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Month's in Review

Raw Foods: The Good And the Not So Good

It wasn’t long ago that raw food bars were all the rage. If you didn’t eat your food raw, you weren’t in with the IN crowd and you were out of the loop in the healthy rage. There are still some raw food bars around but pretty much the fad has died down and, I think, for good reason.

A lot of my patients ask me about the health benefits of eating raw food and I agree there are some foods that are of benefit eaten raw, some I question, and some I never would recommend without cooking. In case you were wondering about whether it’s more beneficial to eat all of your food raw, here’s some pros and cons you might want to consider.

What’s So Great About Raw Food?

To begin with, raw food is anything that has not been heated above 118 degrees. It’s reported by raw food enthusiasts that temperatures above that kill the natural enzymes present in food and make it harder for your body to digest them. It’s true, that your body needs specific enzymes to digest your food. As we get older those enzymes decrease and don’t do the job of digesting as well which may leave us constipated and missing a lot of nutrients from our food.

Now, there are some great, high vitamins and mineral, fiber-filled foods recommended for raw food dieting that are all the things you should include in a healthy diet anyway. They include such foods as vegetables, fruits, legumes, grains and juices as well as monounsaturated fats from olives, avocados, coconut, and nuts. As you can see, it’s mostly a vegetarian diet, but people who practice a raw diet exclusively say there are many benefits such as:

• Lower cholesterol.

• Lower/stable blood sugar levels.

• Lower blood pressure (from decreased sodium intake).

• May prevent stomach and oral cancers (overly cooked, barbecued food suspect).

• High in fiber, helps maintain good bowel health and blood sugar levels.

• Boosts immune system from higher glycoside levels in raw food.

• Avoidance of wheat, dairy, sugar, alcohol, and table salt may help some allergies and aids the body in detoxifying itself.

• Clearer skin.

• Weight loss, sustained.

What’s Not So Great About Raw Food Diet

The raw food diet lifestyle, in its purest form, is mostly a vegetarian diet. I become concerned about vitamin deficiencies, especially deficiencies in B12, which is common in vegetarian diets. This deficiency can result in anemia, and conditions of the nervous system, as well as neurological disorders of cognition problems and dementia. The best sources of B12 are from red meat, and secondly chicken, fish, and wheat germ.

In addition, not heating foods past 118 degrees allows food borne pathogens to stay intact and can result in serious illness. Take eggs for example. Many of my patients brag about how they put a raw egg in a blender with juice, etc, and drink it all down. I cringe and then tell them they’re lucky they dodged a salmonella bullet but may not always, as eggs can be carriers of bacteria.

Depending on how strict you are into a raw food diet, you may also include some fish (sushi, etc), red meat, and milk (non-pasteurized, non-homogenized only). Adding meat and fish works better from a nutritional standpoint, but from a food borne pathogen standpoint could pose some serious problems. Both fish and meat can carry bacteria, like salmonella and others. If you’ve ever suffered a Salmonella food poisoning event, you don’t want to go there again. They can also carry viruses and parasites. Non-pasteurized milk can also carry Mycobacterium bovis that can cause non-pulmonary type tuberculosis. In short, these raw foods can result in some serious illnesses that you don’t want to subject yourself to.

And if vitamin deficiencies and food borne pathogens aren’t enough to scare you away from a raw food diet, some raw foods are included that are in a natural and uncooked state, many of which can be toxic. Here is a short list of these foods:

• Kidney beans and sprouts contain a chemical called phytohemaglutinin, which can be toxic.

• Alfalfa sprouts contain canavanine.

• Apricot kernels – contain amygdalin, which is raw cyanide.

• Buckwheat greens are toxic if raw. They can trigger photosensivity.

• Parsnips – raw, contain furanocoumarin which can be toxic.

In addition, time may be a factor in not choosing a raw diet. Since it is mostly all raw food, it takes a lot of buying and preparation time, as freshness would be of ultimate importance.

Convenience may be another negative, as it would make it hard to go out to eat. Also getting used to it may be hard for people who have eaten meat, sugar, salt and alcohol their entire life to switch to a raw diet.

Is There a Healthy Way To Eat Raw Foods?

The answer to that question depends on whom you ask, mostly. But even many raw food enthusiasts say that the ideal raw diet is 75% raw and 25% cooked, and if I were going to “go raw” this is the way I’d likely do it as well.

• Twenty-five percent of your raw diet could be cooked meat, fish or eggs, but I would add a good digestive enzyme to help digest these proteins especially if you’re past age 40.

• The other 75% could be made up of raw vegetables steamed just enough to soften them and bring out their flavor. Raw fruit and nuts are always great in their natural form and I wholeheartedly recommend eating several servings of these vitamin and fiber rich foods every day.

• As always, drink half your weight in clean, filtered water a day to flush toxins out of your body.

This is what I tell my patients who ask about the health benefits of a raw food diet. There are a lot of positive elements involved, such as eating all the vegetables, fruit, and nuts, and staying away from sugar and alcohol and processed foods. These are healthy changes that anyone can incorporate into their diet whether it’s completely raw or not. To avoid serious illness however, stay away from sushi and steak tartare unless you really can vouch for where they came from and who handled them.

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

________________________________________

Weight Loss Drugs: Are They Really Effective?

Seems at least once a week one of my patients asks me about the safety and effectiveness of some new diet formula they saw advertised on TV or the internet. The answer is a mixed bag of yes, no and maybe, depending on the ingredients in the formula and how they’re being used. If you’ve got a few pounds to lose, it’s only natural that you might be intrigued and tempted to try one of these formulas. So, allow me to share with you some information about a few common weight loss formulas out there, my recommendations, and let you to decide for yourself if you would like to try any.

Prescription Formulas

There are many prescription weight loss pills available, some control hunger, others rev up your metabolism, and still others play around with your insulin level to encourage weight loss. I feel that prescription weight loss formulas have health risks associated with using them. I would say, just leave the prescription formulas alone.

Over-The Counter Formulas

There are dozens of weight loss formulas out there. Most of them are herbal based. Here are some of the most common ingredients in these weight loss formulas, their function, and their health risks:

Metabolism boosters/Fat Burners:

• Green tea extract – helps you burn fat by ramping up your metabolism. A downside is that green tea extract contains a lot of caffeine and could cause some negative effects such as diarrhea, dehydration, heart palpitations, and nausea.

• White willow bark – an herbal derivative that aids in raising metabolism levels. It is also the herb that aspirin is derived from as it contains salicin, a natural pain killer. Often found in “stack” formulas, it doesn’t do much on its own. If you are allergic, or have reactions to aspirin, you will want to avoid white willow bark as well. Like aspirin, it can decrease blood clotting and may interact poorly with prescription medications you may be taking.

• Bitter orange – used in TCM (traditional Chinese medicine) for centuries for many conditions including weight loss. It contains the chemical synephrine which is similar to ephedrine in action, i.e., it revs up your metabolism like drinking caffeine.

• Caffeine – boosts metabolism and can help you sustain exercise so you burn more fat and calories. Too much can dehydrate you, cause heart palpitations, jitteriness and insomnia.

• Ephedra – the ban on this supplement was lifted not long ago but it has too many problems associated with it to use safely.

• CLA (conjugated linoleic acid) - clinical studies have proven this formula effective in burning fat and preserving muscle. A little over 3 grams of CLA a day (3,400 mg) is needed to produce these beneficial effects. Possible side effects may be loose stools and nausea in some people but can be prevented if taken with food.

• Garcinia cambogia – contains HCA, hydroxycitric acid, which inhibits the body’s ability to store fat. No real known side effects, unless taken in very high does, but may have a laxative effect or cause stomach upset if too much is used at once.

Appetite controllers:

• Hoodia – discovered in Africa, it was used by Bushmen to stop hunger pangs on long journeys. The real thing used in Africa may be a lot stronger than the manufactured type sold as a weight loss aid and depends on the integrity of the brand you buy and how they process the Hoodia. Some can be very expensive.

• Irvingia gabonensis – from the West African dika nut, initial studies showed weight loss in the group studied. However, may have been due to decreased food intake, and may take as long as 90 days to kick in.

Carbohydrate/Sugar/Fat Blockers:

• Phase 2 (white kidney bean extract) blocks carbohydrates from starches, i.e., pasta, potatoes, bread, corn from being absorbed.

• Alli – (Orlistat/Xenical). You may have seen TV ads. Weight loss occurs as it blocks a percentage of the food you eat from being stored as fat and moves it quickly out of the intestines. In 2009 FDA received reports of liver injury, and investigations are underway.

• 5-HTP – increases “feel good” serotonin levels in the brain so you can stay on a carb-restricted diet longer to help lose weight. Also helps you sleep. As an adjunct to a healthy, lower carb diet, it can have some value in limited amounts.

Insulin Stabilizers:

• Cinnamon – recent clinical studies were very promising in cinnamon by decreasing blood sugar levels and stabilizing insulin levels. Helps decrease belly fat by decreasing insulin. There is conflicting information, however, that common cinnamon, made from cassia bark, may be toxic to your liver in doses higher than 1 gram as it contains Coumarin. Ceylon or Sri Lankan cinnamon does not contain Coumarin. Best to stay in the 1 gram (or two 500 mg capsule) limit. Diabetics should use with a doctor’s supervision.

• Chromium – a mineral, helps utilize insulin better, decrease belly fat deposits.

• Gymnema sylvestre – an herb used in India for decades as a weight loss aid to lower blood sugar levels in diabetics, it is usually one of the ingredients in weight loss formulas along with chromium and cambogia gordonii. The American National Institute of Health deemed it helpful in controlling blood sugar levels in diabetics. However, diabetics should use under a doctor’s supervision.

Cleansers:

• Herbal slimming teas, or “Dieter’s Tea” - contain rhubarb and senna which are powerful laxatives. These can be used sparingly/diluted as a pre-diet colon cleanse, but do not use these types of teas regularly. They can cause diarrhea and deplete your electrolytes which make your heart fire incorrectly with palpitations, etc.

• Bowel cleansers – contain a lot of herbal ingredients like rhubarb, senna, cascara sagrada, and others. These work to clean the bowel of build up waste and can result in a few pounds of weight loss on the scale, but this is mostly water and waste loss and not fat. Useful as a pre-diet colon cleanse but not as a real fat loss solution.

• Acai berry – another detoxing agent, ads for it are all over the internet touting huge amounts of belly fat loss and almost always by people who are selling it. The benefit of acai berry is in its vitamin, mineral, antioxidant content. The downside; it’s not a magic bullet for weight loss.

Hormone/Sensory Formulas:

• HCG (human chorionic gonadotropin) - HCG is a hormone produced during pregnancy present in urine. It is touted to ramp up metabolism so that you burn a lot of fat quickly. The downside to this routine is that you have to go on a very low calorie diet to accompany it, which may be impossible to tolerate, and is not cheap. Best used under a doctor’s supervision.

• Sensa – works on your sense of smell to decrease the amount of food you eat. If you’ve ever had a bad cold and couldn’t smell you know how much your taste and desire to eat was also affected. Basically same principle. If you eat less, you lose weight.

My Recommendation

Weight loss is not all that complicated. It’s basically a matter of eating less, but nutritionally dense, low sugar, amounts of food, and moving more, i.e., getting more exercise. I feel the best, natural supplements to aid weight loss are vitamins and minerals that support healthy fat and sugar metabolism like the array of B vitamins, L-carnitine, Vitamins C, E, D, and Omega-3’s.

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

________________________________________

Torn Ligaments And Tendons

Many of my patients are very active and exercise every day. This is a good thing, but some of them overdo it or they fail to warm up properly and wind up with torn ligaments and/or tendons. These can be very painful and may necessitate surgery to repair them. Instead of being active and feeling great, these common athletic injuries can have you sitting on the sidelines for several weeks.

If you’re someone who exercises frequently, I’d like to talk to you about how to take care of your ligaments and tendons to avoid injury. First let me give you a little basic anatomy lesson about what your ligaments and tendons do and the most common injuries that occur.

Ligaments and Tendons Help You Move

When you think of going for your daily run, do you realize that there are several ligaments and tendons in your ankles, knees, hips, that if they weren’t there, your legs wouldn’t be able to move properly? Or when you play basketball, they enable your shoulders to keep your arms up so you can make that slam dunk? That’s right. Without them, you couldn’t participate in your favorite sports. That’s why they’re so important to consider before exercising.

Ligaments are flexible cord-like structures that are attached to your bones. They connect your bones/joints together so that they can move correctly. They act like shocks in your car, absorbing the impact of your movements on your bones. Although ligaments are very flexible and have a lot of bend and give to them, they can sometimes give too far, stretch beyond their limit and sprain or sometimes even tear.

Tendons are very similar to ligaments, they are made out of basically the same collagen material as your ligaments, but they have a different job. Tendons attach your muscles to your bones so your muscles and skeletal structure move together when you go for a run. Tendons are also very flexible and stretch quite a bit. Like ligaments, though, they can stretch too far and sprain and/or tear as well.

Common Injuries of Ligaments and Tendons

There are many ways you can injure ligaments and tendons that don’t involve playing sports. For example, in a job that requires repetitive motions of lifting heavier objects overhead may put strain on your shoulder, elbow, or wrist ligaments and tendons. If you do a lot of walking while at work, or are on your feet most the day, you could put stress on ankles, knees, and hips, especially the Achilles and knee tendons and ligaments.

However, most ligament and tendon injuries do come from participating in sports, especially where there is direct foot/ground impact, or players crunching into each other, falling or running into barriers. Let’s look at some of the most common, starting from the shoulders down:

• AC injuries: The acromioclavicular ligament – a big word that can be a big pain. 40% of ACL injuries occur in sports involving primarily the shoulder and upper arm like basketball, baseball, football and even overhead lifting in weight training. Injury to 1 or all 4 of the ACL ligaments usually occurs by either direct force – during a fall directly onto the shoulder with the arm held at the side, or by indirect force – during a fall onto an outstretched arm. There are six grades of severity of ACL ligament injury, all depending on how damaged the ligament is. Symptoms: Pain and swelling over the shoulder joint, restricted movement due to pain, laxity, or wrong movement, of the shoulder joint itself.

• UCL/LCL injuries: The ulnar and lateral collateral ligaments – these are 2 ligaments of the elbow that can be injured doing repetitive back and forth movements such that occur in “throwing” sports like baseball (most common), football and racquet sports like tennis, hockey, polo, javelin throwing. Symptoms: Pain, sometimes swelling along the inner elbow, bruising if the ligament was ruptured, closing/opening the hand, making a fist causes pain.

• Elbow Tendinitis: Tennis elbow and golfer’s elbow are the most common injuries to the elbow and affect the medial (middle) and lateral (side) epicondyles (tendons) of the elbow. This is a painful inflammation and stiffness caused by overuse and may recur frequently. It occurs most often in racquet sports or activities where there is repetitive back and forth movement of the elbow. Symptoms: Pain, swelling, stiffness of the joint, loss of range of motion.

• ACL injuries: The anterior cruciate ligament is one of the 4 stabilizing ligaments of the knee. An ACL sprain or tear is a very common injury in people who exercise moderately to heavily and occurs most frequently in women. It occurs from force placed on the knee from a twisting body movement where the foot is planted firmly on the ground, overstretching the ligament. Symptoms: A pop or crackle sound at the moment of injury may be heard, it is very painful, swelling of the knee occurs, and you cannot straighten out the leg.

• Achilles tendon injuries: The Achilles tendon is the largest and thickest tendon of the body and connects the heel to the lower leg muscles. It can be subject to several times the weight of your body in pushing off into a run or sprint. The Achilles tendon can be injured by improper support in shoes, accidents, or even some medications can weaken it. Achilles tendon tightness is also associated with heel spurs which can be very painful and prevent you from doing any foot/ground impact sports for several weeks. Symptoms: Soreness/stiffness especially noted getting out of bed. An Achilles tear may start with a sudden pop heard at time of injury with immediate pain and inability to stand on the leg.

Treatments for Sprained or Torn Ligaments and Tendons

If you’ve ever had a ligament or tendon injury you know how painful and debilitating it can be. Treatments of these injuries depend on how badly damaged the ligament or tendon is. In mild to moderate injuries, treatment usually includes:

• The RICE formula (rest, ice, compression, elevation)

• A short course of anti-inflammatory medications.

Elbow tendon and shoulder ligament injuries can take longer to heal as it is difficult to completely rest the ligaments and tendons of these areas.

More severe sprains and/or tears may often involve the following:

• Surgery to the ligament or tendon to restore the proper tension to keep bones/joint in proper alignment for correct movement. X-rays and/or MRI films are used to see how badly the ligament or tendon injury is.

• Arthroscopic surgery of the anterior cruciate ligament of the knee sometimes is necessary to repair the ligament. Under anesthesia, several ports are made in the knee for an insertion of an arthroscope to enable the surgeon to see/repair the ligament directly.

• AC ligament separations or tears: Reconnective/reconstructive surgery is often necessary.

Recovery from ACL and AC ligament injuries can be slow and may require several weeks of physical therapy. Afterwards treatments include whirlpool, range of motion exercises, direct ultrasound stimulation, heat, and/or ice to the affected areas.

Preventing Ligament and Tendon Injuries

As I tell my patients, the best way to avoid ligament and tendon injuries is to make sure you take time to warm up before exercising. I can’t stress how important this is, especially in people just starting an exercise regimen, as ligament and tendon injuries can seriously curb their enthusiasm for future exercise. Here are some basic tips on how to warm up each section of ligaments and tendons that are most prone to injury:

• General stretching: Lay on the floor, raise your arms overhead and stretch out like a cat does, slowly twisting in several directions. Do this for about 5 minutes, breathing in deeply as you go. Your muscles, tendons, ligaments all need oxygen to fire correctly.

• Shoulder shrug/rotations: Slowly shrug your shoulders, bring them up to your ears and rotate them backward slowly. This loosens up tension in the large muscles of the neck and shoulders.

• Elbow stretches: Hold your arm out straight ahead, slowly flex your hand/arm back towards you to the mid position and stop, lower your hand back down.

• Leg stretches: Stand straight, bend over and touch the floor with your fingertips and then slowly, gradually try to flatten your palm on the floor. Be sure to keep your feet flat on the floor and do not twist to the side. This stretches your hamstrings and loosens up tight knee and leg muscles.

• Achilles stretches: Stand facing a wall, about 1 foot away from it, lean into the wall, placing the palms of your hands on it. Extend one leg back behind you on the ball of your foot. Slowly, deliberately, bounce your heel towards the floor. This stretches out the Achilles tendon and helps to avoid heel spurs as well from a tight Achilles pulling on the calcaneus bone.

• Weight Train: Start with light weight training to strengthen ligaments and tendons, build up gradually.

• Get Enough Sleep: Inadequate sleep doesn’t allow your muscles, tendons, ligaments to re-strengthen themselves correctly and makes them more prone to injury.

• Drink Water! Your muscles, ligaments and tendons, need water to move fluidly and remove lactic acid that builds up during exercise. It also helps create adequate fluid for joint cushioning. Drink half your body weight in ounces of water per day, more if you are exercising in very hot, humid weather. Sport drinks can also help keep you hydrated.

Exercise does your health a world of good. Injuries to ligaments and tendons, however, can really put a damper on your fitness goals. It’s better to do a little exercise everyday than to do the ‘weekend warrior’ thing and wind up straining and/or hurting yourself. Remember, exercise should be fun and not be something that lands you on the couch watching television waiting to heal!

In Good Health,

Mark Bromson, M.D.

________________________________________

Caffeine: The Good, The Bad And The Healthy

Many of my patients enjoy coffee, tea, and other caffeinated beverages but they read and hear that caffeine is unhealthy and should be eliminated from your diet. They’re always asking me, “Do I have to give up my coffee?”

It’s true that there seem to be mixed messages out there about the health effects of caffeine. Some information says it should be eliminated from your diet completely and yet new research shows that a little caffeine has several worthwhile health benefits!

Let’s look at some facts about caffeine, its downside as well as its health benefits, and hopefully, for all you coffee and tea lovers, we’ll find a healthy medium!

What’s So Bad About Caffeine?

Caffeine use by man has been around for centuries, or should I say eons, as it’s believed to have been consumed even in the Stone Age through the eating of Arabica (coffee) leaves or berries that contained it. In fact, about 80% of people around the world consume caffeine in some fashion every day! It is also used as a drug for pain relief and is present in many medicines and chocolate. In short, it’s a very popular commodity!

Caffeine affects the central nervous system shortly after your first few sips of your morning coffee or tea. It stimulates your brain and makes you more alert, gives you a jolt of energy to get you going and helps with stamina to complete tasks. For these reasons alone, you can see why people are so adamant about having their morning coffee or tea before going to work!

Caffeine affects your digestion/gastric processes, stimulating it and producing more gastric acid. It also speeds up colonic activity. For people who have trouble with digestion and constipation, drinking a little caffeine in the morning seems to help them. So what’s so bad about caffeine?

Well, for one, it is addicting. The more you drink it, the more you crave it and the more your body depends on it. The pre-morning-coffee doldrums is really just your addiction to it prompting you to have some more caffeine. In addition, because it affects your central nervous system it can also contribute to the following:

• Sleeplessness – especially if you drink caffeine after 3 pm.

• Adrenal gland burn out – your adrenal glands produce cortisol in response to stress. High amounts of caffeine overstimulate the central nervous system and the adrenals respond to it as a stressor.

• Belly fat increase – too much caffeine can contribute to increased belly fat from the adrenals over producing cortisol, a steroid your body makes in response to stress.

• Raises blood pressure – but only for a short duration, same as if you were walking up stairs.

However, if you already have high blood pressure, caffeine can aggravate it.

• Women’s health issues – caffeine seems to aggravate PMS and menopause symptoms. This may be because caffeine can destabilize blood sugar levels by over-stimulating insulin secretion. Caffeine also contributes to bone loss in post menopausal women if their calcium intake is also low. Problem pregnancies are also associated with caffeine.

• Insulin stimulation/diabetes control – can decrease insulin sensitivity which can destabilize blood sugar levels making type 1 diabetes harder to control. Contributes to the production of belly fat through cortisol (see adrenal burn out above). Recent research stated that “coffee” decreases the risk for type 2 diabetes, however, not because of caffeine. Other compounds in coffee are what decrease the risk.

• May Contain Pesticides – coffee is grown/harvested in parts of the world where there is very little, if any, control over what kind of pesticides are used on coffee bean crops. Most coffee we drink in the United States comes from South American rain forests. Some DDT with your coffee?

What’s Good About Caffeine?

After reading the list of negatives for caffeine, you might start to wonder, should I really have caffeine in my diet at all? Well, before you give up your caffeine completely, consider some new research out lately that shows some surprising health benefits of caffeine:

• May Prevent Skin Cancer - recent studies show that caffeine added to sodium benzoate in sunscreen had a positive effect on shedding skin cancer cells.

• Aids Weight Loss – caffeine has been present in weight loss formulas for years. It speeds up metabolism to burn more fat and the boost of energy it gives helps dieter’s maintain exercise levels necessary to burn fat/calories.

• Relieves Headaches – caffeine has long been used in OTC pain relief formulas that have about the same amount of caffeine in them as a cup of brewed coffee. It is particularly helpful with migraine, and other types of headaches.

• Helps Asthma – caffeine has been used for centuries to help asthmatics. It dilates airways and allows needed oxygen to enter the lungs.

• Prevents/Treats Parkinson Disease - caffeine has a beneficial effect on the central nervous system and seems to enhance muscles and movement.

• Enhances athletic performance – researchers aren’t sure exactly how caffeine boosts athletic performance. It may make muscle contractions stronger, or because it elevates mood, an athlete may get the kick they need to perform better. Caffeine also stimulates the brain and nervous system so may help ward off fatigue.

A Happy, Healthy Medium

Caffeine has gotten a bad reputation over the last few years and not completely undeservedly. It is true that too much of it can wreak health havoc. It can keep you from sleeping; it can decrease sodium and potassium levels in your body through frequent urination and cause heart palpitations, anxiety and agitation. On a positive note, a little caffeine, no more than the equivalent of 2 cups of coffee a day, or 300 mg, can give you a needed boost to exercise, burn fat, and stay mentally alert.

There are a few things, however, I would recommend to people who would like to keep drinking their coffee, or tea, or a caffeinated soda to ensure that it doesn’t become a health hazard:

• Limit caffeine - to no more than 300 mg a day. Switch to decaf (which still has a little caffeine in it), or half-caff coffee if you would like to drink a cup of coffee more than twice a day.

• Drink Water! Be sure to drink half your weight in water every day to begin with. Then add 1 cup of extra water for every cup of coffee, tea, or caffeinated beverage you drink. This will ensure that you don’t become dehydrated.

• Check B Vitamins: Make sure you take a high quality multivitamin daily and that it has the recommended amount of B vitamins in it, especially B12. B vitamins support the nervous system that caffeine works directly on.

• Limit caffeinated sodas - to 3 times a week. With soda, caffeine isn’t the worst ingredient, the phosphoric acid and sugar is. Switch to diet soda sweetened with Splenda, not aspartame.

• Switch Your Caffeine - to green or black tea, or even hot cocoa (the kind you make yourself from 100% cacao powdered baking cocoa) to get your caffeine boost. They have more health benefits to them than coffee as they are powerful antioxidants. Cocoa has also been shown recently to lower blood pressure and provide heart-healthy benefits.

• Supplement with calcium/magnesium/zinc combo - 1200 mg (3 tablets) a day, to mitigate caffeine jitters and prevent muscle cramps or bone loss. Also helps you sleep!

Many people, me included, enjoy drinking their morning or late afternoon cup of coffee, tea, or an occasional caffeinated soda. There is no reason for anyone who really likes, and can handle caffeine, not to enjoy it in moderation. The time you set aside for a coffee or tea break during, or at the end of your day, can be a little beneficial “you time” which can help you decompress and relax!

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

________________________________________

Blood Clots:Their Symptoms And How To Avoid Them!

Summer is once again here and many of my patients are traveling on vacations, or visiting friends and relatives across the country. Before they go, however, I like to give them some pre-travel advice about a potentially serious medical condition that can occur with long periods of sitting in cars, trains, and airplanes… blood clots.

Up to 600,000 Americans develop blood clots every year with 1 in 3 persons developing serious medical complications from them. I’d like to share with you the same advice I give my patients about the symptoms and risk factors for developing blood clots and how you can prevent them.

What Are Blood Clots?

Blood clots are clumps of debris or fat, coagulated blood, or even surgical materials, within veins. They can start in the legs and travel within the vein system to the brain, heart or lungs and cause a heart attack, stroke, or pulmonary embolism.

What Are The Symptoms of A Blood Clot?

The symptoms of a blood clot are varied, depending upon their origin, but almost always include sudden and/or severe pain at the site. All require immediate medical attention. Here’s a list of the common types of blood clots and their symptoms:

Legs: Blood clots in the legs can often be overlooked as a pulled muscle, as they can feel like a “Charlie Horse” type of cramp. Look for swelling of the leg, warmth to touch, redness or bluish discoloration, pain.

Lungs: Sudden onset of shortness of breath. A stabbing, sharp chest pain that gets worse with deep breaths, fast heart beat and/or an unexplained cough that may contain blood.

Heart: A blood clot that has traveled to the heart will give the symptoms of a heart attack, severe, crushing-type chest pain, and shortness of breath.

Brain: A blood clot that has traveled to the brain is called an ischemic stroke, which is a blockage of blood flow. Its symptoms can include severe/sudden headache, confusion, blurred vision, dizziness, weakness on one side of the body, loss of balance or coordination/inability to walk, inability to speak or understand language.

Kidneys: Not as common as leg or lung blood clots, but kidney clots do occur. The symptoms are sharp pain in the lower back, usually on one side, inability to urinate, high blood pressure, retention of fluid, swollen ankles, and shortness of breath.

What Are The Risk Factors for Blood Clots?

Anyone can get a blood clot at any time, but generally the risks are highest with the following:

• Recent major surgery in the abdominal or pelvic area

• Prolonged bed rest in a hospital, nursing home over 3 days

• Knee and hip joint replacement

• Major trauma to the body such as an auto accident or serious fall

• Pregnancy, or recent childbirth

Other moderate, yet still very important, risks include:

• Age – over 65

• Smoking

• Long sitting during travel in a car, plane, train, bus

• Dehydration – inadequate water intake can cause blood to coagulate

• Under going chemotherapy

• Birth control pills or hormone replacement therapy

• Genetic predisposition

• Obesity/sedentary lifestyle

What Can I Do To Prevent Blood Clots?

Avoiding a blood clot involves reducing your risk factors where possible. In general, the following guidelines can help you prevent blood clots:

• Quit smoking. Period.

• If you travel for long periods, take an “exercise” break where you get up and walk around for several minutes every 2 hours of travel. This is easier to do in car or bus travel, not so easy in a plane or train. However, you can get up from your seat and walk to the restroom, and/or the club car once in a while. Shift your position in your seat, doing leg lift exercises, or ankle rotation exercises at your seat will also help.

• If you are overweight and sedentary, make some healthy, nutritional, diet changes and get up and exercise for at least 30 minutes of aerobic exercise a day. This can be done by taking a walk, riding a bike, Wii FIT in your living room, anything that gets you up and your blood moving.

• Stay hydrated! Drinking the correct amount of water everyday is one of the healthiest things you can do for yourself for several reasons. Drink half your body weight in water every day, and a little more if you consume caffeine. Your blood needs water to stay at an optimum density which is not so thick as to form clots and not so thin as to run too freely and cause profuse bleeding if you cut yourself.

• Find out your clotting time. A simple blood test at your doctor’s office can reveal if you have blood clotting issues present. You may need to make dietary changes (less vitamin K containing foods, take supplements that do not contain it) to help you prevent a clot from forming.

• Vitamin E – A low dose, 200 mg a day, can help prevent blood clots from forming.

• Hormones – if you take birth control pills and you are over the age of 35, you may want to consider another form of birth control. Similarly, if you are menopausal and on HRT, talk to your doctor about your risk for blood clots. Switch to physician-prescribed bioidentical hormones that have much lower risks for serious side effects than animal or synthetic derived hormones.

Blood clots can be scary business. Just knowing the symptoms of a blood clot can buy time in getting medical attention quickly. Though you may not be able to avoid certain high risk factors such as surgeries and/or prolonged hospital rest that may unexpectedly arise in your life, just trying your best to live a healthy lifestyle the rest of the time will help decrease your risk significantly. Happy, fun, and safe summer travels!

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

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Good Hair Starts With Good Nutrition

Many of my patients, particularly those over 40, ask me if there is anything they can do about the look of their hair – it’s lost its healthy, youthful shine, and just doesn’t seem to be as thick as it used to be. There’s a whole lot you can do for your hair just by following some simple rules of good nutrition and supplementing with the correct vitamins.

When your body is healthy, it shows in your hair and your nails. In fact, I can often tell when a patient’s nutritional status is out of whack just by looking at their hair and nails as they are made from the same substance, keratin. Ideally, your hair should have a healthy density and texture, it’s not falling out, and it grows about ½ inch a month. Your nails are smooth without ridges, clear, non-yellowed, don’t chip and peel and grow normally.

A holistic approach to restoring the health and glow of your hair and nails is necessary by starting with some good, basic rules of nutrition that will also benefit the health of your entire body.

Good Nutrition, Good Health, Good Hair

Protein: As I mentioned above, your hair (and your nails) are made out of the same material called keratin, a protein. In order to ensure that this building block of your hair and nails is adequate to produce healthy hair shafts, you need to eat an adequate amount of high quality protein everyday. You should consume at least 50 grams (read labels) of this type of protein on a daily basis, some of which are good sources of B vitamins that are also crucial to hair health.

These include:

• Chicken – rich source of B vitamins

• Fish - good source of B vitamins

• Beef – rich in B12 and other B vitamins.

• Amino acids – like L-cysteine and L-methionine, proteins that benefit hair texture and growth. In addition to being found in protein foods, they can also be found in protein supplement/shake formulas like whey protein. Read labels for amino acid content.

In addition, there are many plant-based, quality proteins that are useful to your overall health as well as your hair which include:

• Legumes - (chick peas, lentils, kidney beans, black eyed peas, navy beans)

• Whole grains - like quinoa, brown rice, amaranth

Vitamins: Your body requires the right amount of many vitamins and minerals to support all its various functions, but when it comes to your hair and nails, the B family of vitamins rules. In fact, deficiencies in the B group of vitamins, particularly folic acid, B6 and B12, will show up most profoundly in lack of hair and nail health. Hair loss, lack of growth, dullness is often a result of deficiencies in these vitamins. The good news is that these conditions can be turned around restoring hair health as soon as these deficiencies are corrected. B vitamins are easily supplemented with a good quality B-Complex formula. They are also found in high quantities in the following sources:

• B9 (folic acid) – spinach, asparagus, romaine lettuce, turnip and mustard greens, broccoli, parsley, calf’s liver, legumes (all).

• B6 – yellow fin tuna, chicken and bananas contain the highest food sources. Other good sources include turkey breast, cod, salmon, and beef. Deficiencies in B6 can cause hair loss particularly in men.

• B12 – calf’s liver, sardines, snapper, and beef contain the highest food sources.

Supporting Vitamins: Your hair (and the rest of you) also benefits from a good intake of other vitamins that support hair health. They are:

• Vitamin C - helps to build collagen, a building block of keratin. Aids in scalp circulation as it supports blood capillaries. 1,000-2,000 mg daily. Good sources include citrus fruits.

• Vitamin E - helps with oxygen uptake, stimulates immune function (which stimulates hair growth). 400 mg daily.

• Vitamin A – watch for over-consumption of food, supplements, containing this vitamin as it can cause hair loss! No more than 10,000 IU daily, preferably from natural food sources of beta-carotene. Good sources include: sweet potatoes, cantaloupe, and carrots.

Minerals: Good health requires a lot of different minerals to thrive. In particular, your hair benefits from magnesium, sulfur and zinc. Laboratory studies have shown that animals deficient in magnesium lost large amounts of hair! Here are some good sources of all:

• Magnesium – pumpkin seeds (raw), rich source. Black and navy beans (cooked). Salmon, sesame seeds, sunflower seeds.

• Sulfur – sunflower seeds, lentils, garlic, yogurt.

• Zinc – beef, lamb, chicken, turkey, salmon, dairy products, peanuts, legumes, whole grains, potatoes, yogurt.

• Iron – anemia can lead to hair loss, shine and beauty. If you are a premenopausal woman you need 18 mg of iron a day. For older women and men, the requirement is 8 mg per day. Be sure your vitamin/mineral supplement has the correct amount of iron in it for your age. Over-consuming iron can create heart and liver damage. Have your iron levels tested to determine if anemia might be contributing to your hair and other health concerns.

Other Nutrients: Other nutrients that are beneficial to hair health are:

• Co-Q10: 60 mg a day.

• Essential fatty acids: Like fish oil, super primrose oil, 1,000 mg a day.

Here you have my recommendations of how to restore your hair shine and health from the inside out. Remember that TV commercial that showed a model with long, thick, luxuriant beautiful hair who told viewers, “Don’t hate me because my hair is beautiful”? Well, of course, she was selling some product that promised to make your hair look just like hers.

The truth is, there are no external products that can completely restore hair health and beauty. They can smooth out frizzies, or add a little oil for some temporary shine and control, but ultimately hair health and beauty has to come from deep within your nutritional matrix. So, eat not only for your health, but to keep your crowning glory thriving for a lifetime!

In Good Health,

Jay Brachfeld, M.D.

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Resistance Training: Lose Fat, Gain Strength Faster!

If you’re like a lot of my patients over 40, you may have a few pounds to lose and would like to regain that youthful, toned, muscular look you used to have. It’s true, as we get older, if we don’t use it; we lose it, muscle strength, that is.

Did you know that people lose 5 lbs of muscle mass every 10 years after the age of 30? That’s right! With that muscle loss comes decreased metabolic rate, which means we burn fat slower and may gain weight faster. However, the good news is that there is a way to reverse this process. It’s called resistance training.

There are so many aspects of optimal health that good muscle strength influences. In fact, toned muscles not only make us look more streamlined but they can actually help us age slower, lose weight, build bone density, and stay agile and less prone to injuries.

Many people trying to lose weight tell me that they do aerobic exercise like walking, running, or cycling, several times a week along with watching what they eat, yet their weight loss is still very slow. When I ask them if they do any resistance, or muscle strength training along with those efforts, they’re surprised to hear that they’ll see results faster if they substitute some aerobic exercise for some resistance training. Let me explain why.

What Is Resistance Training?

Simply put, resistance training is any kind of movement of your muscles against an external resistance like free weights, weight machines, exercise bands, or even lifting rocks, that causes your muscles to contract. Doing these kind of muscle movements causes microscopic tears in the muscle in a process called catabolism, or break down, of the muscle fibers.

The healing and repair that our body does in response is known as anabolism. It causes the muscles to not only repair themselves but also grow stronger, denser, and more resilient. The result of that two-stage process creates a more toned you and increases your metabolic rate which helps you burn fat faster. If you burn fat faster, guess what? You lose those stubborn pounds of fat faster.

Here are some other side benefits of resistance training that I bet you’ll be surprised to know:

Can help lower blood pressure - current research shows that resistance training lowers both systolic (upper) and diastolic (lower) blood pressure by several points. It also decreases stress hormones in the blood which helps lower blood pressure.

• Prevents osteoporosis by building bone – friction of the muscle against bone during resistance training stimulates the bone to grow and become thicker.

• Reverse or slow down the aging process – along with a higher protein intake, resistance training helps release Human Growth Hormone (HGH) which slows aging.

• Improve glucose metabolism – weight training improves insulin usage by utilizing glucose for muscle work. Helps prevent type 2 diabetes.

Aerobic and Resistance Training – Both Work Together

Don’t get me wrong, aerobic exercise is very beneficial to your overall health. It also improves your mood, decreases your blood pressure, increases your metabolic rate, increases lung and heart capacity, and helps you sleep!

However, I have some patients who exhaust and dehydrate themselves doing aerobic exercise every day for 1 hour, trying to lose fat and tone muscles. This is actually counterproductive. You can shorten your aerobic exercise time to 20 minutes, 3 times a week, doing interval aerobic exercise instead which not only energizes you but strengthens your heart and boosts your metabolic rate far better and faster.

Interval aerobic exercise, is doing a 10 minute slower warm up with your chosen exercise (walking, jogging, traditional bicycling or “spinning” on a bike in a club, elliptical machine, swimming, brisk dancing) and then alternating between short, 2 minute bursts of more intense, faster, higher resistance level exercise and slow, resting exercise for the remaining 10 minutes. As you get used to doing intervals like this, you can gradually increase your length of high intensity bursts to 5 minutes.

Resistance training, on the other hand, specifically targets the strength of each muscle group and should be done 3 times a week. Whether you use free weights or standing weight machines in your gym is your choice. However, you may want to start out on weight machines and incorporate some free weight exercises into your resistance training routine after you’ve become comfortable with it. Also, a good warm up session of stretching before resistance training is important to avoid injury. Be sure to also stay hydrated and drink a lot of water while exercising.

In general, a good guideline is 3 sets of 10-12 reps (repetitions), starting with 5-10 lb free weights, or 20 lbs machine weight. Each exercise should be done on an every other day pattern, giving your muscles a chance to rest and repair in between sessions. However, to start out with for the first week or so, you may want to decrease your number of sets and reps to half this amount and gradually build up to this level, increasing your weight slightly as you go. You don’t want to over work previously unused muscles and become sore.

Remember, this is resistance/strength training and not bodybuilding so keep your weights at just slightly tougher than comfortable level to avoid building a lot of muscle mass. Resistance training is very easy, and safe to do on your own, but, you may want to start off with a little personal instruction at a gym with a trainer who can give you a basic resistance training program and help you keep track of your goals.

I hope the basics of resistance training mentioned here will encourage you to add it to your fitness routine. The benefits of resistance training are usually noticeable within the first 3 weeks, and if you’re faithful to your dietary intake, you should see some tangible results in fat loss. Take your measurements before you start resistance training, and then again 3 weeks later. You may not see a big drop in numbers on the scale, as muscle, even though it is smaller and denser than fat, weighs more. However, your clothes will fit better and you’ll start seeing more and more muscle definition. You’ll have more stamina, you’ll look great and best of all you’ll feel awesome!

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

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Aging Eyes:

What To Do About Them?

Having trouble reading a menu or need more light reading a magazine or newspaper? If you answered yes and are over 40, join the club! Millions of people in your age group find their vision is not as sharp as it used to be, have trouble reading labels on food packages in the grocery store, and find they are squinting more and more trying to read traffic signs!

It’s a fact of life. More and more middle aged Americans experience vision impairment of some form or another from simple inability to read fine print to cataracts, which affects more than 65 million Americans. Some have even more serious eye conditions like macular degeneration, and glaucoma, the leading cause of vision impairment in the United States today.

You might wonder whether there is anything you can do to protect your eyes from the effects of aging? Well, I’m glad you asked, allow me to share some information about aging and your eyes along with some specific things you can do to improve your vision and prevent some of the conditions mentioned earlier. First, let’s take a look at a few common conditions that can occur with aging.

Common Aging Eye Conditions

Around age 40, the human eye begins to undergo certain changes associated with age which include the following:

Trouble reading fine print: Holding print farther away from you to read it is called presbyopia that most commonly occurs in people over age 40. Headaches, or a feeling of “tired eyes” may also accompany it. This condition is easily corrected with simple reading glasses that you can buy at the store.

Spots that float: These are tiny dark specks, or floaters, that seem to bounce around your field of vision, most commonly seen on a sunny day. These usually are harmless but if they become bigger or more in number, and/or occur with flashes of light, they can warn of a condition called retinal detachment.

Dry eyes: Dry eye conditions most commonly start to occur over age 45 in most people and can be a result of hormone changes, prolonged computer use, certain allergic conditions or other health conditions. The tear ducts decrease the amount of fluid they produce and dry, scratchy eyes can result. These are usually treated with lubricating drops, (see Prevent Aging Eyes Naturally).

Tearing: One or both eyes may suddenly develop tearing due to the sensitivity to wind or light. It may indicate a blocked tear duct or an eye infection, or allergies (see Prevent Aging Eyes Naturally). Wearing sunglasses to protect your eyes from wind or light can help, but if excessive tearing occurs, see an eye doctor (ophthalmologist) to determine the cause of the tearing.

As you start approaching age 60-65, other eye conditions may start to occur as well including:

Cataracts: This is a condition of the eye where a part of the lens becomes cloudy and doesn’t let enough light in, causing loss of eyesight. Often cataracts stay small and do not affect the eyesight very much. However, they can become larger and thicker and require surgical removal where your natural clouded lens is replaced by an artificial lens. Being out on sunny days without eye protection greatly enhances the risk of developing cataracts. Wear sunglasses or shade your eyes with a hat visor.

Glaucoma: This condition causes a buildup of fluid in the eye, the cause of which is mostly unknown. Treated early, glaucoma can be controlled so that blindness doesn’t result. Glaucoma usually has no symptoms and is found only on an eye exam through a special test that feels like a puff of air blown into your eye.

Age-Related Macular Degeneration (AMD): The macula of the eye contains numerous light-sensitive cells that help you see. Over time, the macula can degenerate and cause sharp vision to decline, making it harder to see clearly, read or drive. Sometimes, laser treatments are helpful.

Prevent Aging Eyes Naturally

There are several things you can do to greatly slow down, or even reverse, some aging eye conditions. They include:

Eat A Vision-Friendly Diet: Lots of leafy green and yellow vegetables, decrease/avoid saturated fats like those found in fried foods, red meat, and hydrogenated oils (transfats). Decrease amount of sugar intake as over 11 teaspoons a day can dehydrate the eyes.

Nutritional Supplements: Many aging vision conditions start with nutritional deficiencies especially of the antioxidant type. Vitamins and minerals such as beta carotene (Vitamin A), Vitamin C, Vitamin E, resveratrol, selenium and zinc, can all help prevent damaged cells from oxidative stress (such as occurs in age-related macular degeneration) and clogged arteries (which can decrease blood flow to eyes). Other agents like lutein (from yellow carotenoid vegetables like squash, sweet potatoes, egg yolks) help absorb blue light from the sun; Zeaxanthin (also from yellow carotenoids) protects against AMD and cataracts; Bilberry contains flavonoids (found in blue, purple, red fruits and flowers) and is very beneficial in improving night vision.

Quit Smoking: Smoking greatly speeds up eye aging/damage through chemical exposure in its smoke. It also decreases Vitamin C in your body that is a crucial antioxidant for your eyes.

Protect Your Eyes: Sunglasses and hats with visors to shade your eyes on very sunny days can help prevent developing cataracts and damage from too much blue light absorption from the sun.

Control Your Health: Other health conditions like diabetes, high blood pressure, Sjogren syndrome have a direct effect on your eyes. If left uncontrolled, an eye condition called diabetic retinopathy can occur which can decrease vision. Uncontrolled high blood pressure, or hypertension, can damage blood vessels in your eyes that decrease blood flow to them and thereby decrease nutrients getting to the eye. Sjogren syndrome is a chronic dryness of all the mucous membranes of the body including the eyes. Some medications for certain illnesses may have vision-related side effects. Ask your doctor about any Rx you take.

Eye Exams: Seeing an eye doctor for yearly eye exams can detect any eye conditions early and treat them before they damage your vision.

Lubricate: Dry eyes cannot only be uncomfortable, they can open the door for other eye conditions. Eye tissues normally rest in a high fluid environment that protects them from harm. When that fluid level decreases, the tissues are more vulnerable to damage. The most important form of lubrication for your eyes comes from adequate water intake in your body in general. If you’re dry, your eyes are. As I always advise my patients, drink half your body weight in ounces of water per day. Other forms of lubrication include drops, which can consist of an artificial tear solution you can buy over the counter, or herbal drops that help clear the itching and redness from seasonal allergies. These are usually found in health food stores.

Decrease Computer Use/Rest: If you work at a computer 8 hours a day, remember to blink! Studies show that blinking slows down while people are in front of a computer screen. Look away at something black in the distance every hour while on the computer for a few moments to rest your eyes. Consider getting prescription computer glasses designed specifically for vision problems that occur with computer use, i.e., “computer vision syndrome”.

Exercise Your Eyes: Overall aerobic exercise is not just for the rest of you! It can benefit your eyes as well as it improves blood flow to your head and eyes. In addition, specific eye exercises really help to decrease eyestrain and re-energize tired eyes. Here are a few good ones that can be done a few times a day if you like:

• Figure 8’s – roll your eyes in the pattern of the number 8 to the count of 10.

• Palming – rub the palms of your hands together briskly until they get warm. Then place the palms of your hands across your eyes and rest them for a few minutes in the darkness of your hands.

I often tell my patients that getting older is inevitable, but aging eye/vision conditions don’t have to be. By being proactive and maintaining a healthy lifestyle full of beneficial eye/body nutrition, hydration, exercise, and protecting your eyes from damage by smoke, computer screens, or sun, you do have some control over slowing down/reversing, or preventing, certain age-related eye conditions from occurring. Protecting your eyes now can help you enjoy healthy vision throughout your lifetime!

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

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Regenerate Joints With Vitamin D!

Are aching, creaking joints making your simple daily activities uncomfortable? For many of my patients, joint pain prohibits them from exercising and that’s not a good thing. I have to tell them that sore, aching joints does not have to be a function of getting older.

The truths is, sore, aching joints and bones, are more likely due to nutritional deficiencies, specifically Vitamin D! That’s right. In fact, many health researchers believe there is an epidemic of Vitamin D deficiency today, especially amongst older people.

Most of my patients, like many people across the country, are deficient in Vitamin D. They work indoors all day and don’t spend much time in the sun. Recent studies have shown that Vitamin D plays an important part in making synovial fluid, the substance that surrounds joints and keeps them moving freely without pain.

Could You Have A Vitamin D Deficiency?

If you have aching and painful joints, the first and best thing you can do for yourself is to get a Vitamin D level test the next time you visit your doctor. Other symptoms of Vitamin D deficiency might include:

• Fatigue – constant tiredness, even chronic fatigue syndrome, can be from Vitamin D deficiency.

• Difficulty controlling your weight - vitamin D regulates weight levels. If your weight is stuck at a certain level or bounces back and forth, your Vitamin D levels may be off.

• Body aches – notably aching bones and joints.

• Race – very dark skinned people such as Hispanics, African Americans, and East Indians, are all at much higher risk than Caucasians of developing Vitamin D deficiency. Their skin is full of melanin, a natural sunscreen, which blocks the type of sunlight necessary to make Vitamin D.

What Can You Do About Vitamin D Deficiency?

There are several lifestyle changes you can make to guard against Vitamin D deficiency. They include:

Diet: When my patients ask about Vitamin D deficiency, I ask them what they are eating (or not eating!) on a regular basis. By what they say, I can tell if they’re likely to have a Vitamin D deficiency. A Vitamin D-friendly diet consists of dark green leafy vegetables, fatty type ocean fish, a little red meat, and sun-dried vegetables like mushrooms or tomatoes which contain good levels of Vitamin D.

Supplements: To truly combat Vitamin D deficiency in today’s world where food is over processed and soils depleted of nutrients, Vitamin D supplements are crucial. Even if you take a good multivitamin that contains Vitamin D, likely the 400 mg provided in them is not enough to get rid of your deficiency as adults require 2-4,000 units a day! Vitamin D3 is the type of Vitamin D supplement you want to look for, or ask your doctor for, as most prescription Vitamin D is the D2 form.

Sun Exposure: If you work indoors all year long and exercise in a gym rather than outdoors, you’re likely to have a Vitamin D deficiency. Taking a 15 minute break and going for a walk or run in midday sun is a good way to absorb enough of the sun’s building blocks to make Vitamin D.

As people age, one of the most debilitating ailments is the inability to move, or get around without joint pain or locking, stiff joints. It severely decreases your ability to participate in the activities of everyday life and most importantly, exercise, which is one of the most crucial aspects to staying healthy at any age.

Knowing the role Vitamin D plays in keeping your joints healthy and moving without pain is significant. Make sure you get adequate levels of Vitamin D everyday to ensure your joints will get the help they need to stay strong and healthy throughout the rest of your life!

In Good Health,

Mark Bromson, M.D.

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Balance Problems: What They Mean

On occasion, I hear from patients who complain of feeling dizzy as if they are going to fall when they turn their head suddenly, or lose their balance if they turn around in a circle. They may also admit to motion sickness, i.e., feeling a little dizzy and unstable riding a bike or traveling by airplane or boat.

Balance problems such as these could be a sign of certain medical conditions. There are many types of balance difficulties and their causes can be simple, such as a drop in blood sugar or dehydration from not drinking enough water.

Other equilibrium problems may be more complex and need neurological testing to determine their cause. Let me explain the various types of conditions that effect balance and their possible causes so you can determine if you need to call your doctor, or re-hydrate with a good mineral replacement drink, or have a glass of orange juice and a snack!

Types of Balance Problems

As I said earlier, balance problems can have simple or complex causes. Basically, they fall into four categories:

Vertigo – a spinning, dizzy sensation with motion of the head or body. This category can be caused by several medical conditions that need a doctor’s care. These include:

• Benign positional vertigo – caused by particles that accumulate in the inner canal.

• Meniere’s disease – excessive fluid in the inner ear, causing dizziness, ringing or buzzing.

• Vestibular migraine – a bad headache that makes you sensitive to motion, turning your head suddenly can result in dizziness or off balance feeling.

• Acoustic neuroma – caused by a tumor on the acoustic nerve (connects inner ear to brain) that can cause hearing loss, ringing in the ears, and dizziness.

• Motion sickness – riding on amusement park rides, boats causes dizziness.

Feeling Faint – a general weakness, usually organic cause (blood pressure or blood sugar drop)

Disequilibrium – a loss of balance or falling, usually from mechanical causes (unstable joints, failing vision, inner ear conditions, side effect of medication).

Lightheadedness - an “out of body” sensation, usually caused by high/low blood oxygen levels from hyper/hypoventilation (anxiety, severe trauma), or inner ear conditions.

Tests for Balance Problems

If you determine that your dizziness/balance problem is not a result of lack of food or water, the next thing you should do is make an appointment with your doctor. There are certain balance tests that can be performed, or you may be sent for a CAT scan or MRI of your head to see if there are any structural causes of your balance problems (like tumor or inner ear abnormality).

Your doctor will discuss your balance problems with you and may ask a series of questions about your dizzy spells including the frequency, what you are doing when they occur, and what type of medications you may be taking to rule out the possibility of a side effect. Next, you may undergo one, or several of the following tests to pinpoint the cause of your symptoms:

EKG, possibly heart echocardiogram: To see if a too slow heart rhythm, or too low blood ejection from your heart could be the cause of your symptoms.

MRI or CAT scan: To determine if there is any physical abnormality such as a tumor or blood vessel blockage that may cause your symptoms.

Tilt Table test: To determine your heart’s response to adrenaline, such as in an anxiety attack or severe trauma. Adrenaline is slowly injected into your arm and the table you are lying on is tilted in different positions.

Hearing test: To determine if you have an inner ear condition.

Electronystagmography – monitors eye movement to see how well your inner ear/balance works.

Dix-Hallpike test – involves turning your head and monitoring eye movements to see if you get a sense of spinning or motion.

VEMP – vestibular evoked myogenic potential test. Electrodes (like those on an EKG) are placed on neck, shoulder, and forehead muscles to monitor contractions in response to sound.

Rotary Chair test – monitors eye movement while you move slowly in a circle in a computerized chair.

Treatment for Your Balance Problem

Once the cause of your imbalance has been determined, there are a number of treatments aimed at solving your problem. These may include:

• Medication dosage adjustment/discontinuation/substitution – often a dosage change is all that is needed to stop symptoms. Other times, a complete discontinuation of a drug is necessary.

• Vestibular rehabilitation - this is a special exercise program for people with inner ear problems to re-stabilize balance.

• Fall prevention – determining if vision, lack of sensation in the feet, weak muscles and joints are contributing to poor balance symptoms. You may need a walker or just a hand held quad cane.

• Positioning procedures – clears crystal deposits out of the inner ear back where they belong.

• Diet changes – reducing salt, caffeine or nicotine can help some people with balance problems completely get rid of their symptoms.

• Surgery – if you have a tumor or malfunction in your inner ear, you may need surgery to correct it. Types of surgery include gamma knife surgery, or stereotactic surgery that delivers radiation directly to the tumor site.

Some Natural Remedies That May Help You

If you experience temporary, occasional motion sickness while traveling by boat or airplane, you may be able to treat this condition yourself with:

OTC’s: Over the counter aids such as a Dramamine, or meclizine that can help you to regain your sense of stability.

Herbal: The Chinese have used Ginger for centuries as a stomach tonic and to restore balance. 250 to 500 mg every 6 hours is the usual dosage. A word of caution, if you take blood thinner-type medications for a heart problem, ginger can add to those effects and make you bleed more easily.

Acupressure: Stimulating certain acupressure points on your inner wrist can alleviate motion sickness. Bands, or bracelets, made for this purpose can be bought in drugstores or airport shops. They have a button or stud on them that presses against the acupuncture meridian on your wrist that regulates dizziness/ balance.

We all can have a bout of lightheadedness or feel off kilter now and then from simple causes like being tired, dehydrated, partying too much the night before, too much caffeine, not eating enough or riding a roller coaster! However, balance problems that occur regularly is your body telling you that something is off somewhere and you should consult your doctor to find out what.

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging
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