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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!

If you’re in pursuit of achieving better health, you should be tracking – where you’re at, where you want to be and what’s standing in your way.

Setting aside time each month for personal reflection helps us determine some important things as we move through the process of change. Here are some reasons I use it personally and professionally:

1. Brings awareness to our present state. This can mean physically or mentally/emotionally, and all are equally important. What is currently going on with your health? Are you where you want to be?

2. What challenges have you encountered over the past month? What did you do to move past those challenges? This helps us see what we were up against and how strong we really are when need be.

3. Allows us an opportunity to analyze what we might have been able to do differently to stay aligned with our goal. This is not about judging yourself, this is about learning from experience – so that you can take that information and use it in future similar situations.

4. What areas of your life did you strengthen and cultivate? Yes, pat yourself on the back! Maybe you learned a new skill like yoga or you built new friendships or came up with new strategies to use moving forward. Whatever it is, celebrate it!

There are so many benefits to personal reflection not listed here but rest assured, it will bring awareness, understanding and transformation if you practice it monthly.

Below is a FREE template that I love to use for reflection and staying aligned with my health goals. Grab yours now!

Monthly Reflections

The history of sugar is a fascinating but troubling story. If you have time to do a little research, you might agree. We won’t delve into the depths of that today but I do want to speak to what happens when we consume sugar and ways you can reduce your cravings for sugar in a sustainable way for the benefit of longevity and better health. 

If you crave sugar (or foods that easily convert to sugar like bread, pasta or rice etc.), feel like you lose control with sugary foods and eventually eat more than you planned to have, you are not alone. 

Did you know that the term “White Gold” is a phrase used for both sugar as well as cocaine? 

They share some common reactions in the body; both have very similar effects on the brain, causing the release of the neurotransmitter dopamine as well as activating opioid receptors.  

Dopamine and opioids activate the reward centers in our brains, make us feel good and provide us with quick energy, all of which cause the body to want more and more. The more we consume sugar, the more we need to reach that state of “high” we previously experienced. Essentially, we build up tolerance and crave more and more over time. 

And, withdrawal is HARD! 

One of the bigger issues with sugar cravings versus cocaine addiction is that sugar is available (legally) everywhere we turn. And just to make matters more complicated, food is a necessity for human survival unlike cocaine or other recreational drugs. 

So, we are a society addicted to sugar, using it in the mornings to get us up and running, in the afternoons to make it through a busy day, and even in the evenings as a means to relax and enjoy our lives. It’s found in every corner of the grocery store, even in “healthy” soups and other products we wouldn’t expect to find it. 

For all transparency, there are other reasons we might crave sugar, one of which is the overgrowth of organisms in the digestive tract. An in-depth look inside the microbiome via a comprehensive stool test is the best way to determine if your sugar cravings are tied to imbalances in the gut. Reach out if you are interested in learning more about this connection. 

So, how do you break up with sugar in a way that doesn’t feel overly stressful and feels more like a positive than a negative? 

1. Start your day with plenty of protein – having a breakfast packed with plenty of protein helps stabilize blood sugar levels and curb sugar cravings throughout the day. 
2. Go slow – my motto with most things is “make small changes over time” – stress is real in most of our lives and trying to kick sugar in a day (or a week!) can cause even more stress which is unhealthy. Simply choose small ways to replace your favorite sugary treats with healthier options. If you want some tips, reach out! 
3. Keep things interesting – Sometimes we reach for sugary foods because we feel bored with food in general. Finding new and exciting recipes or recipe inspiration in cookbooks, magazines, social media or even old family favorites, can help keep food feeling fresh and interesting and in turn you feel less drawn into the quick but temporary excitement that sugar offers your brain and body. 
4. Have a plan and food available as often as possible. When we are hungry, we are most likely to negotiate with ourselves regarding sugar. Surround yourself with healthy snacks and easy to grab meals so that when you find yourself feeling hungry or in need of some energy, you have the right fuel to put into your body and reduce your desire for sugar. 

Of course kicking the sugar habit takes time and patience so give yourself grace as you move through the process of reducing sugar in your day to day life. The more distance you put between you and refined sugar, the less inclined you are to think about it. Your taste buds change pretty quickly as well so you will (soon enough) be able to have small portions of sweet treats and not feel as triggered by them because they will seem less appealing to you overall. 

Take it slow but move in the right direction and your body and mind will thank you!

Be well,

Cecili, CNTP

One of my favorite quotes is “Those with chronic illness aren’t faking being sick. They are actually faking being well.” 

We (those of us with chronic health issues) oftentimes will put on a happy face outwardly while actually feeling like we are falling apart on the inside. 

Chronic issues leave us overwhelmed in many ways. When we initially experience the onset of symptoms there’s a rush to figure out what’s going on and how to fix them. After months and months of dealing with the stress, exhaustion, and fear of not feeling well, we begin to lose hope.

In the beginning, we may openly share our feelings with family and close friends. However, as long periods of time pass, we tend to go silent and turn inward.

• Many of us don’t want to sound like a hypochondriac.
• Many of us don’t want to worry our loved ones.
• Many of us don’t want people to see us as weak (even though we are some of the strongest people around!).
• Many of us don’t want to admit (out loud) how scary it is.
• Many of us don’t want to bring attention to ourselves and how our lives are changing because of our health issues.

There’s a lot that goes on inside that even those closest to us may not fully understand or know about.

Chronic issues tend to move through cycles of high symptom activity and calmer dormancy. We have our own emotional cycles that we move through as well. There are five stages that we can cycle through over and over again: denial, anger, bargaining, depression and acceptance.

If you are smiling even when you are scared, overwhelmed, anger or any other difficult emotion, know that there are many others, myself included, that do the same.

Halloween is such a fun time of year. I love seeing all the kids dressed up and so excited. I love that it marks the beginning of the holiday season. I usually start thinking about new fall recipes that include soups and hearty foods that I haven’t considered for months. That said, it does feel like feel Halloween has become the gateway to a three month long season of over indulging in too much sugar. Something that can cause roadblocks in our pursuit of health goals.

So, how do we enjoy the Halloween season (let’s face it, it’s not just a day anymore!) without causing too much harm? Especially for our kids who love to trick or treat!

I could keep the list going as there are plenty of options on the market that are healthier options than just was lines the front of the stores as we walk in but I just wanted to give you some ideas to try. Explore from the options listed above, these are brands we trust and they also have other varieties to choose from.

Wishing you a happy, healthy and safe Halloween!