Everything You Need To Know About Telemedicine vs. Virtual Care

Due to time and money, more and more people are interested in seeing online doctors. But knowing where to start when you’re new to the concept can be daunting.

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What is mindful eating?

Mindful eating brings mindfulness to food choice and the experience of eating, as defined by The Center for Mindful Eating.

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What to Know About Menopause: Signs, Symptoms and Natural Remedies

Menopause can be a confusing time in a woman’s life, when hormonal fluctuations can cause changes not only to the reproductive system but to the body as a whole.

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What is functional nutrition? Answers from an RDN

What is functional nutrition and how does it differ from the conventional approach to nutrition? Leah Tsui, a registered dietitian nutritionist from Ciba Health

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Trouble Sleeping? How to treat insomnia

Having trouble falling and staying asleep? Here’s how to break free from your insomnia naturally and get deeper sleep each night

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Feeling stressed out? Chronic stress signs, symptoms, and management

Constantly feeling stressed out? Here are the signs and symptoms of chronic stress, and what you can do to manage your stress and feel better

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Do I need custom vitamins? Doctor answers

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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 […]

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Immunity booster: Gut health & probiotics

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Due to time and money, more and more people are interested in seeing online doctors. But knowing where to start when you’re new to the concept can be daunting. What’s the difference between telemedicine and virtual care? And how do you make an online doctor appointment? These are key questions you should have a basic understanding of before you book your first telemedicine appointment. 

What is Telemedicine?

The rising healthcare costs over the recent years have presented a problem for people trying to gain quick access to common yet acute health issues. Waiting for weeks for an appointment with their Primary Care Physicians isn’t an option, and that is if they have one. And sitting for hours in an Urgent Care waiting room to be seen for a UTI isn’t time effective. The advancement of technology created a solution. Telemedicine.

WHO, the World Health Organization, defines telemedicine as “healing from a distance“. Telemedicine is the practice of medicine utilizing modern technology to offer medical care from a distance. An online doctor in one location can administer treatment to a patient in their home or office by telephone, tablet, or computer. These appointments can decrease the cost of practicing medicine allowing the co-pays or payments to be reduced from those of Urgent Care and Emergency Room visits and often even your PCP. 

According to The American Journal of Accountable Care, “The use of telemedicine has been shown to allow for better long-term care management and patient satisfaction.”

Today, when lifestyles are hectic, saving time by removing long waits at medical facilities to have your minor health issues diagnosed could be preferable. 

What is Virtual Care?

So while telemedicine is the practice of online doctors administering medicine to address illnesses, virtual care, also known as telehealth, is somewhat different. Virtual care refers to a broad range of healthcare services delivered virtually to provide care at a distance. 

While telemedicine leans more towards acute treatment, virtual care covers an extensive range of services, such as preventive care, health coaching, mental health services, nutritional coaching, and more. While care may include administering medicine, it also includes preventive care and reversing harmful behaviors and health issues. 

Virtual care can include online doctors, dieticians, coaches, nurse practitioners, psychologists, naturopathic doctors, and other healthcare workers. 

What’s the Difference?

So what is the difference between telemedicine and virtual care? Both are addressing your medical needs via telecommunications, but they have different purposes. Telemedicine is looking to address acute illnesses just as a physical doctor would if you became sick and needed to get in for a prescription-only it is done virtually. 

Virtual care manages your overall health via online communication. It looks at a broader scope and can involve a multitude of healthcare providers. 

Either way, you might talk to an online doctor. Making an online doctor appointment is still easy, but you can also make one for the other healthcare practitioners in their practice that help manage your health. Virtual care often does more than manage care; it can also educate and provide an extensive plan of action to restore your health and includes preventive health and deals with the root cause of your illness. 

Also, because telemedicine deals with acute medicine, you might see a different online doctor each time you have an online doctor appointment. While with virtual care, you generally work with a dedicated team that you see regularly and are able to build a relationship with. 

How Does an Online Doctor Visit Work?

Visiting an online doctor or healthcare professional is quick and easy, whether for a virtual care or telemedicine visit. There is no travel time or sitting restlessly in cold waiting rooms. You can make an online doctor appointment and attend the appointment from the comfort of your own home. 

You will need access to a camera, microphone, and speaker on your phone, tablet, or computer. You will need to verify who you are before beginning your appointment. Your online doctor is a board-certified doctor who is licensed in your state, and the other healthcare professionals you might see have all of their appropriate state licenses and certifications as well. Appropriate licensing is required of every professional working in the online health industry. 

Once you log into your appointment, you might have to wait a few moments in a “waiting room”, this is usually a very short duration and nowhere near the amount of time you would spend in a physical office. When the doctor is ready, they will log in and ask you to look directly into the camera so they can properly identify you. Then they will ask you a series of questions to establish why you are there. From there, your appointment would be much like a physical appointment, only there is no weigh-in, and your vitals are not taken. 

Otherwise, your online doctor appointment is very similar to your physical doctor or other healthcare professional. 

Do I Need to See a Physical Doctor?

For some health issues, you will still need to see a physical doctor. And for some healthcare platforms, like Ciba Health, you will need to have seen a physician within the past 3 years. Once this has happened, Ciba Health can offer ongoing support through video conferences, phone calls, and messaging. 

Types of Appointments Suited for Online Doctor Appointments

Not every type of medical issue is suited for online doctor appointments but many are. Some various examples are: 

  • Cold & flu symptoms
  • Pink eye
  • Urinary tract infections
  • Skin infections & rashes
  • Sinus infections
  • Mental health 
  • Preventative health

Why Does My Online Doctor Need to See My ID?

Before your online doctor or healthcare professional can proceed with your online telemedicine appointment, you must have your identity confirmed. How this is done is by giving your government-issued ID and sometimes your insurance photo. For Ciba Health, you will provide your government-issued ID and a second clear face photo. 

When the doctor comes on the video screen, you will look directly into the camera so the online doctor can compare your face with that of your government-issued identification. This ensures you are who you present yourself to be so that your medical records are accurate. 

Is a Video Chat Required?

If you are wondering if a video chat is required for your online doctor appointment, well, it depends. It’s a matter of your state regulations. Some states require all appointments to be via video. In other states, your telemedicine appointments can be via phone or message. These non-video appointments are usually after initial contact has been made, however. 

Is it Legal to Get an Online Prescription?

Online prescriptions, are they legal? While you cannot just obtain an online prescription with a few clicks of your mouse, you can meet with an online doctor, who may prescribe medication if needed. You must consult a medical doctor first, either by video chat or phone, to obtain an online prescription. 

How Do I Make a Virtual Care Appointment?

While every online healthcare platform is different, at Ciba Health, you will select “Book a first appointment” under the onboarding to-do list to book your telemedicine appointment. You can also choose “Appointments” from the left navigation bar to secure your online doctor appointment. In addition to that, you can select a specialist in the “Book an appointment” section on the dashboard. 

Is Online healthcare safe?

Online healthcare is safe and effective if the patients answer questions truthfully. However, that is the case whether visiting an online doctor or a physical one. The care you receive from doctors and other healthcare professionals is only adequate when they have a full and accurate picture from which to work with, both with online doctor appointments and physical doctor visits. 

When working with online doctors, it is a partnership where they rely on you to provide them with accurate information so they can correctly assess your needs and prescribe appropriate medications, request lab work, or modify behavior. Your responsibility is to read your healthcare plan then follow through. It is essential to make the most of your telemedicine appointment by being honest with your online doctor and following the plan of action. 

In virtual care appointments, you are getting a different level of care as the support is more involved than a one-time visit. So you build a relationship with your providers. Building a relationship provides a certain level of trust that helps in establishing an open line of communication and a safer environment for care. 

How Much Does it Cost?

When booking your telemedicine appointment, you may wonder how much it cost. According to khn.org the average online doctor appointment is $79 as opposed to $146 for an in-office visit. At Ciba Health, we offer an all-inclusive virtual care package with the Complete Care Plan.

 The plan includes: 

  • 12 months of care
  • 4 doctor visits
  • 4 health coach visits
  • Functional health report
  • Access to advanced biomarker testing
  • Unlimited messaging
  • 24/7 access to Ciba Health platform
  • 1 mental health consultation

Ciba Health also offers a Root Cause Discovery Plan for $194, a 2 week-long program to help determine the root of your health issues and address them holistically with a roadmap to good health. 

Are Telehealth Visits Reimbursable?

At Ciba Health, your online doctor appointments and those with our other healthcare professionals are all part of our programs, and you can use your HSA/FSA dollars to pay for your program or get the cost reimbursed to you if you should pay out of pocket. Most insurance companies will fully cover our Depression & Anxiety program. We will gladly prepare a superbill for you to submit to your insurance provider for reimbursement. 

A Matter of Convenience

Seeing an online doctor is the wave of the future. Saving time, effort, and money makes online doctor appointments a perfect way to manage your healthcare. Whether you are searching for telemedicine to meet your acute medical needs or want to regain control of your health with virtual care, online appointments could be right for you. Virtual care can help you find the root cause of your health issue, create a detailed plan to control or improve the issues you are facing and start living a better life. With Ciba Health’s lifestyle plans, there are options waiting for you. 

Start restoring your health today. To find out more about how you can get started with one of our plans, click HERE

What is mindful eating? 

Mindful eating brings mindfulness to food choice and the experience of eating, as defined by The Center for Mindful Eating. Bringing mindfulness into your daily practice is when you are bringing full attention and awareness to your experience, without judgment. This can be applied to food with the principle of mindful eating, where you are taking the time to truly be present with your meals and snacks. 

Increasing awareness 

Mindful eating increases your awareness of why, when, what, how, and how much you eat. When you are able to observe your eating patterns without judgment, you can start to see food in a new light. As you begin to recognize triggers that may lead to emotional eating or “stress eating,” you can gain a better understanding of your relationship with food.

Bring mindfulness into eating 

According to The Center for Mindful Eating, bringing mindfulness into eating can create new experiences, such as: 

  • Allowing yourself to become aware of the positive and nurturing opportunities that are available through food preparation and consumption, by respecting your own inner wisdom
  • Choosing to eat food that is both pleasing to you and nourishing your body, by using all your senses to explore, savor, and taste 
  • Acknowledging responses to food (likes, neutral, and dislikes), without judgment
  • Learning to be aware of physical hunger and satiety cues to guide your decision to begin eating and to stop eating

How can I utilize mindfulness in my day to day? 

Here are some helpful strategies from one of Ciba Health’s Registered Dietitians, Leah Tsui, to bring more mindfulness into your eating: 

  • Consider your hunger and fullness when approaching a meal’s beginning and end. Where do you land on the Hunger-Fullness scale
  • Consider how your food tastes: what does it smell like? Are the textures pleasing to you? What about the taste do you like or dislike? Are you enjoying your food? Whatever you observe, try to do it without judgment.
  • When making food choices, are you choosing the food because you like it? Are you choosing the food for health reasons? Are you choosing the food because you’ve been told to eat this way? Bringing some consideration to your food choices can help bring more mindfulness to how you’re making decisions with your groceries or meals out.
  • Strive to eat your meals and snacks away from your desk and phone—when you are not subject to distractions from emails and ongoing notifications, you tend to notice your food more. 
  • Set a timer for 15 minutes. Did you use the whole 15 minutes to eat? Or did you quickly eat everything because of a time crunch? Practice the art of slowing down to further support digestion in your “rest & digest” phase. 

Menopause can be a confusing time in a woman’s life, when hormonal fluctuations can cause changes not only to the reproductive system but to the body as a whole. What’s more, perimenopausal and postmenopausal women are often not given the tools they need to navigate this transition with confidence—leading to confusion, frustration, and in some cases, worsening symptoms. Understand the signs and symptoms of menopause, and how you can begin natural remedies and lifestyle changes to feel better.

What are the stages of menopause?

While you may know menopause as the decrease in hormone production that happens to women 40 to 50 years of age, these hormonal shifts do not happen overnight. There are three phases to the transition:

  1. Perimenopause: when a woman’s body begins the transition 
  2. Menopause: when you have experienced 12 consecutive months without a menstrual period
  3. Postmenopause: generally 24 to 36 months after your last period, when your symptoms begin to subside

Throughout this transition, your levels of sex hormones continue to decline and symptoms, like hot flashes, appear or increase as your period becomes more infrequent. No matter what stage of menopause you are experiencing, it is important to fully understand the changes your body is undergoing, how to adjust your lifestyle, and what it takes to stay healthy during this phase of your life.

What are common signs and symptoms of menopause?

Perhaps the most stereotypical symptom of menopause is experiencing a hot flash. Some women may have a few hot flashes and other symptoms like fatigue that are manageable with a healthy diet and lifestyle adjustments. Others may experience worsening or frustrating symptoms that need more attention. Common symptoms you may feel during this transition in your life include:

  • Weight gain (especially around the stomach and waist)
  • Mood changes (like anxiety, depression, or irritability)
  • Fatigue
  • Low sex drive
  • Insomnia or other sleep problems
  • Hot flashes
  • Hair loss
  • Joint and muscle aches and pains

Although these symptoms may be common, it doesn’t mean they are easy to deal with. If you feel frustrated with your menopause symptoms, we recommend speaking with your doctor or a functional medicine practitioner. There are natural remedies and steps you can take to stay healthy during the menopausal transition.

Menopause and chronic disease risk

While you may be familiar with the common symptoms of menopause, less well-known is the relationship between menopause and chronic disease. Several scientific studies have demonstrated that early menopause is related to rheumatoid arthritis and chronic fatigue syndrome. Fluctuations in estrogen levels have also been linked to illnesses like cancer, endometriosis, and cardiovascular disease.

However, growing research is supporting the claim that lifestyle and nutrition choices can positively impact health during menopause and decrease your risk for chronic disease.

Unfortunately, most conventional doctors focus on hormone replacement therapy as an answer to the question of menopause. They are not taking into consideration how each woman is hormonally unique or the non-prescription solutions available.

For example, anti-inflammatory foods can aid in hormone balancing and reducing the severity of symptoms during menopause. Foods like tomatoes, berries, fatty fish, and nuts can help reduce inflammation and fight chronic disease risk. Cruciferous vegetables, such as broccoli and cauliflower contain compounds shown to prevent hormone-influenced female cancers.

Through adopting sustainable lifestyle and diet changes tailored to you, it’s possible to feel better during menopause, avoid complications, and stop relying on medication to “fix” your hormone levels.

Functional medicine approach

The key difference between conventional and functional medicine is identification of the “root cause” of an ailment. In functional medicine, lab testing looks closer at a person’s physiology, pinpointing disrupted pathways that may have created the symptom(s) or illness, such as hot flashes or menopause.

Therefore, functional medicine practitioners look at the body holistically, with the ability to identify modifiable lifestyle factors to heal symptoms and rebalance hormones.

Why are peri- and post-menopausal women one of the largest populations that seek functional medicine? Most other methods of healthcare do not address their top two concerns: improving symptoms with personalized solutions (not one-size-fits-all approaches) and reducing disease risks with the safest options. Women are biochemically and genetically different from one another. Plus, an individual’s lifestyle plays a major role in their menopause symptoms.

To address symptoms of menopause, functional medicine practitioners identify what modifiable lifestyle factors can be adjusted to heal and rebalance hormones, as well as tailor supplements and bio-identical hormones to fit that woman’s unique needs.

Learn more about Ciba Health’s personalized, data-driven functional medicine approach to menopause. Chat with a care advisor today to see if our approach is right for you.

Lifestyle changes to start with

If you are dealing with perimenopausal, menopausal, or post-menopausal symptoms, there are simple diet and lifestyle adjustments you can make to feel some relief.

Because managing any major life change can be complicated, we recommend speaking with a functional medicine doctor before making any drastic alterations to your routine. They will be able to identify the root cause(s) of your symptoms, order lab tests, and create a personalized healthcare plan.

  1. Strive to eat a balanced diet, consisting mainly of cruciferous vegetables, fresh fruits, whole non-gluten grains, legumes, nuts, and lean proteins. This type of meal plan can reduce inflammation, menopause symptoms, and risk of chronic disease.
  2. Avoid “empty-calorie” foods (without real nutrients), such as cake, cookies, donuts, processed meats (cold cuts), energy drinks and sodas, fruit juices with added sugar, ice cream, potato chips, and french fries.
  3. Do not exceed the recommended alcohol intake for women, which is no more than 1 drink per day (ie, 12 oz of beer, 5 oz of wine, or 1.5 oz of distilled spirits).
  4. Incorporate more exercise into your daily routine by taking 30-minute walks or bike rides, joining an online group fitness class, or practicing yoga, which can increase strength, flexibility, and mindfulness.

Written and verified by Leah Tsui, RDN

What is functional nutrition and how does it differ from the conventional approach to nutrition? Leah Tsui, a registered dietitian nutritionist from Ciba Health, explains how functional medicine approaches nutrition and how we can benefit from thinking about nutrition in our everyday lives. Read on to find out!

What is nutrition?

Let’s start with the basics: nutrition is the study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease. 

What is a registered dietitian nutritionist?

According to the Academy of Nutrition and Dietetics, Registered dietitian nutritionists (RDNs) are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living. RDNs use their nutrition knowledge to give evidence-based recommendations to help support individuals make positive lifestyle changes. RDNs who provide care with a functional medicine approach address the underlying causes of disease to support the patient towards their highest expression of health. 

How does nutrition impact health?

We often hear the adage of “you are what you eat”—and while you don’t become an apple when you eat an apple, our food choices make an impact on our health. How we eat, what we eat, how we cook our food; all of this comes together to give a bigger picture on how nutrition is impacting health. With functional nutrition, there is the guidance of conventional (metabolic, cardiovascular, thyroid) and functional labs (nutrient levels, food allergy/sensitivity profiles, gastrointestinal function, oxidative stress markers, urine organic acids, hormone profiles, toxic metals, etc) to determine what is the best course of action for a patient. 

How do functional RDNs work with patients?

Functional RDNs will evaluate many factors of what makes you, you! They want to understand your goals and priorities with coming to work with them, so that they know what to assess and can suggest appropriate intervention methods. Medical history, food intake (what you’re eating, frequency, portion sizes, cooking vs. takeout, how you’re eating, etc), medications, supplements, and culture are some important components of what is assessed during an initial consultation. There won’t be any “this is what you must eat” and “never eat that food again”; RDNs are not there to be the “food police”. They want to work with you to create a strategic plan that delivers lasting and sustainable results. 

It’s more than just meal planning and counting calories, because functional RDNs look at the whole person rather than prescribe a particular diet to follow or macronutrient goal to hit. Functional nutrition takes an extremely personalized approach, taking lifestyle factors, culture, biomarkers, mental health, and more into account. The patient-centered approach, rather than the disease-centered approach, is what sets functional nutrition apart from conventional medicine. When health is viewed as a positive vitality, not just the absence of disease, this drives the direction of care towards the whole person.

Add more in! Here are some tips to add more to your life with nutrition: 

  • Add another serving of fruit per day
  • Add another serving of vegetables per day 
  • Add one more glass of water each day 
  • Incorporate a protein into a snack to help keep you fuller, longer 
  • Add healthy fats to your meal (avocado, olive oil, walnuts, etc) 
  • Add more time to your lunch break so you can eat mindfully
  • Add herbs and spices to your cooking to add flavor and promote benefits like anti-inflammation or improving brain health 

Having trouble falling and staying asleep? Here’s how to break free from your insomnia naturally and get deeper sleep each night

We’ve all had poor sleep at some point in our lives, and it can affect so many other areas of our life—especially if you experience insomnia. We know that sleep deprivation feels awful, and can leave us more irritable, depressed, and fatigued throughout the day. Functional medicine dives into all of the lifestyle factors that disturb sleep and why there may be an imbalance in the body’s sleep cycle. Keep reading to find out how sleep works on a hormonal level, the functional medicine approach to insomnia, and tips our doctors recommend to start getting a better night’s rest.

How sleep works (hormonally)

The two hormones responsible for helping us fall asleep (and wake up) are cortisol and melatonin. Cortisol is one of our main stress hormones, meaning it helps us wake up and have energy throughout the day. In contrast, melatonin is our “sleepy” hormone, and having high levels of melatonin before bed lulls us into a deep, restful sleep. 

These two hormones work in tandem with each other and our internal clock, also known as our circadian rhythm, to put us to sleep. Having a low cortisol level and a high melatonin level at bedtime is the ideal recipe for deep, high-quality sleep. However, if there are disruptions to this hormonal cycle, you may wake up in the middle of the night, or feel tired throughout the day and awake at night.

Conventional vs. functional medicine approach to sleep problems

Factors including stress levels, light exposure, stimulants, and temperature can impact your ability to fall asleep and stay asleep throughout the night. Dr. Subhashini Katumuluwa explains, “In conventional medicine, we’re usually pretty quick to turn to prescription sleep aids to help someone fall asleep and stay asleep…In functional medicine, we try to take an inventory of someone’s lifestyle factors and see which of those are likely contributing to someone’s sleep issues. We really look at the whole picture.”

Even if a patient complains about trouble sleeping and says that melatonin supplements help them fall asleep, a functional medicine doctor would try to understand why there’s an imbalance of melatonin in the body, and why supplements work so well for that individual.

Tips to achieve good sleep hygiene and feel well-rested

Maintain a regular sleep schedule. Go to bed and wake up at the same time everyday. If you sleep longer on the weekends, see if there’s a way to prioritize sleep during the week so that you can get the same amount of sleep each day. 

Adjust your light exposure. Make sure you get some sunlight exposure during the day (or get a light box that simulates sunlight if you can’t get outside), and wear blue-light-blocking glasses 2-3 hours before bedtime. Avoid scrolling through your phone during the hour before bed!

Create a wind-down routine. To reduce stress in the evening, create a nighttime routine including breathing exercises, journaling, a bath with Epsom salt and essential oils, or a gentle yoga practice. This will signal to your body that it’s time to transition into bedtime and relaxation.

Avoid alcohol consumption before bed. Especially in the 2-3 hours before bed, avoid alcohol. Everyone processes alcohol differently, but it’s a good rule of thumb to avoid having a nightcap—it can actually disrupt your rest instead of promoting sleep. While it’s often thought to be a helpful sleeping aid, alcohol actually disrupts your sleep quality and contributes to poorer overall sleep. You may feel like alcohol helps you fall asleep faster, but that doesn’t actually mean you will stay asleep or have high-quality sleep.

If you’re drawn to having a glass of wine or beer before bed to help you wind down, it’s time to find a new way to relax and unwind. Here are some relaxing self-care activities you can practice instead of reaching for the wine cabinet:

  1. Take a relaxing bubble bath, with your favorite essential oils.
  2. Snuggle on the couch with some tea and a good book.
  3. Start journaling. Try writing down all the things that happened during the day.
  4. Follow a guided meditation. 

If you suspect you are suffering from a sleep problem, such as sleep apnea, it’s important to talk to your doctor before making significant changes to your lifestyle. See how a Ciba Health doctor can help you with insomnia and other sleep problems here.

Constantly feeling stressed out? Here are the signs and symptoms of chronic stress, and what you can do to manage your stress and feel better

Stress is a natural part of our lives, and in healthy amounts, stress can help us trigger the “flight or fight” response and avoid dangerous situations—like getting cornered by a lion. However, in today’s world, most of our stressors come from things like work, family, relationships, and school – not wild animals. So it’s important to avoid chronic stress, or a prolonged stress response in the body, as staying in “flight or fight” mode for long periods of time can have devastating effects on the body.

What drives chronic stress?

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 people these days constantly feel under attack – perhaps from ongoing deadlines and ever-increasing job demands – and their bodies stay in a stress-induced state. Prolonged stress can cause many other mental and physical issues – most commonly chronic fatigue and anxiety.

What are the effects of 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 includes impacts on the muscles, respiratory system, cardiovascular system, endocrine, and gastrointestinal health. This can lead to the development of health problems such as:

  • Anxiety
  • Depression
  • Digestive problems (eg, heartburn, bloating, nausea, gas, etc.)
  • Headaches
  • Heart disease
  • Sleep problems
  • Fatigue
  • Weight gain
  • Memory and concentration impairment
  • Muscle tension and pain

Chronic stress is also pro-inflammatory, (meaning your body is more likely to experience inflammation), is a key contributor to developing leaky gut, and is responsible for decreasing sex hormones and brain neurotransmitters. If you’re in a constant state of “fight or flight” your body stops doing things that are considered non-essential (like preparing for sex, proper digestion, and reducing inflammation).

What are the signs of chronic stress?

According to Dr. Markyia Nichols, you will likely experience three stages of stress if you are chronically stressed out:

Stage 1: Acute Stress

You may experience one or more of the following symptoms in the acute stress stage:

  • Heart palpitations
  • Difficulty breathing
  • Chest pain
  • Headache
  • Stomach pain
  • Nausea
  • Sweating

Stage 2: Tired but Wired

In this stage, the body is exhausted but is also getting used to staying in a stress-induced state, so you are tired but can’t relax or fall asleep easily. You may experience:

  • Irritability
  • Fatigue
  • Headaches
  • Difficulty concentrating
  • Disorganized thoughts
  • Difficulty sleeping
  • Digestive problems
  • Changes in appetite

Stage 3: Adrenal Burnout

Your body has reached its limit in this final stage, and is beginning to break down. If you have reached this stage, you probably have noticed:

  • Fatigue
  • Body aches
  • Unexplained weight loss
  • Low blood pressure
  • Lightheadedness
  • Loss of body hair

How to combat and manage chronic stress

If you know you are experiencing chronic stress, it’s time to do something about it. Remember, always talk with your doctor and create a plan together with your physician before making any significant changes in your lifestyle.

In the meantime, here are some strategies you can use to combat chronic stress and start feeling better:

  1. Focus on breathing. Slow, steady, deep breathing can signal the brain that it’s okay to relax. Intentionally practice a breathing exercise when you are feeling stressed out.
  2. Eat well. A balanced diet free from empty calories and excess sugars promotes a healthy gut, which can lead to better overall health. What’s more, about 90% of the body’s serotonin (one of our feel-good hormones) is produced in the gut.
  3. Exercise regularly. Exercising not only promotes the production of good cholesterol to protect the heart and cardiovascular system, but it also releases the brain’s feel-good neurotransmitters called endorphins to improve your mood.
  4. Get professional help. Work with a team of doctors, dieticians, and health coaches to reverse your chronic stress and related conditions. See how Ciba Health can help you.

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
  • Fatigue
  • Muscle weakness
  • Muscle aches, tenderness, and stiffness
  • Pain, stiffness, or swelling in your joints
  • Increased or decreased heart rate
  • Indigestion
  • 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:

Fermented foods:

  • Yogurt (look for “live and active cultures” on the label)
  • Kefir
  • Kombucha
  • Sauerkraut (refrigerated)
  • Pickles (refrigerated)
  • Miso
  • Tempeh
  • Kimchi
  • 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.

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