8 WEEKS TO VIBRANT HEALTH
A Take-Charge Plan for Women to Correct Imbalances, Reclaim Energy and Restore Well-Being
by
Hyla Cass, M.D. & Kathleen Barnes
SMASHWORDS EDITION
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PUBLISHED BY:
Take Charge Books on Smashwords
8 Weeks to Vibrant Health
A Take-Charge Plan for Women to Correct Imbalances, Reclaim Energy and Restore Well-Being
Print Copyright © 2005 and 2008 Hyla Cass and Kathleen Barnes
Smashwords Copyright © 2010 Hyla Cass and Kathleen Barnes
This book was originally published in 2005 by McGraw-Hill, New York, NY.
Take Charge Books
Brevard, NC 28712
Editor: Kathleen Barnes
Typesetting/Graphic design: Gary A. Rosenberg
Cover design: Jim English
All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise) without the prior written permission of both the copyright owner and the above publisher of this book.
The purpose of this book is to educate. It is sold with the understanding that neither the publisher nor the authors have any liability or responsibility for any injury caused or alleged to be caused directly or indirectly by the information contained in this book. While every effort has been made to ensure its accuracy, the book’s contents should not be construed as medical advice. To obtain medical advice on your individual health needs, please consult a qualified health care practitioner.
Smashwords Edition License Notes
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person you share it with. If you are reading this book and did not purchase it, or it was not purchased for your use only, then you should return to Smashwords.com and purchase your own copy. Thank you for respecting the author’s work.
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8 Weeks to Vibrant Health
A Take-Charge Plan for Women to Correct Imbalances, Reclaim Energy and Restore Well-Being
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CONTENTS
Part 1—Your Vibrant Health Plan
1. Week 1: Beginning Your Journey to Better Health
3. Week 3: Diagnostic Lab Tests
7. Week 7: Exercise and Self-Care
8. Week 8: Where You Are and Where You’re Going
Part 2—Addressing the Imbalances That Are Making You Sick
10. Balancing Your Brain Chemistry
11. Sex Hormones: From PMS to Menopause
12. Thyroid and Adrenals: Your Energy Glands
13. Blood Sugar Imbalances, From Metabolic Syndrome to Diabetes
14. Digestion, Dysbiosis, and Food Allergies
15. Environmental Toxin Imbalances
16. Musculoskeletal Pain: Headaches, Arthritis, and Osteoporosis
Part 3—Essential Information for Your Journey Back to Health
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ACKNOWLEDGMENTS
My first appreciation is for my parents, who have unfailingly supported and encouraged me. My late father Dr. Isadore Cass, a physician and scholar, was my great teacher and role model, and my mother Miriam Cass continues to be my best cheerleader. Alison Schur, my daughter and best production yet, her wonderful husband Seth, and their precious son, Jacob, make it all worth it. My co-author and friend, Kathleen has been a joy to work with — smart, resourceful, warm, humorous, and a true kindred spirit. Special thanks to my friend and exceptional author Mary Shomon, who came up with the original book idea. My dear friend and fine health writer Nan Fuchs PhD gave me great advice and encouragement, and helped to make this a better book. And much appreciation goes to my many friends who were always there when I needed them, including Toni Galardi, Debra Bass, Debbie Friedman, Ruth Ziemba, my sisters Sharon, Judy and Elaine and their husbands. I also want to thank my dear colleagues who were always available to answer questions and give me feedback: Drs. Cynthia Watson, Murray Susser, David Katzin, Jacob Teitelbaum, Michael Rosenbaum, Shari Lieberman, and Ann Louise Gittleman, among others. My biggest thanks goes to my patients and readers who teach me new things every day, and inspire me to do and be my best.
—Hyla Cass, MD
To Hyla, my deepest respect. In working with her, I found the spirit of true sisterhood. What began as a professional relationship blossomed into a deep friendship that we both will treasure for years to come. I am deeply appreciative of the advice and encouragement of my many friends at the American Society of Journalists who have opened whole new vistas for me in the realm of publishing. Thanks are also in order for my friends Sabra Hammond, Diane Hamilton and Libby Mojica and my sister, Julie Barnes, for their sage advice, strong shoulders and willing ears. Most of all, my deepest love and thanks to Joe Castro, my husband, life mate, and best friend, for his unfailing love, support, and smoothies.
—Kathleen Barnes
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PREFACE
Kathleen and I have made every effort to make this book complete and accurate. However, because it’s not about the conventional or the tried-and-true, there are varying opinions and schools of thought, and even conflicting research (as in much of medicine) on many of the topics covered here. Also, due to constantly changing information, limits in both time and space, and our being human, there will invariably be some errors and omissions.
Fortunately I have a website (www.drcass.com) which is constantly being updated with the newest information. In fact, I see this book as the initial step in an evolving process, and I invite you to participate online. Please e-mail me not only your comments, criticisms, questions, and additions, but also share your own health makeover experiences. I’d like the website to be a place for active exchange, where all of us can learn from each other.
Gone are the days when a doctor—or a book—could claim to have all the answers! In my clinical practice, I invite my patients to enter into more of a partnership relationship, where we work together to solve problems and optimize their health. With this book and my website, I invite readers also to become partners in an ongoing journey of well-being that I hope will last long after the last page has been read.
—Hyla Cass, MD
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INTRODUCTION
There are almost 109 million women over the age of 18 in the United States. Because of our fast-paced lifestyle; the accelerating pressure of career, family, and relationships; and the shift toward more equality in our social structure, we develop more health concerns by the day. We are also more susceptible than men to many conditions, including depression, chronic fatigue syndrome, weight gain, and, of course, hormonal swings. I hear the same laments over and over from young women, middle-aged women, and older women, whether in my office, by e-mail, at public appearances, or even at social gatherings:
“I’m always tired—it doesn’t matter how long I sleep!”
“I can’t catch up on everything I need to do.”
“What can I do about my weight problems? I’m disgusted with myself!”
“I’m always feeling down in the dumps.”
“My whole body hurts! If it’s not my back, it’s my shoulders or my feet.”
“My PMS is actually getting worse as I get older!”
“I have absolutely no sex drive!”
“I had no idea menopause would be this bad. Between the hot flashes and night sweats, I’m miserable!”
“I’m totally confused about hormone replacement therapy. My doctor says there is no other choice—either take HRT with its risks, or suffer!”
And, from most of these women I hear, “My doctor says they are just signs of normal aging or that I’m just stressed and depressed—meaning that it’s really all in my head!”
Nonetheless, problems with fatigue, sleep, anxiety, depression, weight, pain, hormones, and memory are real and often debilitating. Part of the problem is that most doctors simply don’t have time to delve into the reasons for these symptoms. They may have only 10 minutes to hear out a patient, make a diagnosis, and then prescribe a pain medication, a diet pill, an antidepressant, or a sleeping pill.
If you have felt frustrated at not being truly heard and discouraged that everything you’ve done to try solve your health problems has failed, take heart. You’re not alone, and you’re not without tools to become your own health detective.
I have devised the Vibrant Health Plan based on my decades of experience in treating hundreds of women of all ages. As a conventionally trained physician with a specialty in psychiatry, I have incorporated nutrition and other natural techniques into my practice for more than 20 years.
At the core of this practice is a set of beliefs that have served my patients well:
* Treat the whole person—mind, body, spirit, and environment.
* Look for the deepest root problems beneath the symptoms, which includes using the best that science has to offer.
* Apply a continuum of treatments, always beginning with the safest, most natural, and most benign.
Crusade for Reform
I am often asked how I became such a crusader for the reform of conventional medicine. The fact is, there was no single turning point or moment of enlightenment. It has been a long process, beginning with my earliest family life.
My father was a general practitioner who practiced out of our home in Toronto, Canada. From an early age, I recall following him around on his medical rounds at the hospital and going along on house calls. A caring and conscientious GP in an old-fashioned practice, I saw him practice integrated medicine long before that term was coined. Available and responsive, he ministered to his patients with care and skill. He would talk to me about what he was doing, assuming I understood, never talking down to me. Looking back now, I realize that as the doctor’s apprentice, I learned a great deal about the spirit and art of medicine, and even about practical aspects of diagnosis and treatment.
Moving forward many years, I studied medicine at the University of Toronto School of Medicine and then interned at the Los Angeles County– USC School of Medicine. I was struck by the serious class divisions in the system of medical care, experiencing culture shock as I was exposed for the first time to a clearly segregated medical care system with serious divisions based on socioeconomic status. In Canada, health coverage is universal, and I had not seen such a disparity in terms of quality of care and the respect given to patients and their families. Both my experience with my father and my medical school training had already given me a more humane and holistic view of medical care, in contrast to the prevailing mechanized, impersonal system.
My interest in a more relational, holistic approach, coupled with an appreciation for the mind-body connection, led me to psychiatry. During my residency at Cedars-Sinai/UCLA Medical Center, I eventually found that the standard “couch and Prozac” combination of psychoanalytic and pharmacological treatments had their limitations.
I was drawn to a more personal approach to patients, where therapists were more directly caring and interactive with their patients. I discovered art therapy with Helen Landgarten, then guided imagery and other more cutting-edge interactive techniques such as Voice Dialogue with Hal Stone. Not only did these methods work more quickly, but they clearly could affect the body in many ways, from relieving more obvious symptoms to boosting the immune system.
Then, during my family therapy fellowship, I discovered the “systems approach,” where the “identified patient” was not necessarily the true problem! It wasn’t just Johnny who was the “bad kid” or Jenna who was the depressed adolescent. In fact, there were secret family issues (Mom’s depression, Dad’s gambling) that had unbalanced the whole family dynamic, and the children’s problems were the family’s symptoms. Treatment would be successful only so far as the underlying issues (i.e., the parents’ problems) were uncovered and healed.
By the same token, I became aware that the symptoms my patients reported were just messages that something in their body systems was awry. They were clues that needed closer evaluation in order to uncover the real cause. I paid more attention to the mind-body connection and the doctor-patient relationship.
I carried what I had learned into my new medical practice and began to explore the influences of nutrition and lifestyle on health. I observed how imbalance in the body can affect the mind. The brain, after all, is an organ, affected by its internal physiological environment.
It became obvious to me that psychotherapy is more effective once the brain is functioning properly. I went on to discover how many typical psychiatric complaints—anxiety, depression, PMS, even schizophrenia—are frequently related to biochemical imbalances. These can range from low blood sugar, viral and fungal infections, hormonal imbalances, allergies, and toxic overload to deficiencies of specific nutrients.
I am able to diagnose these conditions with the appropriate laboratory tests that give a scientific basis for treatment decisions. Then I can often help correct the imbalances with natural approaches, including the use of well-researched nutritional supplements. In contrast, conventional physicians are most likely to prescribe first and test second, if at all, with problematic results.
The Third Leading Cause of Death
Studies show that doctors are the third leading cause of death, accounting for 250,000 deaths per year. They don’t do it intentionally, but due to a lack of knowledge, errors, and excessive influence from drug companies, that is the end result.
There is little to counterbalance the over-prescribing of drugs, despite the fact that according to one study, there are more than 100,000 deaths per year in hospitals alone, due to medications taken as prescribed. That’s not taking into account drugs that were improperly prescribed or medication-related disability that, while not fatal, takes a huge toll. Or the deaths that were attributed to the condition but were really due to the treatment.
In my move toward “integral” or holistic psychiatry, I found myself treating a variety of medical conditions, from chronic fatigue to irritable bowel syndrome. Patients don’t walk into our offices as disembodied heads. Our bodies do not separate into specialized compartments for the convenience of cardiologists, allergists, endocrinologists, or gastroenterologists. You can’t get to the right diagnosis and treatment without looking at all systems!
Every symptom reflects an imbalance somewhere in the body’s systems. Conventional medicine has segmented the body into the various specialties, and often fails to address the reality of interactive systems.
Holistic or integrative medicine, on the other hand, addresses the interactive systems of the whole person. The patient is evaluated in a variety of ways and supplied with specific health prescriptions—for supplements, foods, exercise, natural hormones, mind-body techniques, and even prescription drugs when indicated. Moreover, the individual has to partner with the doctor in this process, both to carry out the regimen and to give feedback in order to fine-tune the program.
Compared to drug therapy, natural treatments offer safer, more user-friendly solutions with far fewer and less harmful side effects. They work with the body’s chemistry rather than adding what can be toxic substances to an already impaired body.
A Case in Point
I remember one early patient in particular, a 55-year-old college teacher named Jean whose story is pretty typical. She was being treated by her internist for high blood pressure, osteoporosis, and heart palpitations. She was referred to me, a psychiatrist, because of her anxiety, depression, and insomnia. I could find no obvious psychological explanation for these symptoms, except maybe for the stress of her physical illness. She was taking an array of medications, with their attendant side effects. Based on some simple lab tests and my own clinical experience, I determined that a likely common cause was a magnesium deficiency.
After a brief trial on this inexpensive and common mineral, together with a multivitamin-mineral formula and essential fatty acids, Jean was able to decrease her medications. Encouraged by this result, she trusted me enough to eliminate some foods to which she was allergic, which helped her even more. In a short time, not only were her anxiety, depression, and insomnia gone, but she soon was medication-free, depending instead on a list of supplements (I added a few to those mentioned here) to restore her normal body chemistry.
As an integrative physician, I see cases like Jean’s all day long, with sometimes seemingly simple solutions to what appear to be complex conditions. Part of the problem may even stem from the prescribed medications.
Situations like Jean’s leave me with the following questions:
1. Why had Jean’s internist been unaware of her mineral deficiency, or even, of its possibility? Why didn’t he at least give her a basic multivitamin-mineral formula?
2. Why give prescription drugs first? This approach is like unplugging the noisy smoke alarm instead of looking for the fire!
And, more pointedly, why is the prevailing standard of medical practice so symptom- and drug-oriented, especially when this approach so clearly fails to serve the patient?
One answer is all too clear: through sales representatives, medical journal ads, research articles, and conventions, the pharmaceutical industry is the main source of education for many physicians in practice. The bad news is that drugs are expensive and often cause more harm than they cure. For example, the nonsteroidal anti-inflammatory drugs (NSAIDs) for arthritis can cause severe gastric irritation and even ulcers. Or, as numerous human and animal studies show, the statin drugs for lowering cholesterol deplete the body of the essential nutrient coenzyme Q10, which heart cells depend on for survival. This leads us to believe that statins, while certainly lowering cholesterol, may be doing more harm than good. In his 22-page, fully referenced report reviewing this issue, researcher Dr. Peter Lonsjoen recommends that all statins be labeled with a warning to take them with 100–200 mg of coenzyme Q10 daily. Has your doctor mentioned that to you? Have you seen it in any drug ads? This is the tip of the iceberg for the complexity of the pharmaceutical industry and our health (fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf). I cover this in Supplement Your Prescription: What Your Doctor Doesn’t Know about Nutrition.
Most doctors have minimal exposure to more natural treatments, which they dismiss as “unscientific.” In fact, the science is there, published in the very same medical journals that tout drugs. The supplements that I recommend are well backed by published research.
Fortunately, this situation is changing as more doctors are encouraged by the results they observe in their patients who are incorporating natural approaches. (Hint: if you find solutions to your problems in this book, please share them with your doctors.) Physicians and even medical schools are showing greater interest in integrative medicine, which incorporates the best of both worlds.
The medical profession aside, I believe that with all the variables affecting our health and well-being, from diet and lifestyle to toxic exposure, we each need to take greater responsibility for our own health. Rather than taking our body to the doctor as we would take our car to the mechanic, we need to become participants in a working partnership in which the physician becomes a resource.
I wrote the book Natural Highs as a “brain handbook” to help those outside of my own office practice to learn how to change their own brain biochemistry and to orient those who were coming to see me. Now, in 8 Weeks to Vibrant Health, I want to reach the millions of you out there who are stuck, stymied, knowing that something is wrong, but unsure of where to look for the solution. Here is a new handbook, one for the body as well as the mind.
This book is meant to help you learn as much as you can and do as much as you know how to maintain optimum health and find a doctor who is willing to join you in the process.
About Kathleen Barnes
Kathleen Barnes has long personal experience with alternative and complementary therapies. She taught yoga for more than 30 years while working as a foreign correspondent on three continents. She wrote a natural health column for Woman’s World magazine for six years until the first edition of this book launched her on a new career writing and editing natural health and sustainable living books. Writing for professionals and consumers in these and other forums has deepened her understanding of the field, including a practical knowledge of what readers need, want and are able to do.
While this book is often written from my point of view as a physician, Kathleen provided her broad knowledge and years of experience in creating the core content and organization of this book.
She is currently in the process of writing her 13th book and has recently launched her newsletter and website, Living, Naturally at www.kathleenbarnes.com.
With our heartfelt wishes for your success in discovering or regaining a healthy balance in body, mind, and spirit, we both offer you our knowledge and experience, as well as our compassion and our commitment to helping you find your way to vibrant health.
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PART 1
YOUR VIBRANT HEALTH PLAN
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1: WEEK 1
Beginning Your Journey to Better Health
You can treat the leaves or you can treat the roots.
—Ancient Chinese saying
Consider 8 Weeks to Vibrant Health to be an operating manual for your body and mind. It is an eight-week guided program of self-education, self-evaluation and self-care. The self-scoring questionnaires will help you pinpoint areas of imbalance in these 10 major areas:
* Diet and nutrition
* Lifestyle
* Exercise
* Brain chemistry
* Sex hormones
* Thyroid and adrenal hormones
* Blood sugar
* Digestive system including yeast
* Toxins and detoxification
* Weight control
Based on your answers, you will be able to order specific lab tests for further exploration.
The second part of the book will give you detailed information on the key areas of imbalance, suggesting further testing as needed, then giving detailed recommendations to help restore balance. These include dietary modifications, natural hormones, herbs and supplements, detoxification programs and exercises. You’ll create new habits that will help you move into the future with greater resilience, energy and overall health.
Here is how best to use this book:
1. It’s a good idea to read the book all the way through first, to familiarize yourself with the material, including the steps you can take to resolve your health problems.
2. Work through the chapters of the eight-week Vibrant Health Plan one at a time, beginning with your food-mood-supplement-activity record, journal, questionnaire and lab tests, so you have an idea of where you are and where you want to end up on your journey to good health. (The lab tests appear in the early weeks so you can get the results sooner.)
3. Start incorporating the suggested dietary and lifestyle changes. Often, this will be a huge jump-start in changing how you feel. Record these in your journal.
4. Use Part 2 to dig more deeply to better understand and treat your specific problems, one at a time.
5. When you’ve completed the program to address one imbalance, you can start on another. Please be kind to yourself and address only one major problem at a time.
6. Work at your own pace. The suggested eight weeks is a good average, but some women may take more time, and some may take less. It depends on your starting point and your own style.
Your investigation in the first eight chapters of this book will lead you to possible root causes of your health problems. You may appear to have more than one underlying imbalance. You won’t always have to handle them one after another because, in many cases, handling one major problem will resolve others, too. For example, for many women, handling hormonal imbalances will also clear up many other problems such as anxiety, depression, overweight and insomnia.
Some of your investigations may require that you see a doctor, especially if you need prescription medications or some kinds of laboratory testing. Regardless, this book will give you enough information to become a partner with your physician, working together to bring about your return to vibrant health.
Please be realistic. If, for example, you have more than 10 or 15 pounds to lose, we won’t hold out false hope. You won’t lose 50 or 60 pounds in the course of an eight-week program, but you will be well on your way to achieving a healthy weight.
You’ll find easy ways to make better nutritional choices, to make exercise more fun, and to better understand the healing power of herbs and supplements. Most importantly, your intuition will often know what’s best for you, so we’ll give you some tools to help you reconnect with your inner wisdom.
The Vibrant Health Plan calls for gradual changes, so be gentle with yourself! Part of this whole program is learning to really care about yourself, your body and your feelings.
This first week, you’ll start your journal and then pay close attention to what you eat and drink. This will also give you a good idea what to add to or remove from your diet. You’ll get basic information on exercise as well as the importance of quality sleep and proper breathing.
Starting a Wellness Journal
The word journal sounds a lot like journey. In fact, your journal will become the road map on your journey to health. Besides your own reflections, your journal needs to hold extra sheets such as the ongoing food-mood-supplement-activity record, lab test results, newspaper clippings, website printouts and any other information you collect in your exploration. Include some blank sheets for your own notes, as well. We have provided a sample food-mood-supplement-activity record that you can photocopy and use in your notebook, or you can create your own. You can also download it from the book’s website www.drcass.com.
Keep your journal in a handy place. In the coming weeks, you’ll refer to it over and over as you assess your symptoms and create your plan to address them.
For this entire week, and for the rest of your eight-week Vibrant Health Plan, write down everything you eat and drink—meals, snacks, juices, coffee and alcohol. Include the approximate quantities as well. Your nutritional habits will become obvious as you write them down and perhaps will prompt some immediate changes. Do you eat at least five servings of fruits and vegetables a day? If not, you’ll see it easily in your journal pages.
Pay attention to your patterns of eating and drinking, as well. Write down why you ate or drank just then (hunger, boredom, fatigue, etc.) and how you felt afterward (energized, guilty, deserving, etc.). Use a scale from 1 to 5 showing your hunger level.
Here are some examples of questions to consider when you eat:
* How were you feeling before you ate?
* Did you feel true “gut hunger”?
* Were you eating to relieve stress or a low mood?
* Were you eating or drinking out of habit and not really because of hunger or thirst?
* Did you eat hurriedly or calmly?
* Did you eat normal portions?
* How did you feel after you ate (e.g., satisfied, healthy, guilty)?
Notice whether you are eating sugar or drinking coffee to raise your mood, energy, or concentration and then having lows an hour or two afterward when you find yourself craving a doughnut or another cup of coffee. Or notice if you reach for a glass of wine to calm yourself down when you’re feeling stressed.
Your symptoms list is useful in tracking food intolerances, discussed more in Chapter 14. For example, you might notice a stomach ache or diarrhea after eating dairy products or fatigue several hours after eating corn or wheat or even some great health food. Or you might not even have a reaction till the following day. Food intolerances are tricky that way and often need careful detective work to pin them down.
Also note how much you exercise: What you do, when, and for how long. Add up the total minutes spent daily. In addition to time spent at the gym or power walking or using the treadmill in the basement, walking the dog for 15 minutes counts. So do the 10 minutes you spent vacuuming the house and the 20 minutes of weeding the garden or raking leaves. Hey, even folding laundry qualifies.
You’ll also log the hours you sleep each night, meaning actual sleep time, not time spent watching TV or reading in bed.
Include a line or two each day about how you feel, your energy levels and your mood.
Looking back at these entries after just a week can be a real eye-opener. It will help you see some simple ways you can make changes that will have profound effects on your health.
For a sample journal page that you can photocopy for your Wellness Journal, turn to the following page.
You may be surprised at what you discover when you read your first week’s journal.
Kate, a 35-year-old full-time accountant and mother of two teenagers is a good example. Her complaint at our first meeting was, “I just can’t lose those 15 pounds and I am exhausted all the time. My family doctor just told me, ‘What do you expect? Full-time job, two children, it’s no wonder you’re tired!’ But I’m not convinced. I know there are things I should be doing to improve my health, but I’m just too tired to think about them, let alone do them.”
Kate had brought her preceding week’s food-mood-supplement-activity record. She realized that she was getting almost no exercise and that the majority of her diet was made up of starchy carbohydrates—bread, pasta, rice and bagels. Inspired by the possibility of really changing her life, she vowed to stop the starch overload. She planned to eat a protein-rich breakfast and bring a more balanced lunch with her to work, including cut-up vegetables for snacks. She was also going to use the stairs at work instead of the elevator to get to her fourth-floor office. These were small changes, but they were a great start and would make a big difference in her life. After her initial eight weeks, Kate was well on track. She’d lost eight pounds and her exercise program had helped substantially increase her energy.
Daily Food-Mood-Supplement-Activity Record
This work sheet will help you develop a clear picture of your lifestyle: eating habits, exercise, sleep, mood and supplements. For this process to be effective, keep your journal sheet with you and fill it out promptly every time you eat or drink anything including water. For the “Hunger” column, use a scale from 0 to 5: 0 = not hungry and 5 = very hungry.
Add Water
You’ve heard this before, and it’s true: you need about 64 ounces of good, pure water a day. A more exact calculation would be half your weight in ounces. For example, if you weigh 120 pounds, you’d drink 60 oz. It replenishes the amount of water lost in a day through the skin (sweat) and kidneys (urine). Your urine output should be two to three liters a day, clear and light yellow, unless you are taking lots of B vitamins, which makes it bright yellow. Dehydration is more common than we think. For more information, see Dr. F. Batmanghelidj’s Water: For Health, for Healing, for Life: You’re Not Sick, You’re Thirsty! (Grand Central Publishing, 2003).
Avoid tap water, which can be full of contaminants and heavy metals (see Chapter 15). Caffeinated beverages don’t count in your water quota, because they actually leach minerals, taking water with them as well. However, soups counts. Juices technically can contribute to your water intake, but since fruit juices (even pure fruit juices) are so high in sugar, we don’t recommend them. Eat whole fruit instead. If you do drink fruit juice, make it unsweetened, and dilute it at least by half with water.
Invest in a good water purifier and drink form that at home and take along bottles when you’re at work or elsewhere. The good purifiers cost in the neighborhood of $300, but you’ll get some value even form the $12 pitcher-type purifiers.
Why do we need water? Our bodies are composed of 60 to 70% water. Two-thirds of it is in the cells, where it is essential for all chemical processes. The rest is in bodily fluids such as blood and in the lymphatic system, which carry nutrients to the cells and remove the toxic by-products of metabolism from the system. What’s more, studies show that water restriction actually increases fat accumulation.
Here’s an easy way to count your glasses of water: Fill up a 64-ounce bottle with water and refill your cup from it throughout the day until it’s gone. Drink more if you like—this is just the minimum. Water is much better absorbed when you sip it throughout the day rather than gulping down a glass or two every few hours. You can substitute non-caffeinated herb teas, as well.
Make Time for Sleep
Sleep gets its own section in your Week 1 Vibrant Health Plan because it is so essential to all aspects of your health.
Most adults need between seven and nine hours of sleep each night for optimum health, performance, and safety.
According to the National Sleep Foundation, “When we don’t get adequate sleep, we accumulate a sleep debt that can be difficult to ‘pay back’ if it becomes too big. The resulting sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior, decreased productivity and safety issues in the home, on the job, and on the road.”
Yet the average American gets fewer than seven hours of sleep a night, and at least two-thirds of all Americans are sleep deprived.
Make a pledge to yourself right now: Get eight hours of sleep a night, and go to bed as early as possible. Yes, naps count, to a degree, but you can’t add more than one hour of napping into your sleep total because interrupted sleep isn’t as deep and rejuvenating as continuous sleep.
Practicing good sleep habits will contribute to the best possible snooze once you get in bed. This means having a comfortable and comforting bedroom and turning off the TV. Taking a warm bath, drinking a glass of warm milk, and putting on some soothing music will help you get the sleep you need. Having trouble falling or staying asleep? We address this in Chapter 9 on stress reduction.
Here is one case of insomnia that illustrates some of these points. Mira, a patient of mine, noticed in her weekly journal that she was actually not sleeping very well. She was waking up several times during the night and having trouble falling back to sleep. Mira realized that there were some ways she could improve the situation. She began by not watching television before she went to bed. She also cut out her after-dinner espresso and substituted a soothing cup of chamomile tea. The result was, she was able to fall asleep more easily. However, she still needed help staying asleep, as we’ll see.
Breathe Deeply
You can live for a month or more without food, four days without water, but only four minutes without air. Air is the stuff of life. In fact, some Asian cultures believe a person is predestined to take only a fixed number of breaths in a lifetime, so it is a good idea to breathe deeply and slowly to prolong your life.
Predestination notwithstanding, there’s no question that breathing deeply and slowly has profound effects on your body, mind, and spirit.
Deep, slow breathing brings oxygen in exchange for carbon dioxide in individual cells, where it produces the cell’s energy. When we don’t get enough oxygen, we get tired, cranky, and dull because of the increase in carbon dioxide levels. That’s why taking a few deep breaths help recharge your cells and can change your world from dull gray to Technicolor.
Your breathing is a reflection of your emotions. When you are anxious or afraid, your breath becomes rapid and shallow. When you are happy and content, your breath becomes slow and deep. You can also use your breath to change a negative emotional situation.
Imagine you’ve just had near collision in traffic. Your heart is pounding, your adrenaline pumping, and your mind racing. If you simply take 10 deep, slow breaths, these physiological symptoms related to stress will disappear. So, too, will your anxiety. We’ll have more about stress later. For now, remember that your breath and your mind and body are connected.
Most of us breathe too shallowly. In fact, each lung is the size of a football, and most of us are using only one-third of that capacity. Now is the time to develop the habit of breathing more deeply, so begin by spending a few short minutes every day doing just that. You’ll be ahead of the game if you stop several times during the day and take a few deep breaths. See “Deep-Breathing Exercise.”
Deep-Breathing Exercise
* Sit comfortably in a quiet place with your spine straight.
* Relax your belly muscles.
* As you inhale, let your abdomen expand. Feel your diaphragm being pulled down as your lungs fill with air from the bottom to the top.
* Pause briefly when you’ve inhaled fully.
* As you exhale, gently contract your belly and squeeze the air out from top to bottom.
* Repeat at your own pace.
A good resource for learning optimum breathing techniques is Michael Grant White’s website, www.breathing.com .
Stretch Your Muscles
Most of us spend a great deal of time sitting, whether it’s at a desk, on a plane, or while talking on the phone. Some simple stretches, even once a day, will help get out the kinks, promote better circulation, and help you feel centered and energized.
There are some stretches you can do in bed when you awaken, when you’re making your morning smoothie, or even when you’re seated at your desk.
Practitioners of yoga say you’re only as young as your spine, so a flexible spine is an indicator of a youthful and healthy outlook on life.
Start this week to do the simple routine shown in “Morning Stretches” that moves your spine in all of its six directions. You can do it in five minutes.
Morning Stretches
Up and Down
* Stand with your feet shoulder width apart.
* Inhale and slowly begin to raise your arms in front of you and straight up over your head.
* Stretch as tall as you can.
* Breathing deeply, move your arms as if you are climbing a rope, hand over hand.
* Keeping your arms over your head, exhale and slowly press your pelvis forward, arching your back and bending backward as far as you comfortably can. Be sure to have your eyes open for this part.
* Take a breath or two.
* Inhale back to vertical.
* On an exhalation, slowly begin to lower your arms and, with your back straight, bend forward and reach toward your toes.
* When you’ve reached down as far as you can, round your back and relax in this forward-bending posture. Breathe deeply. Do not bounce. Hold for about 30 seconds.
With your back rounded, inhale and slowly curl back up to a standing position.
Half Moon
* Stand with your feet a little more than shoulder width apart.
* Inhaling, raise your arms over your head.
* Clasp your hands together over your head.
* Exhaling, jut your left hip out, bend straight to your right and bring your body into a crescent moon position. If you are doing this correctly, you’ll feel the stretch from the tips of your fingers all the way to your ankles.
* Breathe.
* Inhale back to vertical and repeat on the other side.
Twist
* Sit on the floor with your legs stretched out straight in front of you.
* Exhale and bring your left hand behind you on the floor and twist to the left. Bring your right hand to the outside of your left knee.
* Breathe.
* Inhale and return to the center position.
* Repeat in the opposite direction.
* Sit quietly for a minute or so.
Note: always move slowly into these stretches, taking your time. Do not bounce or force yourself into the pose.
Be sure to record your breathing and stretching in your Wellness Journal. You may notice some changes even the first day. Keeping close track of your progress will serve as an inspiration in the coming weeks. It’ll also help you in your search for the underlying causes of your symptoms, so become a prolific writer and note anything that seems different. As insignificant as something may seem now, a few weeks from now, it may become an important clue.
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2: WEEK 2
Now it’s time to start your detective work by filling out the general health questionnaire. This is similar to the one I use in my office for my patients. It not only gives me insight into what may be going on with them but also allows them to become familiar with my approach.
These are somewhat different from the usual physician questions because they focus on conditions that are body-wide and are not restricted to the individual systems (e.g., cardiovascular or respiratory). You’ll be the only one who will read your answers, and, in order to get to the root of your health problems, it’s essential for you to be completely honest. Copy these blank pages and put them in your journal. You can also download them from www.drcass.com).
Fill out the entire questionnaire. It’s important to do all the sections, even if you think they don’t apply to you. You’ll notice that some of the same symptoms are involved in several imbalances.
Let’s return to Kate and Mira.
Kate’s questionnaire had high scores in all the hormone categories—thyroid (overweight, tired, and cold), adrenal (tired, dizzy when she stood up suddenly), and sex hormones (PMS). She noticed that she might have a brain chemistry imbalance as well, which would explain her low moods. She recorded all this information and then read the relevant sections.
Kate’s educated guess for her most likely problem was hypothyroidism. I agreed. In fact, just her dependence on her morning espresso was a tip-off. Women with low thyroid function have particular trouble getting going in the morning and often use coffee as a wake-me-up. Since low thyroid goes hand in hand with low adrenal function, she’ll need to address both, as described in chapter 12.
Mira had already noticed her unbalanced diet. Then, and after reading the material on supplements, we added more essential fatty acids in the form of fish and fish oil capsules. Her questionnaire showed that brain chemistry (low moods and sleep problems) and hormones (sleep problems, irregular periods, and dry skin and hair) were her main issues.
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3: WEEK 3
You’ll be pretty busy this week, but please take some time to review your journal entries. The little pearls of insight you’ve likely had in the past two weeks will provide valuable leads as you continue your search for renewed health.
Be sure to keep up your nutrition, supplement and exercise routines from Week 1, as you will do throughout your entire Vibrant Health Plan. Research shows that it takes three weeks to form a new habit, so this third week is especially important since your good health habits are becoming ingrained. We hope that these new ways of looking at food, nutrition and exercise will become habits that will stay with you for the rest of your life.
Now it’s time to do some scientific detective work to back up your suspicions about what’s going on with your body. This is exactly what I do in my office. After patients have filled out their questionnaires and I have taken their history, I develop a list of possible imbalances. I then order appropriate lab testing to find out if there is a basis for my suspicions.
Of course, any competent doctor knows that lab testing is no substitute for good overall medical know-how, experience and intuition. We also know that one lab result is not the whole story. These numbers can fluctuate throughout the day or week based on such factors as diet, activities, stress level and where you are in your menstrual cycle. If we get back a result that looks abnormal and doesn’t quite fit with the clinical picture, we can always repeat the test for confirmation. In good medical practice, we treat the person, not the lab test!
Do your lab tests as soon as possible because it takes time for your results to come back. It may take anywhere from a few days at a local clinic to a few weeks for mailed-in tests. While you’re waiting, you will have enough information to proceed without them, and you can incorporate changes when the results arrive. You may also want to defer testing until later and that’s fine, too. Work at your own pace and within your budget.
If you’re lucky enough to have a doctor who’s willing to join you in the quest for your health, you have won half the battle. You can ask your doctor to order some of the basic, office-based tests and maybe even have them covered by your health insurance.
However, it’s not absolutely essential to have a doctor at this point. Many of the lab tests we recommend are available without a prescription. Some are available in community clinics or even in drugstores and supermarkets. Others are available as kits you can purchase at pharmacies. There are some you can do at home—saliva, blood spot (finger prick), urine or hair samples. Others require a drawn blood sample that must be taken by a professional.
We’ll give you more information about where to get lab tests as well as about finding supportive doctors in case you need one to order further tests or write prescriptions. Check out the Resources section. You can find out how to order various lab tests online at www.drcass.com.
It’s also not necessary to do all of these tests. In my own practice, I generally order a CBC, chemistry panel, lipid panel and liver function panel. Others, such as thyroid and other hormone panels, are ordered only as needed. I frequently order more specific tests, such as organic acid testing, amino acid levels, neurotransmitter levels and stool tests. Look for them at Metametrix Labs(www.metametrix.com), or Genovations (www.gdx.net). These can be costly and are not always covered by insurance. Your test results will give you the general picture of what’s happening in your body and where there may be imbalances. Don’t forget to refer to any lab results done in the past year or so. You paid for the tests. They’re yours. Even if it’s been a while, it’s useful to have a baseline for comparison.
When You Get Your Results
Your results will be a series of numbers that may seem confusing, but the important part is that the lab will let you know the normal ranges and where you fall within them. These ranges often come in two categories: the medical norms (averages) and the norms of good health (optimal ranges). The first are average values of the general population, which include people who are not overtly ill but may not be in great health, either. Optimal ranges are where you want to be for good health. The specific meanings of millimoles, milligrams per deciliter, and other units of measure are essentially unimportant for our purposes here. What you really want to know is whether you fall within the normal and optimal ranges. You’ll then focus on the problem areas that fall outside the optimal ranges.
Here are the basic tests we suggest you get this week:
Blood Pressure
Blood pressure is the force of blood against the walls of the arteries. It’s recorded as two numbers: the systolic pressure (as the heart beats) and the diastolic pressure (as the heart relaxes between beats).
This is a very simple test. If you’re visiting your doctor, someone will likely take your blood pressure. Be sure to ask for your results. You may actually have a blood pressure gauge (called a sphygmomanometer) in your home. If not, many drugstores and even supermarkets have machines to do the testing. You may also be able to get your blood pressure taken by your office nurse, at a health fair or at another free screening.
Try not to take your blood pressure the day your period begins since many women experience harmless blood pressure increases then. Also, you may get a deceptively high reading if you’re feeling ill or if you’ve got a cold or flu. Many people also have what’s called white-coat syndrome or elevated blood pressure in a doctor’s office but at no other time. If that’s the case, it would be a good idea to get your own blood pressure monitor so you can check yourself under relaxed conditions.
You can buy good and simple-to-use monitors at most drug stores. There are also the more expensive (but simpler to use) digital devices that will inflate themselves and then gradually deflate, automatically taking your blood pressure and pulse as they go, and may even give you a printout.
Average blood pressure is not more than 120 mmHg (millimeters of mercury) systolic and 80 mmHg diastolic, and that’s what you’re looking for. That means the top number is 120 and the bottom number is 80. It’s usually expressed as “120 over 80” or “120/80.”
Anything above a systolic pressure of 120 may be a cause for concern. However, if you’ve gotten a high reading, you may want to retest in different circumstances several times to be sure there hasn’t been an error.
Conversely, a reading much lower than 120/80 may also be a cause for concern. I can’t count the number of patients who have come to me believing the myth of low blood pressure. They’ve been congratulated by a doctor or nurse for having low blood pressure, say 100/70. The truth is, they are chronically tired, and feel dizzy when they stand up quickly. Rather than meaning they are “extra healthy,” low blood pressure for them is a likely sign of low adrenal function.
Enter your blood pressure reading in your Wellness Journal.
Resting Pulse
You’ll also want to know your resting pulse rate. It’s easy to take it yourself:
Sit quietly for at least two minutes.
Firmly place the index finger and middle finger on the opposite wrist, in line with the large thumb muscle.
Find your pulse.
Count beats for 10 seconds.
Multiply by six.
This is your resting pulse rate.
Normal resting pulse ranges are generally between 65 and 80 unless you are a highly conditioned athlete, in which case your resting pulse may be lower. If your resting pulse is under 60, it could also be a sign of low adrenal function.
Cholesterol and Triglyceride Screening
Cholesterol is a waxy, fatlike substance that occurs naturally in all parts of the body and is essential for normal body function. Cholesterol is present in cell walls and membranes everywhere in your body, including the brain, nerves, muscle, skin, liver, intestines and heart. Your body needs cholesterol to produce such components as hormones, brain cells, vitamin D and the bile acids that help digest fat.
Conventional medicine says that excess cholesterol is deposited in the arteries, where it contributes to the formation of artery-clogging plaque, increasing the risk of heart attack and stroke. In fact, the cholesterol forms in response to inflammation in the vessel wall, so the focus should be more on treating the source of the inflammation than on eating less fat.
While eating foods high in saturated fat and cholesterol can raise your blood cholesterol, the rise is generally temporary and does not usually contribute to plaque formation. The real culprit is excessive intake of refined carbohydrates such as sugar and white flour which cause an inflammatory response, in the form of raised cholesterol. Fat cells themselves (adipocytes) are source of inflammation, accounting for elevated cholesterol in obese individuals.
HDL (high-density lipoprotein) or “good” cholesterol helps clear arteries of fat and cholesterol, carrying it to the liver for removal from the body. LDL (low-density lipoprotein) or “bad” cholesterol deposits cholesterol on your arterial walls and causes them to become clogged
Triglycerides are the fats in your blood, derived from fats eaten in foods or made by your body from other energy sources, such as carbohydrates. The calories you eat that are not used for immediate energy needs are converted to triglycerides and sent to fat cells for storage.
High triglycerides may be a sign of undiagnosed diabetes or low thyroid, and they may reflect an increased risk for heart disease.
Blood cholesterol and triglycerides are usually checked by a simple blood test, available through your doctor, at community screening clinics and health fairs, and through consumer labs (i.e., those not requiring a prescription from your doctor). To get accurate results, you’ll need to refrain from eating and drinking anything but water for about 10 hours before the blood is drawn. Your cholesterol measurement will be given in three numbers: total cholesterol, HDL and LDL cholesterol.
You’re aiming for total cholesterol of less than 200 mg/dL. Here are the ranges:
Normal: 200 mg/dL or less
Borderline-high cholesterol: 200–239 mg/dL
High risk for heart disease: 240 mg/dL or more
Optimal total cholesterol range: 180–200
HDL cholesterol which protects against heart disease should be between 60 and 150 mg/dL. The higher your HDL cholesterol, the better you are assimilating fats in your system. Below 40 mg/dL is inadequate.
LDL (bad) cholesterol levels: The goal is to keep these levels low.
Optimal is below 100 mg/dL
Near optimal is 100–129
High is 160–189
Very high is 190 and above
When looking at your total cholesterol levels, the ratio is more important than the numbers, with an optimal ratio of total cholesterol to HDL at 3:1 or less. Normal range is considered 5:1 or less.
Most conventional doctors have been led to believe that very low total cholesterol is the way to go. Your doctor may prescribe cholesterol-lowering medication called statins but they are not the only solution. Some standards even mandate total cholesterol levels that are impossible to achieve without the use of statin drugs. However, these drugs pose a hazard to your health and there is simply no research that proves they protect against heart attacks. The reason is simple: These so-called cholesterol-lowering drugs don’t address the causes of plaque in arteries.
Here are some statin facts that you may not know:
* A review of five big studies found that the risk of non-fatal heart attack and stroke was reduced by 1.4% in people on statin therapy—but that the rate of serious adverse effects rose 1.8% in those same people. Not a great trade-off.
* There is no relationship between blood cholesterol and heart disease risk in women over fifty or in men over seventy. Statins given to these individuals are not only wasted, but expose them to risk of side effects that isn’t outweighed by benefit to their hearts.
* A survey of South Carolina adults found no correlation of blood cholesterol levels with “bad” dietary habits, such as use of red meat, animal fats, fried foods, butter, eggs, whole milk, bacon, sausage, and cheese.
* A Medical Research Council survey showed that men eating butter ran half the risk of developing heart disease compared with those using margarine.
* Mother’s milk provides a higher proportion of cholesterol than almost any other food. It also contains over 50% of its calories as fat, much of it saturated fat. Both cholesterol and saturated fat are essential for growth in babies and children, especially for the development of the brain. Yet, the American Heart Association is now recommending that children consume a low-cholesterol, low-fat diet. That’s exactly the kind of diet that was linked, in one recent study, with failure to thrive in children. The fact is, children need good fats to provide the raw materials for healthy brain cells.
Statins have been found to help with heart attack and stroke prevention in two groups of people: Those with type 2 diabetes and those who have already had a heart attack or stroke and want to prevent another one. The catch is that the drugs probably don’t help these people because they lower cholesterol, but because they address another, more important risk factor: inflammation.
Pardon this seeming diversion, but statins are overprescribed, and often not worth the risk of their side effects.
Your triglyceride results can be evaluated as follows:
Normal: less than 150 mg/dL
Borderline high: 150–199 mg/dL
High: 200–499 mg/dL
Very high: 500 mg/dL or higher
If you are concerned about your cholesterol levels being too high and the implications for your cardiovascular health, there are two other markers for you to consider:
To test for inflammation, get a quantitative C-reactive protein level. Optimal levels should be 0.7 or less. Normal is up to 2.
Also, high levels of an amino acid called homocysteine, a harmful by-product of protein metabolism, have been associated with heart disease, stroke and Alzheimer’s disease. Optimal level is less than 9. If it’s elevated, you are probably deficient in the essential vitamins such as vitamins B12, B6 and folic acid, and you’ll need to supplement with them.
For a more detailed explanation, including interpretation of lab tests, you can go to such sites as www.webmd.com.
Comprehensive Metabolic Panel
The Comprehensive Metabolic Panel (CMP) is typically a group of 14 specific blood tests that have been approved, named, and assigned a CPT code (Current Procedural Terminology number) by Medicare, and most insurance companies. It is performed on the blood serum (the portion of blood without cells). Here is what it measures, with the normal ranges: