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This is Another excellent blog post from my friend Dr. Laura Ruby:


My vision is finally coming to reality

Like many other women, I am struggling to keep up with the day to day demands of my personal and professional lives. With the holiday season coming down upon us, it is a good time to reinforce the impact that stress has on our health.  Even “good stressors” can have a negative impact, especially when superimposed upon the many other responsibilities we have.

I have taken a short reprieve from blogging twice weekly to deal with some of my own personal stressors.    I have a lot on my plate right now but have much good news to share.   I am finally going to see my vision of a women’s wellness center come to reality in early in 2013 when I will launch Optimal Wellness:  Center for Functional & Lifestyle Medicine.  While this is a dream come true it has “pushed me over the edge” just a little, as I launch this new center on top of continuing with my current endocrinology practice.

More good news… I was chosen as one of the five finalist in the Carroll BIZ Challenge where I am competing for $5000 to use towards the start up of my new venture.  The final competition is at McDaniel College on Thursday November 29th from 4 – 7 pm.   There is a charge to attend but I would really appreciate anyone that can come out to support me and cast a vote for Optimal Wellness!  Order your discounted tickets now.

Functional Medicine: Looking through a new lens

Optimal Wellness will be grounded in Functional Medicine, which looks at chronic illness through a new lens. The underlying concept of functional medicine is based on a partnership between the provider and the patient that systematically looks at a comprehensive timeline to look for the underlying cause of illness.  Illness is  a continuum that starts with wellness and progresses to full blow chronic illness with complication.  In our current medical model, you must meet the criteria of the disease to have your symptoms justified.  So often I see women with symptoms that fall “under the radar” of the medical model and are basically told there is nothing wrong with them because they didn’t fully meet the criteria for the “disease”.

There are multiple potential triggers for chronic symptoms and illness.  Some of the most common ones I have seen are food sensitivities,our  inflammatory diet, bacterial imbalance in the gut, toxic exposure,  and external stressors.  In the past, I have underestimated the impact that stress has on illness.  Mostly because I myself, like many other women, have been told that my symptoms are “in my head” or “just because I am under stress”.  When, in fact, external stressors travels the same inflammatory pathway as illness, infection and injury.

The concepts I am going to share with you are the key concepts related to stress and illness that were presented in one of the first Functional Medicine modules I attended almost a year ago.    In addition to looking for the underlying cause of the disease, an emphasis was placed on “looking upstream”. The best way to illustrate this is to give you an example of a case presentation.

Looking upstream

A 55 year old woman presents to me for evaluation of abnormal thyroid labs, rapid heartbeat and unexplained weight loss. Subsequent laboratory testing confirms the “diagnosis” of hyperthyroidism or overactive thyroid. I could just stop there and treat her thyroid disease with medication, radioactive iodine or surgery. If I “think upstream” I would look back at other systems and search for potential underlying triggers. After further questioning, it is noted that her symptoms were preceded by a major stressor in her life (divorce) and that she has a long term history of persistent gastrointestinal symptoms; bloating, cramping and diarrhea which were present well before her current symptoms. Further testing uncovers a food allergy. So now we have 2 underlying triggers – a major emotional stressor and inflammatory gut disease triggered by a  food sensitivity.  If you recall from previous posts, this leads to systemic inflammation and increased the risk of autoimmune dysfunction, hence the thyroid disease. So, again, the idea is to treat the underlying cause, not just the symptoms of thyroid imbalance. Now this is a watered-down version but hopefully you can see how this approach differs from traditional medicine.

Physiologic response to stress

Both physical and emotional stressors increase cortisol production. Cortisol is our “stress hormone” and is essential in the stress response. Cortisol sets off a cascade of biochemical reactions, one of which is to stimulate the adrenal glands to release adrenalin. This is the basic response we see with acute stressors – fight or flight. Once the stressor is gone, our system quickly rebalances itself. The problem lies with chronic stress; when our adrenal glands become persistently overworked, and then potentially “burn out”. To further compound the problem, inflammation uses the same pathway as stress and stress promotes further inflammation. Guess what? Insulin has the same effect – WOW are we in trouble!

It’s not all in your head

Today’s woman is typically overwhelmed by her constantly multi-tasking hectic lifestyle. We are always taking care of everyone but ourselves. I can’t begin to count the number of women that are gaining weight, despite doing “all the right things”. In many cases, it is the underlying stress response that is creating the issue. Excessive cortisol worsens insulin resistances which makes us gain weight. In my practice, I have been cautious about telling a woman that her illness is triggered by “stress”, because in my personal experience that typically meant that someone was saying “it’s all in your head”. Because of this,in the past,  I  failed to consistently include stress management techniques into my recommended plan of care for my patients, as well as for myself.

Surviving the holidays

I love the holidays but with all of it’s beauty and meaning it is often accompanied by significant stress that can have a major impact on our health.  I can personally attest to that as I just recovered from a viral syndrome that hung on for almost a month and this time last year, a major stressor triggered an attack of Bell’s Palsy.  So as much as I try to “take care of myself” and eat a low sugar, low gluten diet, take targeted nutritional supplements and exercise, extreme stress trumped it all.   So we all need to help each other be realistic with our goals over the next month and try to “survive the holidays” together.

Stayed tune for more tips on Surviving the Holiday over the next few weeks and feel free to share your thoughts of how you make the most out of the holiday season.

To sign up for Laura’s blog posts and newsletters go to http://www.drlauraruby.com



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