Do I need custom vitamins? Doctor answers
Advertisements are everywhere for custom vitamins, personalized supplements, and vitamins tailored to you. But are these supplements really worth the hypeRead more
Hormonal Health: Estrogen, Cortisol & more
Here’s how to optimize your hormonal health Hormones are tiny chemical messengers present in everyone’s body – men and women. They are produced by glands in the endocrine system (pituitary, pineal, thyroid, parathyroid, adrenal, pancreas, and thymus — along with the ovaries in women and the testes in men) and sent to organs and tissues […]Read more
Immunity booster: Gut health & probiotics
Compromised immune system? Here’s what to do. The first step in strengthening your immune system and protecting your body from viruses and bacteria is optimizing your gut health. That’s right, gut health has a huge impact on our immune systems. How are gut health and the immune system related? About 70% of the immune system’s […]Read more
Metabolic Flexibility or Keto? Type 2 Diabetes answers
Many doctors advocate for the keto diet to treat type 2 diabetes, but sticking to a strictly no-carb diet can be difficult in the long run.Read more
Chronic stress, anxiety and fatigue: What you need to know
If you’ve ever experienced a panic attack, acute stress, or extreme anxiety, you may also notice feeling tired and exhausted.Read more
Dr. Markyia Nichols on using less medication
Tell us a bit about yourself, your medical background, and how you found your way to Ciba Health. I started out in OB-GYN, which I absolutely loved. It was fast-paced. It was quite a bit of stress. Although at the time, it just felt like lots of energy and it was fun. I noticed pretty […]Read more
Functional, Holistic, Integrative, or Naturopathic Medicine?
Tell us a bit about yourself, your medical background, and how you found your way to Ciba Health. My name is Sandy Le and I’m one of the Medical Directors of Ciba Health, on the West Coast. Since we’re national, we have West and East regions. I’m a naturopathic doctor. I went to UCLA for […]Read more
Doctors, dieticians, and health coaches – why collaboration is essential
Dr. Innocent Clement: I am the CEO and founder of Ciba Health. Here with us today is my Director of Wellness, Whitney Crouch.Read more
How To Set Mini-Goals And Shift Your Habits
Are you achieving your goals? Did you make resolutions or set goals for this year and feel you’re falling behind?Read more
Custom vitamins & personalized supplements demystified
Advertisements are everywhere for custom vitamins, personalized supplements, and vitamins tailored to you. But are these supplements really worth the hype, and do they give us more benefits than our regular multivitamin?
Dr. Sandy Le, a naturopathic doctor with Ciba Health, answers our burning questions about personalized vitamins and supplements.
What’s the hype behind these tailor-made supplements?
Many tailor-made supplement companies are popping up because of a rise in preventative medicine, and an emphasis on a nutrigenomic approach to medicine. So not only are using someone’s genetics to inform medical decisions, but you’re also delving deeper into their lab work. This will allow your doctor to see exactly what nutrients your body is lacking.
You can then create a specific supplement to optimize those levels. When you buy a multivitamin over the counter, the dosages you get are intact. You and your neighbor could take the same dose. But if we all went in and got blood work done, you would have different vitamin B levels or magnesium levels or different mineral levels than your neighbor.
So the cool thing about these personalized supplements is they’re creating a supplement based on your individualized needs and based upon your blood work.
Should I invest in personalized supplements? Is it really worth it?
It really depends on the person. You have some people who are super healthy, whose genes are amazing, and who don’t have any issues with absorption. They probably wouldn’t need a personalized supplement. But if you are someone who experiences chronic conditions or complains about fatigue, difficulty focusing, or you have leaky gut, for instance, you would really benefit from taking customized supplements that directly address your medical issue.
What is the relationship between functional medicine and personalized supplements?
Using supplements or nutraceuticals instead of universally using prescription medication is a type of modality, that is used in functional medicine. When someone’s coming in to my office for a certain condition or they have a chronic disease, I run all of your diagnostics to see what’s going on, and by utilizing supplements, we can begin treating what’s going on. That’s where functional medicine goes hand in hand with custom vitamins.
Not only are you looking at a person’s lifestyle and diet and fixing things on that end, but you’re also giving them this support through supplements, herbs, and nutrition. It’s also important to make sure that their supplements, lifestyle and diet isn’t contraindicated in the medications that they’re taking.
When should I consider taking supplements? What sort of supplements would be beneficial to overall health?
First and foremost, you would have to set up shop with a licensed functional medicine doctor or naturopathic doctor to get labs done. They would gather all that information and then see if you’re on any medications to recommend any supplementation.
Typically, though, the most common vitamins that are generally safe for people to add-on would be vitamin C, vitamin D, and magnesium, which are in fish oil. Those are generally pretty safe things to add, but of course you always want to check with your healthcare provider and your doctor to make sure that’s okay.
Here’s how to optimize your hormonal health
Hormones are tiny chemical messengers present in everyone’s body – men and women. They are produced by glands in the endocrine system (pituitary, pineal, thyroid, parathyroid, adrenal, pancreas, and thymus — along with the ovaries in women and the testes in men) and sent to organs and tissues through the bloodstream. When hormones (and your endocrine system) are functioning normally, chances are you won’t notice their influence on your body. However, their impact is BIG.
Hormones are responsible for:
- Regulating metabolism
- Stabilizing mood
- Development and growth
- Sexual function
- Cognitive function
- Maintaining body temperature, etc.
It only takes a tiny amount of a hormone to make a major change in the body – so a slight excess or deficiency of any type of hormone can lead to disease. For example, too little of the hormone insulin inhibits the body’s ability to synthesize blood sugar from food, over time giving rise to diabetes and associated complications.
How to know if you have a hormonal imbalance
Symptoms of a hormonal imbalance vary, and in most cases a simple blood work test will confirm if you are suffering from a hormonal upset. However, if you unexpectedly experience any of the following symptoms, it may be time to talk to your doctor.
- Weight gain
- A hump of fat between the shoulders
- Unexplained, and sometimes sudden, weight loss
- Muscle weakness
- Muscle aches, tenderness, and stiffness
- Pain, stiffness, or swelling in your joints
- Increased or decreased heart rate
- Constipation and diarrhea
Symptoms specific to women:
- Heavy, irregular, or painful periods
- Osteoporosis (weak, brittle bones)
- Hot flashes and night sweats
- Vaginal dryness
- Breast tenderness
- Acne during or just before menstruation
Symptoms specific to men:
- Reduced sex drive
- Erectile dysfunction (ED)
- Low sperm count
- Reduced muscle mass
- Reduced body hair growth
- Overdevelopment of breast tissue
- Breast tenderness
Undiagnosed thyroid disorders
According to the American Thyroid Association, an estimated 20 million Americans have some form of thyroid disease. Up to 60% are unaware of their condition. What’s more, women are 5-8x more likely than men to have thyroid problems. Undiagnosed thyroid disease can put people at risk for a range of health problems, including cardiovascular diseases, osteoporosis and infertility.
The thyroid is a hormone producing gland that sits at the center of the lower neck, and it is critical for regulating the body’s metabolism, i.e. the rate at which the body processes food and oxygen into energy. For this reason, the thyroid impact every cell in the body, and too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can have devastating effects on your well-being.
Dr. Subhashini Katumuluwa, a medical doctor with Ciba Health, explains why she sees so many people with undiagnosed thyroid issues: “Patients will come to me and say, ‘I have all these typical symptoms of hypothyroidism like a lot of fatigue, gaining weight for no reason, and I’m always cold. My provider tested my TSH (thyroid stimulating hormone) level, and it came back normal, so they said I don’t have an issue.’ So I really tend to go by how the patient is feeling, so if they’re telling me they don’t feel well, then I will definitely keep digging deeper.”
Diagnosing hormonal imbalances
A conventional medical approach to diagnosing a hormonal imbalance is very much symptom-oriented. If your doctor suspects your symptoms line up with that of a hormone imbalance, a set of lab tests will likely be run to “rule out” any catastrophic diagnoses. Then, medication (often a synthetic hormone) will be prescribed to address the hormone disruption.
For example, let’s imagine a 45 y/o woman comes into her doctor’s office with symptoms of fatigue, irregular bleeding, and weight gain. The conventional approach would be to check a basic thyroid panel, a complete blood count, and possibly prolactin levels to rule out any brain tumors. She will then probably go through an invasive endometrial biopsy and even an MRI, as well as ultrasounds. These methods often produce “normal” results – despite the woman’s clear and grievous symptoms. She will likely be prescribed a synthetic hormone to control the bleeding, and told she needs to lose weight (without instruction on how to do so).
Patients and doctors who have had similar, frustrating experiences with traditional medical approaches that focus too heavily on alleviating symptoms may want to try a functional medical approach, which aims to heal the root cause of disease and illness.
Dr. Katumuluwa continues, “TSH, as a reminder, is not actually a thyroid hormone. It’s a brain hormone. TSH is a hormone that your brain produces to tell your thyroid gland whether to produce more or less thyroid hormone. So, it’s possible for that TSH level to be in what’s called the ‘reference range’ for the lab value, but for that person’s actual thyroid hormone levels to not be optimal.”
There’s a big difference between reference range (what’s considered normal) and the optimal range for that specific hormone. Reference ranges differ for each laboratory, because they depend on the specific test population used by that laboratory. All that a reference range is telling us is where 95% of the people that were in the test population fell. As long as your levels are within that so-called “reference range,” it doesn’t raise any red flags. But this does not mean your level are optimal. Instead of relying on reference ranges, functional medicine practitioners look at optimal level for every hormone to see if there is a deficiency or over-production.
Ways to start fueling hormonal health today
Here are some suggestions for how to balance your hormones naturally while you work with your doctor. These diet and lifestyle changes are meant to compliment (not replace) the advice of your practitioner.
Strive to eat a balanced diet, consisting mainly of fresh fruits, fresh vegetables, whole grains, legumes, nuts, and lean proteins. Eating a balanced diet can encourage weight loss, which can improve hormonal functioning.
Avoid foods that provide calories but few nutrients, a.k.a. “empty calorie” foods such as cakes, cookies, donuts, processed meats, energy drinks, sodas, fruit drinks with added sugar, ice cream, chips and fries.
Do not exceed the recommended alcohol intake, which is no more than 1 drink per day for women and no more than 2 drinks per day for men (1 drink is equivalent to 12 oz. of beer, 5 oz. of wine, or 1.5 oz. of distilled spirits).
Incorporate more exercise into your daily routine by taking 30 minute walks or bike rides, signing up for a group fitness class, or practicing yoga, which can increase strength, flexibility, and mindfulness.
Compromised immune system? Here’s what to do.
The first step in strengthening your immune system and protecting your body from viruses and bacteria is optimizing your gut health. That’s right, gut health has a huge impact on our immune systems.
How are gut health and the immune system related?
About 70% of the immune system’s cells are housed in the gut. The human body is home to thousands of species of microbes, and the gut’s microbiome is key in the development of white blood cells – which fight off infections, viruses, and bacteria that enter the body. Researchers at Johns Hopkins University’s School of Medicine also uncovered that certain cells in the gut lining spend their entire existence pumping antibodies into the gut. Which means the key to boosting your immune system lies in the gut.
Probiotics and gut health
We know that probiotics, or so-called “good bacteria” play an important role in gut health. Probiotics are also a great immunity booster. Dr. Jessica Wei, a physician at Ciba health, explains the 5 R’s of gut health:
REMOVE toxic foods and stress
REPLACE digestive enzymes
REPAIR your gut lining
RESTORE healthy bacteria
REBALANCE your lifestyle to keep a healthy gut
Restoring healthy bacteria points to the importance of probiotics, which not only support gut health but also aid in the maintenance of the immune system – by strengthening our current immunity and also reducing pathogen-related inflammation throughout the body.
Probiotic foods to incorporate into your diet
Eating a balanced diet with foods that contain “healthy bacteria” or probiotics – can help strengthen your immune response and ward off viruses and bacteria. Here are some foods to start adding to your diet:
- Yogurt (look for “live and active cultures” on the label)
- Sauerkraut (refrigerated)
- Pickles (refrigerated)
- Sourdough bread
- Some cheeses
Metabolic Flexibility vs. Keto: Benefits, Drawbacks for Type 2 Diabetics
Many doctors advocate for the keto diet to treat type 2 diabetes, but sticking to a strictly no-carb diet can be difficult in the long run. Learn about metabolic flexibility and what it means for type 2 diabetes reversal in this in-depth article.
What is metabolic flexibility?
Metabolic flexibility is the body’s ability to burn available carbohydrates and fats efficiently without the help of external resources. In other words, the body is able to process all kinds of food. Dr. Subhashini Katumuluwa, a doctor with Ciba Health, explains, “The body is able to use whatever source of food is most readily available, and the body can very easily switch back and forth between using these different types of fuel.”
This is an ideal metabolic state, as the body produces everything it needs to turn food into fuel, and is able to respond and adapt to varying amounts of blood sugar in the body. There are many benefits of achieving metabolic flexibility, including: consistent energy, consistent blood sugar levels, less dependence on synthetic insulin, easier weight loss and maintenance, improved body composition, better sleep, improved immune system functioning, better physical and mental functioning, and fewer restrictive, long-term lifestyle changes.
Diabetes is influenced by a number of factors, including nutrition (macronutrient and micronutrient composition), your microbiome, quality of sleep, level of physical activity, body composition, heart rate, stress level, mitochondrial density and efficiency, and other existing health conditions. Once metabolic flexibility is addressed, many other factors that impact diabetes tend to improve as well.
How is Type 2 diabetes treated by conventional medicine?
“Don’t eat carbs,” is how a conventional doctor or endocrinologist would chiefly advise a patient with Type 2 diabetes. Patients would be advised to avoid foods high on the glycemic index (i.e. foods that spike blood glucose levels after they are eaten), such as white bread, potatoes, apples, and oranges.
Diets low in carbs, such as ketogenic diets or low-carb Mediterranean diets may also be recommended. Conventional doctors may also encourage exercise and prescribe an anti-diabetic medication such as Metformin to improve the body’s ability to burn carbohydrates. However, taking a one-size fits all approach and simply cutting out carbohydrates of one’s diet does not address the root cause of diabetes: the body’s inability to produce insulin and/or the body’s resistance to insulin.
How does functional medicine treat diabetes?
Functional medicine uses testing that identifies the underlying drivers of diabetes, that when addressed can decrease medication need, decrease HbA1c levels, and oftentimes completely reverse diabetes.
We focus on achieving metabolic flexibility, an ideal metabolic state. Once this is achieved, many other diabetic symptoms improve as well – such as weight maintenance, immune functioning, sleep and stress levels.
It is more than symptom control. Other treatments control the symptoms of high blood sugar with diet changes, without actually addressing the underlying causes. We address the root cause of diabetes.
We create a personalized diet and lifestyle plan for you that is sustainable and produces long-term results. Other treatments that focus only on limiting carbohydrates are not feasible in the long run. While blood sugar improves for a while, the underlying insulin resistance issue is often exacerbated by these treatments.
Functional medicine sets realistic goals and lifestyle changes. Other diabetes treatments work as long as you stay on a strict diet of no carbohydrates, but very few people can maintain these types of diets in the long term.
We aim to decrease insulin resistance (which is the cause of high blood sugar). Once a person regains insulin sensitivity, their blood sugar and HbA1c levels stay in healthy ranges, their cholesterol and cardiovascular risk factors improve, and they are able to maintain long term success.
How chronic stress and anxiety can make you tired
If you’ve ever experienced a panic attack, acute stress, or extreme anxiety, you may also notice feeling tired and exhausted. It may even become a vicious cycle of stress, anxiety, and fatigue. Read on to see what you need to know about the relationship between stress, anxiety, and exhaustion, and what you can do to feel better.
What drives chronic stress, fatigue, and anxiety?
In moderation, the body’s response to stress is healthy – it helps us avoid (or fight) aggressors and dangerous predators that could threaten our lives. However, in today’s world, it’s much more likely that stress is contributing to poor health. Generally, when a stressor (such as a tight deadline or a public speaking engagement) has passed, our body’s flight-or-fight response is turned off, and our hormones go back to normal. But, so many executives these days constantly feel under attack – perhaps from ongoing deadlines and ever-increasing job demands – and your body stays in a stress-induced state. Prolonged stress can cause many other mental and physical issues – most commonly chronic fatigue and anxiety.
What are the consequences of experiencing long-term stress?
Long-term activation of the stress-response system and overexposure to cortisol and other stress hormones can disrupt almost all your body’s processes. This can lead to the development of health problems such as:
- Digestive problems
- Heart disease
- Sleep problems
- Weight gain
- Memory and concentration impairment
How does stress impact the workplace?
Health problems due to chronic stress can lead to decreased productivity, more errors in your work, and increased absenteeism due to the recovery time from illness.
According to the American Institute of Stress…
- Over 1 million workers are absent daily due to stress.
- Unanticipated absenteeism is estimated to cost employers over $3.5 million yearly.
- 60% of absences could be traced to psychological problems that were due to workplace stress.
What’s more, according to a 2019 survey conducted by the American Psychological Association, 64% of US adults say work significantly stresses them.
This isn’t surprising, considering the prevalence of anxiety is rising in U.S. adults. According to a 10-year study from the Journal of Psychiatric Research on anxiety among U.S. adults from 2008 to 2018, anxiety increased from 5.12% in 2008 to 6.68% in 2018 – with greater impacts on those under the age of 50.
How can I deal with chronic stress, fatigue, and anxiety?
These statistics mentioned here are particularly relevant for executives and professionals who have stressful jobs and don’t have the time or energy to seek treatment. But – know that there is caring, comprehensive, stigma-free hope and help available. If you feel like you are constantly under stress, anxiety, and/or fatigue, there is a way to feel better.
Here are some coping mechanisms to help in the short-term, from the Anxiety and Depression Association of America:
- Take a time-out. Practice yoga, listen to music, meditate, get a massage, or learn relaxation techniques. Stepping back from the problem helps clear your head.
- Eat well-balanced meals. Do not skip any meals. Do keep healthful, energy-boosting snacks on hand.
- Limit alcohol and caffeine, which can aggravate anxiety and trigger panic attacks.
- Get enough sleep. When stressed, your body needs additional sleep and rest.
- Exercise daily to help you feel good and maintain your health. Check out the fitness tips below.
- Take deep breaths. Inhale and exhale slowly, and follow a breathing exercise.
- Count to 10 slowly. Repeat, and count to 20 if necessary.
- Do your best. Instead of aiming for perfection, which isn’t possible, be proud of however close you get.
For more specialized help and comprehensive care, Ciba Health offers a personalized program to help executives and stressed-out leaders combat fatigue, stress, and anxiety. Learn more by contacting our Care Advisor: https://cibahealth.com/free-consultation/
Tell us a bit about yourself, your medical background, and how you found your way to Ciba Health.
I started out in OB-GYN, which I absolutely loved. It was fast-paced. It was quite a bit of stress. Although at the time, it just felt like lots of energy and it was fun. I noticed pretty early in my career that two things were happening. First off, I was starting to get pretty rundown. Second, I was noticing that I was having to give more and more medications and pills. Every year the same patient would come back with the same issue and need another medication. It started to become really frustrating for me. I realized that it wasn’t what I signed up for. At the same time, I was struggling with all of the stress and the running around, and I was not being kind to my body.
I ended up having an undiagnosed thyroid disorder, which looked normal from the traditional medicine viewpoint. I literally almost retired from medicine. I felt like I wasn’t helping my patients. I was pushing medications. I was sick myself, and I didn’t want to use the same stuff that I was giving to my patients. So through a series of synchronicities and just exploring some other outside of the box therapies, I ended up finding functional medicine. I was at a conference and a friend of mine suggested that I look into it, and I literally fell in love with medicine again. Once I started putting this into practice in my traditional practice, I moved completely out of conventional medicine into functional medicine. I literally saw medical issues reverse within months.
These are the same issues that were requiring years and years of medications on top of medications, and never, ever saw any progress for patients. And here I was in a field where I was able to help people literally reverse their symptoms. I was able to heal myself through using that same medicine, functional medicine, really getting to the root of the issue. I have my own private practice. And again, there were a series of synchronicities and Ciba came on my radar. I knew I had to be a part of it because this is not only cutting edge medicine, but we’re also bringing in all of these tools to be able to validate what we’re doing and really give people some data and information to validate the progress they’re making.
What is your role within Ciba health?
I’m helping to build out the functional medicine team. I’m the functional medicine director of the east coast. So, I’m working with all of the practitioners currently, but mainly I will be based on the East coast. I see my role as helping the company to grow its functional medicine programs and make sure that as we’re developing programs we’re really getting to the root cause of issues. And that as we’re building out our telemedicine platform, which a lot of people are new at, we’re making sure it’s an opportunity for people to really accomplish healing from the comfort of their home. It just gives people a really convenient way to address their health issues, to be proactive, to potentially get the family supported. That’ what we’re, we’re hoping to bring to the world.
Healthcare costs are rising, especially when it comes to prescription medication. Is it possible for patients to decrease or eliminate prescription medications?
Absolutely. And I see it all the time, and that’s what’s really exciting. For a lot of people who maybe have given up on the hope of ever coming off of medication or maybe they’re having side effects from a medication, it is possible. We know that the body knows how to heal. You can cut yourself and the body immediately goes to work to heal. That wound creates a scab. We know the body knows how to heal. The thing is really figuring out the root of the issue that’s creating disease. Once we’re able to pinpoint the root causes and create the change at the root, then the body already knows how to fix itself. You give it the right tools. It knows how to repair. So I like to look at medications as a short-term bridge.
If you’re having an issue and you’re really suffering from a symptom, medication is a short-term bridge while you’re digging to figure out what is actually creating that issue.
We’ll take me for example, with a thyroid issue. Initially, when I was having lots of struggles with fatigue, weight gain, dry hair, and everything, which was really pointing towards the thyroid issue, I was on thyroid hormone for a while. At the same time, I was digging into what was creating the thyroid issue. A lot of people just stay on their thyroid hormone forever. And unfortunately, if you do not figure out what the root cause is, then you can be band-aiding that symptom, but you’re still affecting other organs.
If I had not figured out how to repair my thyroid, for example, but taken the pill just to take care of this one symptom, it doesn’t mean the other organs and joints and hormones that are relying on that thyroid hormone won’t suffer. The other issue with medications is that usually when you’re taking medication, it is literally cutting off or blocking a certain process that’s happening in the body. That process is creating the symptom. You do get relief from that symptom for a period of time. However, when you block a process, a normal process, that’s supposed to be occurring in your body, it’s going to wreak havoc on other systems. This is exactly why these medications have side effects. When you are for instance on a statin drug, for high cholesterol, you will frequently have joint aches and pains while you’re blocking a specific system in the body, because you’re depleting a nutrient in the body. And that creates side effects. Whereas if you look and you figure out the root of the issue, what is creating the inflammation, what is creating the body to create more cholesterol? It could be literally that your hormones are low and the body is trying to create more cholesterol to make more hormones. So once you figure these things out and you repair them, and the body starts to repair itself, then you can naturally start to wean off or eliminate medications.
How did you find out the root cause that was triggering your hormones to act in a different way?
That’s the beauty of functional medicine. We go back to physiology – all of the physiology that we memorized in medical school just for the exam. If you’re in the early phases of the issue, for example with thyroid disease, when you look at someone’s thyroid labs in the traditional medical world, you have this range of “normal” and it’s a very wide range. As long as you’re within that range, your doctor’s going to say that your labs are normal. However, it does not mean that those labs are optimal.
Research studies on healthy people who have vibrant hormones have been done to show what lab ranges are optimal for a person. Because if you’re on the bottom end of the range, you’re not going to feel well, even though your labs are “normal”. With the functional medicine approach, you’re really going back into physiology.
We know that there are a lot of things that can create some imbalance in the body. We do specific testing that goes above and beyond the traditional blood work that you would normally get.
And these could be looking at something as simple as nutrient deficiencies, which were a big one on my list. I was missing zinc, selenium, and iodine – all those things that the thyroid needs in order to synthesize hormone. So if for me, I was running around in the hospital, eating fast food and not getting those nutrients. I could have taken thyroid hormone forever, or changed the way I ate to replenish those nutrients. I was off of my thyroid hormone in no time. Functional testing really goes deep into physiology. We’re looking at the hormones, we’re testing them the right way. We’re looking at nutrient deficiencies. We’re looking at the gut health and gut integrity, which is really important for everything. We’re looking at neurotransmitters. All of these things are important.
We’re also taking the time. A lot of people can relate to going to their doctor and literally having 10 minutes to see their physician. They have two minutes to chat about their issue and hope that the doctor gets a gist of what’s going on. They get a couple of labs and then they leave home with a prescription. In the functional medicine world, we realize how important it is to really take the time to sit down with our patients and discuss the issues and the symptoms.
We figure out all of the psychosocial things that could be contributing to the underlying issue. Stress is a big issue. And if you don’t take that into consideration, you’re missing a key component. You can put supplements and pills and everything in someone’s regimen. But if you don’t address the underlying stress, it literally will not work.
Do you think we are too reliant on prescription medication?
I think that we’ve been in crisis for many, many years. I think that if anything, we’re reaching a point where I think for maybe the first time ever, patients are starting to see that there might be a little propaganda behind all of the pharmaceutical commercials that we’re bombarded with. People aren’t feeling well. I think it’s vitally important now, especially with the pandemic, to open people’s eyes to the importance of being really healthy. Those who have healthy immune systems and are really taking care of those underlying medical issues aren’t the ones that are being impacted by COVID.
In general, I think people are still reliant on medications. And there are some people who really just want the pill. Whatever people’s reasons are, we’re making it easier for people to implement the changes that need to happen in order to have optimal health. That’s one of the reasons why people rely on medications. They don’t have clear instructions on how to get off of them, or they feel like the lifestyle changes that they have to make might be too drastic and won’t be able to do it. One of the things that help us stand out at Ciba and really sets us above and beyond is you have all of the support to get through it and to make it easy.
You can’t tell someone, okay, you need to eat less, eat differently, and exercise more and then send them home without unique, clear instruction. You need to go through someone’s meal plan for a couple of days, see what they’re actually putting into their body. Understand what changes need to be made. You need support, you need someone there who can hold you by the hand as you’re making those changes until it becomes a habit and a way of life.
How might someone who wants to get off of their medication go about doing this?
First off, it’s possible. There is hope. I see it all the time, so it is absolutely possible. And I think it’s important to know that there is a path that you can take. And I think that it is important to work with someone who is an expert at titrating people off of medications in order to do it in a way that’s safe for you. A lot of times, especially with diabetes, as you’re making changes, you want to make sure that you’re really watching your blood sugars and someone else is also gauging that with you. So I think that it’s important to work with a functional medicine practitioner who is not only going to help you titrate off of your medications but is also going to provide you the tools to help your body heal.
There are some medications that are not safe to come off immediately. For example, with antidepressants, you definitely want to be working with someone and repairing your neurotransmitters.
There’s usually not somebody who’s taking a medication and their symptoms are a hundred percent resolved. But it’s one of the good ways that we can use as functional medicine practitioners to gauge the progress of the therapy. Because as you’re healing from the root, you’re replenishing the nutrients, you’re balancing out people’s hormones, you’re adding in the dietary and the lifestyle changes, a person will start to feel better and better. Sometimes there’s even a tipping point where your body’s like, I don’t need this medication and you may actually start to feel worse being on that medication. So that’s one of the ways to do it is really repairing the body prior to titrating off of the medication.
And let’s say for example, someone has had a transplant, all right. And they’re on anti-rejection medicine. You would not want to remove that. But there are a lot of things that we can do in functional medicine world, even in that scenario, to really support the body and make sure that everything else is functioning, even though that medication needs to stay there. So most medications that we’re using for chronic diseases or to patch up or band-aid symptoms can absolutely be removed. If you weren’t born with it, I say most likely it can heal. If you did not come into the world with it, then likely there is some underlying process that is keeping it locked in place, and just work with work with a functional medicine practitione to help to do that. It’s possible.
What can we do to alleviate symptoms without medications? Is this safe and effective?
In functional medicine world, there are so many tools that we have when you’re looking at someone from a holistic perspective and you’re not just physically focused.
There are a lot of things that we can implement as far as mindset shifts that will also help for symptoms. For someone who’s suffering from anxiety, per se, which is big right now, especially with the pandemic – instead of relying on the medication to help in the moment for anxiety, we have natural supplements that do the same thing without being addictive, without the potential for overdose, and that are highly effective.
There is one, I call it nature’s value. It’s called “l-theanine” and it’s the active component in green tea. This is what makes green tea so relaxing. I haven’t traveled this year, but I would use it on airplanes. There are natural supplements and things that you can use to help with symptoms that aren’t going to be damaging to the body and blocking body systems, and that are actually going to help the body to repair.
We also go for mindset and sort of the spiritual shift. We can do mindfulness training. We can do meditation, and then there’s yoga. There are all these tools that we incorporate in functional medicine, when you have a holistic approach that really helps with symptoms.
How might a functional medicine approach to “pain” or symptoms be different from a conventional approach?
It’s a good question. And it’s a big question. I’m hoping with functional medicine practices and principles, we can really start to reverse this epidemic that we have here. One of the issues is that pain is so multifactorial. It’s one thing if you’re in an accident and you have pain medication after surgery for up to a week or so. We automatically assume that you’re not going to need that pain medicine over time. Why? Because the body heals itself. When it comes to chronic pain, and I’m not going to get so much into like addiction because there are things that you can do for that as well. But we have to look again at the root of the pain. So is there something going on in the body that’s creating the pain.
We can look at it from first, the physical level, fpr someone who has fibromyalgia or chronic pelvic pain. There’s a likely some inflammatory process that is keeping that in place and is creating the situation for pain. You end up being on a lot of medication, whether pain medication or auto-immune drugs that are to target that symptom. And this is where the problem is. You’re missing everything else that’s going on in the body that has created the symptom.
The functional medicine approach to pain is we’re going to look for the root cause physically. We’re going to do the functional testing. We’re going to look at inflammation. We’re going to look at the gut. We’re going to look at what you’re eating. Most of the sources of physical pain are what we’re putting into our bodies through our mouth, through our skin, on our skin. Those are the main sources of the physical pain, and then we need to go even deeper.
If there’s emotional pain there, if there’s anxiety there, if there’s depression, is there something going on at home that can be alleviated or we can do some troubleshooting around that? Let’s figure out what is creating the pain so that it does not escalate into brain fog and cancers and all of those things. So I think that’s the difference. I’ll also say that we have so many options besides opioids to address pain. And a lot of them have been and are now being well studied. We’re having more and more research on things such as acupuncture, when before, probably when I first got out into medicine, when someone spoke of acupuncture, you look at them funny.
Now we can say that, yes, this is a valid way of treating pain that is quite effective and has long-term benefits. It’s helping the entire body. And it’s, non-addictive. We are starting to hear about CBD. Our bodies have these special endocannabinoid receptors that are there. They’re in our body amd designed to interact with cannabinoids, which are very healing for inflammation and for pain and for Alzheimer’s and dementia. In functional medicine, let’s figure out what the root is. Let’s use our tools that we have in our toolbox. And while we’re working on that, we have some amazing supplements and tinctures and meditation and breathing techniques that will help you with your pain as we’re figuring out the root to heal it for good.
Tell us a bit about yourself, your medical background, and how you found your way to Ciba Health.
My name is Sandy Le and I’m one of the Medical Directors of Ciba Health, on the West Coast. Since we’re national, we have West and East regions. I’m a naturopathic doctor. I went to UCLA for undergrad and went to a naturopathic medical school in Portland, Oregon. I completed a two year residency in family medicine, and I’ve always kind of been in the realm of working in functional medicine with a lot of other MD’s. Because our view of medicine is basically the same, we’re getting to the root cause of the problem and being able to provide different modalities of treatment. These treatment modalities range anywhere from herbs, vitamins and minerals to doing diagnostic lab tests. So that’s how I finally found myself working with Ciba Health, because it’s such a neat platform where everything is done through telemed – and it’s increasing access to this type of medicine to everyone, which is a great thing.
What is functional medicine and how do you practice it?
Functional medicine is a personalized and integrative approach to healthcare. So it involves understanding “prevention management” or the root causes of complex disease. Functional medicine draws from a number of different healthcare models, for instance holistic healthcare, which is more focused on body, mind, and spirit. It also takes notes from naturopathic medicine, which is focused on getting to the root cause of illness with different modalities like herbs and supplements. Integrative medicine, on the other hand, is a broad umbrella term that encompasses all of these models that offer the most comprehensive, personalized, and effective approach to healthcare. So overall, functional medicine is more focused on personalized health and learning about how our genetics, our environment, and our lifestyle affect us. It’s about understanding how they all interact as a whole system and how we can use that to diagnose and treat based on whatever imbalances that we see. It’s really about getting to the root of the problem.
What was your first introduction to functional medicine? How did that introduction affect you?
When I was in college, I was pre-med. So I was on track just to go to regular, conventional medical school. I spent a lot of time volunteering at the UCLA medical centers. And I noticed that it was such a pill popping culture. Anyone would come in for something, like a headache. And they would say, “Here, take this pill.” Or, my blood pressure is elevated. “It’s okay, take this pill.” Or you have high cholesterol. “Okay. Take this pill.” No one was really delving into what was going on in their life or their diet. No one was saying, “Okay, well let’s do a rundown of your diet. Let’s talk about your lifestyle and why these headaches coming on.” None of these conversations were had then. I’m sure they are now because more people are more aware of the preventative medicine realm and are getting into lifestyle and nutrition and diet, but back then it was more of a pill popping culture. And I said to myself, I do not want to be in this style of healthcare. You’re not even asking the person the basic questions of what they’re eating or how they’re sleeping or what’s going on in their life. Or are they stressed out or not? Nothing.
For those who may not know, what’s the difference between functional medicine and conventional medicine, which we might be more familiar with?
The conventional medicine approach has a strong emphasis on characterizing disorders by diagnosis. It’s heavily focused on what symptoms or behaviors of the disease are happening, and the treatment relies heavily on synthetic medications or surgeries and invasive procedures. In conventional medicine, the body is viewed as different sets of organs that are all separate. There’s no interconnectedness. So when you have a high blood pressure problem or high cholesterol, you go see the cardiologist. Or if you’re having a lot of gas or bloating, you go see the GI specialist. Versus with functional medicine, you’re looking at the body as a whole. When you think about, for example, if the person has gas and bloating, you’re not just thinking about everything GI-wise. You have to keep into account everything else that’s happening in their environment, like what they’re eating and how stressed they are. So it’s a whole body approach.
How is functional medicine related to integrative medicine? How are those different from holistic medicine?
Integrative medicine is a model of healthcare where conventional medicine is integrated with a non-conventional or alternative modally. So that’s inclusive of herbs, chiropractic care, acupuncture, massage, aroma therapy, etc. In integrative medicine, you have a really big toolbox for evaluations and treatments. So it takes into account, not only the whole person, but also the mind, the spirit, and all aspects of lifestyle. Integrative medicine really emphasizes the therapeutic relationship and makes use of whatever appropriate therapies are out there, both conventional and alternative. So you could say that integrative medicine is also holistic. The terms are interrelated. But again, it all gets down to identifying the root cause of the disease.
Could you give us an example of someone who has come to you after they’ve seen a conventional medicine doctor, and tell us what have you been able to add to their patient experience? What have you been able to help them with in a different way than a conventional doctor has?
I had a 32 year old female come into my office because her hair had been falling out for the past year. She’d seen her primary care doctor who ran labs, including thyroid and iron. And everything on those tests came back normal, so the primary care doctor was like, “Well, I have no idea why your hair is falling out. It might be stress-related, but let’s have you go see the dermatologist.” So she goes and sees a dermatologist who says, “I’m looking at your hair under a magnifying glass and microscope. I don’t see anything crazy happening here. I don’t know why your hair is falling out, but go take some biotin.”
So then she comes to me, and she complains about the fatigue and the fact that her hair is falling out. So we run the appropriate labs, probably the same ones that her primary had run, but also we looked into micronutrients. And we found that her iron level, while it was in the range of normal, was on the low end of normal. These ranges can be from like 10 to a hundred and something, and her level was at around 12. So for her primary care doctor, that was normal because it was in range, but that’s really considered low because it’s not at an optimal level.
We put her on iron supplements and within two months her hair stopped falling out. And she was becoming energetic again. That was a very simple thing that was overlooked because doctors are writing her off and saying her levels were normal.
A lot of other people who come in to see naturopathic doctors or get functional medical care are those who’ve had a lot of chronic health conditions or a lot of gut problems. Usually, they’ve gone to many GI specialists, or many different doctors who don’t know what’s wrong with them. They get some medications to keep their symptoms steady. And then we end up stool testing these people and finding that they have leaky gut or overgrowth of bacteria and then treating that cause – and they end up feeling better.
Is it safe to say that if someone walked into a functional medicine clinic or a naturopathic medicine office, they would be heard more than they would be by a conventional doctor?
Right. We spend a lot more time with our patients. New patient visits can be anywhere between 45 minutes to 60 minutes. And then your follow-ups are around that time too, because you’re delving into everything about the person, like their entire health history, their diet, their sleep, the personal questions of their bowel movements. Everything. So we really want to understand the whole picture, and that takes some time.
You’re a member of the California naturopathic doctors association. Can you tell us a bit more about your role within this association and how naturopathic medicine plays a role in your practice?
I served on the executive board for about two years as their treasurer. The whole point of the California Naturopathic Doctors Association is to educate the public right about naturopathic medicine and our role in healthcare and providing access to naturopathic medicine. Because the problem is many insurances don’t cover it. They see it more as an alternative treatment, not a preventative treatment that would actually save insurance companies millions of dollars. So that’s why we are constantly trying to strive for education and awareness.
The model of naturopathic medicine again, is very similar to functional medicine where you are trying to get to the root of the disease. And by doing that, you’re looking at the person as a whole, and you’re focusing on diet, lifestyle modification, etc. You’re working with detox and other natural interventions. So very similar to functional medicine, you will do your diagnostic tests to see what’s going on, and then offering these different modalities as the form of treatment to get to the root of it. I would say the only difference between that and functional medicine is that functional medicine is a type of medicine where MD’s who’ve gone to conventional medical school realize it’s not for them, so they go and get additional training in functional medicine. Versus with naturopathic medicine, you’re learning this in your schooling from the get-go right. So when you’re in your classes, not only are you learning about conventional ways to treat high blood pressure or high cholesterol or gut issues, but you’re also learning what alternative methods there are to treat this and other whole body ways to look at illness.
Now that you’ve explained the differences between these different modalities, who do you think would benefit the most from a naturopathic medicine approach?
Anyone who’s gone through the rigmarole of seeing different providers with their chronic health issues would be a good fit for the naturopathic/functional medicine approach. There’s a time and need for medication, there’s a time and need for surgery, but not everyone needs to be medicated all the time. Someone who’s wanting to get to the root of their problem and not put a bandaid on the situation would really benefit.
If I wanted to go about finding a functional medicine or naturopathic medicine practice, where should I start?
You could definitely start at Ciba Health. We have a telemedicine platform with many providers on staff who are functional medicine trained and who are doctors of naturopathic medicine and they will definitely help you get to the root of the problem. If that does not work for you, there are different platforms out there. For example, IFM, the Institute of Functional Medicine, if you go on their website, you can find a list of functional medicine doctors. You’ll also find a list of doctors on the state association pages naturopathic medicine.
Dr. Innocent Clement: I am the CEO and founder of Ciba Health. Here with us today is my Director of Wellness, Whitney Crouch. Today we’ll be discussing a very important topic, as it relates to collaboration between doctors, dietitians, and health coaches partnering to achieve maximum benefits for our patients.
Whitney, from your experience being the director of Wellness at Ciba Health, you know in the US today, patients have to jump through a lot of hoops to get an appointment with either their primary care provider or with a specialist.
Whitney Crouch: Yes, and there’s a lot of frustration given that patients have to bounce around from provider to provider, with each of these providers giving a different diagnosis or treatment plan. So again, this is really very difficult for the patient. I have seen patients go through a lot of difficulty with that and it really affects them.
Dr. Innocent Clement: So how does this affect our patients, as they have to go through all these processes to be able to set an appointment and see a provider?
Whitney Crouch: With the current climate, during COVID, and even before the pandemic, this is really stressful and confusing for a lot of people because they’re being seen by different providers who specialize in certain parts of the body. They could be seen by an endocrinologist, or a gastroenterologist, or a neurologist. So patients are being looked at through the lens of that body part or system, but they’re also having to go into another office.
So there’s the office aspect. There’s this body part aspect. And then there’s this lack of communication between these different doctors, these specialists, or other care providers, because they may not share the chart notes. They may not have open discussion about the clients and really this affects the client’s outcomes.
This makes it so that as the patient, you may feel confused. You may not know exactly who’s driving your care plan. You may not know exactly what the strategy is, or what the priority is here. If there are a lot of asks that you have to work on for your health, it’s confusing. And at the end of the day, it’s the patient who suffers when balls are dropped or they’re just left confused and feeling unsupported.
Dr. Innocent Clement: I’ve experienced this myself, and I know that it’s a lot of frustration for patients. So what can healthcare providers do to ensure that patients are receiving a streamlined, personalized treatment plan?
Whitney Crouch: So the most important thing is for providers to communicate as a part of a care team for the patient. If providers work together in a multidisciplinary group, they can easily communicate. If they’re not together in a multidisciplinary group, they should actually pick up the phone and call one another and discuss challenging aspects of the person’s health condition. That way, they can provide feedback and make sure that everyone is on the same page, and that details are not lost between providers and appointments. This also ensures the person is really viewed as a whole, and their whole story is shared. Different providers may ask certain questions one way or another, or even not cover certain questions. And that leaves gaps in the person’s history that could be very relevant to their treatment plan.
Dr. Innocent Clement: This is a really important aspect of healthcare: communication. And providing that personalized plan, because every individual is unique. Now, looking at the conventional healthcare system and the way it’s structured today, they treat everyone the same, right?
It’s almost like a one size fits all approach. But we as providers should begin to look at healthcare from a different approach and look at patients as uniquely individual. By looking at their individual biomarkers we will be able to see how you can better support and optimize those health outcomes for patients.
Whitney Crouch: That’s right. Absolutely. I mean, it has to be personalized. Everyone is so unique, from their genetics to their epigenetics. Everyone has a very different glucose, or blood sugar, reaction. For example, if we ate the same size banana with the exact same amount of carbs, we could process that food vastly different. And you can extrapolate that out to everything in a person’s health. If we create a personalized environment where we’re looking at biomarkers, and where different care providers are assessing the same biomarker from a different perspective and applying it to their area of study, then those few biomarkers could mean the difference between a person’s declining health or their condition reversal and their wellness.
Dr. Innocent Clement: Yes, absolutely. So with your insight into the industry today, how do you think these different care providers help the patient?
Whitney Crouch: There are so many care providers right now in the market, and I think it’s really important for everyone to educate themselves on what is out there and what their needs are – because we have different models in the healthcare environment now.
So we have the conventional model, where the patient goes to see the provider and the provider comes up with a care plan and the patient is on their way. And in this model, the patient carries that plan out themselves. The patient may check-in, they may call the office and say, “I have questions and I don’t know what to do.” But if they don’t get the help they need, they may feel lost, throw up their hands, and they’re done. And there is no healing beyond that point.
But the newer model that Ciba Health and others are emerging through is this inclusive, supportive model. So we have doctors, we have dieticians, we have health coaches, and it really takes that kind of a three-prong practitioner approach to support the patient. So for instance, we have a doctor who’s doing some deep-dive into what is actually going on, looking at what are called “functional lab tests” where we look at the whole person and the root cause of problems.
And then once you come up with a care plan that addresses the underlying issue, you need other people to support that care plan and to support that patient. And that could look like a dietician or a health coach, or a combination of the two, because diet and lifestyle are huge in reversing or preventing chronic disease.
Over 80% of chronic conditions are related to diet and lifestyle choices. So it’s not even good enough to just have a dietician or nutritionist visit and come away with a plan. It actually takes multiple visits with someone like a health coach who can help that person change their daily habits and make new habits in order to sustain positive health outcomes.
Dr. Innocent Clement: Absolutely. We need that. It’s very, very important, looking at the healthcare system the way it is right now. What would be an ideal healthcare team, in terms of how you can better support the patient and empower them as they continue in their journey in the healthcare space?
Whitney Crouch: Right. So, I mean, there are some core providers that people would really benefit from to really instill these healthy habits. So creating a root cause care plan, and then being able to actually carry it out. Those are two different things, but together, you have the mental and emotional support and the daily habit formation.
So an ideal team could look like a primary care physician or a functional medicine doctor, in addition to a mental health provider, plus someone to help with diet and lifestyle choices. That could be a dietician or a health coach, or both. So we’re really looking at about two to four practitioners who collaborate and discuss the patient and share what’s going on. They should all look at the big picture and help the person to decide what their priorities are for their health and help them to learn where these new habits fit into their daily life. That way, the patient is empowered to make the changes and drive their own healing journey.
Dr. Innocent Clement: Whitney, could you share our approach at Ciba Health, how we approach our patients, and how we support and empower them from day one?
Whitney Crouch: Absolutely. So at its core Ciba Health is a multi-disciplinary platform of providers. We are doctors, we are dieticians, we are health coaches, and we are mental health professionals who are reviewing your labs, ordering new labs and medications where necessary, and working on your diet and your lifestyle. We also work with you on your mental health and your ability to get to the root of what is causing illness. Basically, we work with you to peel back the layers of the onion. We look at your genetics, you unique biomarkers, and we track your progress. If you’re struggling, we help coach you. We can help you with your accountability and really with your whole lifestyle to change the trajectory of your life.
Dr. Innocent Clement: Excellent. Thank you, Whitney, for sharing your insights and reminding us how important it is to have collaboration between doctors, dieticians, health coaches, and mental health professionals.
Are you achieving your goals? Did you make resolutions or set goals for this year and feel you’re falling behind? Maybe you already have given up on their goals completely. No matter which category you fall into, it’s not too late to still achieve success in your yearly goals. Reassessing and creating mini-goals might be an answer to your plan for success.
Why do I need to set mini-goals?
Mini-goals give you the power and give you the confidence that everything is in your hands. They allow you to set yourself up for success. Anytime you look at the big picture, you see a whole lot of stuff to do and start to feel overwhelmed and stressed. But when you break it down and take a step-by-step approach, you’ve got some manageable tasks that you can easily handle. Mini-goals allow you to feel small wins along the way instead of being disappointed by not seeing as much success as you would like.
How do I set mini-goals?
1. Start with your approach to goals:
Meeting goals is about making choices. There’s a lot of power and freedom in knowing that your choices can get you to where you want to go. No one is stopping you. Set parameters to follow every day, throughout the week and each month that will allow you to successfully meet your goals.
2. Change up the routine and create new habits:
Establishing new habits and routines will eventually lead up to meeting your overarching goals. No matter what goal you want to accomplish, from eating healthy, to learning a new skill, to breaking a bad habit, setting smaller mini-goals is going to help you get there. These smaller goals also help you get things done without overwhelming you.
3. Break your goals up:
Getting specific is really important. For example, if you want to establish healthier eating habits this year you need to break things down by making a series of mini-goals. As you make these goals inside of goals you will hone in on things more and more as you go.
For example, a monthly goal could be: Make a daily meal plan for the month with a focus on vegetables and healthy snacks.
Weekly: Prep my lunches on Sunday evening for the week ahead.
Daily: Drink at least 8 glasses of water, limit yourself to one cup of coffee and cut out sugary drinks.
Just remember to keep your mini-goals simple and achievable. Don’t make them complicated. The whole concept of a mini-goal is to build your confidence and get you moving in the right direction. Mini-goals should get you to build momentum which will lead to progress.
And here are some examples to help you get started:
- Stay offline one day per week
- Meditate every morning
- Read 20 pages per day
- Journal every day
- Get up when your alarm goes off
- Set a regular bedtime and wake up time
- Limit screen time after work
- Start a gratitude journal
- Do a social media detox
- Take a ‘me’ day
- Walk after lunch or dinner
- Drink tea instead of coffee/soda
- Squeeze in 10 minutes of exercise per day
- Eat more veggies
- 30 days of yoga
- Try meal prepping
- Develop a workout routine
- Drink more water
- 30-day squat challenge
- Try a new form of exercise
- Go to bed at a reasonable time
- Explore two new places
- Learn something new
- Declutter your home
- Get started on one thing you’ve been putting off
Intermittent fasting is a nutrition plan that switches between periods of fasting and eating on a regular schedule. Many people use intermittent fasting as a way to manage your weight, but research shows that it might also help prevent some forms of disease.
It’s important to check with your doctor before starting intermittent fasting. Once you get his or her go-ahead, the actual practice is simple.
It can take two to four weeks before the body gets used to intermittent fasting. You might feel hungry or lose focus while you’re getting used to the new routine. But it’s very important to make it through the adjustment period. If you do, sticking with the plan will become way easier over time and you will start noticing changes in how you feel.
Every method can be effective, but figuring out which one works best depends on the individual.
Here are 5 popular ways to do intermittent fasting:
This about which plan that better fits your lifestyle and consult with a functional medicine doctor before implementing it. Consulting with a doctor is especially crucial if you have any underlying health conditions.