Time for a Parasympathetic Response to COVID-19

Time for a Parasympathetic Response to COVID-19

There are so many things right now that can upset us about the new pandemic that is sweeping the world. Who to believe, how to protect ourselves and our family, how much toilet paper is enough? With all these questions and more, it really is hard to avoid having a major sympathetic response, which is our flight or fight mode. This response, when in a sustained state, is counterproductive to staying healthy, because what we need now, more than ever, is to have a parasympathetic response. Which state we are in determines how our immune system interacts with and reacts to our environment, and of particular relevance right now, to COVID-19.

We now know that the importance of slowing COVID-19 is that we can flatten the curve of spread and not overwhelm our health care system so that when people really need it, it will be there. The attached diagram explains it well. We will not “stop it cold” with school closings and canceling events, but we will flatten the curve which I think is extremely important.

COVID-19 Healthcare System Capacity

This is a bigger picture approach to coronavirus, but what can we do personally to get ready? (And no, it does not involve stockpiling toiletries.) There are things that have been covered ad nauseam on a personal level to control the pandemic, if you have not been living in a cave, such as

  • Washing your hands. I won’t get too deep into the importance of washing your hands, but I will say wash them like you’ve been cutting up jalapeño peppers and have to put in contacts or have to pee. Being from Louisiana and loving all things hot, I know what this entails and I imagine you do too. Whoa, Nelly!
  • Don’t touch your face. Ok, this is hard. Touch it with tissues as much as possible, or I guess we’re all going to be walking around with a bunch of crusty noses.

There are other tips that the CDC is sharing via their website. Be sure to read it. None of these things, however, address how to create a dynamic immune system that can take on the challenges of viruses. How do we make a dynamic immune system? Well, one answer is to get into a parasympathetic mode and support it with some very familiar interventions.

The parasympathetic mode of our autonomic nervous system, which is the opposite of fight or flight, sympathetic mode, is the relaxation mode. It’s when we are in this mode that our immune system is better able to identify pathogens, think COVID-19, cancer, and other threats. This is the reason stress, anger, and anxiety are so counterproductive, and when we see people who live in these states, they respond poorly to curveballs like cancer and infection. So how do we shift our autonomic nervous system to this pathogen-killing vigilance of parasympathetic mode? Well, you have heard most of it before, but I want to remind us of the simple things that will help us during this time of uncertainty.

Sleep. This is the most powerful tool we have and most Americans are only getting 6 hours a night or less. They have shown this deprivation to increase our risk of heart disease, diabetes, cancer, and yes, increases our risk of infection. Let me urge you to make this a priority now and in the future. Here are some small steps that may help:

  • Blue light avoidance 1-2 hours before bed (cell phones and computers) or use blue light glasses that filter this cue to wake up.
  • No exercise 3-4 hours before bed.
  • Tape your lips. (See blog on this cheap fix–I love it.)
  • Be careful of caffeine intake. (See blog on how this affects sleep, even what you consume in the AM.)

Food. What you eat matters in the way your immune system responds. If we eat processed, high-sugar foods, then our immune system gets revved up, and not in a good way. It moves toward attacking self, and not toward attacking non-self, or things like coronavirus. That’s why this lifestyle choice of healthy eating is associated with health and not disease. Our immune system likes things it recognizes, such as foods that are in the form nature intended. This helps with the parasympathetic state, which allows the immune system to monitor our environment, and if we get coronavirus, not overreact to it, but to efficiently remove it. COVID-19 gets nasty with overreaction, as it causes our immune system to attack our own systems. Keep it simple. Eat whole foods and avoid inflammatory foods which are processed, high in sugar, and contain preservatives.

Meditation. The simple process of focused breathing qualifies. It’s not necessarily 2-hour deep dives into the Universe I am talking about here, but focused breathing that takes us from a sympathetic state to that most important parasympathetic, virus-killing, state. For some of us, this is a big step, clearing our mind and focusing on breathing, but there are apps for that like 10% Happier. Try it. It could start with just 5 focused breaths and trying to not think about where you are going to get enough toilet paper because the leaves are not yet on the trees for backup.

Exercise. The good news here, as well. No need to be a Tri-athlete, as prolonged intense exercise may be counterproductive, but moderate exercise is key, and here is some support for that:

“Exercise has a profound effect on the normal functioning of the immune system. It is generally accepted that prolonged periods of intensive exercise training can depress immunity, while regular moderate intensity exercise is beneficial.”[1]

Even that staple of just walking 30 minutes a day showed the following:

“A study of over 1,000 men and women found that those who walked at least 20 minutes a day, at least 5 days a week, had 43% fewer sick days than those who exercised once a week or less. And if they did get sick, it was for a shorter duration, and their symptoms were milder.”[2]

Another well-researched exercise that improves parasympathetic response is yoga. If you have the flexibility of an oak branch like me and have done yoga, then you understand it is exercise. The great thing about yoga is that it can meet you where you are physically and help you get as intense as you want it to be, or not be in my case. This is the exercise you can do at home and still be in a virtual class.  This is one of my favorite options for exercise right now.

It may seem counterintuitive to say exercise improves our parasympathetic response, and improves our immune system, but data supports that although you stimulate your fight or flight sympathetic nervous system initially, you have increased parasympathetic nervous system response over time with regular mild or moderate exercise, which will keep you fighting and overcoming viruses.

Supplements. Disclaimer: I love science-backed supplements, and have used them with all the above interventions for years, to significant effect. I will not go in-depth here in supplement analysis but wanted to give some staples with another disclaimer, which is, make sure the supplements you get are FDA inspected, third party tested supplements as they do you no good if they don’t have what they say they have in them. This list is good for anyone who is immunocompromised as well, if tolerable. If needed, there are liquid forms available.

  • Magnesium– Here’s one that you might not be thinking of. This is big for the ability to have a parasympathetic response and it also helps immune function. Most Americans are deficient, so adding some to your regimen can only help (read more in this magnesium post). I would use chelated magnesium like Mag Glycinate or Sucrosomial magnesium like Ultra Mag and take 300 mg or more a day.
  • Vitamin D3– This one helps with immune function and improving responses to things like flu. I recommend at least 2000 IU’s a day. You can use more than 5000 IU’s per day, but be sure to get your levels checked every 2-3 months until you know this is a stable dose for you.
  • Zinc– I like 30-50 mg a day of zinc picolinate or zinc citrate, as most Americans are also low on this mineral. They have shown it to decrease the symptoms of the common cold by 2-3 days in some studies and is essential for a healthy immune response.
  • Vitamin A- because of genetic issues, many people have trouble converting beta carotene from things like carrots and sweet potatoes to retinol (Vitamin A). Vitamin A is a super potent virus fighter so adding in 2500 to 5000 units a day is not a bad idea. You need to make sure you are taking this with Vitamin D, and more is not necessarily better as there can be toxicity with higher doses.
  • Vitamin C- This is a no-brainer for me. My Mama gave this to us every day during cold and flu season and for good reason. It has extensive literature that supports its use to both prevent and treat viral infections. To prevent, I would look at 500 mg a day, and if you get an infection increase this to 2000 mg a day. Here is a paper with an overview of Vitamin C and its benefits.

Though not all the above supplements are directly parasympathetic oriented, they’ll help you get through this time in which a highly efficient immune system is so important.

With the COVID-19 pandemic, we are in unprecedented times. It’s time to empower ourselves and control what we can control. We cannot control the hoarding of bizarre things that will have no bearing on outcomes, but we can calm our autonomic nervous system and get our bodies in tiptop virus-fighting shape. We will all know someone with COVID-19 before this is done, I’m afraid. Yet, we have to go on living and hopefully, thriving, knowing we are doing all we can by taking care of ourselves.

[1] “Exercise and Regulation of Immune Functions” Prog Mol Biol Transl Sci, 135, 355-80 2015

[2] https://www.health.harvard.edu/staying-healthy/5-surprising-benefits-of-walking

 

Cooling the Passion for Sleep’s Sake

Cooling the Passion for Sleep’s Sake

I have an admission to make… I have been in a torrid affair for years and I have to come clean. Yes, my wife knows and has been ambiguous regarding this affair, as I was having it before she met me. It gets me up in the morning. It keeps me up at night. Coffee, why are you such a tough mistress!

 

I love my coffee, and if I could, I would drink it night and day. I started when my grandfather would put it in a saucer to cool it off and let me drink it that way at the age of 3 or 4. If it wasn’t coffee, then it was iced tea in the South, and we drink that more than water. Then, for a treat, we would drink a Coca-Cola every 2-3 days. Caffeine was just a part of life for me, and I loved it. What I discovered is that it didn’t love me back.

My first suspicions of this non-reciprocating love were when I got my genetics analyzed. I had both variants of one particular genetic variation that helps me get rid of caffeine (CYP1A2). This means that if I drink more than 1 cup of coffee a day, I have a 38% increased risk of a heart attack. If I have more than 2 cups that risk goes up to 64%!  Others (hate them) have a decreased risk of heart issues with coffee/caffeine, which is all based on their genetics and very good fortune. What I thought was good for me according to some studies (these studies often contradict other studies saying it’s bad for us, as genetics was not a variable they considered), was going to increase my odds of a heart attack once I knew my genetics. There are also genetics where you increase anxiety with caffeine, which I will explore further below in the section on how to look up your caffeine genetics, but thank goodness I missed the genetic lottery for that one, ADORA2A, although the CYP1A2 was enough I think. This detox genetic variation, CYP1A2, in and of itself,  definitely makes me rethink my relationship, and that was before I figured out what it was doing to my sleep.

Yes, it is official: caffeine disrupts sleep. I know, I know, this is a news flash and why haven’t you heard of this prior to now. Well, now you know (wink, wink).

In all seriousness, we know caffeine wakes us up so why am I stating the obvious? Well for one, I don’t think the common layperson or medical professional understands how caffeine disrupts our sleep by not only delaying sleep, but actually waking us up in the middle of the night and affecting sleep cycles, and this may be from caffeine intake in the middle of the day, not at bedtime.   

I have friends who pound coffee all day and then fall right to sleep an hour or two after. The problem is they don’t understand why they can’t sleep for more than 4-5 hours. Well, I can tell you caffeine is known to be the most common cause of “waking after sleep onset” or WASO (just in case you needed another acronym in your life). Let us now take me as an example. If I have more than 2 coffees a day, especially after 10 AM, then I can guarantee you that I will be awake after 5-6 hours of sleep. I finally put it together by noticing patterns that my Oura ring provides. This handy ring tells me REM, NREM, light sleep, and awakenings. It has given me great insight into my sleep and coffee is a definite detriment.  

Why is something that is so good, it seems, so bad for us at the same time? Well, to understand this relationship, we need to understand the physiology of caffeine’s effects.

Coffee’s primary mechanism of action is its effects to block Adenosine from binding to receptors in the brain that make us sleepy (it has some secondary effects on histamine release in the brain but for simplicity let’s focus here).  Adenosine is an amino acid that accumulates during the day and allows us to fall asleep at night. Caffeine does not get rid of adenosine, but rather blocks the receptors, which is an important fact. When the caffeine wears off, then we still have that adenosine accumulating and it will either bind with a vengeance and we are more tired than when we drank caffeine, or we fight the fatigue with more caffeine and put off the inevitable. The problem with caffeine is its relatively long half-life of 4-6 hours depending on your genetics. This means it can take a full 24 hours to rid your body of the caffeine you took in at 8 AM. If you are dosing throughout the day, then you may have the same amount of caffeine in your system you did after that first cup of coffee, at your bedtime! You may still fall asleep, as the adenosine overwhelms the receptors, but when you have broken down enough adenosine as you sleep, caffeine is still there binding those receptors and boom! Awake you are, and not at a convenient time.  

The above calculations do not take into account if you are a poor metabolizer like me. If you have genetic issues, which there are two main ones, then you may have trouble sleeping with just one cup of coffee or God forbid, an energy drink which in some cases can have over 3 times the caffeine as coffee. There is a lot to consider here as we grab that cup of Joe or energy drink and here are some tools to help you understand the effects of that 24 oz. of coffee from Starbucks and ways to cool down that torrid relationship with caffeine.

  1. Caffeine Apps – Yep, they’ve made an app for that. The simplest, for $3.99, is “Caffeine App.” You plug in all your caffeine intake, from whatever source, and it’ll give you charts of where your caffeine will be at bedtime. What’s scary, is that as I write this and have consumed 2 cups of coffee, 1 at 6:30 AM and 1 at 8 AM, I will still have 50 mg of caffeine in my system at 9:30 PM! This is with an arbitrary 50 mg limit I put in the app. This is like drinking half a cup of coffee and going to bed! Craziness! This is without my genetics, so guess who is only going to be drinking 1 cup a day from now on?

  2. Genetics – I use PureGenomics to understand my 23andme data. Fortunately, it is free, but you need a healthcare provider to sign you up. If you don’t have PureGenomics, I will include a short tutorial at the end to look up your genetics on your 23andme account. This is important, not only for sleep but your overall health as I pointed out before, especially with blood pressure and heart disease.
  3. Decaffeinated beverages – I love coffee and don’t care if it is decaffeinated. I would recommend, 1 cup of regular coffee or other drink, then switch over to the decaffeinated version. You are still going to get some caffeine but about 85% less. This makes me extremely happy and doesn’t disrupt my sleep. If you’re going with decaffeinated coffee, make sure it’s not chemically treated but rather, Swiss water extracted (organic), just to have the best possible experience.
  4. Wean off the caffeine. I know this is unthinkable, but in my journey of health, I have to admit, I’m thinking this is the next step for me. It’s giving me artificial feedback on my health. It allows me to ignore my adrenal health and mask its feedback of stress, not enough sleep, etc. so that I’m unable to connect the dots and make better life choices. I’m thinking I will start with only one cup of caffeine a day. I will add herbal hot beverages to give me the “hot drink” fix. Then, I’m going to start mixing my coffee beans half caffeinated and half decaffeinated for a while. Next, it’s on to just decaffeinated beans, which have about 10-15 mg of caffeine, but allows me to have the taste I love.   It’s a plan, and one I am going to do my best to stick to.
  5. Support your body during the withdrawal. Often, we are using our caffeine as compensation for years of burning the candle at both ends. We can use things that support our adrenals, which are responsible for giving us energy that is independent of caffeine, through cortisol. Two of my favorites are 1. Adrenal for very overworked adrenals and a less aggressive option 2. PhytoADR.  These will help as you look for energy that is not caffeine-dependent. Another option is Energy Xtra when you need that extra pick me up that would normally involve caffeine.

This is basically a cathartic article for me, or my “Dear John” letter, as I had to not only write this for you, but for myself. When I see it in black and white, I can no longer avoid the inevitable breakup that has to happen. I have to do it for my heart, my sleep–and ultimately–my overall wellbeing.

How to find out your genetics in relation to caffeine:

  1. Go to 23andme and login
  2. Click on initials (Step 1 on screenshot)
  3. Click on Browse Raw Data (Step 2 on screenshot) 
  4. Look at 2 specific genes for Caffeine
    • ADORA2A rs5751876 (See image-you will have to put it in as rs5751876 exactly” STEP 3”)- if you get TT “STEP 4” you are more likely to be anxious with caffeine.
    • Next check your CYP1A2 rs762551 just like you did above- CC and CA are the ones that mean you are slow metabolizer. CC is the slowest metabolizer of the two and means even less caffeine is needed to cause hypertension and heart disease.

 

Zip It and Sleep Better

Zip It and Sleep Better

Or I should say, tape it and sleep better. I am about to tell you about one of the most amazing sleep secrets that costs pennies a day (Infomercial sounding? Yep, but not selling anything but good ole tape) and may save your adrenal glands. The secret is lip taping at bedtime.  

The science here is amazing and is based on the work of Dr. Butekyo. He was a doctor working in the ICU who noted that patients that slept with their mouths closed, lived much longer than those who slept with their mouth open. 

There is some complex physiologic process going on here that justify this increased longevity, but suffice it to say, breathing through your nose, creates more nitric oxide, which improves lung and heart function. It also prevents a tremendous amount of sleep apnea and oxygen deprivation. I have been utilizing this technique since the conference I attended by the guru of Butekyo Breathing, and my sleep has never been better. I actually proved this when I monitored my sleep with my Oura ring with and without tape and my sleep scores without tape were much worse. Especially my NREM and REM sleep scores, so I did not get as much restorative, deep sleep as I need.

What is involved with taping?  Well, you can go the cheapest route and use 3M Transpore tape and tape the lips shut which may involve trial periods while awake. This is an issue if you’ve been a long-term mouth breather. Once you’re used to wearing it (most people tolerate it without having to do the longer and longer trial periods) you then wear this before you fall asleep and take it off when you awake. Too good to be true? I thought so too, but let me tell you, this is a life changer for improved sleep. If you like your tape fancy, and I do (I am so Zsa Zsa), you can also use lipseal.com to order amazing tape in the shape of lips that I reuse 2-3 times before throwing away.  

Are there other applications for nose breathing even when not asleep? Yes, and I would highly recommend learning more about nasal breathing for asthma, stress, anxiety, and much improved athletic performance. ButekyoClinic.com is a great place to start if you want to dig further. If you want more information and techniques for lip taping for sleep, here is a good article I found. Also, check out this YouTube video called “Mindfulness Buteyko” which helps calm the mind and teaches soft breathing techniques. 

 

To your much-improved sleep,

Nathan Morris MD

Don’t Drink the Kool-Aid

Don’t Drink the Kool-Aid

I have a really twisted commercial in my head. There are a bunch of kids studying intently, when one of them looks up and says, “Man, I am super focused…” Cue the big red Kool-Aid man. He busts through the wall (awesome commercial back in the day) and starts doling out big glasses of red dye and sugar.

 

Next scene: The kids throwing airplanes, yelling over each other, and running around the room like they are on fire. Ludicrous right? We won’t be seeing that commercial, but basically, that is what’s happening with our kids when they eat and drink foods containing red dye and other artificial food colors (AFC’s).  

I hate to be such a Debbie Downer! “Let kids be kids!” you might say. “Are you saying the Muscle Glow 2000 my kid is drinking after soccer is affecting his behavior?” Yes. It is. The studies are there to back me up. This quote is from an article in 2014: “Artificial food colors (AFCs) are widely used to color foods and beverages. The amount of AFCs the Food and Drug Administration has certified over the years has increased more than 5-fold since 1950 (12 mg/capita/day) to 2012 (68 mg/capita/day). In the past 38 years, there have been studies of adverse behavioral reactions such as hyperactivity in children to double-blind challenges with AFCs. Studies that used 50 mg or more of AFCs as the challenge showed a greater negative effect on more children than those which used less.”

“Greater negative effect” is the way the scientific community has to say it. The way it presents in the home, the classroom, and in my office has shown more far-reaching effects than this study will ever be able to convey. Dyes equal Chaos, whether they cause your kid’s brain to turn off so that they can’t respond to their own name (my daughter), or it ramps them up so much, they are shaky and irrationally angry (my son).

The good news is that AFCs and preservatives are some of the easier things to eliminate from our diet. Simply start by reading food labels. I had my kids read them to me in the store and in the end, made the “Don’t ask for anything that you see if it has colors because the answer will be ‘no’” rule. When they shout out for Fruit Loops and Swedish fish, you can just say, “What’s our rule?” They may pout, but that’s what kids do, then they get over it. 

Many of the alternatives offered to parents with children who present with symptoms of ADD and ADHD are detrimental to the child. Often, meds turn him/her into a zombie while they are active, then when it wears off for the day, it’s like a switch flipped and they are suddenly acting out seemingly with more frustration than before. 

Parental guidance in this can be the difference between a 200 dollar plus amphetamine a month versus having to say “no” to Nuke’m Neon Red Fizzy soda. The side effects with amphetamines often include loss of appetite with stomach irritation, disturbed sleep patterns, as well as loss of creativity. Suffice it to say, it’s much better if you can avoid these drugs.    

Some kids have to have medication and it can be a life-changer, but the majority of kids in my practice were treated without these stimulant medications and did just fine. I treated the patients with things that helped with dopamine production, like Rhodiola Rosea and DopaPlus. As well as things to help calm the brain like CogniMag and Lithium Orotate and L-Theanine. 

Keep in mind, supplements alone do not carry the impact that lifestyle change, like getting rid of AFCs does. I could be the poster child for ADD, (Bless my Mama’s heart. She refused to give me medication.) and I have survived to the ripe old age of 49 with a medical degree behind my name and many accomplishments to show for it.  

Was it easy? Not always. As an adult, I’ve had to remove things that inflame the brain, like AFC’s, gluten, dairy, and ultra-processed food. This has definitely changed my focus, my temper, my gut, and my ability to organize my thoughts in order to accomplish all of the things I want to do. I’ve had to work on my sleep and exercise routines. These changes have affected my entire family in all the best ways. The hard choices are not so hard to make once we experience feeling well, with or without medications. I will take life “without,” thank you.

Nathan Morris, MD

1 Clin Pediatr (Phila). 2014 Feb;53(2):133-40

2 “Children under treatment with MPH showed a lower global Creative Index and lower scores on Fluency, Originality and Creative Strengths, compared to when not under treatment”  Psicothema. 2016;28(1):20-5

Two Simple Interventions that Improve Sleep

Two Simple Interventions that Improve Sleep

I was keeping up on my reading through scientific blogs, and found a wonderful author who is actually a dear friend, also–Dr. Kate Placzek with ZRT Laboratory. Not only is she brilliant, but holy cow, can she write so that the lay person and the doctor both learn a lot. This is hard to do!

 

After reading two of her articles, I wanted to share them as I think they have great information about simple supplements that have huge return on sleep improvement. I hope you find them as beneficial as I did. I am happy to give you a quick rundown of these articles, and how to dose these simple supplements.

 

Vitamin D

In this article, Dr. Kate talks about the role of Vitamin D3 in sleep. I did not know the effect it had on sleep, specifically in regard to serotonin and melatonin, but I did observe that Vitamin D deficiency was detrimental in my patient population for their sleep quality. Now I know why.  

I would recommend taking Vitamin D3 in the morning, although the literature is not clear on timing. I would use between 2000-5000 IU’s a day, especially in winter, or anytime if you live in “Little England,” or as most people know it, “Ohio.” Be sure to get your levels checked by your provider every 6-8 weeks until you know your dosing is stable and don’t take your Vitamin D supplement 24 hours before getting your labs done, as it can artificially elevate the level in the blood tests. 

 

Glycine

I have been using glycine for years in my patients to promote sleep, but I have never written an article that explains it so well, so now I don’t have to!  Here, Dr. Kate, explains what this simple amino acid can do. Not only is it great for sleep, but I also used it for tic disorders (involuntary movement disorders like Tourette’s) and have noticed a big difference in my patients due to its ability to decrease firing in the neurons responsible for those abnormal movements. A truly amazing amino acid, and with traveling, I have found it indispensable for correcting my sleep cycles.

I recommend using GlyMag-Z packs. They are tasty and I like to take it before bedtime on an empty stomach; although, it is not a problem with other supplements. Amino acids need to be taken away from other amino acids, like the ones in food, because they will compete for absorption, and decrease the efficacy of the desired amino acid–in this case, glycine.

 

To your improved sleep,

Nathan Morris MD

The Problem with Genomics

The Problem with Genomics

Interesting title from the man who co-created a clinical genetic interpretation web-app, PureGenomics, but there is a problem. It’s the same problem that our world suffers from in so many ways. Things are viewed as all good or all bad and no middle ground is being found. Whether this is politics, religion, science or the science that is medicine, everyone is trying to discredit everyone else. Where does the truth lie?

Somewhere in between.

So what is this middle ground when it comes to genetics and MTHFR? I think it comes down to viewing genetics as a tool that helps the clinician apply leverage. This leverage is understanding how these polymorphisms, (genetic variations which change the protein structure of enzymes, hormones, and their receptors) affect function, and how this possible change in function may affect clinical outcomes. It’s understanding that this change in function is hundreds of years in the making and is not a mutation, but a change, that in some cases, is beneficial, depending on the environment the organism finds itself in. Let’s use an illustration of the most famous reindeer of all, I mean the most famous genetic polymorphism of all, MTHFR, (got to love that name).

MTHFR is the most misunderstood SNP (Single Nucleotide Polymorphism), just like Rudolf. This is an enzyme, like a lot of other enzymes, that has more than one function. It has many changes in its code, and I think there are around 25 of these polymorphisms (one base pair is exchanged with another), and like so many other genes with mutations, most of these do not affect the function of said enzyme. Two polymorphisms do affect function, but in the literature, there is lots of confusion as many researchers do not seem to understand that enzymes have more than one function, and one SNP may affect an enzyme in one function it carries out but not in another function. For example, C677T seems to affect MTHFR as it goes about creating SAMe for methylation donation for neurotransmitter generation, DNA methylation, and detox.

The other mutation, MTHFR A1289C, does not affect homocysteine but appears to be affect the enzyme more in the pathway of dopamine and serotonin generation. It seems to escape so many peoples grasp that an enzyme is like a Swiss knife, and just because the corkscrew is broken, doesn’t mean the knife cannot open a box. As an example, we cannot say the A1298C mutation is not important because it does not affect homocysteine and the diseases that arises from poor methylation, because it affects another function of MTHFR enzyme.

This is where clinicians and researchers run into problems. We fail to comprehend the context of the polymorphism. This creates frustration when we are using the wrong tool for the job, and making claims that addressing a particular mutation does something, when in actuality it does not. This creates loss of validity in a field that is highly valid and transformational to a clinical practice.

Another problem with SNP’s, and if you ever had teenagers you will understand this, their impact/behavior often is dependent on the crowd they hang out with. Not understanding this complexity, and seeing nutrigenomics as a linear equation, takes away the validity of the field and the clinicians’ claims of what intervention of a mutation will accomplish.

One case is the MTHFR gene which in the presence of adequate riboflavin has almost completely normal function even with the polymorphism at the 677 location.  Often, polymorphisms/SNP’s have fail safe(s), if you will, or supporting genes, and vitamins, that help correct the decreased function of said gene, so that the organism can live, not thrive necessarily, but ultimately reproduce, which per Brian Hawkins brilliant book, “The Selfish Gene,” is what genetics is all about. If we just talk about the MTHFR gene as being the only instrument that matters, and do not see it as one instrument in an orchestra, then we are giving it too much credit. Likewise, if I were to be the violinist in said orchestra, one would also understand that an “aberration” can definitely have an effect on the overall sound, yikes! Now if said orchestra was playing for the hearing impaired, I’d be awesome! In some ways, that is what a gene like MTHFR does when looked at from a historical context.

MTHFR C677T polymorphism was a genetic advantage. That’s right, or it would not be so prevalent (At least 60-70% of us have at least one copy, of the two copies, for this mutation). Why would evolution allow such a thing? Advantage, and a big one if you live in an endemic malaria region. It helped our ancestors survive malaria. Where was this gene most common?  In the Mediterranean region. What is the local diet there composed of? Lots of folate rich foods, which compensated for this less effective methylating enzyme of folate. Sweet huh? The standard American diet does not have a lot of natural folate (lots of synthetic folic acid–another paper for a later date.). This is an issue that leads to problems with a genetic advantage being turned into a disadvantage as an organism’s environment changes from its original environment to the adaption. So, what does this mean for us as we navigate this gene which has generated so much controversy?

We have to understand that we do not have it all figured out. We do know that the data is conflicting in some cases because nuances are not understood by even the researchers doing the research. A lot of researchers believe folic acid is equivalent to methyl-tetrahydrofolate which is in a paper like this, https://www.ncbi.nlm.nih.gov/pubmed/21069462?dopt=Abstract, one has to question the validity of the findings. The actual polymorphism which led to the homocysteine is not directly addressed, but rather the biomarker, homocysteine. It also looked at this polymorphism in relation to people already with cardiovascular disease and did not look at outcomes if we address this gene in prevention (when MTHFR C677T is addressed in blood pressure we see very positive outcomes and decreased risk of stroke). Then we find studies like this, https://www.ncbi.nlm.nih.gov/pubmed/27973419, which seem to support the conclusion addressing methylation is quite beneficial.

What is there to make of this confusion? Should we just throw up our hands and say let’s not look at it or try to make decisions because it’s not clear? I don’t think so. Let’s agree that literature is not completely clear on the benefit of using 5-MTHF in all diseases, but it’s clearly helpful in many diseases. We also know it is much more effective in cellular uptake and this fact is very beneficial in many preventative strategies compared to its synthetic precursor, folic acid. Is it going to be the panacea that so many people have made it out to be? No, because we are giving it to much credit, and when it is not the magic hammer people claim it to be, it allows the faulty logic by the uninitiated, that since it cannot do all things, then all the polymorphisms that can be used in clinical practice are ineffective as well. This could not be further from the truth.

We have a saying where I come from, “Don’t throw the baby out with the bath water” and this is really saying, don’t get rid of the good waiting on the perfect. We as clinicians, who so desperately want to heal, get in trouble when we create the magic hammer where everything becomes a nail. We lose credibility because we a looking for something that works on everything.

Nutrigenetics is a tool. It is incredibly effective as such, and the research supports this. Clinically, ask any psychiatrist if dosing with higher doses of Methyl-folate has not turned around a large number of refractory depressed patients. You would be hard pressed to find one not using this as a clinical tool. Is it where they start? No, nor should it be. The same goes with the functional medicine practitioner. We need to focus on what we know to be the foundations of functional medicine first. Heal the gut, address sleep, decrease stress and eliminate toxins. Then, and only then, should we be then looking at nutrigenetics to help us apply leverage in assisting the above-mentioned areas of focus. It works brilliantly when we understand its benefits, but also embrace its limitations.

Dr. Nathan Morris, MD

Stages of Change

Stages of Change

Happy New Year! January came and went quickly!
Does the New Year have you feeling inspired more than ever to make change? We all know we want to exercise more, eat more whole foods, and feel better! But HOW do we make the required lifestyle changes?
Let’s first review The Stages of Change. If you know where you currently are, it will help you move more easily toward where you want to go.

WHAT STAGE OF CHANGE DESCRIBES YOUR CURRENT LOCATION?

  1. Precontemplation: Everybody thinks you have a problem but you. The best example is the wife dragging her husband to the doctors because of her concerns for his health
  2. Contemplation: You are aware you have a problem, but feel it’s really hard to change. Depression is at an all-time high because you know you should change but feel like you can’t. It’s not the right time with Valentine’s Day & Birthday’s this month plus fear of change are common barriers. You feel stuck.
  3. Preparation: You haven’t made changes yet but have made some of the initial steps. You have been thinking more about what you want and why. You have been looking at different foods in the grocery store. You’ve been reading and preparing.
  4. Action: You have started making the change you have desired to make. You are no longer afraid to give up old patterns and you move right into the action.
  5. Maintenance: You have achieved your goal. Your feel stable with this change in your life and it is now a part of you. It’s time to circle back to precontemplation and start the process over to layer in the next piece of your care plan.

WATCH THIS INTERVIEW

HOW DO WE MOVE THROUGH THE STAGES OF CHANGE?

Stages of change

CHANGE HAPPENS IN COMMUNITY

Change happens in community, not in isolation. If our friends and families are eating toxic food then we are 50% more likely to repeat those same patterns. Families work together to identify what do they want and what are some small changes they can make together. Our homes are the headquarters for our healing. Everyone in the home gets on board with the nutrition and lifestyle required to heal the one with the diagnosis. This creates a United Team; which makes social situations much easier to navigate. When we feel good and confident about our choices and when we practice being Matter of Fact that we are choosing rather than acting as though we are being deprived our friends interests may be peaked. Chances are they too are living with a chronic condition. Read HERE for some more social strategies.

FEAR OF CHANGE

Change: to cause to be different. Doing something different can be uncomfortable, even frightening. Fear of change is a big issue. This makes us stay with what we know even if we are unhappy. But note: staying the same and not making any decision to change are still decisions. A good tool is to use the Change Assessment Tool. What are the pros to remaining the same; what are the cons? What are the pros to changing, what are the cons?

ESTABLISHED THOUGHT PATTERNS

Your brain actually wires itself and forms neuronal connections based on what you do over and over in your life. Vegging out in front of the TV. Having a sugar fix. Sipping soda. Fixing a cocktail to unwind after work. Smoking cigarettes. Biting your fingernails. These activities literally become wired into your brain.  Your brain is a self-reinforcing feedback loop. We are creatures of habit. Over time, patterns evolve which determine your brain’s form and function. What you do, experience, think, hope, and imagine physically changes your brain.You may have the desire to change but you first have to dissolve the old tracking so the pattern is no longer automatic and unconscious. How? Read more here.

CHANGE HAPPENS OVERTIME, NOT IN 2 MONTHS

When we start this road to heal the root cause of our symptom sets; it’s something we will start and only getter better at living the solution. It’s not something we try for a few months and then give up because we don’t see the results we are seeking. You must identify small steps, which are reasonable, and which interest you. Overtime, these small steps will accumulate into big change. Overhauling our lives and then growing exhausted and more stressed from the drastic change is counter intuitive to healing. Look for our next post on care plans.

THE SILVER BULLET MYTH

There is no one thing that you can do to improve any one symptom. These foundation pieces to a Functional Medicine Care Plan must be priority. This foundation is how we make the medical interventions provide results. There is no silver bullet. Results come from establishing a strong foundation. Next you continue layering pieces to work in combination to maximize the medical piece. Once you place something into your plan you maintain it just like pouring the footers of a home’s foundation. What small things can you do to improve the following foundation pieces?

  • Sleep and Relaxation
  • Exercise & Movement
  • Nutrition & Hydration
  • Stress and Resilience (identify stressors and areas where they have been successful in the past so to tap into strengths)
  • Relationships and Networks

Kara Ware is Good Medicine’s Clinical Coordinator and Functional Medicine Health Coach. She also provides online courses and coaching for families living with Autism. You can read more here.

The Truth About Autism Recovery

The Truth About Autism Recovery

Recovery or Remission?

It is true; Children are emerging from this once thought dead end diagnosis. Autism is no longer a mystery. We understand the complex biological and cellular dysfunctions resulting in the symptoms referred to as Autism.

In the face of environmental exposure and toxicity, two processes get started in the human body– a chronic inflammatory response, and oxidative stress. These processes, when that human body cannot adequately address them, further manifest as compromised methylation pathways, vitamin and mineral deficiencies, Th1/Th2 immune imbalance and immune dysfunction, and inflammatory bowel disease.

Children living with AD/HD, ADD, Asthma and Allergies all have similar root causes resulting in the symptoms of each diagnosis.

When these root causes (underlying medical conditions) are acknowledged and addressed, the symptoms of AD/HD, Asthma and Allergies and the behaviors and developmental delays referred to as Autism improve significantly.

Families have many more options today rather than learning to manage their children’s behaviors. Our approach is different than the traditional standard of care such as ABA. ABA focuses on correcting the behavior; we strive to heal the underlying medical conditions creating the behaviors.  When children feel better, they behave better and therefore, their therapies are more productive.

Dr. Nathan Morris, MD and Kara Badgley, Functional Medicine Certified Health Coach, each have spent the past 11 years saving their families from Autism. Over time, they have learned their children have not recovered but more correctly, their children’s  Autism is in Remission.

The Reality

It has taken both Dr. Morris and Kara Badgley more than a decade to heal their children’s bodies from the underlying medical conditions. Every system in these children’s bodies are burdened; it takes time to experience improvement. Recovery insinuates their is a finish line; however Dr. Morris and Kara Badgley both understand they will always need to support their children’s bodies to keep their symptoms in remission.

Regressions are part of the healing journey. Exposure to high inflammatory foods, or environmental triggers such as mold, or high stress levels can create a surge of inflammation; which the child can not regulate. Regressions can happen even when the child is said to be recovered. This is exactly why we choose the word Autism Remission in comparison to Autism Recovery.

Regression is not always a bad thing. We are obsessed with progress; we want this Autism to just go away. Sometimes Regression can sometimes be better explained as Rebuilding. When we are asking the child’s body to perform more efficiently, although this is healthier, and in the long run will create a strong foundation for him/her to emerge, it is uncomfortable and therefore the child regresses for a time. Time and time again we see these “Rebuilding” Phases lead to improved functioning, communication and sleep. If a “Rebuilding” phase goes on for longer than a few weeks then it’s recommended either to see how to better support the methylation and detox pathway or to scale back on the dosage of the most recent supplement/prescription most recently introduced.

WHAT NOW?

To become a patient of Dr. Morris’  Become A Member

COMING SOON:

Autism Remission: DECIDE. CHANGE. TRANSFORM
Remission of your child’s Autism Symptoms  only comes when the parents lead by example. The healing of the family is a shared journey with the child. This life empowers the entire family to heal; which creates sustainable change to experience autism remission. Autism Remission, is a community outreach program offered in communities beginning Spring 2018. Coaching sessions are also available with Kara Badgley. Online scheduling to be available soon.
Conscious Conception: Family Steps to Baby Planning.

The first steps to a healthy family happens before your baby is born. Pre-Natal planning starts with you; your health and your environment.

Preparing your own body prior to conception allows you to optimize your fertility plus your baby’s development& health.  Conscious Conception is a program for couples to be intentional about their family’s future through functional medicine principles

OUR TOP 10 TRUTHS TO SHARE ABOUT AUTISM REMISSION:

Ultimately we all have to find our own way; but these truths will be universal for any journey parents take to save their family.

    1. Make a plan. Autism Remission outreach program helps families to create, organize, budget, document and track their care plan. Success comes from layering interventions to work in combination. A plan helps to layer well timed interventions based on each families current and unique circumstances.
    2. Your child will mirror your habits. If you want your child to do anything, you first have to lead by example. You HAVE TO LIVE THE SOLUTION.
    3. No one said this life will be easy. No one is spared from trials and tribulations. Learning to be thankful in times of misery is a key to self-actualization. Practicing Mind Body Techniques such as deep breathing, yoga & meditation help us to shift into the Parasympathetic Nervous System. It is from this state that we no longer react to the chaos but can hear the guidance we all are praying for…
    4. Begin to think about long term planning rather than short term gain. A journey of placing symptoms into remission is not something you try. It’s something you become. Autism never goes away. Even when you are in remission, there is chance for regression.
    5. A little bit of food dye, gluten, casein and other high allergen & artificial foods and preservatives does hurt. A lot.
    6. There is no cure. There is no one thing, no one silver bullet, that will make everything better. It’s going to be intelligently timing, and layering interventions to work in combination for the rest of time. And yes, THE BASICS ARE ABSOLUTELY REQUIRED.
    7. You are not alone
    8. Your child knows everything you are saying. Please stop talking about how terrible his/her behavior is or how much you suffer in front of him/her. Likewise, they understand way more than we give them credit. Explain what you are doing and why; educate them also as you layer pieces into your care plan.
    9. What you do right now: the thoughts, the words, the actions which create your habits, which create you character, which create your destiny -right now is what counts. Surfacing from Autism is an accumulation of choices every minute of every day that YOU choose (you are in charge, not your child). These choices ultimately take you toward your goal. Focus on what you can do rather than attaching to all the odds stacked against you. (See #4)
    10. Miracles happen. If you choose to show up.

You may also like:
Sleeping on AD/HD
The Missing Element
Cut Autism by 300%

About the Author:
Kara Badgley is the Clinical Coordinator & Functional Medicine Certified Health Coach at Good Medicine. She has been a health coach since 2002. For the past 4 years Kara has worked in the clinical setting with families living with Autism. She co-creates personalized care plans with families based on what they are ready to do. Her passion is to meet a family where they are at in their current circumstances and identify the next reasonable steps, and help the families to budget, organize, document and manage their care plans to live the solution. She loves most when families, who previously had lost all hope; are now enjoying their freedom and their families once again.

To hear more about Kara’s journey through Autism and her insight on How to Live the Life of Recovery click Here.

Disclaimer:
Good Medicine respects families who celebrate their children’s Autism. Good Medicine works with families whose children are clearly struggling and who are clearly in pain; therefore, the family is in pain.

Kara Ware is Good Medicine’s Clinical Coordinator and Functional Medicine Health Coach. She also provides online courses and coaching for families living with Autism. You can read more here.

Mindful Eating

Mindful Eating

Eating is an art, a practice, and should be a pleasure in all cases.

The mindfulness movement is a big one and I wanted to dedicate this article to all the teachers who have been trying to teach mindful eating. Because of them, I woke up this morning with a great memory.

My Daddy, rest his soul, was a tolerant man. In a house where no one questioned much, as was traditional, I dared to ask a question about what I thought was being religious. I asked why we pray before we eat. Daddy looked at me with a little shrug and simply said, “Makes it taste better.”

He probably said that to hush me, and it worked. What he may not have known was that he was absolutely correct.

Pausing before one eats, whether there is spoken word or not, allows the body to get ready to experience food and the nutrients therein.

The body’s parasympathetic nervous system is activated by breathing, anticipation and bringing our full attention to what is in front of us. Our “rest and digest” systems do not kick in if our mind is thinking about 5 different subjects, especially those that have nothing to do with the present moment.

Here are a few tips that bring Mind to Food, and aid in digestion:

  1. “Never eat on your feet.” A brilliant suggestion by a mindfulness teacher I heard talk last month. This is a huge battle for me personally. I grew up in a big family and we never ate standing up. I grew up and decided it was more efficient to do so, and worst of all, I have not had a place to sit and eat for the last 10 years. I would cook (nibble as I cooked) and serve and stand to eat in the same place. It was not a pleasure to eat. I ate to get it over with. Now, I have a family table, plenty of kids old enough to help me so that we can all get to the table and eat….and yet, I find myself eating upright sometimes. Just a terrible habit. The trick is to recognize it, recover from it, and sit down to eat.
  2. Before you start to eat, pause. Taking 5 mindful breaths gives one time to contemplate, give thanks, and appreciate where the food came from. Whether done in complete silence, or in the form of a traditional Southern Baptist prayer (no offense Mama. You know I love you more ‘n my luggage.), this type of breathing lowers blood pressure, heart rate and puts the body in a restful state, calling the blood to the internal organs and allowing digestion to be efficient and effective for nutrient absorption.
  3. Activate your sense perceptions. Look at your food, smell it. When food is colorful, the eyes will activate the digestive glands as well as the nose will. The odor of food influences the tongue’s taste buds. The more we experience our food, the more satisfying it will be, and consequently, the less we will eat. I should say, we will be satiated sooner. This feeling often has no bearing on the amount we end up eating….especially if there is an abundance of something we love. It takes a lot of mindfulness to realize when we are satisfied, but not stuffed.
  4. Chew food until it is watery, then swallow. This mindful action not only allows for proper digestion by activating the salivary glands and those in the stomach getting ready to receive the food and break them down, but also enhances the food experience by allowing the food to touch all of the taste buds in the mouth, which in turn tells the stomach what kinds of enzymes it will take to process the food and how much of those it needs to make. I believe fast eating and improper chewing is the main reason people end up with reflux disease.

I know when I am conscious of these things, I have a really different food experience, my body reacts to that by feeling more energized when I need it to be, and that I sleep better because my body isn’t as stressed as it is when I wolf my food down.

Life is all about pleasure, and nourishing our bodies has a true purpose.

Let your purpose be a pleasure.

Sit down, slow down and enjoy all that is there for you.

Annie Morris, LMT

Sleeping on ADD and ADHD

Sleeping on ADD and ADHD

The diagnosis’ of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) is skyrocketing among primary care physicians.
Although I am not the first one to get on my soapbox and holler about dietary modifications, supplementing for deficiencies, and lifestyle changes, I have discovered, through more research and even self experimentation, yet another common thread among these wonderful, complex children: Sleep disorders.
According to the data, 25-50% of Attention Deficit Disorder is sleep related. When I ask a parent, “How does he/she sleep?” I will usually get an immediate response because they have been dealing with these issues for years.

  • The child sleeps 12 hours per night, yet they are fatigued all day.
  • The child wakes up constantly.
  • The child has problems falling asleep.
  • The child wets the bed.
  • The child does not dream regularly, and if he does, he has night terrors.

These are the typical things I hear in the office, and as I’ve learned, they are many times a result of sleep and airway problems. These kids cannot get enough oxygen because many of them have mouths/airways that are not allowing them to breathe properly, therefore, both the quantity and the quality of their sleep suffers.
It is easy to see things like dark circles and drowsiness in these kids, but there are multiple things that can produce those symptoms, so I’ve had some training recently from dentists and orthodontists who are concentrating on airway problems and sleep apnea to identify some physical factors that will allow for proper diagnosis.

These physical characteristics include:

  • The child has poor posture with rounded shoulders.
  • When looking at the child in profile, their head will jut forward so that the ears are in front of the shoulder instead of being lined up on top of of the shoulder.
  • The child may have crowded teeth, indicating narrowed facial structure, which does not allow the tongue to fit correctly in the mouth.

Problems with concentration, inability to settle down and relax, feeling the need for stressful physical activities in order to keep a higher heart rate, and snoring are all considered for objective diagnosis.

Sleep studies are helpful and seeing a dental sleep specialist is a good place to start.

I can say that almost all of the kids I see, whether they are on the autistic spectrum, have depression, or diagnoses such as oppositional defiant disorder, have a sleep issue plaguing them as well.

From what I’ve seen in my office, and judging from all of the research I’ve done, ADD and ADHD have never been caused by a Ritalin deficiency. If you are concerned on any level about your child’s sleep and/or sleep patterns, consider having them evaluated properly. You too can rest easier with more knowledge on your side. With that in mind I have included a link to look at another major cause of attention issues. Best 5 minute presentation I have seen on this subject
Another Hidden Cause of Attention issues