This song came on today while I was driving home from a Plano hospital after making rounds. May it add peace to your life today as it has mine.

 

Instrument of Peace – Olivia Newton John – Lyrics

Where there is hatred, let me bring love.
Where there is doubt, let me bring faith.
Where there is falsehood, let me bring truth.
Where there is pain, I’ll comfort you.

Where there is silence, let me sing praise.
Where there’s despair, let me bring hope.
Where there is blindness, let me bring sight.
Where there is darkness, let me bring light.

And with these words I speak
Grant that I may not so seek,
To be heard but to hear
To be consoled but to console,
Not to be seen, but to see
To be loved but to love.

For when we give love we will receive.
When we forgive love, we’ll find reprieve.
It is in dying we’ll be released.
Make me an instrument of peace.

We live in an environment surrounded by pollen, pet dander, viruses and bacteria that have the potential to make us sick or sneezy. Our immune system chugs along, day in and day out, sorting through these exposures and fighting back when a potential threat to our health occurs. But is it me, or do we only notice our immune system when it lapses? We get a head cold or cough and then start in on the healthy routine to come back into balance.

Let’s do this: let’s acknowledge the importance of our immune system in a series of lifestyle strategies that are especially important now that the winter colds and flu season has arrived.

Six steps to getting stronger

Here’s a checklist to help keep your immune system strong every season of the year:

1. Nutrition is key. Avoid white sugar and sweets. Grab a piece of fruit or a handful of raisins instead of cookies, cake or pie. Watch out for oil that has gone rancid (use your nose) and check expiration dates carefully on packaged and canned goods. If your body is exposed to a lot of inflammatory foods like these, your immune system is “distracted” in its efforts to protect you.

2. Get moving. Walk 30 to 45 minutes at least three times a week. If walking hurts, try a recumbent bike or water-based therapy. Your body systems all work better when you are active – this includes your immune system!

3. Examine your exposures. Look carefully at your exposures to heavy metals like mercury (silver dental fillings or farm-raised salmon) or pesticides or other potential environmental toxins. See the Environmental Working Group’s “Dirty Dozen and Clean 15” (ewg.org/foodnews/) to get an idea which foods from commercial growers can be safely consumed, and which fruits and vegetables should only be bought from organic growers.

Ask your dentist if any of your mercury amalgam fillings are old and cracked and make sure the dentist knows how to replace them safely so you aren’t exposed to mercury when they are replaced. Chemicals like these interfere with your liver’s ability to detoxify – which hampers your immune system’s ability to do its job.

4. Get your balance. Check with your integrative medicine practitioner and make sure you are on a good balance of antioxidants, essential fatty acids, electrolytes and magnesium. Be aware that everyone’s nutritional needs are unique. If you aren’t getting adequate micronutrients like these from your diet, adding nutritional supplements can be helpful. Ask your practitioner to assess and monitor how much you need.

5. Control your stress. We know that our immune system is closely tied to our hypothalamic-pituitary-adrenal axis, which allows us to respond to both short- and long-term stress. We also know that the strategies here can’t take all of our stress away, but we can certainly learn to cope so that we can become more resilient and less reactive to life’s stressors.

6. Sleep well. Turn off the computer monitor or the TV and start a relaxation practice. It could be breath work or prayer or meditation… figure out how to “unwind” so that your sleep is deep and restful. If there is a question of sleep apnea, consider getting a sleep study and assessing the quality and quantity of sleep.

We know that a lot of our body’s restorative and detoxifying systems kick into gear while we are asleep. Rather than medicating with a prescription drug, explore emotional, mental, physical and spiritual aspects of your health to see if you and your practitioner can understand why you’re not sleeping well.

The winter cold and flu season isn’t a problem for people who follow the guidelines here. Remember our immune system and allow it to function optimally. That is nothing to sneeze at!

Initially published in TriVita Newsletter

Reference:
Textbook of Functional Medicine 2010, Institute for Functional Medicine, Ed. David S. Jones

“Patience is necessary, and one cannot reap immediately where one has sown.” – Soren Kierkegaard

I am delighted to announce that my contract to practice at the Baylor Integrative Medicine Center is now official and signed. I am so grateful to all my wonderful friends at Living Well Dallas who allowed me to continue to work intermittently while we were “crossing t’s and dotting i’s”.

I will be scheduled one day a week at the Virginia Cvetko Education Center at the Baylor University Medical Center. The center is located on the third floor of the Sammons Cancer Center, 3410 Worth Street, Dallas, TX 75246. To schedule an appointment, please call Polly at 214-820-3595.

Be Well,

Claudia Harsh, MD

I have made a move this month out of my full-time integrative practice back into a more traditional medicine job. I am excited to be working with the gynecology oncologists at Texas Oncology at Baylor University Medical Center Baylorin a supportive role. I will be seeing their clients who are being monitored for pre-invasive diseases of the uterus, cervix, vagina and vulva and working with them in the clinic setting. In addition, they have asked me to help set up a “survivorship” program to help cancer patients who have completed their therapies to regain their emotional, mental, physical and spiritual health. The best part of this is that we have NO IDEA what this will look like. One on one patient visits? Group visits? Web-based materials? Develop hand-outs? Just thinking about the possibilities makes me smile.

I also plan to work in the Cvetko integrative medicine center at Baylor one day a week so I can keep my acupuncture skills and continue to care for my integrative medicine clients. This part of the job is still in process. Once it is confirmed, I’ll post a note. In the meantime, the lovely team at Living Well Dallas has agreed to let me schedule over the next few months while all the arrangements are being finalized.

Blessings to you and yours during this season of growth and change!

Claudia Harsh, MD

I add this post written by Lissa Rankin, MD…because she writes well and with passion about health and wellness. 

As a doctor, I always thought that, to be healthy, you simply had to eat well, exercise, get enough sleep, take your vitamins, and follow doctor’s orders. But after twelve years of education and ten years of medical practice, I took a job at an integrative medicine practice in Marin County near San Francisco, where most of my patients were “health nuts” doing everything right- but some of them were sicker than ever. I was baffled. I mean, these folks drank their daily green juice, ate a vegan diet, worked out with personal trainers, slept eight hours a night, took their vitamins, and saw the best doctors.

Compare this to when I worked in a clinic where many of my patients were from the inner city of Chicago. I understood why they were sick. They ate poorly, rarely exercised, smoked, drank, didn’t listen to the doctor, and got sick. That made sense to me.

But the patients in Marin didn’t. From everything I had learned in medical school, these people should have been in perfect health. But many of my patients felt tired, they weren’t sleeping well, their libido went down the tubes, their bodies ached, they gained weight, they suffered from a host of chronic medical conditions- they lost their mojo really.

So, I tried to help my patients by running batteries of tests – some of them common, some of them specialized. And, yes, sometimes I’d pick up something surprising that, would rid my patient of all his or her symptoms. But mostly, I’d find nothing earth-shattering and wind up shrugging my shoulders. It was clear that there was still a big, missing piece of the health puzzle missing. I just couldn’t figure out what it was.

So I changed my patient intake form. I started asking them things like:

  • Is anything keeping you from being the most authentic, vital you?
  • Are you in a romantic relationship? If so, are you happy? If not, do you wish you were?
  • Are you fulfilled at work? Do you feel like you’re in touch with your life purpose?
  • Do you express yourself creatively?
  • Do you feel financially healthy or is money a stressor in your life?
  • What rules do you follow that you would wish you could break?

And the two big doozies:

• What might lie at the root cause of your health condition?
• What does your body need in order to heal?

When I asked my patients what their bodies needed in order to heal, they said things like:
• I need to leave my toxic relationship
• I need to quit my job
• I need to forgive my father
• I need to finally write my novel

The patients who had the courage to follow their own “Prescriptions” started experiencing radical improvements in their health. It was as if by healing their emotional landscapes, their bodies followed! I was hooked. My new book Mind Over Medicine is the result of the exploration that followed into what really makes us healthy and what really predisposes us to illness.

What does YOUR body need in order to heal?

Cancer can be a scary topic, but one type – cervical cancer – represents a real clinical success story. Over the millennia, we’ve graduated to a fuller understanding of how the immune system figures in this disease, which was once the second most common cancer in women.

The cervix is the bottom part of the uterus – and we’ve known about cervical cancer since Hippocrates first described it in 400 B.C. We’ve also known that this type of cancer has been associated with sexual contact since 1842, when a physician in Italy described a difference in cervical cancer incidence between abstinent nuns and other women. (This was before we knew even what caused the sexual infection.)

Thanks to the development of the Pap smear (for Papanicolaou), the 1950s and 1960s showed a decrease in the incidence of cervical cancer. We still didn’t know what caused the sexually- transmitted infection, but we could screen for pre-cancer stages and treat it before it became cancer. Thanks to this strategy, by 1994 the incidence was down to 8 cervical cancer cases per 100,000 women in the U.S.

And now another huge breakthrough is the identification of HPV (human papilloma virus) types as the major cause of cervical cancer. The viral types were first isolated in the 1980s; we can now screen for HPV types which are responsible for both cervical cancer (called high risk HPV types) and genital warts (called low risk HPV types). Most people with healthy immune systems can fight off the virus within two years. But when the immune system is already compromised, the body has limited ability to fight off infection, and cancer may develop. A lifetime use of condoms will decrease the risk of cervical HPV infection by 70 to 80% but will not affect the risk to infection elsewhere on the body.

Although we know a lot about the life cycle of the HPV virus, we are still isolating more and more types of the virus and understanding where it chooses to infect both men and women. Three vaccines are also available. One is a “bivalent” vaccine that protects against the two most common high risk HPV types. One is a “quadrivalent” vaccine that protects against the two most common high risk HPV types and also protects against two HPV types that are responsible for 90% of external genital warts. A newer vaccine targets nine different HPV types – hoping to expand the effectiveness of the vaccine. The key to success with these vaccines is to administer the doses before sexual activity begins, which is one reason it is recommended for girls and boys ages nine to 26.

In addition, to keep the immune system strong on a daily basis, it’s smart to live a healthy lifestyle, including good nutrition, regular exercise, good sleep patterns and taking nutritional supplements if needed.

 

-end-

The Abstract from Michelle D. Holmes and Wendy Y Chen’s recent review article just published in Breast Cancer Research is eye-catching….here it is verbatim:

Many medications have been developed for one purpose but then are found to have other clinical activities. There is tremendous interest in whether non-cancer medications may potentially have effects on breast cancer survival. In this review article, we have presented and evaluated the evidence for several commonly used over-the-counter and prescription medications – including aspirin (and other non-steroidal anti-inflammatory drugs), beta-blockers, angiotensin-converting enzyme inhibitors, statins, digoxin, and metformin – that have been evaluated among breast cancer survivors in prospective studies. Substantial scientific evidence supports the hypothesis that some of these common and relatively safe drugs may reduce breast cancer mortality among those with the disease by an amount that rivals the mortality reduction gained by currently used therapies. In particular, the evidence is strongest for aspirin (approximately 50% reduction), statins (approximately 25% reduction), and metformin (approximately 50% reduction). As these drugs are generic and inexpensive, there is little incentive for the pharmaceutical industry to fund the randomized trials that would show their effectiveness definitively. We advocate that confirmation of these findings in randomized trials be considered a high research priority, as the potential impact on human lives saved could be immense.

Breast Cancer Research 2012, 14:216 doi:10.1186/bcr3336

You know what I’m going to say here…the answer to reducing breast cancer may NOT be adding a pharmaceutical drug. Where is the control group that removed xenoestrogens and pesticides from their environment? Where is the control group that increased their consumption of cruciferous vegetables or supplemented their nutrition to modify their estrogen metabolism? I could go on…

But you know I am going to watch this data carefully …

From the Functional Medicine Forum – this little tidbit about a high dose of Vitamin D prior to the menstrual cycle. BE AWARE: Vitamin D is fat soluble – if your levels are above 45, you should NOT do this!

Vitamin D levels are frequently found to be low among the patient population and such insufficiency is related to myriad health conditions. Thus, repletion of D levels is often a goal of functional medicine treatment strategies. Now a new study shows that even in women not conventionally considered to be vitamin D deficient, a one-time megadose of vitamin D can ease menstrual pain for two months and perhaps beyond.

An Italian study published this week in the Archives of Internal Medicine details a small randomized, placebo-controlled trial of ultra-high dose vitamin D for women with a history of severe menstrual cramps. Twenty women aged 18-40 took a one-time dose of 300,000 IU of vitamin D (cholecalciferol) five days before their next expected period while twenty others received placebo. After two months, patin scores decreased 41% among the treatment group, while there was no significant change in pain scores among the placebo group.

Specifically, fifteen of the women in the treatment group experienced a reduction in self-reported pain scores of at least two points on a standard visual analog 10-point pain scale when compared to their previous four menstrual cycles. The greatest reduction in pain was seen among women who had the highest baseline pain scores. Just four of the placebo group showed any improvement compared to their baseline cycles.

Further, none of the women in the treatment group reported needing to use NSAID pain relievers to treat their menstrual pain while eight in the placebo group reported using NSAIDs.

The women were tested for vitamin D levels before the study and only women with plasma levels below 45ng/ml were allowed to take part. Study participants also could not be taking vitamin D, calcium, or oral contraceptives. They were allowed free used of NSAIDs during the trial but were asked to report their use of such medication.

Menstrual pain is thought to be dependent on uterine prostaglandins, which are synthesized from pro-inflammatory omega-6 fatty acids. The authors propose that vitamin D may act as an anti-inflammatory agent in multiple ways, including regulating expression of the genes involved in prostaglandin signalling.

Though the researchers excluded patients with high vitamin D levels, the cutoff of 45 ng/ml is well above the limit for frank deficiency. Thus, it is plausible that a mechanism beyond simple repletion of D levels is responsible for the analgesic effect. There will certainly be more to come from this line of research investigating vitamin D for pain relief.

http://archinte.ama-assn.org/cgi/content/extract/172/4/366

Are you confused about supplements? Most of my clients are! Their “vitamin habits” run the gamut from never or rarely taking vitamins to taking upwards of 20 or 30 vitamins and supplements a day.

More than half of adults in the U.S. take supplements, and spend about $23 billion on them, according to a recent National Institutes of Health report. Most expect that they will feel better and have less chronic disease because of the supplements. But here’s the kicker: Most of us in the healing professions have had little or no training in nutritional supplementation! Unless we’ve enrolled in fellowships or had additional training, we don’t know how to guide clients in this area.

A lot of those vitamins and supplements are running through the gut and kidneys and aren’t even absorbed. (I don’t mean to trivialize this, but it does give new meaning to the phrase “money down the drain.”)

By definition, a vitamin is a compound in food that results in a deficiency disease if it is removed from the diet. The term “vitamine” was coined in 1912 by a Polish biochemist, Casimir Funk. It comes from the Latin word “vita” meaning life combined with “amine,” because the substance that Funk isolated from the husks of rice, called thiamine, was a chemical derivative called an amine. Funk proved that beri-beri (a weakening disease leading to paralysis and confusion) was caused by inadequate thiamine in the diet.

In the U.S., large-scale fortification of the food supply started in 1924, when iodine was added to salt to prevent goiter (a swelling of the thyroid gland.) In 1933, vitamin D was added to milk to prevent rickets (a disease of soft bones); 1941 saw flour fortified with thiamine, riboflavin, niacin and iron in response to nutritional deficiencies seen in World War II military recruits.

It is rare to see obvious deficiency diseases in America, but it is not rare to see poor nutrition or under-nourished people. We now know that vitamins affect all aspects of our health.

Most vitamins are isolated from plants; in fact there is a lot of data to support the many benefits of a diet that is high in vegetables and fruits. But it is apparent that commercially-grown vegetables have been bred to look nice in the store with a long shelf life. Nutritional concerns are often secondary. It’s clear to me we just can’t get everything we need from food alone. We are gradually figuring out the individual genetic “fingerprint” and now know, for example, that 30% of us don’t have the ability to break down folic acid to its active form. This genetic “glitch” can lead to neural tube defects, Downs’ syndrome, arthritis and more. Adding extra folic acid or supplementing with the active form of folic acid overcomes this genetic problem.

So until we have inexpensive technology to show us our individual genetic “blueprint”, then two questions remain: What nutritional supplements should I take? And where should I buy them?

My usual recommendations include a minimum of these six vitamins or supplements: a high quality Omega-3 fish oil, a multivitamin and mineral complex, a broad spectrum B vitamin, additional Vitamin D, additional iron (menstruating and pregnant women only), and a broad spectrum antioxidant. I add in other supplements based on clients’ specific needs.

I recommend high quality vitamins and supplements from a reputable company. I look for companies that can offer information on product quality (batch testing of each lot of supplement along with testing for contaminants) and are formulated to be absorbed into the bloodstream and body. Otherwise, your money might be going down that drain.

But the very first step to optimal health is good nutrition and a healthy digestive system! Check with your healthcare provider and/or a nutrition specialist, and get on the right track.

I am writing a couple of articles for a nutraceutical company and it’s giving me a chance to pause and reflect on my top recommendations for optimal health and well being. With more than twenty years of medical practice experience, I’ve come to honor the ability of our bodies to come into balance and heal. On the other hand, I see that there are several individual choices we can make to encourage this healing and balance. Here are the top ten recommendations – in reverse order of course!
10) Pay attention to the cycles of nature around you. When the earth is resting in the wintertime, slow down! Dormancy and rest are important times in our lives. These can be distilled down to a monthly conscious awareness of the moon cycle. During the new moon each month, pause and reflect on what you want to grow in your life as the moon waxes to full. During the full moon, consciously pause to acknowledge your accomplishments – we are quick to remember “negatives” in our lives and oh so slow to connect with the positives. For guidance in this process, I recommend studying with Lisa Michaels and the Natural Rhythms Institute. I joined nine Natural Rhythms experts to collaborate on our book “Nature’s Success System” which was published through Hay House last year.
9) Assess the relationships in your life. Do they continue to serve you? Do the friends and family you interact with offer unconditional love and support? Do you offer unconditional love and support to your friends and family? We all know people that “drain” us – recognize who and what circumstances make this worse. Find a mental health professional and explore the reasons why you stay in relationships that are unhealthy.
8 ) Become conscious of your physical health along with your core strength and posture. Move your body every day: walk, run, bike, swim – whatever! Abdominal exercises and pilates can help; yoga, tai chi or chi gong can help you become more conscious of how you hold your body as you stand, sit and exercise. I have gained an appreciation for chiropractors, massage therapists and other body workers through the years. They “repair” the damage that poor posture and overuse and inflammation have caused.
7) Ask your doctor to measure your 25-OH vitamin D3 level. Supplement as needed to the 50 – 80 range. For some people the best dose is 400 IU daily, for some it is 5000 IU. Some people need 50,000 IU weekly for three months to build up their stores and then 1000 to 2000 IU daily. I disagree with “one dose fits all” and suggest that following vitamin D levels is the ideal way to know how much of this important vitamin to take.
6) Add a high quality fish oil to your diet or eat ocean-caught fatty fish (tuna/salmon/mackerel etc) three times a week. Most people benefit for 2000 mg of EPA and DHA daily. Ask for advice from your integrative physician about whether or not you need a higher dose or an adjusted ratio of the two fats if you have an autoimmune or inflammatory disease. Avoid bargain discount fish oil and look for supplements that have had heavy metals like mercury removed. If the brand you’re using gives you a fishy “burp-back”, find a supplement that has had the fish proteins removed from the fat and keep the bottle in the freezer and take the capsule frozen.
5) Learn and practice some time of relaxation breath work every day. It can be as simple as paced breathing – counting on the inhalation to three, holding for a count of three, counting on the exhalation to three and holding for a count of three. While you’re breathing, become alternately aware of the bottoms of your feet and your connection to the earth and the crown of your head and your connection to the sky or cosmos. My favorite type of paced breathing like this connects with a prayer or an affirmation. An example would be an in breath with the mental recitation of psalm 23; I might inhale with the thought “The Lord is my shepherd” and then during the pause I’d consider what it means to have a shepherd. I would then exhale and pause and with the next inhale I’d recite “I shall not want” and then during the pause I’d consider what it means to have all my needs provided. I’d continue through the psalm line by line, stopping and pausing with each breath purposefully.

4) While you’re breathing, learn and practice other types of stress management. For you it may be prayer, meditation or listening to a guided imagery cd. Seek out practitioners who can teach biofeedback techniques or Heartmath™. Consider an energy medicine appointment with practitioners that do Reiki or Healing Touch. Try a “spirit walk” in a nearby park or woods – breath in as you walk on your right foot, breath out as you walk on your left foot. Whatever you choose, make time to do it daily. It is as important as eating and sleeping!

3) Grow your connection to your creator. Honor the gift of life you have been given today. Look with gratitude at the opportunities and blessings that you’ve received. Seek out pastoral or spiritual support to help in this area if needed.
2) Pay attention to the quality and quantity of sleep you receive each night. Sleep is our opportunity to restore our neurotransmitters and remove toxins from our body. What is interfering? Is your brain still wound tightly with worry or anxiety? Is your body sore or inflamed? Is your spirit troubled? Is your nutrition sub-optimal and filled with stimulants like caffeine and sugar? Explore this with your integrative physician – the solution is NOT solely a sleeping pill!
1) Nourish your body with lots of whole grains and colorful, organic, locally-grown vegetables and fruit. Learn to can and freeze the produce when it is abundant to last you through the winter. Add lean protein in a small amounts and keep the processed food to a minimum. Your life force energy is fed by the quality of your food!

May these suggestions guide you to a path of health and healing…Be Well!
Claudia E. Harsh, MD

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