Category Brain Health

The Power of NO

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How often do you agree to do something when you are either completely unmotivated to do it, or are so over-burdened by other responsibilities that you feel like you are shackling yourself to an impossible schedule? Maybe you’re known as the “nicest person” who always manages to make time for everybody no matter what. And maybe you don’t want people to think otherwise about you, despite the fact that your energy and your patience are worn thin by people who always seem to drain the very lifeblood from you, and expect you to drop everything for them at the drop of a hat.

Have you ever considered using the word NO once in a while? By setting limits and boundaries, you keep energy vampires at bay, and you give yourself a chance to balance out your life so that you don’t burn yourself out. I am sure that the people who have taken your availability for granted will be stunned when you respond to a request with NO, but they’ll get used to it. A feeling of complete relief washes over me when I gather the courage to refuse a request, especially if I feel like I am drowning in the wide expanse of my to-do list. Remember that you will be better equipped to serve others if you take care of yourself first.

Natural Antidepressant Combinations I Recommend

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Despite the fact that I was trained in the traditional ways of medicine, I prefer to utilize natural supplements and foods to treat conditions, only turning to prescription medications as a last resort for my patients. I have a particular aversion to prescribing antidepressant medications, and honestly believe that such meds only serve as a bandage for the root cause, which almost invariably is a combination of hormonal imbalance and malnutrition.

When a patient comes to me complaining of symptoms of depression, I always recommend the following three supplements as part of the patient’s daily regimen:

Vitamin D
Folate 800 mcg
B-Complex

Once my patients are on this daily regimen for a few weeks, I have them visit for a follow-up to see if their symptoms have improved. If the improvement is marginal, I add SAMe and 5-HTP to the regimen, both of which are great for treating pain issues. As the patient treatment progresses, I order hormonal assays, checking the thyroid, adrenal glands, DHEA, IGF-1, testosterone, progesterone, and estradiol. If anything is off balance (and in most cases, something is), I will treat the imbalance directly with organ support compounds and bioidentical hormone replacement therapy.

In addition to natural supplements, I also recommend that patients consume whole foods, and avoid processed foods at all costs. I encourage them to find balance in their daily lives, and often demonstrate breathing exercises or discuss meditation with them. I also remind them to stop and enjoy what they have in their lives, to be grateful for what they have instead of dwelling on what they lack.

Rather than turn to SSRI’s, please consider the natural approach first if you are dealing with depression!

If you are in the Los Angeles area, and you would like to schedule an exam, please call Urban Med at (213) 406-8055 to make an appointment.

How I Stay In Shape These Days

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Image shot by Tim Sevard in October of this year.

Since many people have been asking me about how I have been keeping in shape these days, I decided to devote a blog post to the subject. Though I am retired from competing, and am no longer bodybuilding stage-ready, I model frequently, and I also hold myself to very high standards when it comes to body conditioning. The most important factor in staying lean year round is FOOD, so I make sure to eat clean about 95% of the time. I consume about 100 to 120 grams of protein daily, all from whole foods rather than protein powders, and I drink plenty of water throughout the day. I limit my consumption of sugar and avoid processed foods.

Supplements are also an important part of my daily life. Most of the supplements I take have been in my daily regimen for many years, and I rarely miss a day’s dose. They are what I rely on to keep my body healthy at the cellular level. My goal is to maintain my health without ingesting prescription medications. In fact, the only prescription substance in my regimen is bioidentical progesterone cream.

I continue to challenge my body with frequent exercise, and still rely mostly on weight training for the bulk of my exercise. However, I incorporated aerial classes into my regular routine a couple of years ago for an extra challenge. At one point, I had been taking aerial classes 3 to 4 days per week, but my body was screaming out in agony. After a visit with my orthopedist, we discovered that I had arthritis in both elbows and my neck, and numerous issues in my shoulders, so I decided to back off from the intense aerial schedule I was following. These days, I only take a lyra class once every couple of weeks.

I have also been attending kundalini yoga classes on average of one day per week, and I love the unique physical, mental, and spiritual challenges which they present. Though kundalini yoga is a highly meditative form of yoga, the movements (called kriyas) are INTENSE, and I must often take breaks during these movements. I highly recommend this form of yoga for anyone who wants an intensely spiritual experience.

As for weight training, I train an average of six days per week when I am in town. I have adjusted my weight training to support aerial arts movements like straddle mounts, single knee hangs, pullovers and splits, and work my posterior chain (back, glutes, hams) more vigorously than my anterior chain. I usually follow a split consisting of three leg days and three upper body days which are further split (eg, back/arms, delts, chest/abs). I have also been changing the exercises, rep ranges, and lifting styles on a weekly basis to keep myself challenged. It’s definitely worked, because I am getting delayed onset muscle soreness from almost every workout.

Another Annual Orphan Thanksgiving

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This year I am upholding my own Thanksgiving tradition with what I refer to as Orphan Thanksgiving. It is a cozy and enjoyable event for the people who share in this wonderful celebration. I invite friends who don’t have a place to go for the holiday, usually because their relatives live far away.

Though there is a considerable amount of food prep involved, I get a kick out of making each dish and roasting and carving the turkey. You might think that this desire to cook huge holiday meals and have people over is something that was handed down to me from my mother, but my mom never entertained guests in our home, and she never considered herself a cook. My mother’s idea of cooking was to heat up Stouffer’s entrees or throw a piece of meat on the broiler, and when the holidays arrived, she made restaurant reservations instead of spending time in the kitchen. Somehow I had a natural affinity for cooking and baking, and I also quickly discovered how much I enjoyed hosting events. I am certain that my desire to host parties evolved from my tendency to nurture others.

Thanksgiving-Dinner-New-York-CityWhat’s on the table this year? Turkey, stuffing, sweet potato casserole (a HUGE hit), mashed potatoes, and green bean casserole. I’m letting my guests bring dessert to ease the cooking and baking load, since I make these feasts by myself. Since I fully believe in enjoying “normal” foods during the holidays, provided they are enjoyed in moderation, I have no problem featuring a few “forbidden” foods on the holiday table.

Happy Thanksgiving, everyone!

The Magic Of Kundalini Yoga

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I fell into kundalini yoga quite by accident earlier this year, when I decided to sign up for a class at a local yoga studio which was listed on ClassPass. From the first class, I was deeply moved, intrigued, and interested in continuing the practice. I hadn’t been aware of the fact that kundalini yoga is considered to be the most powerful and spiritual form of yoga, but I am grateful that it is now a part of my life. Kundalini yoga also complements my daily meditation practice.

How is kundalini yoga different from other forms of yoga? While it can be VERY physical, kundalini yoga is incredibly spiritual and meditative. You will spend a decent amount of time in “easy pose”, which is a standard pose for meditation. Kundalini yoga consists of chants, repetitive movements, and coordinated breathing techniques which are all designed to increase consciousness and activate the body’s energy centers. Because this type of yoga targets energy blockages, sessions can be emotional, intense, sacred, and filled with a sense of connectedness to everyone.

An article by James McCrae states that the objective of kundalini yoga is “decentralized and selfless – help people actualize their Higher Self”. The practice of kundalini yoga has been around since approximately 1,000 B.C. – 500 B.C. during the time in which the Upanishads were written. Kundalini, or “coiled snake”, refers to the energy of creation which sits at the base of the spine, and which can be activated and made to move up the spine and throughout the entire body. It was brought to the western world in the late 1960’s by Yogi Bhajan.

Kundalini yoga can be regarded as the fast track to spiritual enlightenment, and can bring about immense positive changes to one’s life. It increases awareness, brings a sense of well-being, and also creates a stillness and calmness which help to deflect the stresses of the modern world.

Of Orifices and Zero Freedom

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As a physician, I have had the incredible honor and privilege of studying every part of the human body, to the most minute detail. I have hovered over cadavers which were fileted and displayed for they eyes of inquisitive medical students, and scrubbed in on colon resections, open heart surgery, neurosurgery, cataract removal, etc. During my first month of internship as a newly minted physician, I massaged a dying heart with my gloved hands (no, the patient didn’t survive). I have also delivered over 40 infants via vaginal and Cesarean methods, and have pronounced the demise of patients in the wards. In fact, there are many stories I have collected over the years, some incredibly sad, some disgusting, some frightening, and some infuriating, but all true, and all part of my experience as a doctor.

I knew full well that by signing up for an education in medicine, I would be subjected to disgusting, morbid, frightening things, and that I would face mortality on a regular basis. However, after several years of working in family practice, I began to notice that I wasn’t thrilled with the fact that I examined orifices of every kind on a very regular basis. Whether it was a nostril, a mouth, an ear canal, an anus, a urethral meatus (layman’s term pee-hole), or vagina I had to examine, I was never thrilled about it, and the orifices below the belt were certainly much more bothersome to address. My intense dislike of such examinations, combined with the tedium of primary care and the low insurance reimbursement for services and procedures provided, caused me to retreat from primary care and focus more on the areas I had more interest in, namely, physical medicine, cosmetic dermatology, and anti-aging medicine, all of which are much cleaner and which do not require me to conduct examinations on private parts.

Another feature of primary care which made me cringe was the intense demand on a practitioner’s time. The only time it ever seemed reasonable for me to literally lose sleep night after night as a physician was when I was in training. At this point, there is no way you could convince me that such a thing is healthy, and I refuse to sign up for that. I won’t give up weekends to take on three stacked 12-hour work shifts, and I will not give up the few holidays I celebrate (Thanksgiving, Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day) in order to work. As it is, I give up other major holidays to work, but since the work I perform on those holidays is in bodybuilding and fitness, I don’t mind it at all.

I love being a physician, and I find it incredibly rewarding to make a positive impact on my patients. However, I will not sacrifice balance in my life, or the freedom to pursue my other interests, in order to prove to society what a good physician I am. I don’t believe for a second that running oneself into the ground working as a physician ever sends a positive message to others. I don’t ever want to be the kind of doctor who is saddled with so many chart notes to write that an entire weekend is devoted to completing them. Not for me.

Lasty, I think it’s so strange that society still assumes that doctors are supposed to give their time and knowledge at a moment’s notice, on demand, yet I don’t see those same demands placed on people in other industries. I can’t tell you how many times I have been in a brief conversation with a complete stranger, who dares to ask me a medical question as soon as my profession is revealed. I swear, one of these days I am going to get a t-shirt made that says, “THE DOCTOR IS OFF-DUTY RIGHT NOW…NO MEDICAL QUESTIONS PLEASE”!

My Experience With Food Intolerance

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Before I began competing in 2009, I could pretty much eat whatever I wanted without any digestive or reactive consequence. All that changed by the time I earned my IFBB Pro Card in 2013, when I developed a number of food intolerances which forced me to change the way I ate and what I consumed. It was so bizarre for me to mount reactions to healthy foods which had never caused an issue in the past. During one particular contest prep regimen, I began to notice that every single time I ate broccoli, I would get severe abdominal cramps and a headache which persisted for an entire day (now they last for 3-5 days if I am stupid enough to eat even one small floret). I honestly believe that the extreme and repetitive meal plans which I consumed while competing were major factors in the development of my food intolerance issues.

I retired from competing in June of 2014, yet I developed even more food issues. I noticed that other foods were aggravating my gut, my skin, my head and my mood, so I decided to eliminate them. In January of 2015, I had an ALCAT food intolerance test, and discovered that broccoli on the list of offending foods for me. I also had SEVERE gluten intolerance, as well as intolerance to coconut, flaxseed, mangoes, casein, blueberries, and a number of other foods which are considered healthy. In an effort to allow my body to calm down, I eliminated every food which I had any intolerance to (there were about 30 foods) for close to a year. To this day, I am very careful about the foods which my body rejects, and keep my exposure to a minimum.

I will allow myself to have blueberries, coconut, mango, lobster, cashews, bison, and spinach on rare occasion, and have noticed no reactions. However, I mount strong reactions to other foods and food combinations. For example, within two consecutive days of eating flaxseed, I develop one or two deep, painful, cystic pimples on my face which will not resolve until I stop eating flaxseed. When I eat gluten, I become irritable and emotional, I get headaches, my belly aches, and I don’t sleep well. Of course I didn’t know that this was the case until I did an elimination diet and gradually began feeling better, then tried eating gluten after many months of avoiding it. Every time I ingest gluten containing foods, I notice symptoms which can be mild or severe depending on the food and the quantity eaten. Pizza is VERY dangerous for me now, so if I am faced with the prospect of eating the cheesy, gluten filled meal, I have to take a Glutagest (which breaks down gluten in the food eaten) if I want to avoid the ugly consequences of allowing gluten to enter my body. The combination of pizza and wine is even worse. I might as well forget about functioning like a normal person for a couple of days if I dare to consume this food and drink duo.

I agree that the whole gluten-free trend has gotten a little out of hand, but I also strongly believe that there are many people walking around with gluten intolerance and other food intolerances who have no idea that the foods they are consuming are affecting their health and well-being. I have personally benefitted from going gluten free and avoiding foods my body rejects, and have been rewarded with more luminous skin, thicker hair, better digestion, better overall mood and energy, and much better sleep.

If you suspect that you have food intolerance, try eliminating the suspect food to see if it makes a difference. Trust your body’s signals. And if you want to get a food intolerance test, check out ALCAT.com and Everlywell.com for the kits they offer.

Do You Have Food Intolerance?

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What Is Food Intolerance?

Have you ever noticed that when you eat a certain food, such as tuna, blueberries, avocado, asparagus or broccoli, that you get extremely bloated to the point that you are extremely uncomfortable? Since the foods I mentioned are celebrated for their many nutritional benefits, it might not occur to you that you most likely have an intolerance to that food. Up to 80% of the U.S. population has some form of food intolerance.

Most people are aware of food allergies, but food intolerance is a different phenomenon which can have a tremendous effect on a person’s quality of life. Food allergies appear quite suddenly, from seconds to minutes after ingestion of the offending food, and can be life-threatening, whereas food intolerance is a more gradual process (taking hours to a couple of days for symptoms to emerge), not life-threatening, and may only occur after a large amount of the food is eaten. Food allergies and food intolerance can both cause similar symptoms, such as abdominal pain, nausea, and diarrhea, but food intolerance is notorious for causing bloating, heartburn, irritability, headaches and general malaise. The most common food allergy triggers are peanuts, tree nuts, shellfish, fish, soy, wheat, milk and eggs, while the foods most commonly associated with food intolerance are dairy products, gluten-containing grains, eggs, citrus, beans, cabbage, and broccoli.

People who are allergic to certain foods know that even a small amount of the food can trigger an allergic response, and the response occurs every single time the person is exposed. The immune system reacts to the food by causing a release of IgE antibodies, which then cause a release of histamines and cytokines designed to attack the offending agent. Sometimes the entire body is affected by this response, and symptoms such as shortness of breath, hives, rash, or a sudden drop in blood pressure can occur. Food intolerance, in contrast, is more insidious, and may only occur if a large amount of the triggering food is eaten or if it is consumed frequently. Trigger foods will cause a rise in IgA, IgG, and IgM antibodies, causing the body to mount a delayed reaction which is characterized by mostly gastrointestinal symptoms, but which can cause other symptoms as well. Regardless of how the body reacts, the discomfort caused by poor digestion of the food can be enough to make the sufferer miserable.

Why does food intolerance occur? There are several explanations. One cause is enzyme deficiency. All enzymes are specific to one type of molecule, such as lipases which break down fats. Sometimes an individual can be deficient or completely lacking in a very specific enzyme which is required for digestion of a particular food. A common example is found in lactose intolerant individuals who do not have enough lactase to break down the milk sugars into their constituent parts for absorption in the intestine. The lactose cannot be broken down so it sits in the intestine, causing bloating, spasm and diarrhea when it sits in the digestive tract. Approximately 25% of the U.S. population suffers from lactose intolerance, which amounts to a lot of bloated bellies from the consumption of dairy products.

Another common type of food intolerance is to gluten. Gluten is highly resistant to digestion as it is, and in some individuals, the gluten cannot be broken down at all. The problem with gluten is that it is found in wheat, rye, barley, spelt and kamut, so avoiding gluten can be challenging to say the least. Approximately 1% of the U.S. population has celiac disease, while about 15% have gluten intolerance. Regardless of whether someone has celiac disease or gluten intolerance, ALL gluten must be avoided. However, if there are occasions in which completely avoiding gluten is impossible, digestive enzymes, specifically DPP-IV, can help individuals to digest meals containing gluten.

The list of substances which people may have an intolerance to doesn’t stop there. Some individuals cannot break down phenols, including salicylates, due to insufficient amounts of xylanase, and suffer from behavioral and learning disorders, including ADHD and autism. Some individuals are unable to break down disaccharides, an intolerance which is closely linked to irritable bowel disease, ulcerative colitis, Candida overgrowth and autism. As if all that wasn’t enough to worry about, there are chemical substances in foods which can spark intolerance, such as caffeine, aflatoxins in undercooked beans, amines in cheeses, artificial colorings and flavorings, preservatives, sweeteners, emulsifiers, nitrates, MSG, sulfites and salicylates. Salicylate intolerance can cause a susceptible individual to react to large amounts of salicylate-containing foods, particularly citrus fruits, teas, mint flavoring, berries and processed foods with flavor additives.

The digestive tract regularly takes the brunt of foods, medications, hormones, and chemical additives which can interfere with repair of the gut lining, causing increased intestinal permeability which is more commonly known as leaky gut. Leaky gut is characterized by the loosening of tight junctions between the cells which line the gut, thus allowing food molecules to pass through. These free floating food molecules are viewed by the immune system as a threat and will mount an immune response which manifests as the signs and symptoms of food intolerance. Think of all that food sitting in the gut, undigested. Pretty unnerving, huh?

How To Diagnose Food Intolerance

Diagnosing food intolerance can be extremely difficult since the signs and symptoms often mimic those of food allergy. One method of ferreting out which foods are involved in a food intolerance is keeping a food diary in which all foods eaten are recorded, along with symptoms and their time of onset. After suspected trigger foods have been determined, an exclusion diet can be implemented, in which those foods are removed from the diet for weeks to months. If the symptoms disappear during the exclusion phase, potential trigger foods can be re-introduced after this phase is completed in order to determine which substances are problematic. If the food intolerance is mild, a small amount of the food will not trigger symptoms, and in many cases may still be consumed, especially if enzymes are taken to aid in digestion. Essentially, many people can return to foods which they were mildly or even moderately intolerant of after avoiding it for a period of time.

Blood testing is considered the most reliable and comprehensive form of testing for food intolerance, but there are only a few laboratories which specialize in this type of test. ALCAT, Pinnertest.com and HEMOCODE Food Intolerance System are laboratories which offer food intolerance testing via serum analysis, with ALCAT considered the largest food intolerance testing group in the U.S. We offer ALCAT testing at the facility where I work (Urban Med) because it is considered the gold standard method for laboratory identification of non-IgG-mediated reactions to foods, chemicals, and environmental triggers. Some insurance plans will cover part or all of the expense of the testing, so it is always worth inquiring about insurance coverage, especially since these panels run from $675 to $850. Here’s the thing: though the testing is pricey, it is very specific. In addition, you get a detailed rotation diet for reintroduction of the foods which you have intolerance to after you have eliminated them for the recommended period (3 months for moderate intolerant foods, 6 months for severe intolerant foods).

L-Carnitine Tartrate For Athletic Performance

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I am personally a big fan of l-carnitine supplementation. This amino acid compound, consisting of lysine and methionine, can be found in a couple of different forms. This article discusses L-carnitine tartrate, which is the form known to benefit athletic performance and recovery.

There are a couple of important points to consider when supplementing with carnitine. First of all, insulin must be present in the body for carnitine to enter muscle. One way of taking carnitine is to ingest carnitine with carbs so that there is an insulin release, but another effective option is to ingest carnitine with omega-3 fatty acids. Omega-3 fatty acids optimize cell membrane health, thus making cells more sensitive to insulin. Carnitine serves as a delivery system for fatty acids, so if carnitine levels are high, more fatty acids will be shuttled into cells to be utilized for energy.

Conversely, when carnitine levels are low, fewer fatty acids are moved into the cells and are instead stored as fat. Supplementation with carnitine before intense exercise, especially cardio, will switch the focus on burning fat rather than utilizing glycogen stores, resulting in longer sessions before glycogen stores are depleted. In addition, the presence of carnitine inhibits production of lactic acid, so recovery from intense exercise is more rapid.

Carnitine is not only an excellent performance supplement, it also serves as an excellent means of addressing metabolic syndrome. Metabolic syndrome, characterized by diabetes, atherosclerosis and high cholesterol, can be countered by carnitine’s ability to induce fat loss, prevent atherosclerosis and minimize the development of diabetes. After several months of carnitine supplementation, carnitine levels reach a level at which energy production and performance are enhanced. For this reason, it is best to consider carnitine an essential supplement in your daily regimen rather than as something taken only periodically.

Take 500 to 2,000 milligrams of l-carnitine tartrate daily, along with omega-3 fatty acids, for best results.