Saturday, September 10, 2011

Shifting the Shift

Thank you to everyone who has followed The Shift as I've muddled my way through medical school and shared about it along the way. It's been great to have you along for the ride. Please join me in the next phase at D'Adamo Personalized Nutrition where I'll be blogging at www.dadamonutrition.com/maura/. There, I'll be doing lots of things: sharing patient vignettes, telling you about the growth of the Store in Williamsburg and sharing any wisdom or amusing tales that I gather along the way.

Be well & see you in Williamsburg.

Oh, and if you can't get enough, follow me on Twitter: @DrMauraND.

Monday, August 22, 2011

D'Adamo Personalized Nutrition Opens in Brooklyn!



Let the next chapter begin. This week, D’Adamo Personalized Nutrition opens a brand-new, gorgeous, state-of-the-art facility in trendsetting hub of New York: Williamsburg, Brooklyn. For those of you in the New York City area who have followed Dr. D’Adamo’s work (and my blog from my years in naturopathic medical school using the Blood Type and GenoType diets), we’re headed to your backyard. The space consists of a store where you can purchase supplements from the D’Adamo line, as well as a new line of basics from Vitamin C to melatonin. In the back treatment rooms, we will conduct nutritional consultations that will combine naturopathic concepts with Dr. D'Adamo's proprietary software to create customized wellness plans for customers who are interested in creating a personal lifestyle plan.

About a year ago, Dr. D’Adamo started talking about wanting to open up a spot in Brooklyn, which he has a big heart for, having both grown up and started out as a young doctor there. It has been inspiring to see it become a reality, with Dr. D doing some of the construction work himself on the new space. His father, in fact, practiced naturopathy for many years in Brooklyn when Dr. D’Adamo (the younger) was a child. For Dr. D, it’s an exciting closing of the circle. And it is for my colleague Dr. David Levi and me, as well: we spent four years in school training for this and we are eager to begin connecting with and helping the New York community. David and I will be full-time staffing the D’Adamo Personalized Nutrition Williamsburg. We’ll be doing everything from seeing clients to conducting weight loss groups to giving talks on relevant subjects. Dr. D’Adamo will also be seeing patients a few times a month in Williamsburg.

Get psyched, New York. This is the cutting-edge healing approach that you’ve been waiting for. Please come see us and monitor our Facebook page (D’Adamo Nutrition Williamsburg) and website (dadamonutrition.com) for photos and upcoming events including a Grand Opening Party on September 17. As always, feel free to contact me with questions and comments.

Friday, April 8, 2011

Metabolism, Heal Thyself

For those of you who’ve been on the edge of your seats waiting to hear if my mom’s regimen of winter supplements worked to stave off her yearly bout of flu, wait no more. Recall, I put her on four things from D’Adamo Personalized Nutrition: Proberry Syrup that’s chockfull of virus-blocking elderberry, ARA 6 to build immune competency in the gut, the probiotic Polyflora that also enhances gut immunity, and Genoma Security that contains a number of immune-buttressing botanicals. I’m happy to report that Mom didn’t get sick once! It’s a small miracle, given that she works all day amongst germ-laden teenagers in New York City. Other things that helped her stay healthy this winter were keeping up her daily walks around the city and making an effort to temper her stress levels. Bravo, Mom. It’s interesting to note that the same supplement regimen that can help with keeping the immune system tip-top will also help with seasonal allergies that flare up in the spring. For more blood-type specific tips on how to triumph over spring sneezes and sniffles, go to http://www.4yourtype.com/2011_newsletter_v8n4.asp#Peter.

Now, to the case. Often a patient comes in without any major complaints; we call this a wellness visit. So it was with 33-year old Melanie, a native of Maine who was brought along by her three older sisters who are Blood Type Diet acolytes. With long blond hair, a faux leopard fur coat with matching flats and a hot pink scarf, Melanie was bleary-eyed when she arrived at 10:30 for her appointment. “I usually have had a few cups of coffee by now,” she said, faithfully having followed our instructions to arrive fasting so that we could administer the proper labs. Melanie was in good health, beyond suffering from the stresses of a lifestyle too rich, perhaps, in wine and heavy food. Melanie is a girl who enjoys the high life and didn’t go in much for diets and vitamin-taking. She described her job as that of a “personal concierge,” which, as she talked about it, sounded to me like she essentially throws parties for a living. Not a bad way to pay the bills, but also not a bad way to end up with some extra pounds, poor sleep hygiene, a smoking habit and a penchant for having a drink or four too many most nights of the week.

Very easygoing, with a ready laugh, Melanie told us a bit about her health history: she had survived an almost-fatal car accident about five years ago that left her with chronic back pain and stiffness. She had a history of depression. Her menses are very heavy with some clotting and she had recently gained about 10 pounds; her weight tended to fluctuate up and down. She drinks three or more drinks three or four nights a week (“because of her job”), skips breakfast most days and eats a lot of steak, heavy cheeses and breads. Her biggest concern is getting her body in top condition, as she wants to get pregnant in the next year or two.

By our tests, she proved to be basically fit. An O-positive Secretor, her phase angle (which reveals the health of the body’s cells) is high, her body keeps its water inside the cells where it belongs, showing that she had good water balance, and she is only slightly overweight. Her breath hydrogen tests revealed some dysbiosis—bad bacterial overgrowth—in her gut. Physical exam revealed no abnormalities other than a blood pressure of 135/80. In terms of body type, she is ectomorphic—long and mostly lean—with a little bit of weight around the middle. She doesn’t exercise, but work keeps her active most days.

Melanie made it clear that didn’t want to make any big changes. But then, our goal with her was not to significantly change her lifestyle but rather to introduce some gentle shifts in her daily habits to halt what was looking like a pre-Metabolic Syndrome picture, which is marked by a slightly overweight apple-shaped body, as well as hypertension, low HDL, high blood glucose and high triglycerides. We didn’t have the luxury of running these labs on the spot, but her blood pressure could’ve been better. Add smoking half a pack a day to the picture and the path from Metabolic Syndrome to more serious ills gets a lot shorter: type 2 diabetes, stroke, heart disease and the like.

One of Dr. D’Adamo’s valuable pieces of wisdom is that what we do health-wise—diet, exercise, supplements, stress management—in the decade we’re in completely sets up our health for our following decade of life. So this 33-year old’s drinking and smoking habits and lack of exercise not only aren’t setting her up so well for next year but also her 40s, to say nothing of not readying her body to bear a child. He impressed this upon Melanie. “You don’t have to go crazy with this,” he said, “a little here, a little there, will be fine.” The basic common sense algorithm for Melissa to follow was: eat more protein than carbohydrates and exercise a few times a week, enough to break a sweat. Certainly, diet is going to be the most important part of addressing her pre-Metabolic Syndrome state and we flipped a few switches in the SWAMI software to tailor the diet specifically for her: we removed any foods that would contribute to gastrointestinal overgrowth and we increased foods high in antioxidants and Vitamin B6 (this will improve her hormonal picture for less painful periods and increase her ability to get pregnant). We also emphasized foods high in choline, which maintains the integrity of the body’s cell membranes and, thus, overall health.

The supplements we put her on are as follows. Polyflora O is a potent probiotic that will populate her gut with good flora that will remove the dysbiosis-causing bugs. Hepatiguard contains liver-protecting herbs milk thistle and bupleurum that will help her liver process a rich diet and all of the alcohol she consumes. Deflect for Type O is going to be an essential part of her supplement regimen, as it will block harmful lectins in foods that aren’t chosen from her recommended list from wreaking havoc on her intestinal system, decreasing overall inflammation in her body. This product is especially indicated for Metabolic Syndrome, as it decreases the ability of lectins in certain foods to make the body insulin-resistant.

The last thing we put her on is Quercetin Plus. And now we’ve come to today’s Clinical Pearl. A substance found in lots of produce from apples to onions, Quercetin is a water-soluble bioflavanoid that has anti-mutagenic and antioxidant effects. Recent studies done at Kyoto University show that Quercetin inhibits the growth of cancer cells, particularly in the lungs. In a sense, as Dr. D describes it, this flavanoid acts as the department of sanitation in the lungs and filters garbage-like carbon dioxide. It literally acts as a shield around lungs exposed to smoke. The best thing for Melanie would be to quit, and she will when she’s ready. Until then, there’s Quercetin. Melanie looked happy with the changes we recommended. And though she seemed even happier to have a gigantic cup of coffee with milk and sugar, I have faith that changes will start to seep into her daily routine.

See below for more information on D'Adamo Personalized Nutrition's suppelements Quercetin Plus, Hepatiguard and Deflect. These will work for anyone trying to detox and lose weight this spring.

Check back in a couple weeks for more stories including that of a Parkinson's patient and an interesting pediatrics case.

Quercetin_SpecSheet

Hepatiguard_SpecSheet

Deflect SpecSheet

Wednesday, February 2, 2011

Histona Story

Your faithful blogger is happy to report that she is in her last semester of medical school. After three and a half long years of studying, exam-taking, and practicing my nascent skills on patients who were, and are, well…very patient, I will launch out into the world as a practicing doctor in a few short months. But before that, I am pleased to be on another shift at University of Bridgeport with my favorite naturopathic doctor, the inimitable Peter D’Adamo. I am also working with him (and his colleague, my other favorite doctor Ginger Nash) at his clinic in Wilton two days a week. To say that I am excited about the exposure I am getting to Dr. D’Adamo’s body of knowledge and the GenoType system is something of an understatement. I’m seeing patients heal in ways I never thought possible, and this is largely through minimal intervention. But the protocols we are prescribing are highly personalized and highly specific, so they work in ways conventional approaches sometimes fall short. Too, the approach is natural, which is the direction healthcare consumers are increasingly demanding.

So, with that said, I am happy to say that I am returning to writing more regularly about patient cases, and the treatments we carry out. I dare say you’re not going to find this level of exposure to one of the greatest minds in natural medicine anywhere else, so stay tuned.

I founded this blog to inform my fellow naturopathic medical students about the kind of work Dr. D’Adamo is doing; many of them had expressed interest and curiosity about epigenetics and the application of the science behind D’Adamo’s work. But I hope to continue to write in more layman’s language so more people can understand. If you have any questions or comments, please keep sending them. Or if you’re interested in some topic in particular, let me know and I’ll try to incorporate it into the blog.

Monday morning, 10 a.m. There are six students working on the shift this semester, three fourth-year students and three third-years. Ten a.m. seems like a very leisurely start time to most of us, used to 7:30 classes and we are all in good spirits as we gather on our first day of seeing patients on shift. But the chit-chat quickly comes to a close as we begin a review of the six patients we will see. My first patient is Paolo, an easy-going 34-year old Argentinian who works in Manhattan as a personal assistant (“just to somebody rich, not famous” he replied to my nosy questioning). A friend of his had referred him to the clinic and he was there for the primary purpose of wanting to lose weight. Two years ago he put on about 40 pounds after quitting smoking and now he had a bad sugar habit that put him about 50 pounds overweight. His body impedence analysis showed, though, that his cells were functioning quite well, which indicated that his body was actually in good shape: his intra- versus extracellular water ratio was excellent and his phase angle (which is a measurement of the body’s overall health) was actually quite high at 8.2 (the higher the better). As Dr. D’Adamo said when he came in to consult, inside Paolo was an athlete who had gotten a bit off track with a lazy diet and sedentary lifestyle. We calculated him as an Explorer GenoType (for explanations on the various GenoTypes, see previous my blogs), gave him a strict prescription for exercise and gave him a few supplements: Polyflora O for some slightly gastrointestinal dysbiosis and Histona for metabolic function. We also ran a series of thyroid labs on him because of a family history of hypothyroidism. More on Histona after I introduce our second patient.

“He’s hungry,” warns 12-year old Mati’s mother as we fetch them from the lobby. Because we do a breath hydrogen test (that measures levels of bad bacteria in the gut) we need patients to arrive fasting. It’s past noon, and so I don’t blame Mati—who has a huge grin and red hair—for being a bit fed up with battery of blood tests we run on him before running him upstairs to begin taking his history and doing GenoType measurements. Mati is Hasidic and one of 10 children; his mom looks so young, trim and well-rested that I truly can barely imagine how she has five children who are already married. Ellen tells us that he has a difficult time concentrating and can’t fall asleep. He’s clearly a bright kid, and a keen observer; and happy, for that matter—he laughs loudly as we all crack jokes throughout the appointment. A doctor they see in Brooklyn put him on a Ritalin-equivalent that robs him of his appetite, which was barely present to start. Impedence testing revealed Mati to be, like Paolo, pretty healthy. What’s clear in Mati is that his nervous system had become off-kilter and simply needed to be reset.

The reasons for this were unclear. He reported having anxiety about not being able to fall asleep; clearly the kid was a budding insomniac and we were going to do our best to head this off as soon as possible. Mati came out as a Teacher (A+ Secretors with a lean body type are often Teachers) and we walked him and his mom through the diet. Since Mati subsisted on carbs alone, the change was going to be difficult. He was going to have to stay off wheat and introduce more of the superfood vegetables and proteins, such as turkey, salmon, eggs, yogurt, soy and kale. Mati looked at me with great suspicion when I asked him to limit the cookies. D’Adamo also gave this patient Histona, but this time for its effects on neurobiology. We also gave him Cortiguard (to stabilize his cortisol levels) and zinc (which is often low in patients with ADD). I also suggested that they seek out a kids’ yoga class, which would help Mati relax and focus.

Now, what exactly is in Histona that makes it good for someone who wants to lose weight and someone who has neurobiological problems? The answer is magnolia: yes, the beautiful pink magnolia flower. Magnolia is one of the only bioflavanoids that can cross the blood-brain barrier. Magnolia is one thousand times more potent as an antioxidant than vitamin E and specifically targets the brain cells. Its main components are honokiol and magnalol. Both of these have strong anti-anxiety effects and have been shown in studies to have cortisol-lowering effects; remember cortisol dysregulation is what’s keeping Mati up at night. Cortisol should peak upon waking and fall throughout the day. Mati’s is rising when it should be at its lowest. For Paolo’s metabolism, magnolia is excellent because of the same cortisol-regulating effect. High cortisol will effectively slow down the metabolism by hindering thyroid function and also by increasing insulin release, which causes the body to store unused calories as fat.

The key is cortisol. We see so many patients with cortisol dysregulation layered on top of other pathologies that I’m starting to believe that stress truly is the gateway to most illnesses. A recent study published in JAMA said, “"Effects of stress on regulation of immune and inflammatory processes have the potential to influence depression, infectious, autoimmune, and coronary artery disease, and at least some (e.g., viral) cancers." Dr D’Adamo told me, “Stress can be both provocateur and co-factor. In our line of work stress is an especially important factor, since when it does factor into the equation it is a sure sign that the compensatory mechanisms are no longer up to the task. I like to think of stress as the water that finds the crack in the sidewalk, which then seeps in and freezes, further weakening the structure.” We’ll check back in with these two patients in a couple of months.

For more on Histona, click here:


HistonaUlterior_SpecSheet