Skin Wellness- How to Maintain Your Beautiful Exterior

Posted on May 6, 2013 by mcminnclinic

True story: Her hands were cracked, dried, bleeding and painfully burning. She had tried all of the usual over-the-counter remedies, and had been to 4 different dermatologists. She had been placed on numerous prescription salves, and she had taken oral steroids and other medications. Still she suffered for months on end with no relief. Nothing was working. She came to see me as the doctor of last resort. I started with a history and then proceeded with an examination. She was dry all over, but her hands were in particularly bad shape as described above. After contemplating the issue, I started her on a targeted nutritional program to build her skin health from the inside out. When I saw her back in the office a few months later, I could hardly believe my eyes! Her hands were as smooth as a baby’s bottom. The thick, dry skin was gone. There was no sign of the cracking and bleeding. The patient was relieved that she didn’t have to live a life of suffering with this painful condition, and she was delighted with the outcome. I shared her joy in seeing such an amazing recovery. All of this was accomplished with no drugs, but only by fixing her gut and giving her body the nutrients it needed to heal itself.

I use this story to illustrate the importance of skin health, and to point out that we need to build skin health from the inside out. We tend to take our skin for granted until something goes wrong. Also, we focus on the cosmetic topical aspect of skin care while ignoring the underlying functional and structural integrity of the skin. Certainly topicals may be helpful, but attention to the fundamentals of nutrition, hydration, hormone optimization, detoxification, and stress management plays a crucial role in optimal skin health.

Skin is the largest of all of our bodily organs. It is what interacts with and protects us from our environment; heat, cold, chemicals, UV radiation, and infection. It has many important bodily functions such as: detoxification, regulating hydration, and controlling body temperature. It carries blood vessels, and is home to many of our nerve endings. It houses the fifth sense, which is the sense of touch. Finally, it is the first thing that we and others see, so understandably it is important for our appearance to others and our own sense of self.

It is also important to understand that many underlying medical conditions, including nutrient deficiencies and toxins, may manifest themselves as skin conditions. Drug reactions, cancer, infections, gut dysfunction, rheumatologic conditions, allergies, and more may present as skin conditions. Stress, both acute and chronic, may affect the appearance and health of the skin. All sorts of skin conditions, including eczema, psoriasis, and hives may experience an exacerbation during a time of intense stress.

As you can see, skin is not just something to hold our innards in. It deserves its rightful place, right up there with heart and brains, in the list of complex and important organs. Now here are some tips to help you maintain beautiful, glowing, youthful, healthy skin at all stages of life.

*Attend to the foundations of wellness: Nutrition, optimal hydration, exercise and restorative sleep. All of these affect your skin health.

*Diet: It all starts with what you eat. Start with a whole food (not processed food), mainly plant food diet, with added lean protein, and some “good fats.” Your body needs the fiber to keep the gut healthy which affects the skin. Your skin needs the bioflavenoids for healthy vessels and blood supply for the skin. It needs the protein to help build the skin. It needs the good fats to build healthy cell walls and lubricate the skin.

*Foods rich in the “good fats” include: salmon (and other cold water fish), walnuts, canola oil, olive oil, flax seed, flax oil, and fish oils.

*Maintain good gut health. Good digestion, absorption, and metabolism are important for these nutrients to get to the source.

*Add a good multi-vitamin and multi-mineral

*Also add extra beta-carotene, biotin, and B complex

*Add extra anti-oxidants: Vitamin A, C, E, D, and selenium.

*Antioxidant rich foods such as blackberries, blueberries, strawberries, plums, and green tea may also be helpful.

*Avoid frequent prolonged hot baths and hot tubs.

*Avoid harsh detergents.

*Avoid over exposure to household cleaners and chemicals.

*Avoid lotions, oils, sprays, sunscreens, etc. with toxins and harsh chemicals.

*Acupuncture and Chinese herbals may also be helpful.

*Avoid sugar, simple carbs, and processed food.

*Get your hormones tested, optimized, and balanced. Hormones play a critical role in maintaining skin health.

*Healthy levels of testosterone for men and women are important for skin moisture thickness.

*As women lose their estrogen, everything dries out, creating a significant increase in facial wrinkles. Supplementation with bio-identical estrogen can help tremendously. Also, topical estriol face cream may also be very effective for wrinkles, and skin moisture

*Don’t smoke- this is disastrous for your skin.

*Avoid overexposure to the sun or tanning beds.

*Use natural skin care products without toxins.

*Dry brush exfoliation in the AM before your shower may also be helpful.

*Topical Vit C and Vit E, and regular skin care may also be helpful.

Bottom line: Take care of your skin, so that it can take care of you.

Osteoporosis

Posted on May 2, 2013 by mcminnclinic

Osteoporosis (thinning bones) is one of the most dreaded diseases of women, and with just cause. Like a silent killer it sneaks up on its victim without symptoms, until finally it becomes a potentially fatal disease. About 30 million Americans suffer from osteoporosis, 80% of whom are women. In fact, in the United States nearly 50 percent of all women between the ages of forty-five and seventy suffer from some degree of osteoporosis. About a quarter of these will eventually go on to have a hip fracture later in life, many of whom will die of complications related to the fracture. In fact, the lifetime risk of death from a broken hip for a 55 year old woman rivals the death risk from breast cancer. The ravages of osteoporosis are not confined to broken hips however. Thinning bones also result in other fractures, as well as collapsed vertebrae, disfigurement, disability, and chronic pain. Overall osteoporosis results in an $18 billion price tag for the American health care system.

So why is this becoming such an epidemic? As with many other common diseases, the modern American diet, sedentary lifestyle, and stress have a lot to do with it. In some less developed cultures, osteoporosis is actually quite rare. Our high sugar, processed food, fast food diets often don’t have the vitamins and minerals needed to build new bone. Also, we don’t get out in the sun as much as we used to. This creates a lack of vitamin D, which is necessary for building healthy bones. Weight bearing exercise also stimulates bone strengthening, but more and more, we have become a sedentary society. Finally, our body reacts to this stressed out culture we live in by raising levels of the hormone cortisol, which then results in thinning of the bones.

What actually happens in osteoporosis? Childhood, adolescence, and early adulthood are the prime opportunities for building strong bones. Our skeletal system reaches its greatest density at about the age of thirty. After that we start a long steady decline. With the onset of menopause, women begin an accelerated period of bone loss. In fact white women in America tend to loose 30-40% of their bone mass between the ages of 55-70.

So who’s at risk? Women are at greater risk than men, and caucasian women are at greater risk than African-American women. Asian women fall somewhere in the middle. In general you’re at greater risk if you’re fair skinned and blue eyed, if you’re thin or small framed, if you smoke, if you’re sedentary, if you rarely get out doors, if you drink too much alcohol or coffee, or if you went through long term depression. You’re also at increased risk if you went through late puberty or early menopause, if you have a poor diet, if you have a history of chronic liver or kidney disease, if you took steroid drugs for an extended period of time, if you had a hysterectomy with ovariectomy, if you have a history of anorexia or bulimia, if you’ve had a prolonged absence of menstrual periods, or if you don’t get enough calcium in your diet. Stress and a poor immune system may also contribute to bone loss. Osteoporosis tends to run in families, so if your mom has it, you’re more likely to get it. Some drugs such as those in the Prilosec or Nexium family put the patient at significant increased risk of osteoporosis.

The key is to get tested. Ideally one should get tested with a bone density screening either before or during perimenopause. Although the fractures don’t show up until later, it helps to get a baseline test in order to establish a trend later on.

Hormones play an important role in bone health. In fact, the primary cause of osteoporosis is hormonal imbalances that interfere with the bone-forming cells. Estrogen prevents bone loss. Progesterone, and to a lesser degreee, testosterone, actually help to build new bone. Together, progesterone and estrogen offer a powerful one-two punch against thinning bone disease. DHEA, melatonin, growth hormone, and calcitonin also support sturdy bones. On the other hand excessive levels of cortisol (the stress hormone), and too much thyroid can lead to bone loss. When it comes to using hormones for bone health, I prefer to use bio-identical hormones. Artificial progestins have actually been found to cause bone thinning.

Here is a game plan to help you to keep your bones strong:

*Healthy diet

*Regular exercise (especially weight bearing)

*Stress reduction

*Targeted nutritional supplementation

*Bio-identical hormone Optimization.

The optimal bone- building diet should include foods that are rich in the building blocks of bones such as nuts, seeds, flax, soy, fish, yogurt, broccoli, and green leafy vegetables. At the same time we should avoid excessive caffeine and alcohol, sugar, and refined grain. Eliminate soda from your diet and reduce red meat. Keep a lid on the added salt and avoid processed foods. Supplements should contain calcium, magnesium, vitamin D, boron, silicon, vitamin C, strontium, and vitamin K.

Take care of your bones and they’ll carry you through into your happy, healthy, vibrant golden years.

Grumpy Ol’ Man Syndrome

Posted on December 12, 2012 by mcminnclinic

On a given day if you asked my wife, she might claim that they named the above medical syndrome after her own beloved husband. I must admit that I have my good days and bad days on the home front. However, I take some comfort in knowing that I’m in good company. In fact, if my women patients are right, “grumpy ol’ man syndrome” has reached epidemic proportions.

The usual scenario is that the wives drag their husbands in, kicking and screaming the whole way. Of course, the men are in complete denial and are busily hoping that Scotty will beam them up at any moment and rescue them from any event in which “feelings” are discussed. Guys need to have just the right pretense for talking about such things. It’s OK to ask “how’s the marriage” when you’re riding around in a golf cart with a good ol’ buddy, or out in the middle of a lake on a fishing boat. It’s like foreplay; the only acceptable ways to engage in such conversation is if the foreplay is centered around football, golf, beer, fishing, hunting, or NASCAR. Just to cold turkey and purposely sit down and have a talk about sensitive issues such as feelings can seem extremely unmanly and may be down right uncomfortable, even with the doctor.

Fortunately the wives are on the case big time, and they usually have the common sense to come with their strong silent types to the initial doctor’s appointment. Although I know going into it, who is going to be the communicator, I at least show the guy enough respect to address the question directly to him. “How’s it going” I say. “Fine,” or some other one worder is usually about all I get. Then the truth spews forth like an Icelandic volcano from the fairer half. “He’s grumpy, sullen, irritable, moody, depressed, and he has no sex drive. He comes home after work and just crashes into his Lazyboy. He doesn’t have any energy, and he doesn’t want to do anything. He has no interests, no get up and go, no joy in life. He’s totally disconnected. And he’s getting fat and lazy.”

On the face of it such phrases may sound like fighting words. Instead, more often than not, he agrees with her, or through his silence and lack of argument one can assume that she is not too far from the truth. Now we’re starting to get somewhere. Just like when you look up at the summer night sky and see the big dipper, it all comes into focus. He has “Grumpy ol’ Man Syndrome.” Another name for this dreaded and all too common condition is “Andropause.” At that moment, I know that I can help him.

Just like women go through menopause, men go through a similar process wherein their levels of hormones (in this case testosterone) fall to well below the acceptable range. Also just as a woman’s menopause may have dramatic affects on her health, her mood, and her behavior, so too andropause may insidiously choke the life out of even the most macho of men. They often become a shell of their former selves. The men, their wives, family, friends, and co-workers all suffer the dreaded consequences of the decline in testosterone and its accompanying symptoms.

At the risk of seeming to be biased toward men, after all I personally fall into that category, I have to stand up for the guys just a bit and let them off the hook. In many instances they can’t help it. The behavior, as I described above, is not of their choosing, but instead it is often hormonally driven. If only they had a robust and balanced hormone profile they most likely would be their usual lovable and manly selves.

True story: I had a patient in the office just recently who fit this description to a tee. His wife drug him in back about 6 months ago with the classic symptoms of “grumpy ol’ man syndrome.” He was clinically depressed, grumpy, frail, had no libido and was starting to suffer from ED (erectile dysfunction). We did all the appropriate lab testing and found that his testosterone was quite low. I put him on a program of hormone repletion, nutritional supplementation, and life style changes. WOW! He came back in for his follow-up visit and announced that he was feeling fantastic. As he put it, his energy was “through the roof.” He could hardly believe what a difference the program had made for him. The depression was gone. Energy was better. He was exercising again. He was interested once again in sex, and interested in life in general. His ED had magically disappeared, and he was thinking much more clearly. He and his wife were both ecstatic. She had her beloved husband back. He had his life back, and they had their marriage back. There is no antidepressant or any other “drug” in this world which could have achieved this outcome for this patient.

Furthermore, low testosterone and andropause can have even more dire consequences. A study published in the Archives of Internal Medicine describes an 88% increase in mortality in male veterans with low testosterone. Other published studies form reputable medical journals have linked low testosterone with poor cognitive function, Parkinson’s disease, Alzheimer’s disease, osteoporosis, hardening of the arteries, heart failure, insulin resistance, diabetes, and metabolic syndrome. Testosterone decline may also contribute to abdominal obesity, decreasing muscle mass, joint pains, loss of self confidence, fatigue, disturbed sleep, anxiety, and excessive worry. Low testosterone is not just about muscles and libido. It is about optimal health, and even mortality.

Testosterone must be respected. Like all medications it must be used properly and must not be abused or used in excess. Testosterone replacement should never be done if it is not medically indicated. Furthermore, the replacement program must be conducted properly with adequate monitoring to attain optimal levels, while paying attention to possible side effects. If done properly, it is safe and may be profoundly effective. Testosterone replacement therapy is not for everybody. However, in the presence of “grumpy ol’ man syndrome” like with my patient described above, it can make a remarkable difference in the life of the patient and his partner.

Bottom line, if you suffer from “grumpy ol’ man syndrome,” get your T checked, and get it optimized. If your loved one shows signs of this dreaded disease, drag him in and get him checked for “low T.” You’ll be glad you did.

Feeling Fat, Fatigued, and Depressed; Think Low Thyroid

Posted on November 26, 2012 by mcminnclinic

Many experts now agree that millions of Americans are falling through the cracks when it comes to the diagnosis and management of low-thyroid conditions (hypothyroidism). Unfortunately, the lack of proper attention to this issue often results in the patient living a life of fatigue, low mood, struggles with obesity, and many other problems.

Although the thyroid gland is small, it has powerful effects on the body. Thyroid hormone regulates the metabolic rate of every single cell. If thyroid function is underactive (hypothyroid) a person can have a multitude of symptoms, sometimes subtle and sometimes profound. These symptoms may include, but are not limited to: fatigue, weight gain, cold extremities, low libido, dry skin, aches and pains, fibromyalgia, constipation, hair loss, brittle nails, poor memory, low stamina, headaches, puffy face, and low body temperature. Perhaps the most common and important of the symptom being varying degrees of fatigue.

Diagnosis of low thyroid conditions, like most medical conditions, starts with listening to and examining the patient. Symptoms, as mentioned above, family history, and physical signs often point to the diagnosis of hypothyroidism. If thyroid disease is suspected, a thorough lab evaluation should also be performed to assist in the diagnosis. However, the goal is to treat the whole patient, and not just to treat the labs.

If hypothyroid disease is confirmed, then proper treatment may include thyroid medications. There are several medications on the market, which may be quite helpful in relieving low thyroid symptoms. These include Synthroid, Armour thyroid, Cytomel, compounded thyroid, and others. One patient may respond well to a particular medicine, while another patient may find that a different medication works best to alleviate his or her thyroid related symptoms. Although Synthroid is often the drug of choice for many physicians, I have found Armour thyroid to be particularly effective in many of my low-thyroid patients. For others, Cytomel may be the key to alleviating their symptoms.

In summary, thyroid dysfunction is a condition that may have a profoundly negative impact on many patients. Yet according to various experts, millions of Americans suffer from inadequate diagnosis and treatment of hypothyroidism. Proper evaluation and treatment of these patients may help tremendously in improving their symptoms, and their quality of life.