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Travel tips to prevent autoimmune flares on the go

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Although managing an autoimmune condition requires us extra care with diet, stress levels, sleep, and exertion, that doesn’t mean making travel off limits. Many people with autoimmunity have learned how to travel flare-free, even though it may take some extra prep time before hand. Be mindful to go into a travel experience with the mentality for a slow and steady marathon and not an all-out sprint.

Although travel can be busy and distracting, self-care must always be a priority. Taking command of some travel basics will allow you to relax and better enjoy your trip so you can come home rejuvenated instead of needing a vacation to recover from your vacation.

Here are some tips to manage your autoimmune condition while traveling.

Know what to expect food-wise and plan ahead

The autoimmune diet, or some version of it that works for you, will prevent you from flaring and crashing. Do some research and planning to make sure you can stick to it on your journey.

For instance, is there food you can safely eat where you’re going? Find out if there are health food stores in your area, or gluten-free friendly restaurants that serve other safe foods.

If you’re staying in a hotel room, make sure it will include a mini fridge or ask them to have one in your room. Some people even bring their own mini crockpot or hot plate to heat up frozen meals — stews, curries, stir fries — they cooked ahead of time.

Bring safe snack foods for when you’re stuck on a plane or on the road so hunger doesn’t tempt you to stray into dietary danger zones. Ideas include coconut chips, beef jerky, celery, sardines, olives, nuts and nut butter packets (if you’re ok with nuts), and other filling snacks.

Bring glutathione support. Travel includes many stressors, such as lack of sleep, jet lag, different time zones, long days, unfamiliar environments, crowds, and so on. Stress is hard on the body, but glutathione is a great defense system that works well for many people. Glutathione is the body’s main antioxidant and it helps keep inflammation and flare-ups under control. It basically protects cells from damage caused by stress and toxins.

Glutathione is not absorbable orally on its own but glutathione precursors are N-acetyl-cysteine, alpha-lipoic acid, cordyceps, and milk thistle. You can also take s-acetyl-glutathione, or liquid liposomal glutathione. A topical glutathione cream may help too.

Is your hotel room overly toxic? Call your hotel and ask whether scents are used in the rooms. Some hotels offer room options for extra sensitive people, such as allergy-free bedding, air purifiers, and windows that open.

Carry a mask. Sometimes you just can’t avoid toxic exposure, whether it’s from pollution, exhaust, perfumes, or the person next to you on the plane sneezing and coughing. It’s becoming more common to see people wearing a face mask when flying or in polluted cities, and it’s a good idea to always have one with you. A good face mask is comfortable and is easy to breathe through reducing the load of toxins and other pathogens in the air. This can help prevent flare-ups and glutathione depletion. Some companies even make face masks  for children and babies.

Ask my office for more advice on managing your autoimmune condition and improving your quality of life.

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Could you be developing an autoimmune disease?

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You could be developing an autoimmune disease, one of the most common diseases today, and are not aware of it. This is because autoimmune diseases sometimes start off as “silent” autoimmunity. This means your immune system is attacking tissue in your body but the damage isn’t bad enough to cause symptoms yet.

Autoimmune disease is more common than cancer and heart disease combined, and that’s just the diagnosed cases. Many, if not most, cases of autoimmunity are happening without a diagnosis.

This is because medicine does not screen for autoimmunity until symptoms are advanced and severe enough for a diagnosis and treatment with steroids, chemotherapy drugs, or surgery.

Autoimmunity: The disease for the modern era

Autoimmunity can affect any tissue in the body or brain. It occurs when the immune system attacks and damages tissue as if it were a foreign invader.

Common autoimmune diseases include Hashimoto’s hypothyroidism, Graves’ disease, multiple sclerosis, lupus, rheumatoid arthritis, type 1 diabetes, celiac disease, and psoriasis. More than 80 different autoimmune diseases have been identified so far.

Autoimmune disease affects 1 in 5 people, the majority of them women. It is believed women are more commonly affected because of their hormonal complexity. Although autoimmune disease is very common, the statistics do not tell the whole story.

Autoimmunity can happen long before diagnosis

Autoimmunity can begin long before damage is bad enough for a disease to be diagnosed. Many people can go years, decades, or even an entire lifetime with symptoms but never have damage bad enough to be labeled disease.

As an example, autoimmunity against the pancreas can cause blood sugar issues long before the development of type 1 diabetes. Additionally, about 10 percent of people with type 2 diabetes, which is caused by diet and lifestyle, also have pancreatic autoimmunity. This is called type 1.5 diabetes.

One of the most common autoimmune diseases is Hashimoto’s hypothyroidism. Patients may need to gradually increase their thyroid hormone because although they were diagnosed with low thyroid, the autoimmunity was overlooked and left unmanaged.

Or a patient may have an autoimmune reaction that has not been recognized as a disease. For instance, autoimmunity to nerve cells may produce symptoms similar to multiple sclerosis (MS), which is an autoimmune reaction to nerve sheathes. However, because the autoimmunity is not attacking nerve sheathes specifically, the patient cannot be diagnosed despite MS-like symptoms.

Autoimmunity can attack anything in the body

People can also have symptoms that suggest many types of autoimmunity. Although symptoms vary depending on which tissue is being attacked, many autoimmune sufferers experience chronic fatigue, chronic pain, declining brain function, gastrointestinal issues, hair loss, weight gain or weight loss, brain fog, and more.

Fortunately, functional medicine offers lab testing that can screen for autoimmunity against a number of different tissues. We also use strategies such as an anti-inflammatory diet, blood sugar stabilizing, gut healing, addressing toxins, and habits that minimize stress and inflammation.

Ask my office if autoimmunity may be causing your strange and chronic symptoms.

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Artificial sweeteners fail dieters; cause health risks

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If you use artificial sweeteners to avoid gaining weight, you’re not only wasting your time but also possibly causing future health problems, according to a new study.

The study found that not only do aspartame and sucralose not prevent weight gain, they also raise the risk of disease in people who use them regularly.

Some research even shows long term use of artificial sweeteners leads to weight gain.

Recent research shows about a quarter of children and more than 40 percent of adults in the United States consume artificial sweeteners daily.

Some people eat them purposefully in the mistaken belief that is better for their health. Many others, however, are unwittingly consuming them in everyday food products.

Artificial sweeteners hiding in many foods

Artificial sweeteners are hiding in many foods unbeknownst to most people. These products are not always clearly labeled and some are even labeled with misleading claims such as “natural ingredients.”

While we expect to find artificial sweeteners in foods labeled “light,” “reduced sugars,” “diet,” and “sugar-free,” they also show up in “smart” popcorn, granola bars, yogurt, and even a popular pediatric electrolyte drink.

Artificial sweeteners linked to obesity; disease

Studies also suggest long term use of artificial sweeteners leads to weight gain and chronic diseases such as diabetes, and heart disease.

Participants in a randomized trial who used artificial sweeteners as part of their weight loss program were shown to have a slight increase in their body mass index, a 14 percent higher chance of developing type 2 diabetes, and a 32 percent higher chance of developing heart disease.

Lobbyists for the artificial sweetener industry and researchers agree other variables need to be considered and more research needs to be done.

Why artificial sweeteners cause weight gain

One reason it’s believed these fake sweeteners lead to weight gain and obesity-related health risks is because they trigger sugar cravings that a person eventually gives into.

Another theory suggests that consuming foods with artificial sweeteners leads a person to feel “virtuous” and thus justified in overindulging later.

Animal studies show artificial sweeteners trick the brain into thinking you’ve eaten sugar, which can trigger inflammatory cascades and disease.

Artificial sweeteners also alter the gut microbiomein a way that promotes obesity and diabetes.

Functional medicine approach to sweeteners

In functional medicine, we see time and time again that people naturally lose their cravings for sugar and starchy carbs when they eat a whole foods diet that stabilizes blood sugar, lowers inflammation, and promotes brain health. You won’t feel drawn to regular use of artificial sweeteners when you have no cravings for sweets in the first place. Ask my office how we can help.

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Having low blood pressure also carries health risks

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Most people worry about high blood pressure, and with good reason as it portends numerous health risks. However, low blood pressure brings a different set of problems, such as reduced brain function and increased mortality risk. If the upper or lower number deviates by more than 10 from 120/80, it pays to be aware low blood pressure may be affecting your health.

Blood pressure pushes blood through about 100,000 miles of veins, arteries, and capillaries in the body, carrying oxygen, nutrients, immune cells, hormones, neurotransmitters, and other vital compounds.

High blood pressure strains blood vessels. However, low blood pressure means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. This deprives those tissues of sufficient oxygen and nutrients. You may have chronic nail fungal infections and cold hands and feet if so.

Adrenal fatigue as a cause of low blood pressure

The most common cause of low blood pressure in a functional medicine model is poor adrenal function.

The adrenals are two walnut-sized glands that sit atop the kidneys. They produce stress hormones and help regulate blood pressure. Many people today suffer from adrenal fatigue due to chronic stress. Other causes of adrenal fatigue are poor diets, low blood sugar, chronic infections, gut problems, inflammation, and unmanaged autoimmunity — all stressors.

Adrenal fatigue symptoms include chronic tiredness, low blood sugar, losing function between meals, getting sick all the time, and low blood pressure.

Orthostatic hypotension when you stand up

Orthostatic hypotension is a common type of low blood pressure that causes lightheadedness when you go from sitting to standing. This happens because the blood pools in the legs upon standing, slowing blood flow back to the heart and thus the brain. You will be diagnosed with orthostatic hypotension when the top number of your blood pressure falls by 20 and the bottom number by 10 upon standing.

Although orthostatic hypotension is a red flag you need to address your low blood pressure, it becomes more dangerous when it makes you faint or fall. Orthostatic hypotension is commonly found in those with low blood pressure and low blood sugar but people with high blood pressure can have it too.

Functional medicine tips for low blood pressure

If you have signs and symptoms of low blood pressure and adrenal fatigue, consider an adrenal saliva test. This test measures levels of the adrenal hormone cortisol throughout the day. This gives you a more precise therapy target and follow-up testing will let you know if your protocols are on the right track.

Everyone knows a person with high blood pressure should avoid salt, but adding some good quality sea salt to your diet may help boost low blood pressure. In fact, you may be one of those people who craves salt.

A nutritional compound that can help raise low blood pressure is licorice root extract, or glycyrrhiza, which can extend the life of cortisol in the body and improve blood volume and electrolyte balance.

Of course, it’s important to address what is causing adrenal fatigue. Adrenal fatigue is always secondary to something else. One of the most common causes is eating a diet that causes low blood sugar. Eating a good breakfast, skipping sweets and sweet drinks, minimizing starchy foods, and eating regularly enough to sustain blood sugar are helpful strategies.

For more advice on supporting healthy adrenal function and blood pressure, contact my office.

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Exercise your throat muscles to reduce snoring

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Snoring happens when the tissues and muscles in the upper airways become too “floppy” during sleep and vibrate. Researchers found simply exercising those muscles to maintain their tone can help reduce snoring.

In a 2015 study, researchers looked at groups of men and women who did not have obstructive sleep apnea, which is associated with many health risks, but snored due to mild or moderate sleep apnea.

For the study, all the participants were instructed to irrigate their nasal passages (such as with a neti pot) three times a day to rule out nasal blockage as a cause of snoring. (Sinus infections also cause snoring and regular nasal irrigation can help combat this.)

Then the subjects were divided into two groups. One group used nasal strips and deep breathing exercises to address their snoring.

The other group performed 8 minutes of tongue and palate exercises three times a day.

At the end of the three-month study, only the group who performed the exercises saw a difference in their snoring — and it was a significant difference.

The exercise group saw the frequency of nightly snoring drop by the 36 percent and the intensity of sound by 59 percent.

This explains why people who regularly sing, play horn instruments, and even play the didgeridoo also report fewer problems with snoring.

Throat and palate exercises to reduce snoring

As with any exercise, the key is to stick with it and keep up the frequency. You’ll also need to perform these on a long term basis for the benefits. Add the exercisesto your commute, tooth brushing routine, or along with your morning cup of coffee. Your bed partner will thank you and you may experience feeling more rested and energetic during the day.

  1. Push the tip of your tongue against the roof of your mouth and slide it backward 20 times.
  2. Suck your tongue upward against the roof of your mouth 20 times.
  3. Push the back of your tongue down while keeping the tip touching the inside of your front teeth 20 times.
  4. Lift your soft palate and uvula 20 times.
  5. Using your index finger, press the inside of your cheek muscle away from your teeth 10 times on each side.
  6. When you’re eating, bite down, then lift your tongue to the roof of your mouth as you swallow, without tightening your cheek muscles.

Midlife hormones, inflammation, and snoring

Although nasal congestion and obesity can cause snoring, many people notice their snoring kicked in during midlife.

Some research shows this is due to a decline in reproductive hormones — estrogen in women and testosterone in men. These hormones play a role in the part of the brain responsible for throat and palate muscle tone during sleep.

Inflammation of the upper airways have also been shown to increase snoring. Adopting an anti-inflammatory diet may help reduce swelling in those tissues and reduce snoring.

Ask my office about maintaining healthy hormone levels and reducing inflammation through nutritional and lifestyle means.

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Doctors should emphasize exercise, not weight loss

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Do you dread going to the doctor because you know they will pin your health problems on your weight? Or maybe you quit going to the doctor all together to avoid feeling embarrassed and ashamed. Because the stigma attached to body size has been shown to cause weight gain, researchers are calling for doctors to emphasize exercise rather than weight loss.

Although it’s true obesity is linked to myriad inflammatory health conditions, it’s also true that diets fail the majority of people and often lead to weight gain. Also, some people are overweight due to genetic predisposition, numerous starvation diets, a history of an eating disorder in response to childhood trauma, and so on.

For those people who have spent a lifetime battling their weight and the stigma associated with it, a visit to the doctor simply opens a Pandora’s box of shame, despair, hopelessness, and self-loathing. Many decide it’s simply healthier not to go.

Policy may shift to taking the emphasis off weight

Fortunately, the Centers for Disease Control and Prevention is aware of the ineffectiveness of shaming patients.

A recent essay published by the CDC called for doctors to lay off patients who don’t meet the body mass index (BMI) guidelines and instead shift the focus to helping a patient exercise regularly.

The essay argues that avoiding “fat shaming” will go a long way to establishing better doctor-patient rapport and trust, thus facilitating a patient’s sense of positivity and willingness to adapt healthier habits.

Diets and thinking you are fat lead to obesity

Studies consistently show diets actually lead to long-term weight gain and obesity.

What’s even more shocking is that the perception you are overweight also leads to long term weight gain, even if your original BMI was in the normal range.

In other words, telling a patient they are too fat can actually make them gain weight, not lose it.

And telling yourself you are too fat will do the same.

Addressing obesity and health without stigma

Clearly, telling people they are too heavy and need to lose weight isn’t working.

The key, say researchers, is to promote the idea that a person can be healthy at any weight. This requires decreasing the stigma, establishing trust and rapport, and encouraging exercise and healthy behaviors. It also requires taking into consideration the patient’s social and financial situation.

According to recent studies, regular exercise improves health at any weight. It also reduces the risk of chronic diseases such as diabetes, heart disease, and Alzheimer’s.

Focusing on regular exercise also shifts the focus away from judging the person’s body and instead puts it on behaviors that can be influenced, barriers that can be addressed, and progress that can be measured at follow-up visits, regardless of weight.

Diets have a terrible track record for the majority of people. However, exercise is an area where most people can succeed, regardless of their body size or fitness level.

Ask my office how we can help you improve your health in a way that works for you.

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Ignored by doctors, women choose functional medicine

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It doesn’t take long once you learn about functional medicine to realize it attracts primarily women. Why? Chronic disorders affect more women than men and conventional medicine’s treatment of women often ranges from disappointing to dehumanizing.

Conventional medicine failing women

When women show up at doctors’ offices with “mystery” symptoms from chronic disorders they are often left feeling demoralized and hopeless.

What are some of areas where conventional medicine fails women?

Mystery symptoms dismissed as psychosomatic or whining. Autoimmune disease overwhelmingly afflicts more women than men and can cause years and even decades of symptoms before diagnosis. Many women are told to exercise more, meditate, or take anti-depressants for their symptoms but given no real solutions.

Told to exercise more for chronic fatigue. Chronic fatigue affects four times as many women as men. However, these women are often simply told to exercise as many doctors don’t believe in chronic fatigue, even though it is now medically recognized. These women often end up feeling worse.

Pain in women undertreated. Studies show doctors are slower to treat pain in female patients in emergency rooms and generally undertreat women for pain due to the belief that childbirth makes women more resilient to pain. 

Fibromyalgia, a disorder of chronic pain, also affects mostly women and is often regarded as not legitimate.

In fact, some researchers believe disorders such as fibromyalgia and autoimmunity are so frequently belittled and dismissed because they affect predominantly women.

Poorer response to female heart disease. Women have worse outcomes from heart attacks because medicine looks at male-based heart symptoms. For instance, many women do not have chest pain. As a result, treatment is often less aggressive than necessary.

Hospital childbirth practices traumatic. If there is one place where many women lose their faith in medicine, it is during a hospital childbirth. Women are often pressured into unnecessary procedures or left hung out to dry emotionally in the event of a problem or emergency. As a result, many leave the hospital with postpartum PTSD.

Female sexual abuse survivors also experience worse outcomes in hospital childbirth scenarios.

Male-based studies don’t translate to female patients. Most medical models are based on male physiology. As a result, many signs and symptoms that present differently in women go misdiagnosed or dismissed. Autism and heart attacks are two examples.

Plus, women experience chronic diseases such as autoimmunity, fibromyalgia, and hypothyroidism at significantly higher rates than men and thus are often told their symptoms are “in their head.”

Functional medicine for women

Fortunately, in functional medicine we conduct comprehensive histories, examinations, and testing with all patients regardless of gender.

We specialize in working with chronic so-called “mystery” disorders that predominantly affect women and are explained in the scientific literature.

One thing we frequently hear from women is how good it feels to finally be heard. Ask my office how we can help you.

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Looking at coconut oil in proper context

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The American Heart Association (AHA) recently announced coconut oil is bad for you. This is the same advisory organization that endorses breakfast cereals loaded with sugars and artificial additives.

It’s important to look at this coconut oil advisory in context: Saturated fats have been proven repeatedly not to be bad for your health or raise the risk of heart disease when you eat a diet that is low in sugar and carbohydrates and high in omega 3 fatty acids (such as from cold water fish and raw nuts).

Sugars and carbs biggest heart disease culprits

In fact, studies also show it is sugars and excess carbohydrates that inflame the arteries, lead to arterial plaques, trigger production of the “bad” types of cholesterol, and promote obesity.

Likewise, polyunsaturated fats, which the AHA recommends in place of coconut oil and other saturated fats, are high in omega 6. Although we need a healthy ratio of omega 6 to omega 3, the average American eats far too much omega 6 already, thus promoting chronic disease.

Inflammation, not cholesterol, is a culprit

Excess omega 6, which is ample in polyunsaturated vegetable oils, is linked with chronic inflammatory disorders, such as fatty liver, arthritis, and irritable bowel disorder. Chronic systemic inflammation has also been found to increase the risk of heart disease.

Meanwhile, cholesterol has been found not to be a factor in heart disease risk. What matters are levels of inflammation (as measured by CRP or homocysteine on a blood test) and levels of the “bad,” or dense, LDL from eating too many sugars.

Big difference between saturated and trans fats

Although it’s not clear which saturated fats were investigated in the study panning coconut oil, the majority of studies linking saturated fats to heart disease include hydrogenated, or trans, fats. Trans fats are inflammatory, artery-clogging, brain damaging fats that should be avoided at all costs. It is incorrect to group them with natural saturated fats.

Health benefits of coconut oil

In a nutshell, if you manage your blood sugar levels with moderate to low consumption of complex carbohydrates, you avoid sugars and processed carbohydrates, you eat plenty of omega 3 fats, and your diet includes 7 to 10 servings a day of vegetables and low-glycemic fruit, chances are you can safely enjoy liberal amounts of coconut oil.

In fact, coconut oil has been shown to have healthy heart benefits even. The heart prefers the fatty acids found in coconut oil as a source of fuel.

Coconut oil is also known to:

  • Increase metabolism
  • Curb appetite
  • Fuel the brain
  • Lower triglycerides
  • Fight bacteria, viruses, and fungal infections

The AHA diet can raise risk of heart disease

Unfortunately, the AHA promotes pro-inflammatory foods that are high in sugars, processed carbs, and omega 6 oils — the very foods most associated with chronic diseases. To their credit, however, they also promote 7 to 10 servings of produce a day and ample omega 3 fatty acids, both of which are excellent anti-inflammatory approaches that support heart health.

If you follow the AHA advice to replace calories from healthy natural fats with AHA-approved foods high in industrialized oils and processed carbohydrates, you may find both your blood test results and symptoms worsen. Ask my office for more advice.

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Feminine products loaded with absorbable toxins

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Sadly, millions of women and girls absorb high levels of toxins every month thanks to lax manufacturing standards of tampons and sanitary pads. These products are loaded with highly absorbable industrial contaminants — the body takes in more toxins through the vaginal wall than through ingestion.

Manufacturers are not required to list the ingredients used in tampons and sanitary napkins. However, the main material cotton is a crop notorious for genetic engineering and heavy use of pesticides.

Feminine hygiene products also contain synthetic fragrances, bleaches, foams, gels, anti-bacterial agents, and surfactants.

Although the FDA offers recommendations, there are no regulations manufacturers are required to follow regarding the use of toxic chemicals in these products.

Why toxins in tampons are more dangerous

Lack of regulation and oversight means anything goes in manufacturing of feminine hygiene products, including the use of cancer-causing chemicals.

Vaginal tissue is far more permeable than other areas of the body. In fact, it’s so good at absorption that drug companies are looking at ways to deliver drugs vaginally as a way to bypass metabolization.

Because compounds absorbed vaginally do not pass through the liver first, this also means they go into the bloodstream in much higher concentrations than if they were ingested.

Additionally, the thin ridges of the vaginal wall not only provide more surface area to enhance absorption, they also can retain chemicals.

Conventional sanitary pads contain myriad toxic chemicals, plastics and synthetic fibers that sit against the permeable skin of the vulva for days every month.

Toxic chemicals in feminine products

Sadly, most feminine hygiene products are loaded with toxins. This includes not only tampons and pads, but also feminine wipes, washes, douches, sprays, and creams.

These chemicals include dioxins and other bleaching chemicals, pesticide residues, anti-bacterials, unknown fragrances, dyes, spermicides, phthalates, and surfactants (also used in detergents).

Studies show the chemicals used in feminine hygiene products have been linked to cancer, hormone imbalances, reproductive harm, allergic rashes, and asthma.

Douches in particular have been linked to numerous reproductive and health disorders and should be avoided.

Safe alternatives in feminine products

Fortunately, natural alternatives exist, although they are dwarfed in number by the brands with toxins (look online for more options). Go for chemical-free pads and tampons, or consider the menstrual cup or even cloth pads.

For other feminine products such as wipes, washes, sprays, and douches, remember that the body is innately intelligent and functions best with the right support.

Support your vaginal health by minimizing sugars and starchy carbs to prevent the yeast and bacterial infections that drive women to these products.

Taking probiotics can also support vaginal health, and these days you can buy brands geared specifically toward that.

Also, in addition to eating a whole foods diet, rule out a sensitivity to gluten, dairy, or other foods — many women have found food sensitivities causes vaginal itching and inflammation.

Ask my office for more advice.

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How do you really know what’s in your supplements?

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The United States enjoys liberal access to nutritional supplements. We can buy virtually any supplement from multiple sources either at the local grocery store or online. Other countries can be more stringent when it comes to access and don’t enjoy near the wide range of variety.

However, the freedom around nutritional supplements in the United States means consumers must be wary of shoddy, fraudulent  and even unsafe supplements with misleading claims. It’s important to learn how to be a smart supplement shopper to make the most of our supplement-shopping freedom. You may be surprised to learn the worst supplements aren’t from some shadowy corner of the internet, but rather usually from your local drug or grocery store.

At the same time, it’s also important to protect consumer access to supplements. The FDA’s approach to the industry is often viewed as unnecessarily aggressive due, it is widely believed, to the influence of the pharmaceutical industry. As the rates of “untreatable” or “mysterious” chronic diseases and dementia continue to skyrocket, people increasingly turn to alternative health care and nutritional supplements to address their health concerns. This has turned the supplement industry into one worth many billions of dollars.

What supplements to avoid

The supplement industry has created its own standards of quality that manufacturers can choose to comply with in order to reassure their buyers only the purest ingredients are used.

Avoid cheap, mass marketed supplements comprised of synthetic or inflammatory fillers (such as wheat and corn), poor quality ingredients, inactive ingredients, and artificial colors. There is also no way of knowing how shipping and storing has affected the ingredients.

What to look for in quality supplements

For starters, avoid fillers that use wheat, corn, starches, and magnesium stearate. Also, research the origin of the ingredients. Herbal ingredients can come from heavily polluted areas in other countries and be loaded with toxins. Good companies test their ingredients for toxins.

Research the brand. Are they formulated with a health-care professional and scientific advisory board? Are there peer-reviewed studies to back up the ingredients? Does the company test purity?

What is their marketing like? Do they use sleazy snake-oil selling tactics? Or do they cater to licensed practitioners and provide educational seminars to teach about the products and how best to incorporate them into a health care plan?

Also, look for supplement companies that send their products out to independent labs to test for quality and purity.

NSF International, and independent organization, certifies supplements on three levels of quality:

Certified Good manufacturing practices (CGMPs): Guidelines that assure a product conforms with what’s listed its label.

American National Standard for dietary supplement products: Testing that ensures products contain what is on the label and not undeclared contaminants.

NSF Certified for Sport: Screens for athletic banned substances.