Photo by Hotfield.

The longest night is now behind us with the passing of Winter Solstice, and the days will slowly become brighter: Winter has officially arrived! In Chinese medicine this is what we call the Yin (cold, dark, slow) time of year, as opposed to Summer’s Yang (warm, bright, energetic). In this season we should meditate more, sleep in when possible, and take care of our fatigued bodies.

Chinese medicine is a great way to keep your body cold and flu-free. Practitioners often use moxibustion this time of the year for its power to keep dampness, that heavy sensation and lack of energy, which is a real problem here in the Northwest. Acupuncture points are chosen to keep the immune system in check, and also to keep energy at a balanced level.

Speaking of energy, you may notice that you don’t have the same amount of “get-up” you do in the summer, which is a good thing. It’s not lethargy, it’s nature’s cue to take it a little slower in the winter. The ground is cold, animals are hibernating, and life is building up to slowly burst forth in the spring. Unfortunately, we don’t have the luxury of taking a few months off to sleep as the animals do. For us, there’s no difference in our work and school schedules and life goes on as usual.

Here are some simple suggestions for slowing down and making the most of the season:

• Stop drinking iced drinks and go for the warm versions of these. I recommend a nice herbal tea, as coffee increases dampness in the body.
• Choose warm, nourishing soups and stews over cold foods and salads. Be sure to choose good quality meat and fish for these meals.
• Eat more in season vegetables like sweet potatoes, yams, and winter squash.
• Cook your own food instead of eating out! This will warm your house (the heat from the stove) and warm your heart (nourishing yourself and those you love). If you don’t have time to cook, consider setting up a slow cooker to simmer healthy meals for you while you’re at work.

Happy Wintering!

Amy Chitwood, L.Ac. is a graduate of the Oregon College of Oriental Medicine. She is nationally board certified in Chinese herbal medicine and manages the Portland Acupuncture Blog.

Photo by digitonin.

Whenever my grandfather was offered a glass of water to drink, his response was always, “No thanks, water makes me rust!” When it comes to hydration, there are two kinds of people: those who carry water bottles everywhere they go and those who prefer to drink non-water beverages (juice, tea, coffee, soda), like my grandfather.

Water creates pressure in plant cells, which keeps the leaves and green stems perky and upright. Your body is 60% water and just like the sad wilted house plant that you neglected, your body responds physically when you forget to water it.

It’s something like 40 days that you can survive without any food (hence the 40 day hunger strike). On the other hand, go without fluids and you won’t make it past 3 days! Water is the most important nutrient you can give you body.

Your body relies on water to move oxygen and nutrients into your cells and tissues, to remove toxins and waste products out of your cells, to break down fat cells for weight loss, to lubricate joints, to provide fluid for the discs that protect the spine and other important stuff too.

Lots of people don’t realize that every day symptoms like headaches, back pain,  low energy, poor concentration, joint pain, wrinkly skin and poor immune system can be caused by dehydration. The good news: these symptoms can often be relieved by staying hydrated!

But what if I’m not thirsty?

When you’re dehydrated, your brain gives you a signal called the thirst reflex, but when you don’t give your body what it’s asking for, over time this thirst reflex dies down, and you just don’t get thirsty. Also, many people confuse the thirst with hunger, reaching for a snack instead  of water and sabotaging their weight loss efforts.

Even if you can’t stand the thought of drinking, you’ll find that as you slowly increase your water intake, your thirst reflex will improve and drinking water won’t feel like such a chore.

Health benefits of staying hydrated include:

• Better concentration and ability to focus
• Higher energy levels,  less fatigue, and improved mood
• Fewer headaches
• Weight loss
• Improvement in low back pain
• Improvement in joint and arthritic pain
• Improved immune system- less colds, sore throats, flu and sinus infections
• Improved skin quality and less wrinkles
• Improvement in acne and other skin problems
• Reduction in kidney stones
• Improved cardiovascular symptoms, lowered cholesterol, reduced blood pressure
• Relief from constipation and more regular bowel movements

How much water should I drink?

The rule of thumb is to drink half of your body weight in ounces. So if you weigh 120 pounds, you’ll need to get an average of 60 ounces daily, which is about 8 8-ounce cups of water. If you weigh 200 pounds, you’ll need 100 ounces of water per day, which is about 13 8-ounce cups.

Remember to increase your water intake with on a hot sunny day, with excessive sweating and exercise, or when you drink caffeinated beverages such as coffee, tea and sodas that are dehydrating to the body.

Another easy rule to follow if you can’t be bothered with counting your glasses per day is to go by the color of your urine.  If your urine is dark or amber yellow, pour yourself a glass of water and start sipping!  If your urine is clear or pale yellow, then you’re right on track!

Of course these are general guidelines and there are a few conditions (such as congestive heart failure and some kidney diseases) for which these guidelines would be contraindicated. You should consult your physician before dramatically changing your water intake.

Dr. Nishant Rao is a co-founder of WellWire.com. He is a well-traveled naturopathic doctor and new father, practicing an integrative approach to create wellness in and around Los Angeles. Become a patient or discover his practice.

Photo by Bonguri.

Vitamin D has been all over the news as the latest nutrient whose Recommended Daily Allowance has come under great scrutiny.

Dietary vitamin D is unique in that it is not actually a vitamin and would be better classified as ‘pro-hormone D’.   We can thank Sir Edward Mellanby for the mishap in nomenclature going back to 1919 when the first notion of vitamin D being activated by sunlight was established.  In our closest attempt to imitate plant photosynthesis, when sunlight strikes our skin a series of chemical reactions takes place and vitamin D is converted to a hormone called cholecalciferol (D3).

Semantics aside, vitamin D is fat soluble so your best food sources are from animal fats; fatty fish (salmon, mackerel), egg yolks, butter, liver, and full fat milk.  Now the reason I bring this up is that the quality and quantity of saturated fats has greatly decreased since the low-fat-spandex-aerobics craze of the 80′s (apologies for the mental imagery).  Sure, foods are often fortified with vitamin D, but this process of refining and then fortifying creates anything but a whole food product.

Historically the primary evidence of vitamin D deficiency has been rickets and stunted bone development in children.  Generally speaking this was treated with either direct sun exposure, or light boxes designed to provide adequate levels of UV light sparking the chemical conversion to D3.

I seriously doubt that historical D deficiencies were due to a dietary lack of vitamin D, as our ancestors consumed very adequate portions of saturated fats (which we are now learning are not the evil doing artery clogging grease they were once thought to be).  With the RDA slowly rising it really makes me wonder whether part of the reason is that we have severely cut off our supply of raw materials, namely high quality, organic saturated fats.

You need 15 minutes of sun exposure per day to activate the dietary vitamin D.

Eating whole animal foods provides a large amount of precursors that are converted to D3 with the sun exposure.  Of course, it is essential to balance the necessary 15-20 minutes of sunscreen free sunshine a day (more if you have darker skin) and the increased risk of skin cancer (if you’re going to spend hours in the sun get a fur coat like all the other mammals).

Do you know how the RDA was established? The Food and Nutrition Board of the Institute of Medicine (IOM) set the AI (adequate intake) levels assuming NO vitamin D was being synthesized in the skin through exposure to sunlight.  This was back in 1997 and since then we have seen the RDA climb from 200 IU’s upwards.  The new official guidelines from the IOM won’t be released until May 2010 but until then they are recommending 400 IU’s for kids under 10.  The chairman himself, Dr. Frank Greer, takes 1000 IU”s of vitamin D a day which is an ideal dose for adults.

What it does for you:

• Increase energy
• Lift mood
• Regulate calcium & phosphorous
• Increase immunity
• Increased bone health
• Prevents cancer

It really isn’t very difficult to get vitamin D into your diet if you are allowing yourself consumption of whole animal fats, here are some examples:

• 1 Egg yolk 25 IU’s
• 3 oz can of sardines 230 IU’s
• Liver
• Cod liver oil (make sure the product has not had the natural vitamin D stripped out and a synthetic version put back in)
• Yes, of course all those fortified foods

It is then very easy to activate the vitamin D with 15 minutes of sun a day

• frisbee
• nothing – 15 minute sun bath
• walk, jog, stroll
• cup of tea outside
• tai-qi, qi-gong

In an effort to simplify RDAs, statistics, news, mixed information, and the numbers:  Whole foods and some sunshine – Doctors orders.

Dr. Nishant Rao is a co-founder of WellWire.com. He is a well-traveled naturopathic doctor and new father, practicing an integrative approach to create wellness in and around Los Angeles. Become a patient or discover his practice.

Photo by.

The picture was not just to get your attention, It will make  lot of sense in a minute. Before I get to the adrenal glands, what is functional medicine?  Naturopathic medicine can be practiced from a functional medicine perspective and often is.  However, any form of medicine can be applied in this fashion and if the approach is to be labeled holistic it almost has to be.

Functional medicine individualizes treatment, does not get overly hung up on black and white laboratory results and interprets symptoms as part of a complex message from the body .  Does this make sense?  A quick example.

A test result of higher than 120 mg/dl fasting blood sugar (FPG test) on two occasions is considered a positive marker for pre-diabetes.  What if it is 100 mg/dl?  Some individuals (those who fall outside of the statistical chart which led to the decision of 120 mg/dl) may experience typical symptoms even if they do not meet the criteria for a diagnosis.  We often call this a sub-clinical diagnosis, or in this case functional medicine

The point is not getting too hung up on pure data. It only tells part of the story and is captured at a single moment in time, viewed though a very small lens and under high magnification.  Functional medicine is by its nature more holistic, as you still use the laboratory results but only as a piece of information for insight.  The  whole person tells the whole story – always.  

Understanding this slightly different approach sheds light on subacute adrenal fatigue. It may be one of the most under-diagnosed functional impairments in today’s high stress society.  

Sitting like small hats above each kidney the adrenal glands are most known for producing adrenaline.  In addition, they also create what is often called ‘the stress hormone,’ or cortisol.  Go back to more primitive times, and you and I become a fairly tasty two legged snack for several predators.  We, like most pray animals, have a flight and fright response.  

The original function of this adrenal powerhouse was to help us through a very acute stress response, such as the flight from a predator.  These glands can become overworked after a period of time at which point we often use the label adrenal fatigue, or adrenal exhaustion.  Remember, this is from a functional perspective if these glands stopped working completely so would you.  There is a saliva test which we can use to gain a window of biochemical insight called the A.S.I. or adrenal stress index.  This test measures the circadian rhythm of the hormone cortisol which should be at its highest in the morning and slowly diminish during the day.

Depending on where in the spectrum of adrenal exhaustion you are, the levels or cortisol will vary.  At the start of the stress response cortisol will be very high, and over time as it is unable to keep up, it will diminish.  The symptoms you experience will span somewhere in-between the effects of high cortisol (belly fat, insomnia) and low cortisol (fatigue, inflammation).  Your experience of adrenal fatigue will match a combination of the following symptoms (this list is in no ways exhaustive):

• Low energy especially upon waking – you need some coffee or something to get you going
• Chronic fatigue
• Low libido
• Difficulty falling asleep, staying asleep, insomnia
• Poor skin regeneration
• Thyroid function impairment
• Blood sugar imbalances
• Chronic muscle and joint pain
• Inability to lose weight
• Inflammatory conditions (asthma, eczema, allergies, and may more)  This is particularly interesting because you know what the standard of care is for these conditions?  Pharmaceutical cortisol = cortisone!!!

These are the reasons that adrenal fatigue goes so undiagnosed in conventional settings.  The symptoms are at a first glance unrelated.  There are many ways to treat adrenal fatigue, but there are far more ways to prevent it.  Since the treatment of such a condition is very individualized, I will focus here on prevention.  You will be surprised again I think at how simple these are.

• Avoid caffeine and stimulants after midday
• Get into a regular sleep pattern
• Exercise regularly
• Back to basics nutrition (whole foods, especially protein,  and healthy non-hydrogenated fats)
• Stress management 
• Switch to sea salt
• Eat the yolk!

If you have more questions, please don’t hesitate to ask.

Dr. Nishant Rao is a co-founder of WellWire.com. He is a well-traveled naturopathic doctor and new father, practicing an integrative approach to create wellness in and around Los Angeles. Become a patient or discover his practice.