clumps or strands
  • Slow or no hair growth
  • Thinning eyebrows
  • Sparse eyelashes
  • Brittle or cracked nails
  • Nail ridges
  • Dry skin
  • Fine lines and wrinkles
  • Eye circles
  • Acne

Contrary to popular belief, these symptoms are not from getting older. While aging causes a decline in hormones, environmental and dietary factors also have a hand in speeding up the aging process. While we can’t control our biological clock, what if we could get a handle on things we can control? It starts with our endocrine system.

The endocrine system is comprised of eight main glands:

  • Pituitary
  • Pineal
  • Thymus
  • Thyroid
  • Parathyroid
  • Adrenals
  • Pancreas
  • Gonads

The glands, located in separate areas of the body, must work in perfect alignment and synchronize to achieve optimal balance. If any part of the pathway “short circuits,” the body immediately signals its distress and begins the healing process. The symptoms you experience are nothing more than indications of the dysfunction occurring at the cellular level.

So why do we develop these symptoms and what can we do to reverse them?

Good question. The reasons are many. The most important thing to identify is WHY you are having the symptoms? For example, the emotional impact of hair loss is likely the same for everyone, but the cause of why it is occurring is starkly different for each individual.

Here are some of the most common causes of endocrine imbalance and its effect on the hair, skin and nails.

  1. Declining Estrogen. Estrogen stimulates collagen production and blood flow and contributes to the smooth, firm appearance of skin. As estrogen levels drop, so does collagen production. Without adequate collagen, the skin loses its elasticity, hence developing the appearance of wrinkles.
    Treatment: Topical estrogen use has shown some improvement in appearance, but the risks of estrogen outweigh the benefits. Although not a permanent solution, some temporary options to enhance collagen stimulation include:
  • Tretinoin
  • Vitamin C
  • Alpha hydroxy acids
  • Chemical peels
  • Dermabrasion
  • Laser resurfacing
  1. Elevated Androgens. Estrogen dominance results when estrogen is higher in RELATION to progesterone. Although the absolute value of estrogen declines, the estrogen/progesterone ratio favors estrogen dominance. Estrogen dominance causes estrogen to convert to testosterone. Elevated levels of testosterone triggers a chain reaction which ultimately leads to the typical “male pattern baldness” in both men and women.
    Treatment: Balance estrogen/progesterone ratio with natural compounded progesterone. Restoring depleted progesterone levels helps decrease estrogen dominance and thereby decreases conversion to testosterone.
  1. Bacterial/Fungal Infection. Any compromise to the immune system can weaken hair follicles and dermal layers of the skin. While treating the infection is important, it is even more important to identify WHY an infection is present. Infections are red flags that there is something more going on.
    Treatment: Oral Nystatin may be used to treat if there is any suspicion of a systemic fungal infection. Antibiotics for bacterial infections must be used with caution and only given once a definitive cause is identified. Developing antibiotic resistance only worsens the problem. Use with caution.
  1. Everything is blamed on the thyroid. Whether the thyroid gland is under functioning (Hypothyroid) or over functioning (Hyperthyroid), the wrath it leaves on the hair and skin is emotionally scarring. IT IS IMPERATIVE THAT THYROID LEVELS ARE TESTED IN ITS ENTIRETY. Too often the diagnosis of thyroid disease is missed due to an inadequate testing of thyroid panel. To fully evaluate a thyroid condition, the following levels should be done: TSH, Free T4, Free T3, Total T3, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies, Magnesium, Vitamin B12, Vitamin D, Iron levels.
    Treatment: Once an accurate diagnosis of Hypothyroid or Hyperthyroid is made, appropriate treatment is given and monitored. If hair and skin continues to be effected after thyroid is in balance, LOOK FOR ANOTHER CAUSE.
  1. Medication Side Effects. Answers we seek the most often sit right under our nose. Always, always assume a medication can cause side effects, until otherwise proven. Even if the symptom is not listed in the package insert, don’t assume that is can’t happen. Simple to identify and simpler to reverse.
    Treatment: Revisit all medications and ALL SUPPLEMENTS.
  1. Leaky Gut. This requires a whole article in itself. GI health and “Leaky Gut” are single handedly catapulting modern medicine to all new heights. EVERYTHING STARTS WITH THE GUT. LET ME REPEAT………HEAL THE GUT…..HEAL THE BODY! Foods we consume are infested with hormones, antibiotics and other unknown chemicals. Going up against the food industry to change their habits can leave us frustrated and defeated. But changing OUR habits can leave us complete and empowered. As the gut flora is disrupted, it creates a “hole” in our ozone in the gut. This leak causes release of many known and unknown cytokines. The inflammatory nature of the cytokines triggers a disruption in the normal hormonal pathway. As mentioned above, we can now understand what happens when hormones are not aligned. Assume even the healthy foods you consume contribute to the leak.
    Treatment: Navigating through the lumen of the GI tract is a winding tortuous ride to unknowns. Begin by decreasing consumption of high reactive foods: gluten, sugar, dairy, non-organic meats and produce. To track your body’s response, maintain a food journal and monitor any physical or emotional improvements. You can also restore the gut’s natural flora with a pro-biotic. You may also consider having an extensive food sensitivity panel testing done. The MRT Leap test measures 150 of the most common food sensitivities.

The complexity of the endocrine system and its effects on the body is quite extensive and many entities are still unknown. The points discussed here are only a mere entry point into the depths of what lies within our cells. Skin is that glorious organ that blankets and shields us from the daily trauma we endure. Waiting around for science to discover the answers will only leave us feeling more impatient and confused. But taking charge of our own health proves to be our greatest ally.

LISTEN TO YOUR BODY! THE SYMPTOMS YOU EXPERIENCE ARE YOUR BODY’S ATTEMPT TO GET YOUR ATTENTION. Every symptom is just as important as the next. Don’t ignore when your body is talking to you. It could be the most important conversation you will ever have! If you are listening to your body and ready to move forward with healing, contact our office today!

How many of these symptoms describe you?hypothyroidism-symptoms

  • 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.