Karva Chauth: some tips on the Indian traditional day of fasting, love & rejuvenation

Karva Chauth is an ancient Indian tradition practiced by Hindu women in which the woman prays for her husband's good health and long life. It is a day of celebration of love and togetherness, and of gratitude for all the blessings. After fasting for the entire day, women dress up in colorful traditional clothing and jewelry in the evenings and pray together in a group before sunset, but eating only after sighting the moon in the presence of their husbands in the night. The visualization of the moon is a big but fun challenge for all in the household and community. The mischievous moon is most evasive that night!

This day of fasting and prayer incidentally coincides with the change of the season and the cooling of the weather outside. It is an excellent practice as it detoxifies the body as well as the mind, and what better time to do it that at the change of the season. Intermittent fasting allows the body especially the gastrointestinal system (includes the liver) time to rest and release toxic material (Ama, a term for toxins in Ayurveda), and stimulates body organs to rejuvenate and function better. Do remember that during the fast, there is release of a variety of toxins from the body tissues and this can lead to symptoms of aching, fatigue, brain fog, headache and irritability. It is better to prepare for the day of fasting by starting to clean up your eating habits from a week before the day of the actual fast. This includes giving up alcohol intake and reducing caffeine. Being prepared will result in less adverse symptoms during the actual fasting period.

A few words of caution: If you have an illness like cancer, heart disease, kidney disease or a  current infection, fasting may not be appropriate for you. If you are a diabetic, and on either oral medication or insulin for it, please make sure you eat intermittently and/or change your medication schedule on the day of fasting. If you are pregnant please do make sure you are consuming fresh fruits and veggies and water or lemonade during the day. Always consult with you physician whether it is advisable for you to fast at all.

Tips for the morning of the Karvachauth fast:
Traditionally women eat Sargi (a snack) after prayers and before sunrise on the day of the fast. Try to eat protein rich foods, and not eat a high sugar or carbohydrate laden meal. The latter will cause blood sugar fluctuations during the day which will make you more hungry and irritable. Protein, on the other hand, stabilizes mood and blood sugar keeping you full longer. Nuts are a great option as they not only contain protein but also have excellent essential fats which nurture the brain and body throughout the day. Make sure to hydrate very well in the morning especially if you follow a strict "no-water" fast!

The fun part:
Remember fasting is not just a ritual for the body, it is also rejuvenation for the mind and our opportunity to return to the wholeness of our souls. It is your time to relax & regenerate! So make the most of it! 
A few tips:
Listen to soothing music, practice meditation or mindfulness, try some pranayama (breathing techniques), restorative yoga techniques or corpse pose (Shavasana) with the intention to heal the body, mind and soul. During the day if you have the luxury to be off work (or at least take half a day off!), try to pamper your self with a spa massage or at least do a self-massage (self -abhyanga). Don't over-exert physically or mentally. Read your favorite book. If you're ok with consuming water during the fast, sip some chamomile tea or other herbal teas; take a warm bath with a few drops of your favorite essential oils, especially if you feel fatigue, headache, or body aches. If nothing else, take a nap or just go see a movie with your friends. Celebrate you! This is your chance!

After the evening puja (prayer typically done with a gathering of friends), start with a glass or two of room temperature or luke-warm water. You can even add a little lemon and honey to the water. Natural, unsweetened coconut water is also a great option for slowly introducing electrolytes back into the body. I hear most women craving for tea or coffee, but those probably are not good ideas as they can cause gastric distress and even nausea. I would also not recommend consuming any ice cold fluids.

Typically the moon is notorious for playing hide and seek within the clouds on the day of Karva Chauth! Once you're fortunate enough to having a viewing (hopefully an early one!), follow these tips to break your fast in a healthy way:

After the moon is out and finally the fast is broken, please venture slowly into eating again. First add in some fresh fruits in small amounts. Then after a little while have your dinner. Fresh home made yogurt or coconut kefir (if you are dairy sensitive) are great as they help in the digestion of nutrients which the body greatly needs after a full day of starvation. Moog lentil soup (daal) with a little white rice and ghee are great options along with some easy to digest well cooked vegetables. Eating fried and oily foods  may be counterproductive as those are harder to digest and our stomach's digestive fire (agni, an Ayuvedic term) as well as our pancreas may not be ready for such heavy foods.

Finally enjoy and celebrate your time with family and friends! 

Many of my patients asked me to advise them on some tips to fast safely, so I decided to write this blog. Hope you found it useful. I would love to hear from you about your experiences and any other tips you may have...

Please share and reach me through my social media or email me

Image source: http://www.4to40.com/greetings/cards.asp?festivals=Karva_Chauth-Karwa_Chauth-163

A Functional Medicine Physician's approach to an Overburdened Detoxification System

You must have heard that “we are what we eat”, but are we really just that? Actually “we are what we eat (or drink), breathe, breakdown, digest, absorb (from our gut and skin), and cannot eliminate from our body, whether it’s through our thoughts, skin, breath, urine and stool! Even though we are designed to have built-in detoxification and elimination pathways, they can get overwhelmed with years of toxin exposures which our bodies are now having to handle more so than ever before in our evolution history.

My job as a Functional Medicine physician involves around dealing mainly with chronic ailments. I usually have to be a medical detective trying to help patients who have been through the conventional medical system of diagnosis and treatment of a “disease” and have found no relief.
Below is a quick check list that I keep in my mind of patients who might have signs of an overburdened detox system. 

Those with:
1. Multiple Chemical Sensitivities (MCS):These patients react to just about everything- medications, nutritional supplements, foods, odors and chemicals in the environment!
2. Chronic neuropsychiatric conditions: Depression, Anxiety, Seasonal Affective disorders, Mood swings and refractory mood disorders, Chronic recurrent Headaches/ Migraines, ADHD, Learning Disorders, Autism Spectrum Disorders,
3. Neurodegenerative diseases: Parkinson’s disease, ALS, Alzheimer’s dementia, some forms of peripheral neuropathies, Multiple Sclerosis.
4. Mitochondrial disorders: Chronic Fatigue Syndrome, Fibromyalgia. Neurodegenerative disorders are also due to disturbances in mitochondrial energy production.
5. Immune system imbalance symptoms: frequent and chronic infections, allergies, asthma, eczema and other chronic dermatitis, autoimmune diseases (Hashimoto’s thyroiditis, Grave’s Disease, Rheumatoid Arthritis, Ulcerative Colitis to name a few), multiple food sensitivities, Dysbiosis (imbalance of gut bugs with possible Yeast Overgrowth or Small Intestinal Bacterial Overgrowth).
 6. Signs of endocrine disruption: male and female infertility, precocious puberty, PCOS, PMS, fibroids, chronic pelvic pain, endometriosis, adrenal fatigue, hypothyroidism.
7.  Metabolic Conditions: overweight, obesity, hypoglycemia, hyperglycemia, Insulin Resistance, Diabetes Mellitus Type 2.
8. Recurrent pregnancy losses, premature births9.  Cancers10. Chronic isolated low white cell counts (Leucopenia) or low red cell counts (Anemia) without any known associated cause.

You are probably aware that Functional Medicine practitioners usually take very detailed histories, do detailed examinations, and may do extensive specialized lab (Biomarker) testing. Not every test in the list below usually needs to be done on every patient. Based on clinical evaluation, the need for testing as well as the interventions are very individualized. For example, no two patients with type 2 diabetes or depression will have the same cause for it and thus testing and interventions will vary widely.

While the list below is by no means exhaustive, some general evaluation guidelines are:

1.       Detailed history and intake with the help of Medical Symptom Questionnaires, Toxicity and Exposure questionnaires, Environmental and Occupational Exposure Questionnaires.

2.       Detailed Nutritional, Dental and Physical examination.

3.       Conventional Lab tests: can be done from local labs like Labcorp/ Quest etc

·         Complete Blood Count looking for low white cell count, anemia, low patelet count.
·         Complete Metabolic Panel looking at liver enzymes, bilirubin levels, alkaline phosphatase, gamma glutamyl transferase levels.
·         Kidney Function Tests: Blood urea nitrogen, creatinine, cystatin C
·         Metabolic testing: Fasting and 2 hour post prandial insulin and blood sugar testing, fructosamine, hemoglobin A1C, detailed lipoprotein profile to assess for LDL and HDL particle numbers and sizes and other markers of inflammation specific to the vascular system
·         Indices like C-reactive protein, ferritin, fibrinogen to evaluate presence of inflammation.
·         Detailed thyroid function tests along with evaluation of antibodies against thyroid gland.
·         Iron absorption and storage assessment

4. Functional Labs to test for Biomarkers: These can be:

•  Stool Assessments: to look for growth of disease causing bacteria/yeast in the gut, and also to assess the balance of good vs bad bacteria in the gut; looking for parasites; markers of inflammation of the gut; markers of deficient detoxifications ability in the gut itself (which can lead to recirculation within our body of our own estrogens, cancer promoters and hormone mimickers from the environment, instead of them being eliminated in the stool); assessment of pancreatic enzymes production; looking for markers of healthy absorption vs malabsorption.

•  Assessment for nutritional deficiencies (of all fat and water soluble vitamins, minerals, essential amino acids, antioxidants {including the master antioxidant, glutathione}, essential fatty acids). Nutritional support is a key factor influencing the proper functioning of the different phases of detoxification as I have mentioned in my previous blog
•  Serum testing for food sensitivities (IgG), and environmental and food allergies (IgE).
•  Specialized genetic and antibody testing for Gluten as well as cross-reactive foods antibodies.
•  Saliva testing for male and female hormones and adrenal health. If you are placed on Bio-identical hormones, you must periodically also get testeded to see how the hormones are metabolized in your body, which can vary widely. If not adequately metabolized and detoxified these can increase the risk of cancer (like breast, prostate and other hormonally related cancers) development.
•  Testing for neurotransmitter levels, as well as balance/imbalance between the excitatory and inhibitory neurotransmitters. This can be helpful in patients with anxiety, depression, attention problems or chronic sleep issues.

•  Looking for heavy metal toxic burden on the body, if indicated by a detailed clinical evaluation. One example of this would be if you have silver mercury amalgam(s) in your teeth especially old ones.

•  Assessment for signs of oxidative stress or damage (similar to rusting of iron that occurs in nature on exposure to oxygen) to the body due to toxins: these tests look for markers of DNA damage, as well as damage to circulating fats (lipids) in the blood. Damage (aka oxidation) to LDL, the bad cholesterol, may lead to coronary artery disease.

•  If indicated, checking for chronic stealth infections due to bacteria, parasites and viruses which may harm the immune system and other organ systems. These could present as chronic fatigue, muscle and joint pains, autoimmune diseases and many other vague nagging symptoms.

•  If indicated, evaluating and testing for mold exposure and mycotoxins. You may need to find a physician who has experience in diagnosing and treating mold related illnesses. 

•  Genomics Testing: to assess for genetic variations known as SNPs (Single Nucleotide Polymorphisms) - like the commonly known MTHFR variants among so many others - which may lead to an increased genetic susceptibility towards accumulating toxins  and limit the detoxification capacity of our phase 1 and/or phase 2 liver enzymes.

Most of the above testing can be ordered by any physician, but the interpretation (which really is the key!) can probably only be done accurately by a trained Functional Medicine (FM) Practitioner. I strongly feel that someone with a chronic health issue, should start with a FM doctor as soon as possible, while fully realizing that in some parts of the country and many parts of the world this is not an option. Also, there are some FM practitioners who are not medical doctors and may not be able to order some of these tests. In those cases the tests could be ordered by your regular MD, with results being preferably interpreted by your trained FM Practitioner.

For some general guidelines on how to reduce and manage toxins in your life, you can read my blog..

If you feel that toxicity may be responsible for your chronic health problems, I encourage you to locate an Institute for Functional Medicine Certified Practitioner (IFMCP) in your area and get evaluated.  

Good luck in your journey towards optimal emotional, mental and physical health!

8 Tests for Heart Disease That Many Doctors Miss

Most people have their blood pressure, heart rate, lipid profile, fasting blood sugar, and even vitamin D levels measured during their yearly physical. Your physician may do an EKG or a stress test. All of these tests may be "normal," but there are other significant risk factors for metabolic issues that contribute to cardiovascular disease, that may be completely missed unless more testing is done.

Below is a list of some easily run lab tests and calculations which give insight into risk for insulin resistance, metabolic syndrome, inflammation and risk for future coronary heart disease. In my opinion, these tests should most certainly be a part of any patient's assessment for metabolic disorders and development of heart disease:

1. Triglyceride to HDL ratio

This is a simple measure of insulin resistance, risk for diabetes mellitus type 2 and cardiovascular disease. A ratio less than 3.0 is considered normal, and more than or equal to 3.0 is suggestive of insulin resistance. An elevated ratio should prompt counseling the patient about therapeutic lifestyle change with close follow-up of metabolic markers for prevention of development of diabetes, hypertension and coronary artery disease.

2. Fasting insulin levels (and, if possible, two-hour postprandial insulin levels)

Usually at the yearly physical your physician will measure fasting blood sugar, and may even measure hemoglobin A1c levels, which are markers for pre-diabetes and diabetes. In my opinion, abnormalities in these are late developments. Insulin is a hormone produced by cells in the pancreas; it's responsible for regulating blood sugar levels and for promoting uptake of glucose into the cells for use as energy or for storage as fat. Measuring insulin levels two hours after a glucose load may be the first indication of metabolic problems in your handling of sugar (or carbs).

Sometimes a two-hour insulin measurement may be difficult, so in my practice I measure fasting insulin levels, which are the second measure to go up. These two can be early markers of insulin resistance, much before fasting blood sugar starts going up. Excessive insulin levels lead to increased serum triglyceride levels, decreased serum HDL (good cholesterol) levels, increase in levels of the small dense LDL (the plaque-promoting form of bad cholesterol) particles. Insulin resistance is a risk factor for hyperlipidemia, diabetes, hypertension, all of which contribute to atherosclerosis and plaque formation, which in turn is a risk factor for heart disease development. I encourage my patients to work toward a fasting insulin level of at least less than 6 microunits per mL (ideal is 4).

3. High-sensitivity C-reactive protein (hsCRP)

CRP is produced in the liver in response to nonspecific inflammation in the body. The high-sensitivity CRP is an assay which detects low levels of CRP specific to inflammation in the blood stream i.e., vascular inflammation, which could be the cause for development and progression of heart disease. Standard lipid tests do not test for inflammation, and this marker can be easily tested through your local labs. Even if your lipid profile is normal and you do not have other cardiovascular disease risk factors like hypertension or obesity or diabetes, if this marker is elevated, it is cause for concern. If somebody has already had a cardiac event like a heart attack or stroke, and this marker stays chronically elevated, it could be predictive of a high risk for future repeat heart attack or stroke. The therapeutic goal for hs-CRP is less than 0.7 mg/L, preferably as near to 0 as possible. I like to repeat this a few times to be sure it is actually staying high.

A word of caution with hs-CRP: though a marker of inflammation, it can also be a marker for infection and acute injury, so if you've had any recent surgery or procedure; have a respiratory, gum or other infection; or have the flu, please wait until your symptoms are resolved before testing, as this marker will be elevated due to that acute event.

4. Red blood cell magnesium levels

Red blood cell magnesium levels are the best way to assess magnesium status. Clinical signs of magnesium deficiency could be fatigue, weakness, muscle cramps, seizures, numbness and tingling in the extremities, mood and sleep issues, irregular heartbeats and also spasms in the arteries which feed the heart, contributing to heart attacks. Magnesium supplementation may reduce the risk of coronary heart disease, so try to keep levels at the high end of the lab range, though I monitor clinically more often.

5. Homocysteine levels

Homocysteine is a toxic amino acid and elevated levels can be a risk factor for development of cardiovascular disease and stroke. Elevated homocysteine levels damage LDL cholesterol, causing its oxidation. Oxidized LDL leads to plaque formation in the coronary arteries. Homocysteine is produced as an intermediate in the metabolism of amino acids methionine and cysteine. Activated forms of vitamin B12 and folate are needed for the conversion of homocysteine into methionine, so elevated homocysteine can be one of the indicators of deficiency in these important vitamins (remember that there are drugs like Methotrexate and acid blockers like Nexium which block the metabolism or absorption of these vitamins and may cause elevations in homocysteine levels). Serum homocysteine is great screening test for patients who are at a risk for cardiovascular disease and stroke, especially when there is a family history but no other known risk factors. Strive to keep levels around 8 micromoles/L.

6. Ferritin levels

Ferritin is an iron-containing protein produced in the liver, and signifies the stored form of iron. Ferritin can also be a marker of inflammation. Moderate elevation of ferritin may lead to a 2-3 times increased risk for development of diabetes. Though the normal range in your lab for ferritin can be from 12-150 ng/mL in women and 12-300 ng/mL in males, studies have shown high ferritin levels increase cardiovascular risk. Lowering the iron stores to near optimal level of between 70-80ng/mL will improve outcomes in cardiovascular disease including reduced risk for heart attacks, strokes and also improve life expectancy. As a side note, I don't think that ferritin levels less than 50ng/mL are in any way normal (even though your lab may show it in the normal range) and reasons for low iron stores must be looked into.

7. Testosterone levels (in males only — no correlation with heart disease has been found in women)

In males, testosterone deficiency has been associated with a high risk for cardiovascular disease. In elderly males, lower free testosterone level has been shown to be associated with a high prevalence of cardiovascular disease. If your total and free testosterone levels are low, work within integrative or a functional medicine physician to find out why that is the case. Replacing testosterone may not be the only answer.

Males should try to keep testosterone levels between 350-600ng/dl. Remember, more is not always better with testosterone therapy if you need it, and always seek out a physician well versed in male hormonal replacement therapies, or someone who can help guide you to support your body’s hormone production naturally!

8. Testing for chronic infections

Many pathogenic bugs have been shown to have a significant correlation with development of coronary heart disease as well as acute coronary syndromes (heart attacks). Some of these are herpes simplex virus, cytomegalovirus, and H. pylori. Ask your physician to test for antibodies to these bugs through your local laboratories.

Print out and take this list to your physician to help them better evaluate your risk for heart disease, or find a functional medicine physician who is well versed in managing and counseling patients with metabolic disorders!

This article first appeared in Mind Body Green

12 Tips To Help You Prevent Breast Cancer

During 2013, a whopping 232,340 new cases of invasive breast cancer are expected to be diagnosed among women in the US; about 2,240 new cases are expected in men (yes, men!). Breast cancer is related to a state of excess estrogens, known as estrogen dominance. Uterine fibroids, breast cysts, PMS, infertility, migraines, and even prostate cancer in men can be related to estrogen dominance.
We really are what we eat, drink, breathe, think, and cannot eliminate! While food most certainly is to be regarded as the best medicine, it can also be the biggest poison. When there's diminished elimination of physical and emotional toxins, they build up, which may lead to DNA damage and ultimately cancer.
Some of the best strategies for breast cancer prevention are:
1. Food is always first!
Eat antioxidant-rich foods like organic fruits, vegetables, nuts and seeds, and healthy fats and oils like avocado and extra virgin olive oil. Eat your rainbow of 8-10 servings of vegetables and fruits every day to get optimal phytonutrient benefit. Especially include cruciferous vegetables like broccoli, cauliflower, brussels sprouts, kale, cabbage, and bok choy, which provide indole-3-carbinol (I3C), a phytonutrient which helps metabolize estrogen.
Remember: Sugar is cancer’s best buddy! It activates cancer genes and fuels growth of cancer cells. Eliminate sugar from your diet in every shape or form.
2. Quit smoking.
A study published in early 2013 in the Journal of the National Cancer Institute showed that smokers have a 24% higher risk and former smokers have a 13% higher risk of invasive breast cancer than non-smokers.
3. Avoid alcohol.
Alcohol changes the way estrogen is metabolized in our body, which can lead to estrogen dominance. Women who drink alcohol have higher body estrogen levels than those who don’t.
4. Consume a diet low in animal-based foods.
Animal-based products are extremely inflammatory and expose the body to a high dose of arachidonic acid, an inflammatory mediator. Fill half your plate with veggies!
5. Exercise regularly and develop a yoga practice.
Any amount of exercise, mild or intense, will reduce the risk of breast cancer. Aerobic exercise reduce the risk of breast cancer development, by changing the metabolism of estrogen in our body and increasing the ratio of “good” (2-hydroxyestrone) to the “bad” (16alpha-hydroxyestrone) estrogens.
Yoga balances and regulates the endocrine system, and thus our hormones. It also builds the immune system, while promoting lymph flow, the latter being extremely important for drainage of toxins from the breast and the lymph nodes in the axilla (arm pit).
6. Do regular breast self-exams and breast massage.
They can be life saving! Get clinical breast exams at your yearly physicals, and mammograms if appropriate.
7. Maintain the right body composition and fat percentage of your body.
Obesity and visceral adipose tissue (VAT, i.e., the fat accumulated around your abdominal organs) are extremely inflammatory! Find a Functional Medicine practitioner who is trained in First Line Therapy/ Therapeutic Lifestyle Change, a special program specifically targeted to reduce this fat factory of our body.
8. Reduce other inflammation-causing issues in your body.
It's important to get tested for food sensitivities and eliminate from your diet all foods to which you may have allergies or sensitivities. Get checked for, and treat chronic infections in the gut, mouth and sinuses.
Remember, inflammation makes the immune system less effective in doing its job, and a less effective immune system leads to progression of cancer cells!
9. Avoid toxins.
These can take the form of:

• Inflammatory foods that are filled with trans fats, artificial coloring and preservatives.
• Household cleaning chemicals, pesticides and insecticides.
• BPA-containing plastics, which can be used for storing food and water.
• Personal care products and perfumes: these may contain hormone-disrupting chemicals like pthalates and parabens.

10. Consume a good-quality protein at each meal.
Your body needs essential amino acids at every step to function optimally. Work with your physician to get a comprehensive stool analysis, which will tell you whether the protein you're eating is getting digested and absorbed as effectively as it should.
11. Balance mind, body and emotions with meditation, breath control and emotional freedom exercises.
Here are a few tips:

• Meditate daily.
• Learn and practice yogic breathing exercises.
• Practice forgiveness every day!
• Journal before going to bed to detoxify the mind.

12. Sleep is your best friend!
A study published in August 2012 showed an association between less sleep and development of aggressive forms of breast cancers in women.
If you suffer from chronic sleep issues, work with your physician to find the underlying cause and correct it. Using drugs isn't the answer!
I hope to have given you a message of empowerment that you can do something to prevent breast cancer. I would love to hear from you if you've used any of these measures.
You can look for a Functional Medicine practitioner in your area here.

This blog first appeared in MindBodyGreen

Do You Have Chronic Inflammation & What Can You Do About It?

Seems like everyone's talking about inflammation these days! More and more studies are coming out linking chronic inflammation to a vast majority of chronic diseases, even cancer.
But, is all inflammation bad?
Not at all! Some inflammation is absolutely necessary for our survival. It helps us overcome any acute insult or injury to the body. For example, if you cut your finger, cells are recruited to the wounded area, and through a very complex mechanism, the body heals itself quite efficiently. That's an example of inflammation working to heal you.
Similarly, if you contract a bacterial infection, the body quickly produces inflammatory chemicals known as cytokines, which help kill the foreign invaders. During this fight between the bugs and your immune system, you feel terrible, but only for a short time. Soon, you're up and on your merry way again with little long-term botheration from the incident.
It's only when this inflammation becomes chronic or long term—like a low-grade smoldering fire which does not die out—that it leads to major problems.
Normally, during a period of low-grade inflammation, the body tries to warn us that something is wrong. It does this by producing many nagging signs and symptoms, like:

• Aching of joints and muscles
• High blood pressure
• Rising blood sugars
• Headaches
• Sleep issues
• Allergies
• Skin issues
• Frequent abdominal pain and other gut issues
• Mood swings
• Difficulty with sleep
• Low energy levels

If we do not heed these symptoms and allow the inflammation to persist unchecked, after years (yes, years!), the inflammation becomes evident in the form of a heart attack, stroke, Alzheimer's disease, cancer, or an autoimmune disease like multiple sclerosis, ulcerative colitis or rheumatoid arthritis, which can no longer be ignored by us.
Some signs of chronic inflammation are:

1. Chronic fatigue and low energy.
2. Mood issues including anxiety, depression, and panic attacks.
3. Memory problems, brain fog, or loss of focus.
4. Difficulty falling asleep, waking up in the middle of the night, or unrestful sleep.
5. Gut symptoms including acid reflux, IBS, constipation, diarrhea, blood or mucus in stools, intermittent abdominal pain, gas and bloating.
6. Chronic muscle and joint pain, swelling, redness.
7. Chronic allergies and asthma requiring frequent medications.
8. Chronic skin issues like eczema, psoriasis, redness of face and cheeks, or hives.
9. Frequent or daily headaches, tremors, easy loss of balance, tingling and pain along nerves in the extremities, dizziness.
10. High blood pressure.
11. Metabolic syndrome, abdominal obesity, or diabetes mellitus.
12. Low bone density or osteoporosis.
13. Heart disease, peripheral vascular disease.
14. Diagnosis of cancer: Yes, taking action is possible even after being diagnosed with a cancer as you can still try to prevent future development of new cancers at other sites.

What should you do if you have any any signs of chronic inflammation?
1. Find a functional medicine physician who is well versed in evaluating your symptoms.
This person can help you eliminate the root cause of the chronic inflammation, rather than focusing on just suppressing symptoms.
2. Avoid all inflammatory foods.
This includes refined sugars, sugar substitutes, juices and sodas, trans-fats, dairy products, non-organic eggs and meats from grain fed animals. I also suggested you eliminate any foods to which you may be sensitive/ allergic, all GMO foods, and foods with a high glycemic index.
3. Eat real foods.
Incorporate large amounts of antioxidants, phytochemicals, and fiber-rich fruits and vegetables, nuts and seeds, small amounts of grass fed meats and wild small fish, healthy spices like turmeric, ginger, garlic, and herbs like cilantro, parsley, oregano and rosemary in your diet.
4. Stop eating microwavable lunches or dinners.
Don't eat dead packaged and processed foods which have no life force!
5. Sip green tea on a regular basis.
It cuts inflammation and calms the mind!
6. Try to avoid toxins as much as possible in your daily life.
You'll give your liver a much-needed break.
7. Incorporate a daily exercise regimen.
Do yoga, tai chi or some other form of movement exercise. Move the body whenever you get a chance!
8. Meditate daily and breathe deeply.
Who doesn't love peace of mind? It's also great for your nervous system.
9. Focus on optimal sleep.
Your body restores and regenerates itself daily when you sleep!
10. Find time for rest and rejuvenation on a regular basis.
Try to make time for mini-vacations and spending time in nature!
11. Get regular massages.
Better yet: learn the technique of self-massage and practice it daily!
12. Get your vitamin D levels checked and maintain optimal levels.
Use supplements if needed. Vitamin D is not just a vitamin, it functions as a hormone messenger molecule in crucial body processes!
13. Maintain a positive mental attitude about life and people!
Remember, just like your gut affects the brain, the brain in turn affects the gut, where the majority of our neurotransmitters are made.
Cutting down your risk of inflammation will most certainly reduce your chances of developing chronic diseases, so I urge you to take corrective action, one baby step at a time.

This blog was first published on MindBodyGreen

15 Simple Ways To Reduce Toxins In Your Life

Every day, we're exposed to toxins, from our food, water and air! Our body therefore, has a built in, efficient detoxification system which works 24/7, through our liver, gut, skin, kidneys and lungs.
The liver, our main filtration system, has two detoxification phases, and each is very important. The Phase 1 pathway leads to the production of toxic intermediates (free radicals), which then must be rapidly acted upon by the Phase 2 pathway so as to render these harmless. If Phase 1 is overactive and Phase 2 is sluggish for any reason, we run a risk of build-up of the toxic intermediate products from the Phase 1 pathway. These intermediary chemicals are more detrimental than the original toxin itself!
Some simple strategies to reduce your toxic exposure:

1. Stop eating canned food (even if it's organic)! 
Cans are lined with BPA (Bisphenol A), a Persistent Organic Pollutant (POP). POPs can linger in the human body for up to 100 years! POPs preferentially induce Phase 1 enzymes (Cytochrome P450 enzymes) of your liver detoxification pathways, causing production of free radicals, which in turn deplete the antioxidant reserves of your body.
2. Avoid plastic water bottles.
Drink water all day long, but don’t drink it out of plastic bottles! These also contain BPA.
3. Read your make-up ingredients carefully!
Most makeup products (even the brand name ones) contain phthalates and Triclosan, which are endocrine disruptors and hormone mimickers. Your makeup should contain only natural ingredients. Remember, if you can’t eat it, don’t apply it on your skin or body!
4. Use only natural household cleaners!
Synthetic cleaning chemicals produce a byproduct called dioxin, an endocrine disruptor, immune modulator, and carcinogen which induces Cyp1B1, an enzyme of the Phase 1 liver detoxification pathway. This leads to increased production of 4 Hydroxy Estrogen, a “bad” estrogen, associated with breast cancer development.  
5. Find a biological dentist and get any silver-mercury fillings, removed safely!
Mercury accumulation in the body can cause autoimmune and neurological problems. It binds to sulfhydryl groups in Glutathione (GSH), the master anti-oxidant of the body, rendering it ineffective in its job as a free radical quencher. Mercury depletes GSH and selenium, a crucial mineral for thyroid health and proper production of thyroid hormones.
6. Stop eating toxic, denatured, pesticide-laden, genetically modified and processed “dead” foods!
Consume grapefruit, onions, garlic, cruciferous veggies, cilantro, parsley, all of which help the liver in its detoxification role. Eat organic whenever you can. Consume a good quality protein at each meal as both the detoxification phases need amino acids to function optimally. Avoid charbroiled meats, which selectively induce phase 1 enzyme, Cyt1A1. If you have concerns about your diet not being optimal in nutrients for any reason, at least consider consuming a good quality multi-vitamin multi-mineral supplement. I'm partial to this brand. (Full disclosure, it's my line of supplements!) 
7. Stop any form of substance abuse.
This includes tobacco, alcohol, drugs, even stimulants like caffeine!
8. Know that pharmaceutical drugs can be the biggest burden for your body to attempt to detoxify.
Always discuss with your physician in detail regarding the need your prescription medications. Review safer options, and understand their side effect profile well.
9. Drastically reduce your stress levels.
Stress is a toxin, especially when chronic! Our body cannot differentiate between emotional and physical stress, and reacts similarly to both, by producing generous amounts of the stress hormone cortisol. When elevated for long periods of time, cortisol can lead to undesirable chronic diseases and symptoms like high blood pressure, weight gain, metabolic syndrome, diabetes, IBS, sleep issues, and it even increases your risk for heart attacks and strokes.
10. Investigate any food allergies. 
 Food allergies and poor gut health are inflammatory! Excess inflammatory markers chronically circulating in the blood behave like toxins and slow down the efficacy of the liver detoxification mechanisms. A Comprehensive Stool Analysis and a food sensitivity test can help you identify your trigger foods.
11. Lose excess fat.
Fat stores toxins! Lose excess body fat, especially the inflammatory Visceral Adipose Tissue (VAT). Our body’s intelligence believes that the solution to pollution is dilution, and since most toxins are fat soluble, it tries to dilute the blood content of these by pushing them into the fat cells!
It's crucial to remember that fat reduction should always be done under supervision of a trained health care practitioner. If liver detoxification pathways are not supported before initiating a fat or weight loss program, one can become very sick when fat loss causes release of large amounts of stored toxins into the blood stream. You may have heard of people getting quite ill after losing weight rapidly. So, please exercise caution!
12. Shake it up!
Movement mobilizes toxins! Exercise regularly to gently release toxins through skin via sweat. Yoga is great to enhance lymphatic drainage. Slow deep breathing releases toxins through lungs.
13. Get those bowels moving.
Our gut has been called the “Phase 3” Detoxification pathway! Avoid constipation, so that once the liver has done its job of converting the fat soluble toxins into water soluble compounds, they are easily and rapidly eliminated in the stool. Constipation leads to recirculation of toxins in the body, increasing toxic exposure, thus increasing risk for cancers and other chronic diseases.
14. Prevent emotional toxins from building up!
Practice journaling, meditation, forgiveness, mindfulness, and emotional release techniques on a regular basis. Don’t hesitate to seek professional help if needed.
15. Last, but probably one of the most important is sleep!
It's the best way to rejuvenate the body’s detoxification capacity both on a mental and physical level. Assess whether you wake up refreshed every morning. If not, please get evaluated for why that is so! It could be the most important thing you did for yourself!
Hopefully some of these simple reminders will help you. For additional individualized help and functional testing of your gastro-intestinal tract health, food sensitivities, toxin testing; adrenal health evaluation, or testing for micro-nutrient, vitamin, mineral and antioxidant deficiencies (which impact your liver’s ability to eliminate toxins), find a Functional Medicine Physician in your area.

This article was first published in MindBodyGreen 

Calming the Vata winds of the holiday season!

The festive season of fall and winter is a time of reflection on the year gone by and a time to be thankful for one’s blessings. It is also a time of overindulgence in seasonal treats, which compromises the body. To counteract these effects, traditional cultures of the world have devised some simple lifestyle techniques that I use in my Integrative Medicine practice.

Integrative Medicine is the coalescence of modern Allopathic medicine with an upcoming field of medicine called Functional Medicine and traditional and complementary healing methods like Ayurveda. Traditional Chinese Medicine, Acupuncture, Mind-Body healing techniques like yoga, meditation, and healing touch, to name a few.  These tools in the tool-box of any Integrative Medicine practitioner are pulled out at the appropriate time. Integrative Medicine is truly “whole”ness in medicine. It is as individualized as it gets! While my main area of focus is Functional Medicine (finding out the root cause of illness, i.e. the ‘how’ and ‘why’ of any disease process), I do integrate it with other ancient healing arts, my favorite being Ayurvedic Medicine, which was an integral part of my upbringing in India.

Ayurveda, a 5000-year-old consciousness based healing tradition from India, is made up of two Sanskrit root words, Ayus (life), and Veda (knowledge) — Ayurveda means the knowledge or wisdom of life. Ayurveda’s premise is that we are an inseparable part of the universe, so are most certainly impacted by even the subtlest of changes in our environment.

According to Ayurveda, at the time of conception each one of us is infused with a different proportion of the five great elements (known as “The Panch Mahabhutas”) — Space (Akasha), Air (Vayu), Fire (Tejas), Water (Jal) , and Earth (Prithvi) which contributes to three major mind-body constitutions or body types of Ayurveda (Doshas) namely, Vata (preponderance of space and air), Pitta (preponderance of fire and water), and Kapha (preponderance of water and earth). While detailed discussions of these three Ayurvedic mind-body types and their subtypes is beyond the scope of this article, it is pertinent to state that the objective of any integrative physician should be to understand and evaluate their patient’s unique Dosha and to try and restore it back into balance.
Environmental changes are very closely mirrored by our body systems. During such transition periods it is of utmost importance to give our body as much nourishment as we can, so with minimal effort it continues to maintain harmony of all organ systems. At these times, I would prescribe an individualized regimen of lifestyle, diet, sleep, exercise, and mind-body techniques to match, balance and support my patient’s individual constitution.

Fall and winter is Vata season (November through February). Vata Dosha controls all movement in mind and body, i.e. blood flow, breathing, waste elimination, movement of thoughts, to name a few. It even governs the movement of Pitta and Kapha Doshas, hence Vata is rightly considered the leader of the three. It is imperative to keep Vata in a balanced state at all times since when out of balance, it pushes the other two Doshas out of balance very easily. The qualities of Vata Dosha are: cold, dry, rough, light, windy and irregular, so an increase in these qualities during the Vata season can cause dry, cracking, dull and rough skin; exacerbate worry, anxiety, irritability, spaciness and sleeplessness (insomnia) in some; cause slowing or irregularity of the bowel transit time leading to constipation, gas, bloating and IBS-like symptoms; cause spells of forgetfulness; painful joints and even easy fatigability.

If one is predominantly of Vata constitution, that is, eating mainly a Vata-aggravating diet (cold, raw foods and liquids), living a Vata-aggravating (irregular schedules) lifestyle, or is in the Vata time of life (from 60 years of age on up), the effect of Vata imbalance on skin, mind and all body organs is even stronger. To counter these, Ayurveda suggests some simple but very effective techniques that reduce the chances of forming toxic residues (Ama) and enhance the flow of vital life force energy (Praana) and build the sweet essence of health and vitality (Ojas) within us:
•Abhyanga: Daily full-body self-massage using warming and heavy Dosha specific Ayurvedic essential oils
•Stay warm, keeping the skin, head and ears covered to prevent further drying and loss of moisture;
•Preferentially using natural silk or wool clothing rather than synthetics;
•Using sweet and floral essential oils in your warm bath regularly;
•Diet:  Ayurveda recommends cooking with Dosha specific herbs and spices; drinking warm fluids throughout the day; eating fresh, warm and well-cooked foods and avoiding raw and cold foods like salads. Most certainly avoid processed, stale foods including left-overs as they have no life force or Praana left in them.
•Eat largest meal around noon when the digestive fire (Agni) is at its strongest. To pacify Vata, sweet, sour and salty tastes are best eaten at this time. Eat your meals in a peaceful environment.
•If you are expecting some dietary indiscretions in the day, sip ginger tea or eat some sliced ginger a few minutes before your meal.
•Avoid all stimulants: caffeine, nicotine;
•Practice breathing exercises (Pranayama) daily, especially when stressed and anxious;
•Meditate; practice Yoga daily;
•Maintain regular sleep-wake schedule in spite of irregular and demanding holiday schedules. Routine is the key!
•Ensure regular daily bowel elimination to prevent build up of toxins.
•Keep some “me” time in the midst of the chaos.

My aim is to help explore these expansive wonderful fields of Integrative Medicine and Functional Medicine with the intention to empower one with the basic knowledge of how ‘real’ food and a nourishing lifestyle not only prevents illness but creates a positive impact towards leading “whole-istic” lives.

Cheers to a blessed, healthy and safe ‘Vata’ season in this New Year!

This article by Dr. Manisha Ghei was first published in HUM Magazine.