Which Supplements Should I Be Taking?

photo fish oil capsWith so many nutraceuticals available to the public, it is easy to be confused about which herbs and supplements we should be taking.  Naturopathic medicine isn’t just about being natural.  It is an individualized system of medicine that targets treatment plans to each patient to get to the root cause of their imbalances.  So although I suggest you work with your Naturopathic or Integrative Doctor to figure out a treatment plan that is tailored for your needs, there are some important supplements that can benefit most everyone.

Omega 3 fatty acids: There is a reason why omega 3 fatty acids are called essential fatty acids.  They are not only essential for our health, but our bodies are incapable of producing them on their own.  The most important components to look for are EPA and DHA.  Unlike pharmaceutical medications that work on a specific biochemical pathway, omega 3 fatty acids, specifically EPA and DHA, work on a wide of range of systems in the body to reduce overall inflammation, help balance hormones, and improve brain health (e.g. cognition, mood, memory).  Omega 3 fatty acids can be found in fish oil.  It is crucial to supplement with physician grade fish oil only in order to ensure superior manufacturing standards and the elimination of all mercury through proper methods.

It is important to supplement with omega 3 fatty acids and not omega 6 or omega 9.  Don’t be fooled by supplements that contain omega 3-6-9 thinking more is better.  Before the advent of industrialized oils and processed foods, our diets consisted of a 4:1 omega 6:omega 3 ratio.  Due to the high amount of industrialized oils, processed foods, and processed grains, we now consume a 20:1 ratio.  Omega 6 and omega 9 fatty acids are not unhealthy per se, but we need to work on tipping the scales towards more anti-inflammatory and the highly beneficial omega 3 fatty acids.

Probiotics:  Probiotics refer to the healthy bacteria in our bodies, mainly in our gut and genitourinary tracts.  These good bacteria help create a healthy local environment to aid in digestion, increase our immunity and even start the seeding process of the immune system in babies born through the birth canal.  Many cultures have fermented foods in their cuisine such as kefir, kombucha, natto, miso, kimchi, and sauerkraut to name a few.  These foods are often eaten on a daily basis because we lose our healthy bacteria in our stool everyday.  However, in the States, we don’t necessarily eat fermented foods daily. And considering 70% of our immune system is located in our digestive tract, it is important to replenish what we lose everyday.  Our immune system isn’t just about fighting colds and flus but a healthy immune system is involved in preventing some serious illnesses like autoimmune disease and cancer.  Some studies show that one reason for the sharp rise in colon cancer after age 50 is due to the natural decline in healthy bacteria.

B Complex:  B Complex taken daily is an excellent way to address stress and fatigue.  We deplete our vitamin B levels when we are stressed and unfortunately, most of us live in a constant state of some kind of stress.  And remember, the body does not know the difference between a wedding and a funeral.  Even good stress is perceived as stress by the body.  Of course, it is important to address how we process stress and work on managing our stress levels through some sort of daily practice, whether that be meditation, abdominal breathing or just doing something fun.  Keep in mind, we don’t need to have an all or nothing approach by telling ourselves we don’t have enough time and do nothing at all or take an hour long yoga class everyday.  Even 30 seconds of simple abdominal breaths throughout the day can be quite helpful.

Vitamin D:  Due to our diligent use of sunscreen as well as factors like working indoors all day or living in a location greather than 35 degrees in latitude,  there is a vitamin D deficiency epidemic due to lack of full exposure to sunlight.  Vitamin D is produced for free when sunlight hits our skin but sometimes this isn’t possible due to our work schedules, geography or season so supplementation may be vital.  Vitamin D is not a vitamin at all but acts like a hormone in the body and is involved in almost every tissue in the body.  Vitamin D deficiency is related to age related chronic diseases such as cardiovascular disease, chronic inflammation and cancer as well as bone health, chronic colds and flus, weight gain, diabetes, fatigue and depression.


Easy Ways To Treat Acid Reflux

     Acid reflux, which is also known as GERD or “heartburn,” is a common symptom that many people experience.  The symptoms vary greatly and can appear as just a sore throat, a slight chronic dry cough, a burning hot feeling in the abdomen or chest area, chest pain, common indigestion or a slew of other digestive or respiratory symptoms.  Often, people feel worse after eating, at night or when laying down.  The common treatment for acid reflux is some kind of over the counter or prescription medication to reduce stomach acid.  It is true that the symptoms are occurring due to stomach acid leaking into the esophagus so lowering stomach acid does often temporarily curb the symptoms.

     However, this is merely putting a bandaid on the symptom and not getting to the root cause of the matter and ultimately, can make the situation worse.  Just to go over a little anatomy, the esophagus (the tube where our food travels into our stomach), is made up of a much more delicate tissue.  The esophagus leads into the stomach, which contains high amounts of hydrochloric acid and digestive enzymes necessary to digest and break down the food we eat.  In order to withstand such high amounts of acid, the lining of the stomach is much thicker than the delicate esophagus.  There is a sphincter (the esophageal sphincter) or “door” that is located between the esophagus and stomach.  It is important for this “door” to remain closed so the harsh acids from the stomach do not leak into the esophagus.  Reflux or heartburn happens when acid from the stomach somehow makes its way from the stomach into the esophagus or higher into the throat and larynx.

     What most people don’t realize is that this “door” or sphincter, needs a certain level of acid in the stomach to remain properly closed.  When stomach acid levels go down, the sphincter becomes relaxed and opens slightly, allowing acid to leak out of the stomach.  Over time, with chronic use of over the counter and prescription acid blockers, stomach acid levels reduce further, the stomach has a harder time doing its job of breaking down food leading to other digestive imbalances and further, the sphincter or “door” becomes more and more relaxed, stays open and leads to more acid reflux.  Acid reflux in some is genuinely caused by an overabundance of stomach acids.  But many are actually due to not enough stomach acid.

     So what causes acid levels in the stomach to go down anyway?  One of the main reasons for decreased stomach acid is STRESS.  If you think about it, if a tiger is chasing us, we want our bodies to focus on running away and getting us to safety, not relaxing and digesting food.  This is a necessary and protective mechanism.  The problem is, in our modern world, many of us often live in a state where we feel as if that tiger is constantly chasing us.  So, our body is in a constant state of stress, trying to outrun that tiger.  Unfortunately, this wreaks havoc on our digestive system, which is meant to function optimally in a relaxed and calm environment.  Think about if you’ve ever heard upsetting news or had an argument while eating a meal and instantly lost your appetite.  There is not only a strong mind body connection but a strong physiologic link between our nervous system, stress and our digestive systems.

     So as you can guess, one of the main treatments for heartburn and acid reflux is figuring out how to process and dissipate stress.  We will never get rid of stress in our lives.  But we can control how we react to stress.  We need to do things DAILY to process stress.  This means different things to different people and may include conscious breathing, exercise, meditation, watching a movie, prayer or listening to music.  It is when these self care tools don’t work, that you may need to seek out the help of a Naturopathic Doctor to assist with deeper natural therapies.

     Some other tools that are also effective for dealing with the inflammation and discomfort of acid reflux include organic apple cider vinegar.  1 tsp of organic apple cider vinegar in a small amount of water 10-20 min before meals is very helpful for naturally optimizing our stomach acid levels as well as alkalinizing the body and helping to digest our food.  Another helpful therapy is mucilagenous herbs such as marshmallow and slippery elm.  These plants naturally have an almost slimy type quality to them which helps soothe inflamed tissues.

Anti inflammatory diet

     The apple cider vinegar, herbs and nutraceuticals will definitely help heal the body and reduce symptoms.  But ultimately, it is important to remember that the cause needs to be treated.  Your Naturopathic Doctor, Osteopathic Doctor or Integrative Medical Doctor can work with you to get to the root cause of where your symptoms are coming from so your body can truly heal on a deep level.

Vitamin D Is Not Really A Vitamin

photo sunshine rays     Vitamin D may be called a “vitamin” but it really functions like a hormone in the body.  Vitamin D has a function in almost every tissue in the body and has been linked to almost every age-related disease including cancer (breast, prostate, colon), cardiovascular disease, and chronic inflammation as well as autoimmune disease, chronic colds and flus, weight gain and hormonal imbalances, fatigue and depression.  The sun is our major source of vitamin D and for myself, living in Los Angeles, it’s easy to assume that we all have enough of it.  But I can assure you, there is a vitamin D epidemic happening.  In fact, my own vitamin D levels were extremely low when I finally measured my blood level.  And the majority of my patients have all had low levels as well.  How many of us are inside all day working on computers or at a desk while the sun shines outside?  We have been warned by our dermatologists and the media about the dangers of sun exposure and its role in creating skin cancer.  We’ve been trained to shield ourselves from the sun and most cosmetics now have some sun protection in them.  It is true that too much sun exposure can lead to skin cancer, especially depending on the type of skin we have.  However, some studies reveal that skin cancer and melanoma may not necessarily be related to sun exposure as lesions have been shown to begin in areas of the body never exposed to sun.  It may seem counterintuitive, but it is vital that we be exposed to full sunlight without sunscreen in order to produce vitamin D. 

The Sunshine Dilemma

UVA rays are long rays from the sun that do not cause sunburn but penetrate more deeply into the skin which may lead to premature aging, discoloration and wrinkles.  UVA rays can pass through glass and clothing but do not prompt the skin to create vitamin D.  UVB rays help start the process of making vitamin D when they hit the skin but they are also the rays that lead to sunburn.  UVB rays cannot penetrate glass or clothing so we can’t produce vitamin D just by sitting near a window.  Due to the fear of sunburn and skin cancer, we have done an amazing job of slathering ourselves and our children in sunscreen.  However, in an effort to protect ourselves, we have eliminated a crucial and necessary source of health.

How much sun do I need to increase my vitamin D levels?

In short, the amount of sun we need is unique to each individual.  It depends on factors such as latitude, season, altitude, time of day, cloud cover, melanin content of skin, age, weight, etc.  Something called minimal erythemal dose (MED) describes how much time it takes for your skin to turn pink in the sun.  A formula for safe sun exposure to the sun is to expose 25% of your skin (hands, arms and lower legs) to the sun for 25-50% of the time you estimate it would take for your skin to turn pink from the sun (MED).  For example, if you are fair skinned, your skin may turn pink in 10 min of sun exposure.  If you stayed in the sun for 2.5-5 min (25-50% of your MED), you would create about 1000IU of vitamin D.  It is recommended that you do this a few times per week during the times when there is access to UVB rays.  The balance lies in not staying in the sun so long that your skin turns pink. 

What type of vitamin D should I be taking?

The best and cheapest way to obtain vitamin D is obviously through sunlight.  However, factors such as geography and latitude affect how far UVB rays must travel from the sun to our skin and can greatly inhibit how much vitamin D we make.  For instance, if the equator is at a latitude of zero degrees, New York CIty is at a latitude of 40 degrees.  If you live above 35 degrees latitude, you will not be able to make vitamin D from sun exposure from around November – March no matter how long you are sitting outside in the sun.  2/3 of the United States and all of Canada is above 35 degrees latitude.  So proper testing and sometimes supplementation are necessary.  In terms of testing, make sure to test blood levels of 25-hydroxyvitamin D (25D) as opposed to the previously measured 1,25-dihydroxyvitamin D. It is also important to realize there are different forms of vitamin D. Vitamin D2 is produced in plants and fungi when exposed to sunlight and is significantly less effective in raising low vitamin D levels in humans.  Most vitamin D2 supplements are synthetic and is often prescribed by MD’s.  It is the only prescription vitamin D available.  Vitamin D3, on the other hand, is the naturally produced form in humans in the skin.  It is important to remember that not all supplements are created equal and to only take supplements that are high quality, all natural, physician grade and found at reputable health food stores, natural pharmacies or through your local Naturopathic or Integrative Doctor.

What dosage of vitamin D should I be taking?

The amount of vitamin D3 you should be supplementing with depends on several factors as well as your blood level, so it is important to consult with a doctor who is knowledgable about the role vitamin D plays in the body and how and when to supplement.  The RDA for vitamin D for people up to age 49 is 200IU/day and 400IU/day for those over 50.  The upper limit of vitamin D was set at 2000IU/day.  The majority of vitamin D researchers feel that these levels are inadequate.  RDA levels were developed to prevent rickets and other bone diseases.  They were not set to prevent vitamin D deficiency as we understand it now.  The conservative upper limits recommended by the government do not make sense when 30 min of sun exposure in the middle of the day can increase our vitamin D by as much as 20,000IU.  If Mother Nature gives us such a large dose of vitamin D from mere sun exposure, how can 2000 IU possibly be considered harmful?  I suggest working together with your Naturopathic or Integrative Doctor to choose a target serum blood level and subsequent proper individual dosing.

5 Simple Steps To Total Health

Trying to live a healthy lifestyle with our busy schedules may seem daunting and downright impossible. All you need to focus on are 5 steps to keep you balanced and well.

1. EAT: If you’re feeling overwhelmed and confused about which diets and nutrition trends to follow, focus on just eating REAL FOODS. Ask yourself how many steps did this take to get from the earth to look like this? A carrot looked like a carrot when it came out of the ground but an organic vegan brownie, although a much healthier option than processed sweets, did not grow on a brownie tree somewhere. Choose brown rice over bread or pasta since rice comes out of the ground looking closer to the grains of rice we see as opposed to the processing that bread and pasta go through.

2. DRINK: Aim for half your body weight in ounces per day. So for example, if you weigh 100 lb, drink 50 oz filtered or spring water per day. If you weigh 200 lb, drink 100 oz water per day. If you are sweating profusely due to the weather or exercise or you drink anything that causes your body more stress like soda, coffee, or sugary juice, add a glass of water for every glass of non-water that you consume. Many people are dehydrated and don’t even know it because their bodies have simply adapted to not getting enough water. Chronic dehydration can lead to all sorts of long term symptoms such as constipation, joint pain, inflammation, and even mood imbalances.


3. Don’t forget to BREATHE! So many of us walk around actually holding our breath and don’t even realize it. Focus on doing several deep abdominal breaths when you are in the shower, at a red light or waiting in line somewhere. Try working up to 100 abdominal breaths per day.


4. MOVE: You don’t need to take a spin class or practice yoga for an hour everyday.  It does not have to be all or nothing.  Simply focus on moving your body.  In Chinese Medicine, pain and disease come from a stagnation of energy and the purpose of exercise is to move our vital force or life energy within our bodies. Try to walk everyday, even if it means parking your car farther away than usual or just walking around your neighborhood with your dog. Instead of meeting a friend for a meal, go for a walk in a park or window shop together. Feel free to do multiple short walks throughout the day instead of one long walk.


5. SLEEP: This is one of the most important aspects of maintaining and improving health. Sleep is not only when the body repairs itself, it is also when different hormones come into play to do everything from increasing collagen to reduce wrinkles to helping the body lose weight and increase vitality. It is most important to go to bed before midnight so the body can produce as much growth hormone as possible (the “fountain of youth” hormone) and reduce cortisol (the stress hormone).  Try to create a routine and go to bed and wake up at the same time everyday and aim for 7-9 hours of sleep to create optimal hormonal balance.


Don’t get overwhelmed by all the health information that bombards us. If you can just focus on these five steps of EAT, DRINK, BREATHE, MOVE and SLEEP, you will notice great improvements in your overall health.


The Dirty Dozen

There is a lot of discussion today about organic vs. conventional foods. Our health is not just about one variable but rather, an accumulation of experiences, reactions and choices.

Think of your body like a bucket. When this bucket gets full due to things like daily stresses, too much sugar, environmental toxins, etc., it is easy for the bucket to overfill. This is when we experience symptoms and eventually, disease. It is not ever one thing that causes the bucket to overfill but rather a cumulative effect that causes disease or imbalance. This is why you may have noticed that your seasonal allergies are worse when you’re stressed or eating a poor diet or your pain is worse when you haven’t slept enough.


If you can keep your bucket less full by eliminating as many physical and energetic toxins from your body, you will be far less susceptible to illness. One way to lower your toxic load is to consume as few pesticides as possible by eating organic foods. Sometimes it can be difficult to eat a diet that is 100% organic due to budget and/or accessibility. The following are fruits and vegetables that contain the highest levels of pesticides. So be sure to choose these as your organic options:


  • Celery
  • Peaches
  • Strawberries
  • Apples
  • Blueberries
  • Nectarines
  • Bell peppers
  • Spinach
  • Kale
  • Cherries
  • Potatoes
  • Imported grapes

The following are foods that are shown to absorb less pesticides and are safer to eat as a conventional option:


  • Onions
  • Avocado
  • Sweet corn
  • Pineapple
  • Mangos
  • Sweet peas
  • Asparagus
  • Kiwi
  • Cabbage
  • Eggplant
  • Cantaloupe
  • Watermelon
  • Grapefruit
  • Sweet potato
  • Honeydew