My Five Favorite Medical Myths

My Five Favorite Medical Myths

When you leave med school and residency, you are pretty sure you’re all that and a bag of tater chips. I did. Then, practicing medicine became a long and humbling journey. I’ve learned a lot, and I thought I’d share some falsehoods from my training, just in case these rumors are still circulating.

1. The body does things randomly. 

This is a common misconception in medicine. The doctor will say, “Oh, you have high blood pressure, well this pill will help lower it.” It may be true the pill will help, but high blood pressure is a reaction to a problem. It doesn’t just pop up.  You do not have a “pill” deficiency.  The question should be, “What is the body trying to tell us?” If we take the high blood pressure example, it may point to issues like nutrient deficiency like magnesium, or sleep apnea, or generalized inflammation, which leads to more diagnoses than just hypertension. The body is always talking to us. Functional Medicine helps us interpret what it’s saying.  

 

2. Nuts cause diverticulitis. 

This was passed down with relative authority in my training and was accepted as the truth by the medical community. We told patients to avoid nuts, popcorn, and fruit with small seeds. Diverticula are small pockets that form in the colon walls due to tissue weakness caused by increased pressure due to a lack of fiber. The assumption of nuts and seeds causing diverticulitis seems reasonable at first because small things fit in small pockets. The truth is, taking away the above foods takes away a great source of fiber for our good bacteria, which are essential for low pressure in the colon, and may increase your risk for diverticulitis. The research supports that these foods don’t cause diverticulitis.  

 

3. A calorie is a calorie.  

If I could get this belief to die, I would be a happy provider. “If you want to lose weight, eat less the 1400 calories a day” was the mantra they taught me. It didn’t matter where those calories came from. No one seemed to understand different foods cause totally different hormonal responses. For example, 100 calories from vegetables/ protein cause leptin release, curbing hunger and decreasing fat deposition. Sugar does just the opposite. You release ghrelin, which increases appetite, and fat deposition because of the insulin spike. Also, your genetics are a factor in determining which calories are best for you. For some people, monounsaturated fats like avocado cause weight loss, whereas saturated fat like coconut oil causes weight gain. You need to understand your genetics if you are going to understand why a calorie is just not a calorie. Even without your genetics, you can make your calories go a lot further by choosing to eat whole foods.

 

4. What you eat is irrelevant to your health. 

When I left med school, the knowledge about the GI tract’s role in our immunity was in its infancy. That it is associated with diseases like arthritis, depression, anxiety, asthma, allergies, and so on was not being taught. Our diet has everything to do with our body’s “random” actions. If you have a medical issue, the diet is the first thing to change.  Over 90% of our immune system activation occurs in the small intestine, and an overactive immune system drives all the diseases listed above and many more. It makes sense to start here. You’ll usually see amazing results if you remove the most inflammatory foods like sugar, gluten, and dairy.

 

 5. Vitamins make expensive urine. 

This is a saying in medicine that is as old as the hills. I still hear it often, and the literature doesn’t support it. Here is an example of why this is not true-90% of us are deficient in choline and need supplementation. 

Here is a list of things choline does for us: 

  • Unborn children have improved stress resiliency and improved cognition 
  • It prevents fatty liver disease
  • improves mentation and helps fight memory loss. 

Surprise! It’s not expensive at all and definitely does not go into your urine. There are countless minerals like magnesium, vitamins like zinc and vitamin D3, and supplements like curcumin, resveratrol, and omega 3’s, to name a few where research shows supplementation makes a huge difference. Now absorption matters here, and the quality of the supplements determines bioavailability, but this is complete crap that “vitamins make expensive urine.” 

I’m glad for all these myths now. Having believed them and then finding out they weren’t true, I assume nothing and research everything now. 

The Long Hard Ride

The Long Hard Ride

I was cleaning out my house for the last time (it took me three trips from Ohio to Colorado to get completely moved) when I found a gift from my wife from years ago. It was a wedding gift: a leather-covered flask and on the front was the quote “For the long hard ride.” When she gave me this, we were riding horses in Kentucky every weekend, sometimes 25 miles a day. And when in Kentucky, do as the Kentuckians do and drink your Vitamin B (Bourbon). Life took us away from riding, 4 kids tend to do that, but this memento from my wife reminds me of some lessons from those days of horseback riding.

 

Lesson 1: No fear. 

The worst thing you could be on a horse is fearful. Because they know it, as they are very intuitive animals, and take their cues from the rider. This is counterproductive, as you lose control, and then bad things happen. It is a self-fulfilling prophecy. The same goes for now. When we are full of fear, we do not see the opportunities available to us, and we miss that which can improve our lives. Living in fear creates the sense of “not enough,” and there goes happiness. Meditation, yoga, and prayer are wonderful ways to center ourselves and live in abundance, where we are right now, at this moment. Give it up, let it go, and let in all the amazing great things that want to come into your life. The ride will go much smoother.

 

Lesson 2: A little goes a long way. 

I had occasionally overindulged with the aforementioned Vitamin “B” while riding. I went from enjoying myself to a miserable time, pretty damn quick. As we are at home the question “why not?” is often asked when it comes to things that are mood-altering. Harmless enough, right? Well, here and there, sure, it can be enjoyable and relaxing in small doses. The problem is large doses disrupt your sleep, you may become depressed, and you create a cycle involving said substances. To get out of the weirdness we are living in, the cycle may leave you constantly trying to crawl out of your self-induced mood changes. I encourage you to enjoy the long ride by not overdoing it early on, as it can make a long trip much longer.

 

Lesson 3: Be prepared. 

Early on, I bought saddlebags for all the things that can go wrong on the trail. I packed them with about everything I might need when I was going to be 10-15 miles from camp. Well, folks, we are a long way from camp right now. We need to be prepared. Whether it’s getting enough sleep, supplements to support immune responses, or eating right, these things will get us through like nothing else in our “saddlebags.” You can see my blog here on these things, but it’s important to realize that this has to be a lifestyle choice for the long term.    

 

Lesson 4: Get in a rhythm. 

This will be a long hard ride indeed if you don’t get into a rhythm. We rode gaited horses, if we were not in sync with the gait, man, it hurt the next day. Well, daily life is the same way. I decided after 2 weeks of flopping around like a fish and seeing how long it took till my body funk drove me to the shower, that I had to create normalcy in my life again. Now, it’s get up, meditate, drink my coffee, get a shower, answer emails, do things like writing my e-book that is halfway finished, or other projects I never got around to, like straightening the garage, go for a walk help make supper and have a family dinner. This has done wonders for my mood and outlook. A schedule helps. Going to sleep at night is much easier when you feel like you didn’t Netflix your way through the day.

 

Lesson 5: Maintenance for your horse. 

A lame horse is not good for a long ride, of course. They require maintenance. If you just thought you could pull it out of the stall and go, it’s probably not going to go well. When we get hit with this virus, we need to be prepared and all the things mentioned in Lesson 3 apply here. We can’t take Zinc and Vitamin D for a month or two and expect it to do the trick. The same goes for diet, sleep, and stress reduction. It is a long-term commitment, just like I made to my animal so that he could do what I asked of him. Your body is the same way.

 

I wish it wasn’t going to be a long hard ride, but until we get enough testing and tracking of people who are infected, this virus may be around longer than we like. This is not to discourage you, but to encourage you to not be a sprinter in this race, but to create abundance so that you find joy and contentment, no matter the circumstances. It helps on the “long hard ride.”

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