Phoenix integrative and naturopathic medicine blog

Understanding Your Risks for Heart Disease: An Update

Posted by Robin Terranella on Tue, Jan 26, 2016 @ 10:01 AM

A few years ago, we created an informative a white paper “Understanding Your Risks of Heart Disease. While the information is still very valid and important to know and understand, it was also time for an update.  There is a lot of new information that has come to light in the last few years in regards to cardiovascular disease (CVD) we want to share with you.

heart healthIn our first white paper on heart disease risks, we introduced you to a study called JUPITER (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin). This study turned focus to a marker of cardiovascular inflammation called hsCRP (high sensitivity C-Reactive Protein). This study was of particular importance because it identified a new population of individuals at risk for heart disease.  This study looked to examine why patients who had normal levels of cholesterol still ended up with CVD.

While this study was aimed at justifying the use of preventative treatment (statins therapy) with the subjects, Southwest Integrative Medicine took it as key data in determining where to look to understand risks for heart disease more broadly.  

JUPITER Addresses Additional Risks for Heart Disease

For starters, JUPITER determined that there was more to CVD than high cholesterol and blood pressure, which is traditionally what physicians look at to determine your level of risk for heart disease. The fact that hsCRP levels alone predicted an increased risk for heart attacks and strokes is important for several reasons.  For one it tells us that damage to the artery wall may be the real problem with cardiovascular health more so than cholesterol floating around and clogging things up. Possibly even more important is that it alerts us that hsCRP levels needs to be put in the list of items to check to stratify your risk of cardiovascular event.

Yet many people don’t have this marker checked and this study is now several years old. Rather than checking what the hsCRP level is and trying to find out why it is there, most doctors just prescribe lipitor or some other statin medication. This may work fine in the short term to lower hsCRP (for those that can take statin medication without side effects). However, what about those that can not take them or don’t want to? Additionally hsCRP is part of an alert system that tells us inflammation is present. The marker is not the inflammation itself. Reducing the hsCRP with a statin is the equivalent of shutting off a fire alarm when there is a fire and thinking there is not a problem.  A more appropriate reaction is to find out why the hsCRP is high to start with.

More Recent Studies on CVD Risk

More recently, researchers have been looking at other markers that could be indicative of CVD and how it is related to inflammation and hsCRP. While inflammatory markers can be caused by several factors, this study looks at inflammation as it relates to something called Endothelial Dysfunction.

What is Endothelial Dysfunction?

Endothelial Dysfunction is a dysfunctional state of the inner lining of your blood vessels, or your endothelium. More specifically, this dysfunction is a shift in the balance between vasodilating (opening capacity) and vasoconstricting (closing capacity) substances produced by (or acting on) your endothelium (inside of your artery). This activity is governed by several substance that come from the endothelium. One of the main characterizations of this condition is reduced Nitric oxide production. When the artery wall encounters nitric oxide it causes the wall to relax and open. This is associated with more blood flow through the artery. With endothelial dysfunction there is decreased nitric oxide and therefore decreased blood flow (think high blood pressure and hardening of the arteries).

Endothelial dysfunction is an important aspect of both the early and late stages of atherosclerosis (artery blockage). For instance it  plays a crucial role in the pathogenesis of cardiovascular issues including: acute coronary syndrome, hypertension, Peripheral Arterial Disease, Erectile Dysfunction, stroke, etc.  Additionally, once the arteries are blocked this ability of the artery to expand and increase blood flow become even more important.

Most research seems to support the fact that endothelial dysfunction perpetuates cardiovascular disease. Therefor if we can detect and treat it early, we may be able to reverse or prevent cardiovascular disease.  Additionally looking at the connection between inflammation (hsCRP) and endothelial dysfunction may point us to a true cause.

Endothelial Dysfunction and Inflammation

As noted above decreased nitric oxide production is one of the hallmarks of endothelial dysfunction. By making use of the amino acid arginine, nitric oxide is produced by an enzyme called nitric oxide synthase. This works perfectly fine when there is enough biopterin around to support nitric oxide synthase. This enzyme needs biopterin as a cofactor to do this work. However inflammation in the body impairs biopterin production and use which leads to reduces nitric oxide production.  While that is pretty convincing, there is other evidence that inflammation creates and perpetuates endothelial dysfunction.

Homocysteine is a molecule that is also associated with cardiovascular disease. As it turns out homocysteine accumulation also reduces nitric oxide production. However, this could be the impact of inflammation on enzymes involved in reducing homocysteine.  We know inflammation does lead to high homocysteine.  We also know that several other things could cause high homocysteine so it is important to not draw do many conclusions on what is causing what. However, since high homocysteine alone is linked with impaired nitric oxide this should be kept imbalance as much as hsCRP.

What You Need to Know About Inflammatory Markers

There are many ways to lower the levels of inflammation and homocysteine. One study looked at the role of different pharmacological and nonpharmacological agents to restore endothelial dysfunction. Before looking at ways to lower it, the first step is to test your levels so you know what the baseline is and if treatment is even needed.  If you know there is a problem here, the next step is to find and treat the cause, instead of just the number. Factors like infection, autoimmune disease flare-ups, elevated blood sugar, toxin exposure (heavy metals and other toxin exposure) are just a few common causes of inflammation. Homocysteine elevation is typically caused by too little consumption or absorption of vitamin b12, and folate. Some people also have a genetic factors that influence these.Fotolia_99962609_Subscription_Monthly_M.jpg

What is important to remember is that Endothelial Dysfunction is relatively reversible when it is treated properly. When you look at the risks for cardiovascular health from a broader perspective, it translates into an improvement in endothelial health and heart health.

Lets not forget the impact of a general unhealthy lifestyle heart disease risks. Here are some of the most common unhealthy lifestyle choices that increase your risks for one reason or another: 

  • Smoking
  • Excessive alcohol consumption
  • Lack of exercise
  • High saturated fat diet
  • Not enough water intake
  • Obesity
  • High sugary foods and poor blood sugar control

When trying to determine your overall risk for heart disease and a cardiovascular event, look beyond blood pressure and cholesterol. There are several more advanced tests available that look at the things mentioned in this article, Lp(a), LDL particle size and more. If you want to reduce your risk, make sure you are getting a thorough evaluation from your doctor.


For more information on heart disease risk and integrative treatments for heart disease, click below or give us a call 480.451.5407. 

More on Heart Health

Tags: heart health

Case Study: Treating Eczema with a Detox Diet Program

Posted by Robin Terranella on Mon, Dec 21, 2015 @ 10:12 AM

Every day, our bodies are bombarded by external (and even some internal) toxins, which overwhelm and overload the natural detoxification systems in our bodies. Pesticides, pharmaceuticals, pollution; these chemicals practically saturate our soil, air, and water, making it virtually impossible to escape from toxin overload.

The result?

Overburdened detoxification systems can spell out chronic health issues for every individual, no matter the lifestyle. These health issues can include weight gain, headaches, skin problems, fatigue, cancer, mental fog, decreased functions of the immune system, and cardiovascular issues.

How and Why Do Detoxification System Get Overburdened?

Like many health ailments where genetics and environment play a role, detoxification is no different. Problems arise where susceptibility and exposure overlap. For instance, a specific toxin like a pesticide, gets eliminated from the body through a particular pathway. If a person with a genetic defect in this enzyme avoids all pesticides they will be fine. In fact, if they simply avoid most pesticides, they will be fine. If they do neither, the body will build up with these toxins and it will cause damage to other areas of the body. We are exposed to hundreds of these types of toxins, daily, in our jobs, household products, chemicals, air pollution, carpets, plastics, etc.

Here are two examples of toxins you can avoid by paying attention:

  • Bisphenol A (BPA)
      • This chemical is used predominantly in the production of plastics. You can click here to read a comprehensive list of serious health issues linked to BPA exposure.
  • Pesticides and fungicides
    • It has always made sense to us that any chemical that kills living things might be worth avoiding in our food supply. Try to make it a priority to eat foods that are 100% pesticide free to minimize your exposure.

You can learn more about how specific toxins affect and disrupt the endocrine system, here.

Curing Overburdened Detoxification Systems with Detox

For those with both susceptibility and exposure, there are multiple approaches that can assist the body in getting rid of the toxins (detoxification). In some cases, we want to narrow down which toxin is causing the problem and focus on that detox pathway. Other times, a simple detox diet works great.

Here at Southwest Integrative Medicine, we offer a 21-day detox diet program to our patients suffering from health issues caused by toxin overload. This program focuses on removing toxin exposure from diet and environment. It does this by stimulating and enhancing the organs of elimination to get your body back to a healthy state.


The following is a detailed testimonial from one of our patients who completed our 21-day detox diet program earlier this year after a traumatic and frustrating eczema flare-up.

“In July of 2015, I started having these intense itching outbreaks all over my body. Sometimes they would start on the bottom of feet and work their way up. Other times it would be my face. The itching would start around my lips and cheeks, and then work it’s way around. Then there were days when the itching would just be patches all over my body in various areas. It started off rather mild, an inconvenience and annoyance more than anything… but after about two weeks, it started to get intense. The itching would wake me up at night and sometimes bring me to tears because if I scratched it, it would burn and just itch deeper. I felt like the itch was deep- like it was seeping deeper and deeper into my body. I would lay there with ice packs all over trying to calm it, applied Aveeno lotions and creams to no avail, and finally gave up on fighting it myself and went to my dermatologist. I was diagnosed with eczema and prescribed a steroidal topical cream called “Triamcinolone”. I was also instructed to stop using anything with a fragrance, fabric softener, and to “try to avoid sweating”. Seriously- try to avoid sweating? Beyond the fact that such advice seems ridiculous, I teach dance for a living, so sweating is inevitable for me.

After 3 days of applying the cream twice daily, I broke out in the worst rash of my life. Other than a few pimples during puberty, I have been lucky in the area of skin condition for almost my entire life. This rash literally took over my entire body. It started with a few blistery pimples on my chest, and it just went everywhere. The areas of highest concentration were my face and chest. These pimples were painful, swollen, and very red. Beyond that, the rash was embarrassing. It was at this point that I decided I did not just want to treat the symptoms of eczema; I wanted to get to the root of the problem and solve it. That’s when I contacted Dr. Terranella and Southwest Integrative Medicine.

21 day detox diet

Dr. T. put me on a 21-day detox, and by day 3, any itching had completely stopped. By day 7, the rash was completely gone. I have just completed the 21 days and my follow up with Dr. Terranella, and I can honestly say that I am so glad that I chose to go this route. My skin may even look better now than it did before the rash outbreak. As Socrates once said, “Let food be thy medicine”!

Thank you to Dr. Terranella and the entire Southwest Integrative Medicine team!

- H.W., Age 30


If you are experiencing similar issues with eczema, or suspect that your chronic health issue might be related to an overwhelm of toxins in your body, call us today to set up a free consultation or click below to fill out our 3-week Detox Diet Program form.

A Case Study  on Detox

Tags: detoxification, diet, obesagens, eczema

How your mood affects weight loss, diet and exercise

Posted by Robin Terranella on Mon, Nov 30, 2015 @ 09:11 AM

Do not ask yourself; do I have an affective disorder? Instead ask yourself if motivation is an obstacle getting in the way of your weight loss goals? Motivation and overwhelm affective disorders can lead to, overeating, lethargy, and issues with sleeping all play counterproductive roles in a quest for a healthy lifestyle. This means starting with a healthy mental state will get you further in the long run.

push-ups-888024_640.jpgThe Mood Sabotage

Being happy, sad, indifferent, frustration are all part of the spectrum of normal human emotion. Sometimes emotions are influenced by events that are seemingly out of your control. More often than not the events that occur on a daily basis are neutral. It is our reaction to these events that creates emotion. This reaction is based on expectations. Gaining more insight into your expectations and what makes these emotions come about can give you immense insight into why your weight loss goals have been thwarted. This is where counseling and setting realistic expectations comes in play.

Your brain chemistry and response is also something you can optimize to smooth out the ups and downs (anxiety and depression). You can think of anxiety and depression as being part of a spectrum of mental health with anxiety on one end and depression on the other end. In the middle is a mood that is normal and even. Before anxiety on the spectrum would be stress, then high stress, then mild anxiety, etc. On the depression side it would also be stress, then low mood, then mild depression etc. These emotions, while influenced by expectations, are also greatly influenced by things like genetics, the types of foods you eat, hormones, and many other things.  These things can change the levels of neurotransmitters like dopamine, serotonin, norepinephrine, and others.

For instance hormones can act to reduce anxiety as they act as stabilizers to the nervous system in the brain. Some females experience this during menstruation as PMS in mild cases or PMDD in more severe cases. Males too can experience changes in emotional states as testosterone declines with age. This is know as Andropause.  These imbalances in both men and women can lead to anxious and high stress moods or low mood and depression.

Sometimes your emotional ups and downs are based on how your body makes and breaks down your neurotransmitters. One example of a problem with creating neurotransmitters is MTHFR. This genetic defect creates a roadblock in some neurotransmitter production. There can also be a roadblock on the side of neurotransmitter breakdown.

Integrative Medicine For Weight loss

If you are someone who has struggled with weight loss it may be time to look at the bigger picture, not just diet and exercise. The mind and your mental state plays a huge role in how your body performs but it is not just a matter of having the will power. Leaving your weight loss success up to will power is a fools game. Things will come up and you will miss workouts, eat the wrong foods etc. Knowing this you should plan for what your going to do in these times. 

One thing that makes sense is to prepare or semi-prepare your healthy meals in advanced. If you run short on time or you are super hungry your meal is practically ready for you.  This also removes the mental burden of deciding what you should have for a meal. Most of the time the default and quick meals we go to are often the least health for us. You can take this a step further and create a meal plan for the week and a list of back up meals and restaurants to use as a backup.  This way you don’t have to constantly worry about and think about what you are going to eat.

Balanced emotions and mood will help you balance the scales in your favor. Getting the brain chemistry balanced is a great place to start.  How do we know what and where the chemicals are imbalanced? Genetics can give us tremendous insight into where the neurotransmitter imbalance lies. Nutrigenomics is the practice of using nutrition to optimize the bodies function based on your genetics. You can think of it like improving the ability of your body to manufacture and use different biochemicals.  The example above we looked at how an MTHFR defect could decrease certain neurotransmitter production. A person with this can improve the function of their body and brain by supplementing with L methylfolate foods or directly with this supplement.

Balancing hormones and using nutrigenomics can put you in clear and motivated mindset.  However, even with a clean, motivated mindset, poor habits can make new routines hard to implement. Be sure to put parameters in place that will set you up for easy success in the beginning.

What About Diet and Exercise?

What diet is more important than exercise? Yes diet and exercise are important. However in the context of gaining momentum most people will have more success with diet initially. This is important because you want to use momentum to your favor. Take the low hanging fruit to bolster your long-term goals. Momentum and motivation go hand in hand. When things get hard and your weight loss stagnates, negative thinking and psychology come in. Some studies even show that a healthy diet is more effective for weight loss than exercise alone.  Plus exercise takes more time.

For instance,  if a 200 lbs man wants to lose a pound a week without altering his diet, he would need to run over 3 miles a day. However, if he cuts 500 calories out of his daily caloric intake for a week (check the calorie counts at Starbucks when you go for your morning latte to gain a sense of what that looks like), his results would be about the same. This does not mean you should not exercise but choose the exercise programs that are going to give you the most results for the effort.  For instance muscle burns more calories than fat, so having more muscle on your body will aid in calorie burn throughout the day. This happens even if you are sitting all day.  The exercise that is going to have the most impact for weight loss is resistance (weight lifting) training.

What about diet plans? Can those be effective without cutting calories?

According to the Journal of the American Medical Association, after a recent study of 59 individuals on various fad diets, no diet came out as a clear leader.  Being able to follow the diet changes you set is critical. Whether it is simple caloric restriction, eliminating certain types of foods, etc being able to follow the plan is more important that the plan itself.

The reality of weight loss is that it takes several different variables including the right mental state - free from stress, anxiety, depression, and negative thinking.  To be successful you need a long term plan that incorporates the right mental state, the right eating and exercise habits.  Here at Southwest Integrative Medicine, we offer this kind of physician-guided holistic weight loss to help our patients reach their weight loss goals. If you are interested in learning how we can help, don’t hesitate to reach out for a free consultation, today!

Set Up a Free Consultation

Tags: Andropause, weight loss phoenix, MTHFR

TRT: Cutting Through the Hype to What You Really Need to Know

Posted by Dr. Robin Terranella on Wed, Oct 28, 2015 @ 10:10 AM

It may seem like everywhere you turn these days, there is a steady stream of advertisements promoting an increased sex drive and healthy libido with products like Viagra or testosterone gels and patches. However, Low Testosterone levels, or Low-T is something that many people actually do not believe is very common, when it actually is. In fact, more than half of the patients that we check are experiencing low testosterone levels.

On the other side of these advertisements, articles are also frequently published that discuss how testosterone therapy may damage your heart, and just plain myths surrounding low testosterone treatments. Today, we want to cut through all of the chatter regarding this topic and give you the 5 things you should know about testosterone replacement therapy.

But, before that, it’s important to make sure you have your background information. For starters, what is testosterone?

What is Testosterone?testosterone

Testosterone is the primary sex hormone produced, for the most part, in a male’s testicles. Small amounts of this androgen hormone are also produced in the adrenal gland of both males and females.

Like Estrogen in women, Testosterone is the trigger for puberty in boys, bringing about external adult male characteristics like, a deeper voice and facial and body hair. Internally, Testosterone is also responsible for sperm cell production, increased energy and libido, and strength.

Around the time a man reaches 35 - 40, his hypothalamus tells the pituitary gland to decrease Testosterone production. This is typically a natural progression, but some men can experience more low-T symptoms than others that may qualify them for Testosterone Replacement Therapy (TRT). In some cases testosterone production declines at much earlier ages for unknown reasons.


What Qualifications are needed for TRT?

There are a lot of differing opinions by physicians out there today on what constitutes as healthy or “normal” Testosterone levels. Some physicians argue that optimal Testosterone levels should be a goal, rather than “normal” levels, and that men with normal serum levels of 500 mg/dl could still be considered good candidates for TRT. Other physicians believe that the words normal and optimal are synonymous.

According to a study reviewed in the Journal of American College of Cardiology, men with levels in the 600’s have a reduced risk for cardiovascular. Based on these findings, we here at Southwest Integrative Medicine believe optimal is better than normal, and that serum levels between 600-1000 ng/ml are what we should be looking to achieve in men over the age of 30.

With this information in mind, here are the five things you should know about testosterone replacement therapy, before you make a decision:

  • TRT is not a replacement for a healthy lifestyle.

Testosterone Replacement Therapy is a very effective treatment for men suffering from low testosterone, but there are also ways to increase your levels naturally as well. Before you choose TRT, try making some alterations to your current diet and exercise plans.

Studies show that both testosterone and HGH are boosted as a result of short, intense exercise. The more muscle groups and more intensity involved in your exercise, the better for testosterone production. By incorporating a combination of high-intensity interval training (HIIT) and weight training, you can take progressive steps in optimizing your body to produce the testosterone hormone, naturally.

Diet is another factor of a healthy lifestyle that can aide in the production of testosterone. Aside from a balanced a healthy diet, which everyone benefits from, incorporating high protein snacks can also be beneficial. The avoidance of plastic containers is also something to consider, as they can actually leach into your food and create an estrogen-like effect, called xenoestrogen.

There are also internal stimulants in the form of herbal treatments like ginseng, Eurycoma longifolia, and Tribulus terrestris that can aid in making your testosterone more bioavailable. For more information, take a look at our list of internal simulants.

  • TRT is safest when an actual deficiency is present.

It is not uncommon for men to take supplements or go through TRT, when Low-T is not actually present. It is important to know that TRT is not without risks, which we will discuss a little later in the article. If you are someone with normal levels of testosterone, you may be unnecessarily subjecting yourself to these possible side effects. In other words, TRT is going to have more up side and the least amount of down side when Low-T is actually the cause for your current symptoms.

On the other end of the spectrum, some men do not even know they have Low-T because their health is void of the normal symptoms. In fact, according to a study done by The Journal of Endocrinology and Metabolism, 1 in 4 men have Low-T, and of that, only a small percentage actually displayed the symptoms of it.

Your safest avenue for hormonal balance and health is to make sure you have your hormone levels tested with your physician regularly, regardless of the present of symptoms.

  • TRT is not a panacea.

depression and fatigueSome men can experience Low-T symptoms without actually having low testosterone. That is why it is important to get tested if you start experiencing symptoms to ensure that you actually have a deficiency that merits a discussion about TRT with your physician.

Symptoms of low testosterone include;

  • Fatigue,
  • Low Libido,
  • Increased Weight,
  • Depression, and
  • Foggy thinking
  • Poor memory
  • Erectile dysfunction
  • Decreased bone strength

If you are experiencing some or all of these symptoms, we would recommend taking a test to determine if you actually have low testosterone. However there are several other health issues that can cause these symptoms.

  • Health Benefits to TRT.

Aside from the commonly touted benefits of testosterone replacement like, increased stamina and libido, there are numerous benefits to correcting this hormone deficiency. Improved blood sugar regulation and decreased levels of LDL cholesterol and triglycerides are of the more important positive side effects.

If you have trouble regulating your blood sugar, studies show that men that go through TRT find that their blood sugar improves. The spike in energy that occurs from increasing your testosterone levels can also have a positive impact on your metabolism and often leads to weight loss for men going through the therapy.

Symptoms of age like decreased muscle mass and bone loss are also things that can be slowed when increases to your low testosterone levels are made. While many men seek our testosterone replacement therapy for the more uncomfortable issues like low libido or erectile function issues, we recommend that you choose TRT based on your symptoms as a whole and the additional benefits it can bring to your well-being.

  • Health Risks with TRT.

No treatment is without risk, this includes TRT. Here are a few health risks to be aware of before you choose testosterone therapy.

The first category of risk to discuss is cardiovascular. In a study published in The Journal of the American Medical Association, researchers followed 9,000 men with cardiovascular conditions, where only a ¼ of them having were enrolled in TRT. At the close of this study, almost 26% of the men in TRT had a cardiovascular event, while nearly 20% had an event that were not taking TRT.

What does this mean?

While the difference in percentages is scientifically significant, the researchers methods leave much to be desired. Upon our review of the study, we discovered that little was included in the study in terms of patients monitoring. For instance the dose of the testosterone each subject was receiving and their target testosterone level. The method of testosterone administration and the levels of estradiol and red blood cells. All of these variables should have been controled for to some degree and non were because it was not a controlled study. So very little can actually be deduced from this particular study as to how TRT affects cardiovascular health. However much has been said in the form of advertisments for lawyers looking to create lawsuits against big pharma. This has created a lot of confusion surrounding TRT therapy.

There is a very rare cardiovascular risk, however, that affects around 10% of Low-T patients.  This is an increased production of the red blood cells called PolycythemiaIf there is a risk of cardiovascular issue associated with TRT, this is likley it. As noted above this was not monitored for in the above study. Thankfully, a blood donation can easily remedy this and put a patient back on schedule with their TRT.


In some cases testosterone therapy can also cause changes in your prostate health.  While some studies have shown that testosterone thereapy can improve the health of a prostate, there is also evidence showing it can increase the size of the prostate. In the cases where the prostate size increases it is typicaly triggered by estrogen. This enlargement is a benign reversable enlagment. While there is no clear association with testosterone therapy and prostate cancer, it is important to heavily monitor any changes in your prostate during treatment with TRT.

Like any treatment, there are risks associated with TRT. That is why it is important to have your symptoms thoroughly assessed, as well as go through all of your options with your physician before you begin. Have questions about your hormones? Give us a call and we will setup a free consult.

Ultimately, Testosterone Replacement Therapy can be a very beneficial treatment for men looking to reverse their Low-T levels. In fact, some patients who’ve come to our physicians regarding this issue have expressed that they didn’t even know they felt bad until TRT showed them what it was like to feel good again.

If you or someone you know is experiencing some of the Low-T symptoms we laid out in this article, try taking our Low-T test, or contact our staff at Southwest Integrative Medicine, today, to have your testosterone levels checked. You may be a candidate for Testosterone Replacement Therapy.

Take the  Low-T Test!


Tags: Low T, testosterone replacement therapy

Healing Happens with Acupuncture

Posted by Dr. Christy Cline on Mon, Sep 28, 2015 @ 08:09 AM

Acupuncture, the ancient art of healing, has had a foothold in Eastern medicine for thousands of years, and is even rumored to have been practiced as far back as 4,000 years ago. While modern medicine often holds this method of healing under a microscope, analyzing its effectiveness, its history of success certainly is a testament to its tenure.

Today we here at Southwest Integrative Medicine will dive a little deeper into the origins and treatment processes of Acupuncture, its ideology, and ailments that can be treated with Acupuncture.

history of acupunctureA Brief History of Acupuncture

As we mentioned before, the exact date of origin for Acupuncture is still a mystery for historians. What we do know is that the first text about the practice, written in approximately 2674 B.C.E., is called the Nei Ching Su Wen, and it involves philosophical questions and ponderings about medical concepts that are as relevant today as they were 2,000 years ago.

In comparison to Western medicine, where theories are presented and the current physiological facts are used to explain them, the Eastern methodology of Acupuncture has long been viewed as medieval and retrogressive. However, the more we examine the history behind acupuncture, and the context within which acupuncture theories were manifested, its validity and efficacy are increasingly illuminated. In fact, acupuncture is really very similar to modern medicine, in that it is based on cleared document treatment process that is based on subjective information, observation, analysis, and practice over thousands of years.


Western versus Eastern Medical Ideology

As noted, acupuncture is similar to western medicine in that they both have a process for both diagnosis and treatment. In both acupuncture and western medicine, symptoms are observed and used as information to support a diagnosis. Where the two forms of medicine veer is in the types of diagnosis and the information used for the daignosis. Chinese medicine puts equal weight on subjective information as objective information but Western medicine puts much less emphaiss on the subjective information. Where western medicine finds understanding in the visible, tangible, physiological condition, acupuncture draws diagnosis from a position of both sunjective, metaphysical, and physical. This is important because the acupuncturists wants to know things about your body that only you could know.  This is as much h true today as it was 2000 years ago.

For example, a person with chronic intestinal issues would most likely be diagnosed with Irritable Bowel Syndrome (IBS) in western medicine. Because treatments surrounding IBS are always changing, their treatment of IBS would have looked very different even 50 years ago in comparison to today. In contrast, an acupuncturist would likely explain this condition as a Spleen-Chi Deficiency and the treatment for it would be the same today, as it was years ago. The treatments of conditions in eastern medicine mostly stay the same  and instead there is a deepening of the knowledge and understanding of how these patters emergy in the human body. .


The Common Acupuncture Treatment Process

Acupuncture is effective in maintaining good health, and also in addressing a wide-range of health problems. Many patients seeking medical attention often use acupuncture as an alternative to western medicine, whereas some even use a combination of the two.


The process begins with an interview or evaluation with an acupuncturist or physician specializing in integrative medicines. In this consultation, you would go over your medical concerns and allow the acupuncturist to review how the different functions in the body are working and things like your pulse and your coloring, temperature, and texture at different parts of the body.


Since acupuncture is rooted in the Ancient Chinese principle of Chi, where optimal health is achieved through free-flowing chi, all treatment will be based around realigning a patient’s chi. A person’s Chi is believed to flow through 12 defined pathways (plus two main ones), or meridians, that are all connected to vital and specific organs within the body. There are about 365 acupuncture points along these meridian pathways where blocked chi or dysfnctinal chi can be targeted and brought back to balance through the insertion of needles.

During your treatment, depending on the medical issue, the appropriate points along your meridians will be activated with a sterilized needle. The needles come in different lengths and gauges, but the majority are hair thin and made of stainless steel. These needles stay in place for about 30 minutes, but timing can fluctuate depending on the patient’s needs.

Fear of Needles Addressed

It is not uncommon for patients with a fear of needles to be apprehensive about the treatment, but once the needles are in place, they are generally not felt at all. In fact, many patients often experience a calming effect from the treatment and are pleasently surprised by the ease and comfort of the procedure, overall.


Common Ailments Treated with Acupuncture

Acupuncture is often used for a wide-variety of ailments and conditions. From injuries, to cancer treatment side effects, to chronic pain, acupuncture is an alternative way to healing and/or recovery. Some conditions can be reversed within a single treatment, while others require more treatments.

Here are just a few of the areas that acupuncture can address:

  • Injury pain
    • Shoulder pain, tennis elbow, rotator cuff tendonitis, knee issues
  • Chronic pain
    • Lower back pain, neck pain, headaches, arthritis, sciatica
  • Neuropathy
  • Side effects to cancer treatments
  • Reproductive health issues
  • Autoimmune diseases
  • Digestive problems
    • Gas, bloating, pain
  • Mental health issues
    • Insomnia, stress, anxiety, depression

Whether your beliefs are camped in the visible and tangible facts of western medicine, or the metaphysical-physical combination of eastern medicine, or even if your beliefs lie somewhere in the middle, the thousands of years of practice and results achieved through acupuncture cannot be denied.

If you are unsure if acupuncture is the right course of action for your medical needs, give our physicians here at Southwest Integrative Medicine a call to schedule a consultation.

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If you are interested in learning more about the complex and deeply rooted history of Acupuncture, download our free eBook, today!

Tags: acupuncture phoenix, Acupuncture

MTHFR and How Nutrigenomics Can Help

Posted by Dr. Robin Terranella on Mon, Sep 14, 2015 @ 08:09 AM

Every person is different and this is a product of nature (your DNA) and nurture (your environment). What's new and interesting about the DNA peice is both the availbility of testing your DNA and the ability to optimize how bodies function based on the DNA. This is especially true with the MTHFR mutation and other mutations like this. You may think that everyone makes biochemical molecules exatly the same but that is not true. The template is the same, but each person has slight alterations in the template (the DNA) creating differences in how biochemical molecules are produced and destroyed. These differences are partially what makes us unique. However, some of these alterations can also predispose people to certain health issues and MTHFR  and food allergies are common examples of these.

Recently, we here at Southwest Integrative Medicine explained the MTHFR variation in a case study on nutrigenomics (nutrition on genetics) and MTHFR . The idea behind Nutrigenomics is that specific vitamins, nutrients, and diet alterations can be used to improve a person’s health when looking from the persective of alterations in their genetic makeup.

Due to the holistic and individualized nature of Nutrigenomics, it has become a very popular alternative to traditional Western medicine for individuals with many different health conditions like mental health, fibromyalgia, headaches, and autoimmune diseases. When done properly, treatment for a mutation of the gene Methyltetrahydrofolate Reductase, or MTHFR (for readability sake), can help mitigate autoimmune disorders.

Today, we will be going over just how Nutrigenomics can help people afflicted by an MTHFR gene mutation. Before we do, let’s first take a closer look at DNA.


What is DNA?

When diving into the complexities of MTHFR, understanding what DNA is helps paint a better picture of how the genetic alterations occur across our population. Deoxyribonucleic Acid, or DNA, is made up of base pairs, like, guanine, cytosine, adenine thymine. The "double helix" of DNA is created by these base pair bonding together. Different combinations and sequences of these base pairs create the genetic code that tells our body which protein(s) to make and how to make them. When a change occurs in a base pair sequences from the normal, you get a different protein. That one change can cause a slightly different protein or a majorly different protein. It all depends on the spatial configuration of the molecule, but in any case, the change in base pairs will change the shape of the protein.


What is MTHFR?

A big part of the "altered proteins" we are referring to are enzymes. Not really the enzymes in the digestive tract, per say, but the enzymes that help the body create and destroy different molecules inside the body. MTHFR is an enzyme produced by the MTHFR genes, and is part of a bigger process called methylation. In basic terms, the process of methylation changes the activity level of a variety of different molecules. Mythylation is critical for things like neurotransmitter production, cell membrane integrity, detoxifcation, energy efficiency and utilization, artery responsiveness.

Alterations in the MTHFR enzyme interrupt the methylation cycle because it is a critical enzyme for methylation. The severity of the enzyme change will determine how slowed the methylation process is. There are two main MTHFR genes, that when altered, impact the enzymes function. However, there are several other enzymes in the process of methylation that can also effect the overall cycle as well.

MTHFR and Nutrigenomics

Types of MTHFR Mutation

Two genes have the predominant effect on the MTHFR enzyme, and they are the C677T gene and the 1298C gene. The purpose of distinguishing these two mutations is so that doctors are better able to see the severity of the MTHFR mutation. The C677T mutation is the biggest influencer on the overall effects on the MTHFR gene.
  • Homozygous: This gene is passed down from both of the parents of the afflicted individual leaving them with two altered copies.

  • Heterozygous:  MTHFR mutation is passed from just one of the parents.

  • Compound Heterozygous: One mutation is passed from one parent, and the other respective parent passes the other.In this case the affliced individual has one copy of each of the above stated MTHFR genes.

Symptoms of an MTHFR Defect

Due to the fact that an MTHFR defect causes abnormalities in normal processes of the human body, there are a wide variety of symptoms or side effects that can be triggered by it. For example, an MTHFR defect often causes high levels of homocysteine, which is associated with the following;

  • Cardiovascular disease

  • High blood pressure

  • Glaucoma

There is also strong evidence linking it to mental health disorders, migraines, Fibromyalgia, Chronic Fatigue, and many other health issues due to a slow down in methylation.


How Nutrigenomics Works

Nutrigenomics looks at how the actual bioactive components in food can help or hurt your health based on the specific genes in an individual. Optimizing the gene nutrition interaction can make a dramatic impact in how a person’s body goes through metabolic and physiological processes.

Simple Nutrigenomics Steps For MTHFR Gene Mutation

Since Nutrigenomics works on an individual’s health with a mixture of their genetics and nutrition, here are some tips for minimizing the issues associated with an MTHFR mutation:

  1. Avoid Folic Acid

When you have an MTHFR defect, folic acid is one such vitamin that your body cannot process. In addition, when you consume folic acid it binds up all the active-folate carrier proteins and making the amount of usable active-folate reserves even worse.  Many grains are fortified with folic acid so these should be avoided.

  1. Invest in a Healthy Gut

The very nature of an MTHFR gene mutation is that your body is unable to process and eliminate a lot of everyday toxins within the body. Therefore, aiding your digestive tract can lessen the effects of toxins caused by the MTHFR mutation. Try probiotic foods like homemade broths and yogurt or supplements like probiotics and avoid processed grains and refined sugars.

  1. Say No to Processed Foods

Especially being physicians that specialize in integrative medicine, we cannot express enough, the negative effects of processed foods. Dealing with an MTHFR mutation is no exception to this sentiment because it will have a negative impact on points one and two above.

  1. Eat Plenty of Greens

As physicians, we will always promote eating healthy greens, but for an individual with a gene mutation, eating uncooked dark leafy greens (DLG) give your body a source of active folate, plus all the other benefits that DLG have.

  1. Detox, Detox, Detox

The process of methylation is needed for detoxifcation of the body from numerous chemicals. This is happening whether you want it to or not. When methylation is impaired, the toxins build up or get eliminated through alternative pathways. By enhancing the natural detoxifcation pathways that you do have control of, you reduce the methylation burden on the body and improve how everything works. There are several methods for eliminating toxins that people with or without this gene mutation practice on a daily basis. Sitting in a sauna or steam room, drinking plenty of water, body scrubs, exercise, healthy bowel movements and colonics are ways to aid your body in the detoxification process.


An alarming 40% - 60% of the population is affected by a MTHFR Gene Mutation. By getting a genetic test to determine your genetic make-up, and adhering to some of the tips we’ve laid out, you can lessen the impact this mutation has on your everyday life and well being.

Many people will greatly benefit from working will a physician that specializes in MTHFR and similar genetic issues. To learn more about nutrigenomics and how an MTHFR might be effecting your health, contact our team at Southwest Integrative Medicine, today.


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Tags: MTHFR, nutrigenomics

Combatting Seasonal Allergies in Phoenix

Posted by Dr. Robin Terranella on Mon, Aug 31, 2015 @ 09:08 AM

Pollen allergies can be a hassle. No matter where you live, it seems like pollen can follow you almost anywhere. In order to understand how to combat pollen allergies here in Arizona, we must first understand how allergic reactions happen and what the body does to bring its systems back into balance after a reaction occurs.

What is an allergic reaction?

An allergic reaction occurs when the body attempts to fight off what it has detected as a foreign entity invading its systems. When something foreign comes in contact with your body, be it bacteria, virus, pollen, or dust particles, the body tries to isolate and eliminate the offending entity. To do this, your immune cells produce histamine, which then triggers a complex physiological process. The process is an inflammatory reaction that causes the following:

  • A dilation of the the capillaries (small blood vessels) in the offended area, allowing more white blood cells to aid in eliminating the foreign entity.
  • Increased fluid and swelling in the affected area.
  • Thus, signaling more white blood cells to the area, Eosinophiles in particular.

By using this response, the immune system can isolate and then destroy the foreign entity, or pathogens. Unfortunately, with allergies, your body reacts to a false alarm, because allergens are not actually pathogenic or harmful. So the immune system is combatting pollen and dust the same way it would a virus or bacteria. However, this process is only triggered when the immune system recognizes the allergen as a foreign invader. Many people encounter pollen particles every day and have no immune, histamine, or inflammatory reaction to them at all. This is because the immune system has not tagged the pollen with a "forgein invader sign" (an IgE immunoglobulin).

For those of us who do have the allergic reaction to pollen, it is important to note that most traditional allergy medicines don't treat the underlying hyperactive immune response, but rather the result of the hyperactive immune system. There are several types of Antihistamines, like Benadryl and Claratin, that perform the same function, which is to block or decrease the histamine activity when it is released from the immune cells (mast cells). Decongestants are another option for allergy medicing that decrease the mucus created by the mucus mebranes and also widen air passages.

While both of these traditional medication types are effective in treating symptoms, they do not address the underlying cause, which is a sensitivity to allergenic molecules. When you treat the underlying cause, the symptomatic treatments are less necessary, or sometimes not needed at all. It is important to know this because your body can become dependent on some allergy medications, decongestants, eye drops, or nasal sprays.

With an integrative approach you can treat both the cause and the symptoms.

Allergies in Phoenix

How pollen causes allergic reactions

When people think about a seasonal pollen allergy, they typically think of sneezing, watery eyes, a runny nose, and malaise. This happens because the nose, mouth, and throat (nasopharynx) acts as a filtration device for your lungs. When an allergen enters this area the hairs and muscus membranes act as a barrier to prevent entrance into the body. Increased muscus secretions occur when the immune system detects the foregin entities and white blood cells rush to the area. People with allergies are thus caught in the cycle of reactivity until the immune system no longer detects the allergens.

Pollen allergies in Phoenix

In the greater Phoenix area, the highest pollen counts during the spring and fall season are caused by trees and weeds. However, during the summertime, pollen counts are caused more by weeds, grasses, and dust storms. Those with pollen allergies will have a more abbreviated allergy seasonn in Phoenix. This means your symptoms will likely only be present during the peak Spring and possibly Fall seasons.

Here's a list of the most common pollens for weeds and trees in Phoenix (for a complete list, visit the pollen library):


  • Arizona Cypress

  • Arizona Walnut

  • Arizona White Oak

  • Box Elder, Ash-Leaf Maple

  • Narrow-Leaf Willow

  • Palo Verde
  • Single-Leaf Ash

  • Texas Mulberry

  • Velvet Ash

  • Western Poison-Ivy

  • White Mulberry


  • Ambrosia-Leaf Burr-Ragweed

  • Annual Ragweed

  • Black Mustard

  • Carruth's Sagebrush

  • Cattle-Spinach

  • Chinese Mustard

  • Dragon Wormwood

  • Five-Horn Smotherweed

  • Flat-Spine Burr-Ragweed

How to manage your seasonal allergies

To curb your allergy symptoms in Phoenix, or anywhere, histamine levels (the main culprit for seasonal allergy symptoms) need to be managed.

From a naturopathic perspective, there are two options for improving how your body manages histamine.

  1. Improve how your body breaks down histamine.
  2. Reduce the amount of histamine the body makes.

The best way to improve how your body breaks down histamine is to determine if there is a problem with your enzymes that are responsible for that breakdown. There are three main enzymes in your body that breakdown histamine, and people with seasonal allergies often have a defect with at least one of these enzymes, causing slugish histmine breakdown. In some cases, there is simply a deficiency in certain nutrients or vitamins that impair the bodies ability to break down histamine. Ergo, you can improve how those enzymes work by taking the supplemental vitamins you are lacking. 

Of course, before any of this can be done, you must first determine what your body is reacting to, and this can be done by having your doctor do a blood allergy panel. This will be particularly useful if you plan to take allergy shots that desensitize the immune system to offending allergens.

However, we here at Southwest Integrative Medicine believe that the control you are seeking for your allergies can be achieved without relying on allergy medicines. Contact us today to learn more.


If you do suffer from pollen allergies here in the Phoenix area, see the upcoming pollen forecast at the following link.  


Free E-book: The Role of Oral,  Injectable, and Intravenous Vitamins

Tags: allergy treatment

Avoid these gluten-free diet mistakes

Posted by Dr. Robin Terranella on Mon, Aug 17, 2015 @ 08:08 AM

Some people choose to eat a diet that does not include gluten out of personal preference, while others choose to for dietary reasons. Regardless of why a person is living a gluten-free lifestyle, it’s important to be aware of the ingredients within the foods we eat, beyond just the gluten-free label. As integrative medicine doctors, we often encounter patients who are avoiding gluten, but make the following gluten-free mistakes.

Here are the three main mistakes that we here at Southwest Integrative Medicine want to help you avoid:

Gluten-free1. Just because it is gluten-free does, not make it healthy for you.

As the popularity of a gluten-free lifestyle increases, many food production companies have stepped in to provide their take on gluten-free products. You can hardly walk down a grocery store aisle without seeing an item labeled as being gluten-free. For those suffering from a gluten allergy or those simply choosing to omit it, it may be tempting to supplement the normal gluten-free staples with new items you may have previously thought you would be destined to live without. Sweets and speciality breads are just the tip of the iceberg on items that can be gluten-free, but still not particularly healthy for you.

Aside from foods that are notoriously unhealthy, the reality is that even some relatively healthy foods may be tampered with in order to make them gluten-free. These changes are not always for the best. Gluten alternatives can often double the amount of carbohydrates that are typically found in similar, gluten-laden products. An unhealthy amount of added sugars may also be included in gluten-free products.

2. Sometimes gluten-free products include additives that are not healthy.

These additives are the same as the ones we discussed above, which bring about excess carbohydrates and increased sugar to gluten-free products. What is worse are the inflammatory issues which people attempt to leave behind by eating gluten-free, that may still be caused by the additives.

These unhealthy additives include rice flour, potato flour, cornstarch, and tapioca starch. When people begin to eat these seemingly healthy gluten-free items, it can come as a shock to them that they are not actually receiving the health benefits they are seeking. Instead, many people who are on an ill-managed, gluten-free diet can  not only notice a stop in weight loss, but in some cases, even weight gain.

As we said, these items, specifically corn, oats, and rice, are known for causing inflammatory issues, much like gluten. However, the reality is that all of these health issues can be avoided simply by reading the label and being aware of the ingredients involved in making the product gluten-free.

3. Some products are labeled gluten-free as a marketing ploy.

What is gluten anyways? Gluten is the protein inside grains like wheat, rye, spelt, and barley. If a product does not typically contain one of these items, then it is naturally gluten-free. Just as food companies have attached themselves to the gluten craze by creating a host of unhealthy foods to satisfy people’s palates, they have done the same by labeling items that are already without gluten as gluten-free. While this is not something which will affect your diet, this is something we would like our readers to be attentive about.

Don’t spend extra money on a product labeled “gluten-free” when the same, unlabelled item is equally as free of gluten and costs 25% less. Take the time to understand which items are naturally gluten-free and save yourself money on groceries.


At the end of the day, we advise you to take the extra time to read the label of the product you are about to purchase. It can save you not just money, but also excess calories, and harmful additives.

We at Southwest Integrative hope that you are able to proceed with your gluten-free lifestyle, enlightened by this information. Should you need any further integrative medicine treatments, feel free to contact us by clicking the button below.

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Tags: Gluten-Free

What is the best type if exercise for weight loss?

Posted by Dr. Robin Terranella on Mon, Jul 20, 2015 @ 05:07 AM

If you’ve been grinding away on a cardio exercise program and/or starving yourself in an effort to lose weight, we have good news: there is a better way. One that’s not only more effective but more pleasant.

Lengthy sessions panting and sweating on the elliptical or treadmill certainly boost your heart rate and burn calories. In the short term it will help you reduce your weight. And although ingesting fewer calories than you burn will surely lead to weight loss, you could also be cutting back on nutrients essential to maintain the health of all areas of your body, including bones and muscles. Over the long term, too much of this type of exercise can lead to joint or muscle problems, injuries and fatigue. In addition the initial weight you loose will start to slow down.

The truth is, the best type of exercise for long term weight loss is strength building, also called resistance training.



Resistance training is the act of a weight resisting the force of your muscle against gravity. Take a bicep curl, for instance. The bicep muscle contracts and pulls the weight against the force of gravity pulling it down. The act of pushing or pulling against the weight actually creates micro tears in the muscle which is partially responsible for the soreness with a workout. With these tears the body repairs and rebuilds the damaged muscle and builds it stronger to respond to the training. The heavier the weight or resistance the more muscle building that develops. So resistance training then is training your body to handle more and more resistance.  As your muscle are able to lift more the muscle grow and develop. This is good because muscle is more metabolically active than fat thus increasing your metabolism. Additionally when your muscles are sore the repair process burns more calories as it is and added calorie expenditure. This is called "after-burn" and in this way you are burning fat while building muscle.


Starting in our 30's adults naturally lose around 3% to 5% of muscle mass annually depending on your activity level. That muscle is usually replace with fat but not always. The loss of muscle along with the replacement with fat and decreased muscle strength is referred to as age related sarcopenia. While sarcopenia is not destined to occur in every person, with age some muscle loss will occur regardless of what you do. So what can you do if anything to prevent muscle strength, mass, and function decline? How is this process related to weight loss and overall health?

Resistance training or weight lifting can actually prevent or even reverse the process of sarcopenia. The thing is you have to be lifting enough weight so that it actually matters to your muscles. That means the weight lifting should cause your muscle to be sore afterwards and it should burn during. Most people make the mistake of doing the same exercise with the same weight month after month and year after year. While this is not bad, you are doing less good and it won't make much of an impact to prevent the sarcopenia with age. 

With regard to weight loss, when the muscle gets replaced with fat your metabolically changing inside and initially the scale actually won;t change much. Over time, however, that metabolically less active tissue will require less calories.  If there is not a corresponding decline in caloric intake, you will gain weight. This is at least one reason many people struggle to loose weight when they get in their 40's and 50's. By the time it becomes a noticeable problem, there has already been so much changes that have occurred in the body, it is difficult to turn around. If this is you, consider hitting the weights or getting a trainer to get those muscle sore. Just be sure you know what you are doing so you don't get injured.

Aside from strengthening muscles, improving metabolism, and weight loss, resistance training also strengthens joints and ligaments. For those at risk for falling and bone fractures, it improves your balance, coordination and flexibility. Post-menopausal women with declining bone density, can combat these declines, thereby reducing risk of fractures. In terms of cardiovascular function it improves HDL cholesterol, reduces triglycerides, and improves how blood sugar is processed.

The combination of eating fewer calories, using strength training to boost metabolism and keeping your hormones in balance causes your body to burn stored body fat. You will lose weight, and you will be in better physical condition overall.


You can head to the fitness center to work out or lift weights in the privacy of your own home. But you don’t even need fancy equipment or a gym membership to engage in highly effective strength training. You just need to put some extra effort into finding the resistance to use. Think about it in terms of the different major muscle groups:

  • Chest – The main movement of this musce group is pushing. Push-ups can easily be done at home and on the road. There are different angles you can place your hands to work different aspects of the chest
  • Back – The main movement of this muscle group is pulling. Remember you have to pull against gravity. You could use a water jug pulled to your chest as you are bent over. A pull up bar would also be useful.
  • Legs – The main movement of the legs it to extend the body from a full squated or semi-squated position and push the body up. This occurs when we get up from a chair, walk, or run. To strengthen the legs you can start with standing from a seated position multiple times in a row. As it gets easier you have to do more or change the angles of the squat to make it harder.

Exercise bands are also very useful in the home setting and you can use YouTube to learn new exercises and proper form. There are plenty of free initial workout videos from well qualified trainers.

These are movements you could easily do or incorporate in the course of normal everyday activity. The key is to have enough resistance where your muscles actually respond. The key here is, if you are not getting sore, the muscles will not respond.  Regardless of the program or capacity in which you decide to incorporate resistance training, bear in mind your muscles require rest in between periods of exercise. There are different programs but a general approach is to schedule your resistance training every other day – or 3 days a week.

Here at Southwest Integrative Medicine, we take a holistic approach to all aspects of wellness, including weight loss. If you have additional questions about what type of exercise is best for you, or you want to start a personally tailored weight loss regimen, we are here to help.

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Tags: weight loss phoenix

Why Can't I Sleep?

Posted by Dr. Christy Cline on Mon, Jul 06, 2015 @ 05:07 AM

Don’t you just hate it when you can’t sleep? Whether it takes forever to fall asleep or you keep waking up during the night, you are simply not “with it” the following day.  The severity of sleep issue vary from occasional poor sleep due to stress to a full on sleep disorder like insomnia. Even when it is an occasional issue, poor sleep can effect you even if you lose just an hour of sleep for one night. For chronic sleep issues, the cumulative effects will be more significant. The result of poor sleep can vary from the most obvious symptoms like fatigue and poor concentration to less obvious like anxiety, panic, migraines, and high blood pressure.  Identifying the cause(s) is the first step to correcting your sleep problems. We will discuss some of the more common one's here.


Hormonal Imbalances

Hormones regulate numerous aspects of your body’s ability to function. When they fluctuate or are consistently out of balance, you can have trouble falling asleep or staying asleep. For instance, low progesterone or high estrogen can cause insomnia and irritability. Low estrogen can also cause sleep disturbance since it can cause hot flashes and night sweats.

In turn, lack of sleep can affect your body’s normal production of hormones.  So in some cases you’re caught in a never-ending cycle of sleeplessness. Other sleep-affecting hormonal imbalances are low testosterone, high cortisol, and low melatonin.  Having a trained eye evaluate your hormone levels is a great place to start for improving your sleep.


We all function according to our own internal rhythm and daily patterns also know as circadian rhythm.  This is created by your daily activities and influenced by the environment around you. This internal clock is partially responsible for you being a morning person (lark) or a night person (owl). Another perhaps bigger influence is your genetic make-up. Since we are genetically unique how well we sleep, how much we sleep, and when we sleep can be influenced by how we create and breakdown neurochemicals that influence sleep. It's hard to say how much sleep you need specifically but when lack of sleep influences your ability to function at your best, there is an issue. Typically sleep patterns range from 6 to 9 hours nightly – with optimal being around the 8 hour mark.

Genetics influence all kinds of things that can effect your sleep. For instance, it can affect your body’s production of melatonin, the hormone that tells your body when it’s time to get ready for sleep. In general, darkness induces melatonin production and light stops production, which is why we get sleepy at night. In some cases, when you can't sleep it is because you are not making melatonin.  Another genetic example is an excess of excitatory neurotransmitters like norepinephrine. This neurotransmitter makes you excited but can also can prevent you from sleeping when there is too much around. Through understanding how your genetics influence your neurotransmitters we can support the imbalances with nutrition.

Side Effects From Medications and Recreational Drugs

The things you ingest can affect your ability to fall asleep and what stages of sleep you are able to enter. For instance, many types of medications (and recreational drugs) can cause insomnia. In some cases it is the medication itself and in other cases it is the body's response to the medication or drug.  Alcohol and many classes of Benzodiezepines cause a rebound insomnia, occurring anywhere from 3-6 hours to 24-72 hours after cessation of their consumption. They usually help you fall asleep but the sleep quality is poor as reflected by only entering the superficial stages of sleep.  Stimulants like nicotine and caffeine can all have detrimental effects on your sleep pattern since they counteract the effects of sedative sleep hormones and neurotransmitters like melatonin and serotonin.

Obviously when you can't sleep emotional and psychological factors only make things worse. Worrying about impending activities or deadlines and conflict at home or at work are common examples. Your body and mind require a “winding down” period in order to transition successfully to sleep mode. So what can you do to help get in a "sleep mode?"

Getting In A Sleep Mode

Practice good “sleep hygiene” to create the best possible environment for you melatonin to be stimulated. Following these practices will help you fall asleep faster, get in a deeper stage of sleep, and stay asleep:

  • Try creating a pre-sleep routine that enables you to unwind. Reading, meditating and taking a warm bath are all good ideas.
  • Don’t nap during the day.
  • Don’t eat a heavy meal shortly before bedtime.
  • Eat a small protein source -- it contains L-tryptophan, which helps induce sleep. It also helps keep your blood sugar balanced.
  • Don’t exercise vigorously shortly before bedtime. Do try relaxation exercises or yoga.
  • Don’t use your bed for non-sleeping activities like watching TV.
  • Get plenty of exposure to natural light during the daytime.
  • Maintain consistent times for going to bed and getting up.   
  • Make sure your bed is comfortable and your bedroom is relaxing, dark and a sleep-appropriate temperature.
  • Turn the lights down and all electronics off, 30 minutes before bedtime.

Talk to Your Doctor

If you can’t sleep, it’s important to find out why so you can take corrective action. A holistic approach facilitates both diagnosis and planning a treatment regimen individually-tailored for your personal situation. Wouldn’t you rather fall asleep easily and wake up refreshed?

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Tags: Sleep