What are histamines?

Histamine are a part of our immune system. They are chemicals that are released by white blood cells into our bloodstream to defend against an allergen. When histamines are released, we can have an allergic reaction. This can be caused by allergies to pollens, mold or certain foods.

This reaction is initiated as a way for our bodies (the immune system) to remove those allergens from our body in any way possible. They can be released through sneezing, running and itchy eyes or even through the skin. Essentially, when we are exposed to allergens, our immune system sends a message to release histamines which are stored in mast cells. As histamines are released from mast cells, our blood flow increases in the area where the allergen is identified. Increased blood flow then causes inflammation we experience.

Do you experience any of these common histamine reactions?

• Sinus issues and congestion
• Seasonal allergies
• Asthma
• Redness and inflammation of the skin
• Hives
• Migraines
• Joint pain
• Emotional instability
• Anxiety
• Irritability

If so, you may find relief by avoiding certain foods. Read on to find out which ones are highest in histamines.

How to avoid histamines in our diet

Because it can sometimes be difficult to pinpoint all the ways histamines get into our bodies, it is a very good idea to avoid high histamine foods until you are able to address other aspects of your health. Many people find that they only need to remove these foods temporarily and then they can systematically reintroduce some of them to determine which ones are problematic and require long term removal.

• Alcoholic beverages, especially wine, champagne, and beer
• Fermented and soured foods such as sauerkraut, kimchi, vinegar, kefir, yogurt, kombucha, soy sauce, sour cream, buttermilk, etc.
• Foods that contain vinegar, such as pickles, mayonnaise, and olives
• Cured meats, such as bacon, salami, pepperoni, lunch meats, and hot dogs
• Dried fruits Citrus
• Aged cheeses
• Walnuts, cashews, and peanuts
• Avocados, eggplant, spinach, and tomatoes
• Smoked fish and canned fish like mackerel, mahi-mahi, tuna, anchovies, sardines

As you are going through the healing process and slowly reducing the load on the body, you may find the following supplements to be beneficial for reducing your histamine response:

• Quercetin
• Butterbur
• Stinging nettle
• Mangosteen

Many bacteria found in the microbiome in the gut also produce histamines. If you really suffer with a high histamine load it would be a very good idea to have a comprehensive stool test done to see if you might be dealing with overgrowths of histamine producing bacteria.

At the most basic level, anemia is a condition in which you don’t have enough healthy red blood cells or hemoglobin to carry adequate oxygen to the body’s tissues. It develops for many different reasons:

• Circumstances where iron stores in the body and bone marrow have become depleted
• Insufficient B12 or folate to properly mature red blood cells
• When there is any kind of dysfunction in the process of creating and then recycling red blood cells.

Approximately 20% of females (often duet o blood loss from menstrual cycles) are affected by anemia. Half of all pregnant females are anemic because of the higher need for iron during pregnancy, and only 3% of males present with iron anemia. Females generally have smaller iron stores than males and, when they are cycling, there’s more opportunity for blood loss, resulting in anemia.

Symptoms of anemia can include:

• Pale skin, lips the same color as the skin, pail nail beds
• Fatigue and weakness, shortness of breath on exertion which can indicate the body is struggling to deliver oxygen to all of the cells
• A sensation of pins and needles
• Disturbed vision
• A reduced sense of taste
• Concave or brittle nails
• Low grade headaches
• Difficulty swallowing and/or an inflamed tongue
• Fissures or cracks at the corners of the mouth

The number one symptom reported with anemia, despite the type, is unrelenting fatigue.

As incredible as it might sound, there are over 400 types of anemia. That said, the most common types of anemia we see include the following:

A whole host of blood markers should be used to evaluate the presence of anemia to determine the type of anemia a client or patient is dealing with. These include red blood cell count, hemoglobin, iron, total iron binding capacity, iron saturation, ferritin and more! Running only part of these markers will leave your practitioner only understanding part of the story when it comes to anemia which can be a huge disservice to you, the patient.

A very interesting consideration when dealing with anemia is that intestinal parasites, Candida and other pathogens can be underlying drivers of anemia. These pathogens consume iron and the body will prioritize the production of white blood cells to fight the invaders over the production of red blood cells. Additionally, the body will sequester iron when pathogens are present in an effort to starve out the predator, causing low iron levels. In this case, having a client start iron supplements or infusions could be counterproductive.  It is imperative that anemia is properly evaluated.

A comprehensive stool test with proper analysis is recommended if you are dealing with anemia. Identifying whether or not you have any aggressive, overgrown bacterial, parasitic or viral pathogens that need to be addressed is highly relevant when evaluating anemia, especially prior to supplementation, as I mentioned. Also, a comprehensive stool test can pick up on blood loss in the digestive tract that could play a role in anemia.

As you can see, there’s more to anemia that meets the eye. If you have been told you are anemic or relate to the symptoms of anemia, I recommend you reach out to discuss how we can work together to better understand why anemia is present and what type of anemia you are experiencing.

There are lots of strategies to address anemia but they require understanding which type of anemia you are experiencing. Don’t guess, it could cause more harm than good.

How do you feel after meals?
Tired? More Energy?

Either way, it can be a sign of blood sugar dysregulation.

Have you ever heard of Insulin Resistance and what is Insulin anyways? Let’s take a look at this important hormone – because it is extremely important.

Your body wants to maintain a constant supply of easily-accessible energy in the form of blood glucose sugar (like a fuel line to an engine). Just as you do not want to flood your engine, your body is careful to keep blood sugar levels in a narrow optimal range. “Flooding the system” with high amounts of sugar or refined carbohydrates triggers the pancreas to release a hormone called insulin. INsulin tells all your cells to take IN and store excess energy, effectively removing it from the bloodstream. Insulin also turns off glucose production in the liver and fat burning in cells (there is no need to pull from savings if you have sufficient income).

How does someone become Insulin Resistant? 

If your diet is high in sugar and refined carbohydrates, your body is constantly pumping out insulin to keep your blood sugar in the optimal range.

Over time, your cells can become desensitized to insulin constantly “knocking at the door”. Like the boy who cried wolf, cells stop responding to insulin’s signals, a phenomenon called insulin resistance. This leaves the excess sugar in the bloodstream, where it can damage the blood vessels (and contribute to inflammatory diseases). Similarly, the signaling pathway that controls production of new glucose in the liver is disrupted, resulting in unnecessary sugar production to add to the already elevated levels in the blood.

This vicious cycle continues unless insulin sensitivity is restored through diet (reduce carb/sugar intake) and lifestyle (movement, sleep, regular meals, etc).

Did you know?

According to experts, having a meal should never cause an increase in energy or a drop in energy. Eating should only cause hunger to dissipate or stop altogether. If you feel fluctuations in your mood or energy before or after eating, it is likely a sign of poor blood sugar function.

Choosing the right foods can help resolve insulin issues and fiber is extremely important when it comes to blood sugar regulation. Fiber acts to slow digestion and prevents blood sugar spikes that promote over production of insulin. And, most of us don’t get enough fiber.

Be sure to gradually increase your intake of fiber, don’t necessarily jump in with both feet. Increasing fiber too quickly can cause you to feel bloated among other things.

General guidelines for daily fiber intake range from 25-35 grams daily – men generally benefit from more fiber than women but everyone is unique.

One of the most important things to understand about Insulin is that it is rarely evaluated or monitored via blood work. Conventional medicine will generally use Glucose as a baseline for determining if someone is moving towards Type 2 Diabetes, likely due to our failed insurance system guidelines. However, increased insulin or Insulin Resistance is a precursor to the development of Type 2 Diabetes. Insulin is a relatively inexpensive way to check for early signs of blood sugar dysregulation but, in our current health care (really it would be better named “sick care”) system one would actually need to be diagnosed with and already have Type 2 Diabetes for a practitioner to begin looking at Insulin levels. And most of us don’t know how best to advocate for ourselves in a doctor’s office, from a preventative perspective.

If you experience any of the symptoms listed above, my recommendation would be to push to have Insulin be a part of your regular, routine bloodwork, even if you have to pay out of pocket.

If you think you may have issues with blood sugar dysregulation, reach out today and schedule a consultation!

Ozempic and Wegovy (semaglutide) are widely popular right now. 

When weight loss drugs hit the market, the make a big splash but Semaglutide is making massive waves in the weight loss arena. And, it has quickly evolved into a vanity drug despite being a medical drug.

What is Semaglutide? 

Semaglutide is a peptide that helps regulate how our bodies manage sugar and metabolism.

As with most weight loss drugs, the news is on fire touting the benefits and ignoring the potential issues associated with their use. As a side note, Semaglutide is intended to work as long as you take it. What happens after side effects cause people to discontinue using it? Weight gain. Frustration.

Curious about the possible side effects? Check out this partial list:

• Nausea
• Vomiting
• Increased risk of thyroid tumors
• Increased risk of pancreatitis
• Depression
• Diarrhea with urgency
• Constipation
• Bloating and Gas
• Headaches
• Dizziness
• Fatigue
• Loss of appetite
• Abdominal pain
• Heartburn
• Yellow eyes and skin
• Hair loss

There is also a VERY long list of medications that should be avoided if you use Semaglutide. If you are a user of Semaglutide or are considering using it, I highly recommend not skipping the fine print.

The human body actually has it’s own built-in mechanisms that these drugs mimic, without the side effects.  

Semaglutide mimics a peptide that is naturally made in the body called glucagon-like-peptide-1 (GLP-1). GLP-1 is released in the gastrointestinal tract when we eat. This prompts the release of insulin to regulate our blood sugar levels. GLP-1 also communicates with the brain to help reduce appetite when energy is not needed and creates a feeling of fullness or satiety.

Turns out, there are bacterial species in our microbiome (the collection of bacteria that reside in our digestive tract) that take food we don’t fully digest (like fiber!) and transform it into GLP-1 (and other molecules like PYY that helps regulate blood sugar) that control appetite and metabolism. 

Modern food processing negatively impacts our natural ability to produce adequate amounts of GLP-1 and PYY by removing many of the beneficial molecules like fiber and polyphenols that feed the bacterial populations responsible for these important processes. The more we move towards a diet heavy in processed foods, the less healthy our microbiomes become and in turn, the less healthy we become.

While these weight loss therapies seem like magic bullets, they are not without negative effects on the body as a whole. 

We recommend taking a more personalized approach to weight management that includes a look at each individuals microbiome, comprehensive blood work, dietary intake, stress levels, sleep cycles, body movement and of course, food relationship.

The greatest results do, most often, come with looking at each person as a unique individual and creating a balanced approach that is sustainable.

The cost of health insurance premiums and the high deductibles many of us pay can feel maddening. On the flipside, declining coverage due to the high costs of coverage would leave us feeling extremely vulnerable. So, most of us pay the premiums and rarely meet our high deductibles – what we are seemingly paying for each month is peace of mind that in the event we need some type of acute care we will not be left to deal with hospital bills amounting to tens or hundreds of thousands of dollars for an unforeseen surgery or illness. For a lot of people, peace of mind is worth every penny.

Our insurance and medical systems are great for just such events, acute care.

Unfortunately, it is not a system of prevention and furthermore, it is not equipped to deal with chronic health issues outside of prescribing a pharmaceutical – a band-aid.  And so, more than 1/3 of people with insurance end up supplementing with visits to acupuncturists, functional medicine practitioners, chiropractors, and message therapists (just to name a few) that are often times not covered by insurance.

For people experiencing months or even years of symptoms, going from doctor to doctor to try and uncover what is going on, looking for a diagnosis, relief from symptoms, answers of any kind, the insurance system most often fails them. And, let’s not forget, time is very valuable. Many people spend way too long trying to make the insurance system work for them and in the end, it simply doesn’t.

A “cash pay” system opens doors for people dealing with health issues that are simply not available inside the insurance system. A cash pay system is a system where a provider has decided to opt out of accepting health insurance.

What are the benefits of a cash pay model and why should we be looking inside this health based system for answers to our ailments?

Cash pay practices offer transparent costs.

Unlike the wide swings in pricing under the insurance model, cash pay practices offer clear and transparent lab costs. It’s quite complicated but essentially, providers and insurance companies can negotiate rates privately which means there is no one standard pricing index for the cost of services or labs leaving us all scratching our heads trying to determine how to understand our invoices or bills. Most cash pay practices discuss costs of labs and other fees up front, well before any lab orders or services have been ordered or rendered. Full transparency and no confusion. And most cash pay practices offer testing at a fraction of the cost of testing through insurance.

Cash pay practices offer significantly greater time with their patients.

Accessibility is imperative for health and wellness. Your health history and story matter.

Stepping out of the insurance model means practitioners have about 16 hours more a week they can spend directly with patients and/or research as opposed to administrative time spent dealing with billing and insurance.

An insurance-based practice is designed to be a high volume-based business, causing extremely short appointment times with providers. This is one of the major problems with our current medical system. Time is essential when trying to fully understand the complex issues that people with chronic health issues are dealing with. Moving outside the insurance system means providers can spend as much time as needed with each patient.

Cash pay practices can offer comprehensive testing options and truly personalized and targeted wellness plans.

Under the insurance system, lab tests must be deemed medically necessary. Outside the insurance system, providers can run any test, any time with no need for lengthy battles with insurance companies on why a test is needed and they don’t require hard to pinpoint diagnosis codes to justify running or rerunning tests.

It is access to these comprehensive tests that help uncover as much specific information about each client as possible. This makes it much easier to see patterns and trends of dysfunction that can explain the way the patient feels (symptoms) and allows the provider to build a truly personalized plan to correct those imbalances.

Cash pay practices are more affordable in the long run.

The combination of having access to comprehensive testing and spending ample amount of time with patients really is the difference between sick care (the insurance model) and health care. You are more likely to get well outside of the insurance models pharmaceutical approach when using a functional medicine approach and a cash pay system.

Being able to get real answers and begin implementing real solutions as opposed to simply taking a drug means you will no longer be moving in and out of doctors offices at all (this ends up being expensive when you calculate time and money spent). Most functional medicine providers prioritize relationship building and client education, ensuring they are empowering their clients or patients. This means the money you spend out of pocket has an enormous return on your investment!

So, in the end, spending money out of pocket (despite having insurance) means you will more likely get answers and feel better sooner rather than (maybe) never. It’s that simple.

The most beneficial hormone for improvement in quality of life and metabolism is also the most resisted and misunderstood hormone by most health care providers, especially those who have not taken the time to learn the medical literature outside of what is taught in school. This hormone is THYROID! Thyroid improves quality of life and metabolism in every cell of the body.  If you have ever thought you may benefit from thyroid hormone supplementation and were told everything looks “normal” – it can be very confusing and frustrating. Most often the only test ordered to check for thyroid function is TSH. Sometimes T4 is also tested. This is a problem, because the most important thyroid hormone, and your symptoms, are ignored!

Imagine there is a group of kids inside a room in your house with the door closed, and you want to know what they are doing. If you ring the doorbell on the front porch of the house, will you find out the answer? Of course not! It doesn’t even make sense, does it?

TSH is like ringing the doorbell. To know what those kids are doing, you need to know the level of free T3, and sometimes even reverse T3. If only TSH is tested and it shows to be in the “normal” range, you will likely be told that there’s nothing that can be done; that everything looks “normal”.

Symptoms of low thyroid function include (but are not limited to) feeling weak, cold, tired, fatigued, thin hair, skin and nails, weight gain, increased body fat, loss of energy and motivation, brain fog, decreased memory, depression, and loss of well-being. You do NOT have to fit the box of a diagnosis to get treated and to feel relief.

If your free T3 is on the low end of the range, even if TSH and free T4 are in the “normal” lab range, many people still feel symptoms and have trouble getting relief unless they supplement with the right kind of thyroid hormone.  Multiple scientific studies, including psych and endocrine literature, support the use of thyroid hormone to treat symptoms even when the levels in the blood are within the normal range on lab tests. Many studies also demonstrate that only high physiologic levels result in resolution of symptoms. Thyroid hormone may be prescribed off-label to treat symptoms. With the right kind and the right dose for you, relief is in site!

However, not every thyroid hormone prescription is created equally. The one that is most commonly prescribed is Synthroid or Levothyroxine, which is only T4. If you take T4 only, it will  suppress T3 and you may not feel any better or you may even feel worse.

Desiccated thyroid is a natural thyroid hormone that is a combination of T4 and T3. NP Thyroid is commercially available and is made in the USA. It can also be compounded, which costs less and may be better absorbed, especially if you have a sensitivity to wheat. When you take thyroid hormone, it is considered exogenous supplementation if you still have a functioning thyroid; exogenous replacement if you no longer have a thyroid gland.

If you are wondering why you are experiencing symptoms of low thyroid function, it could be one or more  of three things. Your thyroid gland may:

1. not be producing enough T4

2. not be converting T4 to T3 (remember T3 is the active form of thyroid and the most important one)

3. have receptors that have become resistant to thyroid hormone, and therefore less effective, despite your blood levels showing to be “normal.”

Reminder: TSH alone is NOT an accurate measurement of thyroid function.

Aside from relieving symptoms, there are many benefits! Thyroid hormone:

• Protects against cardiovascular disease, diabetes, cognitive impairment, fatigue, weight gain, increased cholesterol, and memory loss.

• Regulates body temperature, metabolism, brain function, energy, and fat burning.

• Increased metabolism and lipolysis which leads to weight loss and lower cholesterol and blood sugar levels.

• May restore normal menstruation and fertility in women with PCOS.

Risks/side effects may include:

• Sweating, palpitations, tachycardia, tremor, or nervousness, but these are typically symptoms of endogenous (caused by something internally, without any supplementation with thyroid hormone) hyperthyroidism and not exogenous replacement.  Endogenous hyperthyroidism is NOT caused by taking thyroid hormone.

• Side effects are rare with exogenous supplementation or replacement.

• Exogenous replacement does not cause the side effects of endogenous hyperthyroidism, but many people (including healthcare providers and practitioners) will state and claim that it does.

• Studies from the psych literature and endocrine literature repeatedly show no harm to high dose replacement. Harm is only due to an underlying autoimmune disorder, called Grave’s disease (in which case you would have an overactive thyroid at baseline, not underactive).

SUMMARY:

1. Raising T3 levels to optimal will improve symptoms, whereas using T4-alone does not. A combination of T4 and T3 is required in order to optimize T3.

2. Desiccated thyroid is the best choice for supplementation or replacement, either compounded or NP thyroid. Armour thyroid is now too expensive, and others are difficult to obtain due to shortage.

3. It is low T3 at the cell level that is responsible for the symptoms of low thyroid, not TSH and not T4.

4. Commercial thyroid may not be absorbed well in people with corn or gluten sensitivity; compounded is the better choice in these cases.

5. Symptoms, signs, and Free T3 levels are the best guide to therapy and adjustment in dosages.

6. There are perceived risks, especially when looking at TSH only.

The goal of treatment is to provide functional improvement, improved quality of life, energy, and mental alertness as a psychosocial benefit. Imagine that, improve your quality of life with something natural AND that makes sense!

This information was adapted from Worldlink Medical.

With gratitude,

Megan Miller, FNP-C

The digestive system is home to so many moving parts. One breakdown along the pathway won’t result in terrible symptoms right away but will eventually cause dysfunction that can snowball over time into bigger problems.

Take a look at the many responsibilities and organs involved in digestion.

The digestive system works like a well-oiled machine where every process depends on the success of the prior process. If you have dysfunction at any point in the digestive process, it will not only affect every process that happens afterwards but can also impact organ systems outside of the digestive tract.

Did you know that the digestive system serves as a transportation highway for ingested food to move through the entire digestive system so that the following things can happen?

So, the number one thing we can do when we have symptoms, regardless of what they are or where we feel them in our bodies, is to look at the gut, in its entirety. 

We use a top to bottom or north to south approach in the digestive system for anyone dealing with health related issues. Why the gut? It is the system that fuels the body and if it isn’t working well it will affect all other systems in the body. 

This means that even if you have Ulcerative Colitis (like me), we won’t simply focus on the large intestines (UC affects the large intestines), instead, we will look across the entire digestive tract, starting at the top –  the brain and then work downwards through the entire system.

Not using this North to South approach means you will miss potential issues that are contributing to the onset of UC to begin with. Focusing only on the area that has been effected leads to unidentified problems and this means you will likely never feel optimal and we strive for optimal health outcomes. 

You might be thinking, “that’s a lot of information to collect” and you would be right. It takes an in-depth look at truly comprehensive blood work and stool testing as well as a lengthy amount of time with a practitioner asking all the right questions. 

This top to bottom approach we use uncovers real answers and allows us to work on imbalances in many areas of the body which results in you feeling just as you should….amazing!

I hope you find this helpful in your endeavor to prioritize your health related issues.

With all the popular diets that emerge each year it’s really difficult to decide which might work best for you. I have spent more than a decade researching ways of eating (diets) and here’s what I found:

The diets that result in the best health outcomes all share one commonality: they all remove highly processed foods and focus on consuming real food – the kind made by nature!

If you want to feel your best, here are some tips I recommend.

And just as a preface, I highly recommend that if you have any digestive related symptoms you address those issues and treat then as your #1 priority. If for any reason your digestive system is not functioning properly, it may result in an inability to breakdown and absorb nutrients. If you are going to put the effort into finding the right diet, be sure you will be able to reap all the benefits!

Ok, here we go:

#1 – If you are looking for the best way to eat, focus on eating more real food and reducing or eliminating as many highly processed foods as possible. Your body will thank you.

Add a variety of new vegetables and fruits to your diet each and every week. TIP: Visit the grocery store when most others don’t (like a Friday night) so that you can browse the produce section without all the stress of a Sunday afternoon grocery store run. This will allow you to explore all the bounty you may be missing out on.

Of all the bacteria that play a role in our health and wellness that reside in our gut, NONE prefer sugar, fat or even protein….they thrive off of plant fibers and the more variety, the happy their community is which means the healthier we are!

#2 – This might be a tough pill to swallow for some since there are so many convenient options on every corner but, if you can mostly make your own food, you will be well rewarded. Cooking at home has a lot of advantages including knowing every single ingredient you will be consuming and knowing that your food is not combined with countless chemicals. Convenient, fast foods usually use low grade oils that can contribute to inflammation, dyes that our bodies are not capable of breaking down and WAY too much sugar – heck they even put sugar in soup!

On top of being clearner to eat, you are also able to get creative and have fun with new ingredients, flavor profiles and recipes when you cook your own food. If this feels hard, simply start by reducing the number of times each week you eat out – Rome wasn’t built in a day!

#3 – Next, remember these two acronyms and don’t get bogged down with all the heavy details of weighing and measuring food or calorie counting that can feel so overwhelming:

MVP – Minerals, Vitamins, and Phytonutrients

PFC – Proteins, Fats and (specific) Carbs

Our bodies thrive when given optimal amounts of all those amazing compounds that help provide the right type of energy for us. Check out this Nutrient Guide for the specifics of MVP’s – it is really helpful for choosing foods rich in MVP’s so you don’t have to do the digging online.

As for PFC’s, I recommend focusing on consuming as many different types of vegetables and fruits (these are specific carbs) as possible, having smaller portions of high quality protein and enjoying lots of health fats most of the time. Here is a Macronutrients handout that might be helpful for PFC’s. The most important thing to remember is this: listen to your body when you eat. If you notice any of the following symptoms, remove the offending food. Avoid the food for a few weeks then try it again, in isolation, to see how you feel. If you aren’t sure which food caused the issues, start food journaling.

#4 – Lastly, digestion works best when we are in a relaxed state so try eating intentionally. This really means to simply slow down, take a few deep breaths prior to eating, relax and clear your mind of all the worries of your day.

I keep a candle on my table (where I eat 95% of the time) and light it just prior to eating. The candle is really what has become a reminder that eating is a time to relax but it also creates a nice mood as well.

To sum it all up, most of us are looking for ways to improve our health and longevity. Diet is but one thing to consider but it’s a big one as our food is how we provide energy to our cells which handle countless, critical operations that keep our bodies running. Instead of buying into the diet culture, use these simple tips to make small changes over time around food and you will see and feel the difference.

Happy eating!