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Suzanne Somers does it Again!

Suzanne Somers’ new book, Sexy Forever: How to Fight Fat After Forty is another wonderful tribute to her quest to spread the word about the benefits of preventive medicine. This book offers tips for balancing your hormones, recharging your metabolism and detoxifying your life! Prevention is the name of the game and Suzanne Somers is sharing the right message – how to live a preventive health lifestyle.

Is Your Doctor a Clinical BioChemist? Considering Amino Acid deficiency as the cause of Fatigue and Depression

The statement “you are what you eat” is only partially true. The statement should be “you are what you Absorb”. This statement can reflect those substances which are harmful or helpful to the body.

When assessing a patient for disease states, it is essential to consider one’s diet as well as the ability to adequately break down food particles and turn it into the necessary building blocks needed to run the body efficiently. This concept is very apparent when considering fatigue and depression and their potential relation to adequate and specific amino acid levels in the body.

Part of the problem with our ability to adequately make this link and diagnosis exists in our failure in medicine to recall the biochemistry we were once taught in medical school. An old mentor of mine use to say “the only diagnosis you will miss is the one you don’t think of”, referring to our need to continue to read and expand our differential diagnosis. To be sure, we were taught the biochemistry, but have unfortunately, yet conveniently embraced a “pharmaceutical prescription for every malady” mentality.

Be sure to consider the probability of amino acid deficiency in the consideration of causes of depression and fatigue. For example, amino acids are an absolute requirement for the synthesis of hemoglobin (which carries oxygen in the blood), neurotransmitters (the chemicals on which your nervous system run), your hormones (which control your metabolism).

A great example of this is apparent in the loss of Glutamine in the diet and subsequent effect it has on gluconeogenesis (a vital metabolic pathway that creates glucose for energy and maintains blood sugar levels). Glutamine is also integral in the production of glutathione (an incredible substance which is Neuroprotective, a strong antioxidant, and involved as a detoxification substance in the body).

Another common example is the extreme fatigue persons who over exercise may experience from the excess loss of Isoleucine, Leucine, and Valine which are essential in skeletal muscle health. If you are exhibiting signs or symptoms of fatigue and depression, do not assume that you absolutely need a prescription or are in fact, clinically depressed until you get your amino acids (and potentially your vitamin levels) assessed. There are tests which give reliable quantitative levels and assessment of these vital building blocks.

Eating the right protein and having a healthy gastrointestinal tract to digest and assimilate the food into the correct nutrient building blocks can actually be the keys to improving or correcting your depression or fatigue.

Not Your Mother’s Thyroid Disease

Frequently, patients present having been previously diagnosed with hypothyroidism (low thyroid). Most times, patients are currently being treated with medication but are looking for relief of symptoms and not just satisfying some numerical benchmark outlined by their physician. There appears to be a disconnect between treating the numbers and treating the patient when it comes to thyroid disease. After all, what is the point of cumbersome testing or taking daily medication if not for the promise of feeling well?

Much discussion typically surrounds the use of T3 (to use vs not to use and the form in which it is used). Many times, discussion also centers around what tests are appropriate and best represents each patients clinical situation. It seems, there are as many different ways to test and treat hypothyroidism as there are practitioners. Furthermore, many practitioners tend to order only the tests they were taught to order during their training. Many times this restricts the investigation to TSH and free T4. This approach may be adequate for many “run of the mill” cases of hypothyroidism. But, if your therapy is not progressing to afford you the best quality of life possible with optimal thyroid hormone levels, further investigation may be required to get a full assessment of your malady.

There are several factors to keep in mind when considering the best treatment for hypothyroidism:
Although patients may have an adequate TSH level with treatment with Levothyroxine (T4), this does not insure adequate conversion of T4 to T3 (the much more active hormone form).
If you are on T4 or T3 and are not getting the anticipated response, it may be worthwhile to get a RT3 (reverse T3) level. This is an inactive alternate isomer form of T3 which can “clog up” the thyroid hormone feedback system, thus actually worsening the clinical picture despite what would seem appropriate medication doses. Many persons with adrenal dysfunction or iron/ferritin deficiency have the propensity to make RT3.
Excessive caffeine and alcohol can worsen the dietary intake of iron, Vitamin B-12, Vitamin C. Limiting these in excess may help to meet the necessary dietary requirements.
Excessive physical stressors such as recovering from surgery, prolonged illness, sleep deprivation, or emotional stress for prolonged periods can cause excess or low levels of cortisol production from the adrenals. These changes in adrenal function can increase the production of RT3 and decrease conversion of T4 to active T3.

If your current thyroid therapy does not seem to be working, it may be worth discussing the effect of RT3 and/or the use of T3 in addition to your current regimen.

In Health,

Dr. Gary F. Joseph

Protect your health with “Protected Time”

I’m always impressed by the amount of research done and level of understanding possessed by my patients. To be sure, most arrive to the office having done a considerable amount of reading and inquiry about his/her respective malady. It is not odd for clients to travel hours to an appointment, taking time from work and family, and spending money in an attempt to find an answer to why they do not feel “well”. In a nutshell, I tend to have clients who are “committed” to being well.

Unfortunately, it is not odd to find a dichotomy in behavior which may be detrimental to progress. This detriment manifests in the following statements:

“I don’t have the time”
“I am just too busy”
“Every hour of my day is used up”
“All I do is work”
“Work is too hectic right now”
“between work, my spouse, the kids and taking care of my mother, I have no extra time”

Typically, these are the statements made after a discussion about setting aside time for Stress Reduction Techniques, exercise, planning/shopping for/preparing meals for the week, reading a specific book intended to educate on a specific aspect of health and wellness.
While each of the above statements are real impediments in our lives, they are also precisely entities that block our progress in attaining true wellness. Said simply, the easiest thing that I can do for a patient is write a prescription for a pill, cream or nutrient. The most impacting thing I can do is help clients modify behavior through education and practical, realistic options that fit their life.

When presented with the above noted pushback, I often refer to a personal story that opened my eyes when considering my health and wellness at the expense of other “important” competing factors.

Several years ago, I acted in an medical administrative role and also was practicing medicine in the ER. I was called into a meeting and quickly informed that one of our colleagues had suddenly and unexpectedly died in an accident. There was terrible shock at the death of this young, vibrant husband, father, friend and colleague.

After the announcement was made, there was a 2-3 minute discussion about this tragic loss. Immediately after, the next hour was spent discussing how we were going to cover the schedule as the absence of this “workhorse” would leave us in a manpower shortfall. Planning was done, the schedule was covered, and we went on. The world didn’t stop, the hospital didn’t close, patient care never missed a beat. This is a lesson we should keep in mind when prioritizing work vs personal health and wellness.

It is at this point we should discuss the concept of Protected Time.
This reference is typically directed at Medical Residents, Researchers, Pilots, Physicians who share administrative and clinical responsibilities. The intention is to provide a safe haven for ones personal health, the health of the general public they impact, and the integrity of research and education. It was also created because left to our own devices, we will spend time fulfilling the insatiable demands of clinical medicine at the expense of time in research, education or personal health. It is meant to remove any option that will jeopardize these critical, yet sometimes under appreciated and less lucrative pursuits. Without Protected Time, Pilots and Medical Residents do not sleep, Research does not get finished, students who depend upon clinicians do not get undivided attention.

In a similar manner, we must identify which CRITICAL ACTIONS are not being performed in our lives that may be negatively impacting our intended health goals. For most of us, a failure to allot 15-60 minutes each day (in either uncut or divided portions) to devote to stress reduction techniques (yoga, tai chi, qi gong, prayer, meditation), exercise (whether it is core strength, a few floor exercises or range of motion stretching), adequate nutrition (eating small frequent meals or planning a healthy meal strategy for the week), personal relationships (including sex), should alert us to the fact that we NEED Protected Time. We need time that is untouchable by others or by our own excuses.

Here are a few suggestions in how to institute protected time into your life:
1. Have a face to face discussion with yourself to discuss what short term and long term goals you have for your live and wellness.
2. Write down these goals.
3. Write down what action/excuses you have for not being able to achieve these goals.
4. Consider what scenarios would occur in the long run regarding these excuses if you died or became seriously impaired tomorrow (what you will find is life goes on).
5. Discuss aloud your goals, impediments and corrective actions with your loved ones, work colleagues, or friends.
6. Write down what you would do with an extra 15-60 minutes per day, if you were afforded such time (by the way, a daytime nap is perfectly OK if it is not enabling you to achieve a more significant health or wellness goal.
7. Identify where you need help to attain these goals and ASK FOR HELP.
8. Commit yourself to attaining these goals and take the duty of this Protected Time out of your own hands. That is, make this a mandate that even you cannot cancel. Make this a “it is what it is” situation. I love this one because we actually get to turn the table on our own excuses. We find that most people who we consider “eccentric” are only those who do what they want without regard to the perceived demands placed on them by others OR oneself.

Remember, you are the most incredible power of your own life. Be sure to Protect your health and wellness with Protected Time.

Be well.

In Health,
Dr. Gary F. Joseph

The information provided on this blog is for reference use only, and does not constitute the rendering of legal, financial or other professional advice or recommendations by the BodyLogicMD affiliated physician. This page is not for the use of diagnosing and/or treating medical issues.