Natural Antidepressant Combinations I Recommend

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


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.

My Years As An Arachnophobe

I spent the bulk of my childhood as an arachnophobe, all because of two incidents which occurred when I was rather young. The second incident was even more jarring than the first, and scarred me for many years.

The first incident occurred when I was six years old while I was at summer camp. All the kids had gone swimming in an effort to beat the triple digit heat, and were in the locker rooms getting dressed after a fun afternoon in the pool. I was standing at one locker, almost completely dressed, and just needed to put on my socks and shoes, so they were sitting on top of a bench. Suddenly, one of the girls shrieked, which triggered a domino effect, causing several other girls to follow suit. These girls jumped on top of nearby benches, looking down at one spot on the floor. I simply stood where I was, puzzled by their reaction.

Our teacher came in and asked one of the girls what all the noise was about.

“There’s a spider on the floor!”

The teacher looked at the floor, then said, “Oh yeah, that’s a black widow. We’d better kill that one!” Whereupon she grabbed one of my sneakers and deftly smashed the spider to a mushy black pulp.

I was so horrified that I refused to wear my shoes. When my mom picked me up, she asked me why I wasn’t wearing my shoes. “The teacher squashed a black widow spider with my shoe!” I was so adamant about my refusal to wear those sneakers that I wouldn’t even wear them after my mom had scoured the soles of the shoes, removing any remaining spider residue from them.

The second incident occurred less than a year later. I was staying at my best friend Tammy’s house in Sun Valley, an area which is known to have rattlesnakes and tarantulas. Tammy’s family had a habit of catching tarantulas and giving them to their poolman, who would defang them and sell them to pet stores.

One afternoon, we decided to go to the movies, and returned to the house shortly before dark. I was sitting in the rear passenger’s seat, Tammy’s brother Chad in the middle, Tammy on the left, her sister Wendy in the front passenger’s seat, and her mother in the driver’s seat. Tammy’s mother pulled into the garage and closed the garage door, and we began filing out of the vehicle.

As soon as Wendy set foot on the garage floor, she exclaimed, “Nobody move! Tarantula in the corner!” Sure enough, there was a large tarantula in the far right corner of the garage, about six feet in front of me. Wendy carefully tiptoed past me to the wall to pick up a small, empty aquarium to place over the tarantula, thus trapping him. Her movement must have startled the tarantula, because it sprung up about two and a half feet in the air and forward, landing about eight inches from my feet.

Wendy said, “Don’t move!”, which was almost unnecessary because I was paralyzed with fear. By this time, she had grabbed the aquarium, and quickly placed it over the tarantula, who sprang up and hit the base of the aquarium and fell back to the garage floor, trapped in its glass dungeon.

That second incident really solidified my arachnophobia. I spent the next 28 years so afraid of spiders that, although I would never shriek or lose my cool, I would simply leave a room if I saw a spider in it. My mother became accustomed to me leaving a room and saying, “Mom, please kill the spider there!”. Once I was an adult living on my own, I would ask my boyfriend to rid the room of any spider who dared to chase me out of there.

What cured me was a touch of desensitization therapy which took place at, of all places, the Los Angeles County Fair in 2001. My then-husband Pete and I encountered an exotic pet petting zoo at the fair, and two tarantulas were featured in the zoo. Pete was well aware of my arachnophobia, as he had been ridding the house of spiders for me for a few years. I never liked his method, which consisted of capturing the spider and letting it go outside, because in my arachnophobic mind, he was just releasing a pissed off spider who would find its way back into the house and terrorize me once again.

It was Pete’s idea for me to hold a tarantula so that I would benefit from desensitization. I honestly think that his psychiatry rotation (he was a medical student then) had influenced him to make the suggestion, but it made a lot of sense to me, so I begrudgingly agreed to hold a tarantula.

I remember the handler placing this hairy, scary creature into the palm of my hand. I have very small hands, so the tarantula’s legs extended along my fingers and my wrist. It rested there for about 15 seconds, kind of hovering, and I could barely breathe at first, then I calmed down when I realized the spider wouldn’t do anything to me. Then it decided to crawl along my forearm, and that is when I told the handler to get the f*$@ing thing off of me!

Guess what though? It worked. Since that day, I have not been freaked out by a spider’s presence. More recently, I saw two black widow spiders, and quickly stomped on them with, you guessed it, a shoe-clad foot.

Hot Logic Mini Review…These Make GREAT Holiday Gifts!

Here’s another review of the Hot Logic Mini, which is an ingenious product! It comes in six great colors, and can be plugged into any electrical source. You can even use this while traveling in your car!

Go to http://www.hotlogicmini.com to order, and make sure to enter my discount code STACEYNAITO for 20% off your order!

Another Annual Orphan Thanksgiving

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!

Yes I Write Prescriptions. No I Won’t Write One For Your Brother.

As a fully licensed, board-certified physician, I have written my share of prescriptions over the years for medications, imaging studies, etc. I recognize that it is an incredible honor and privilege to be able to write scripts, and I never take advantage of it. However, there are people out there who think nothing of asking me to write prescriptions for them, simply because I am a fully credentialed physician conveniently standing there in front of them. What is especially irritating is when people dare to ask me to conduct curbside consultations or write prescriptions for their family members or loved ones who not only aren’t there with them to be examined, but who are complete strangers to me. Tell me, how in the world am I supposed to conduct a medical evaluation on a complete stranger, sight unseen? These same individuals also tend to get offended when I kindly tell them that their loved one needs to be seen in person by a qualified medical professional who can assess their condition and administer the appropriate treatment.

So if you are the kind of person who is in the habit of asking doctors to do similar favors for you or your family, please understand that your requests are unreasonable and inappropriate. If your husband, sister, son, cousin, or best friend needs medical attention, do the responsible thing and either tell that person to go see a doctor, or take that person to the doctor.

The Magic Of Kundalini Yoga

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.

Switch Up Your Gym Routine!

Are you bored with going to the gym and doing the same old thing? If so, it’s time to switch things up! Simply by changing the repetition range, lifting technique or body part split, you can infuse your workouts with something new and exciting. If you really want to ramp up your routine, add plyometrics or calisthenics, or perform supersets or giant sets.

If you don’t exactly know how to make the changes I am suggesting, I have broken down different exercise elements so that you can easily make changes to your workout routine which will keep you interested.

CHANGE REPETITION RANGE – If you have a habit of doing four sets of 15 repetitions regardless of which exercise you are doing, how about switching it up? Perhaps you can do a warmup set at the same weight which you usually eke out 15 reps, but push yourself to do 20 really good reps. Then increase the weight and do 3 sets of 8-10 reps, and perform them with intensity.

STACK REP RANGES IN PYRAMIDS – Another thing you can try is pyramids, which basically consist of gradually increasing or decreasing the rep range, while decreasing or increasing the weight lifted accordingly. You can perform ascending, descending, or ascending-descending pyramids.

Ascending Pyramids = You will gradually increase the weight used, and decrease the number of repetitions accordingly, with each set. For example, your first set may be 20 repetitions, the second 15 reps, the third 10 reps, and the fourth set 7 reps. Ascending pyramids are effective for increasing strength since you gradually increase the load on the muscle worked.

Descending Pyramids = You perform your first set at a heavy weight, eking out about 6 to 8 solid reps. Subsequent sets will consist of gradually decreasing the weight used, and increasing the number of repetitions accordingly. For example, the second set may consist of 10 reps, the third 15 reps, and the fourth set 20 reps or to complete failure. Descending pyramids are effective for increasing muscle girth since the gradual drop in weight enables you to perform sets to failure.

Ascending-Descending Pyramids = With this pyramid approach, you gradually increase the weight used, and decrease the number of repetitions accordingly, with the first few sets, then DECREASE the weight used and increase the number of reps to finish out the routine. Because of this, I recommend performing odd numbers of sets. For example, your first set may be 20 repetitions, the second 15 reps, the third 8 reps, the fourth set 15 reps, and a fifth and final set can consist of 20-25 reps.

CHANGE THE NUMBER OF SETS PERFORMED – If you are in a rut because you always perform four sets of every exercise, challenge yourself and do 5 or 6 sets. A great way to shake out the cobwebs in your routine is to go for volume, perhaps performing 8 to 10 sets of each exercise to really work your muscles to exhaustion.

CHANGE YOUR LIFTING TECHNIQUE – Many people tend to perform exercises rather rapidly every time they train, so they don’t really focus on what they are doing. There are a couple of ways in which you can challenge yourself and break through plateaus if you have this tendency. One method is to perform negatives, which basically means that after you lift the weight in the concentric phase (in a bicep curl, this would be the phase in which you curl the weight toward your shoulder), you slowly return the dumbbell to the starting position for a count of 5 or 6 seconds. Another great method is rest-pause, in which you perform a repetition at a normal rate, pause briefly, then go to your next repetition forcefully. When using rest-pause technique, slightly increase the weight used to really challenge yourself.

CHANGE YOUR BODY PART SPLIT – If you always train legs on Tuesdays and chest on Fridays, perhaps you might want to switch things up. If you aren’t seeing enough desirable changes in your lower half, add another leg day and focus on the areas which you would like to improve. If you always train your entire body every time you hit the gym, start splitting up body parts so that you devote more time to getting maximum recruitment in the muscles you train.

ADD PLYOMETRICS OR CALISTHENICS – Adding ballistic movements like plyometrics or calisthenics can serve as the catalyst for rapid body transformation. Just be careful if you have hip, knee, or ankle issues. Try adding moves like jumping jacks, jump squats, mountain climbers, burpees, and X-jumps.

PERFORM SUPERSETS OR GIANT SETS – Try stacking two or more exercises together without resting in between exercises to increase muscle fiber recruitment. You can either stack weighted exercises, or perform a combination of weighted moves and plyometrics.
Examples are:
Leg press machine/jump squats
Incline bench chest presses/pushups/dumbbell pullovers

Of Orifices and Zero Freedom

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”!