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Do you constantly feel tired, stressed, and have muscle aches? Seem to always be craving salty or sweet foods? You might feel like you have ‘brain fog’ and cannot remember things. You may have talked to your doctor and it appears nothing is wrong with you. It is frustrating to have these problems without knowing what it is or how to fix it. You may blame it on your busy and fast-paced lifestyle, but it actually could be a syndrome called adrenal fatigue. Most doctors do not think this is real, but functional medicine doctors have a different approach. Here are 5 nutrition, stress management, and supplement tips on how to help your adrenal health! 

What is adrenal fatigue?^1-4

Your adrenal glands sit right above your kidneys and are responsible for releasing cortisol, the stress hormone, and adrenaline. They are part of the ‘fight or flight’ response that help to increase your heart rate and blood pressure in stressful situations. These help give you the energy to complete your daily tasks and power to overcome stress situations like dealing with work deadlines. 

Adrenal fatigue is a syndrome that is associated with several symptoms like extreme tiredness and mood swings. It often comes from chronic stress like the loss of a loved one or worsening of a preexisting condition like diabetes. This results in a greater release of cortisol until the stress is too much and your adrenal glands get tired. The hormone release becomes irregular and lower than it should be, leading to symptoms.

Here are the symptoms:

• Constantly feeling tired or struggling to wake up in the morings
• Difficulty sleeping
• Muscle aches
• Weight gain
• Brain fog
• Depression
• Anxiety
• Lightheadedness
• Hair loss 

The symptoms of adrenal fatigue are nonspecific and you may notice you have quite a few of them. That is what makes it so hard to determine if you have poor adrenal health or if it is another condition like depression or entering menopause.

How do I know if I have adrenal fatigue?^1-3

If you have some signs or symptoms of adrenal fatigue, you might want to consider getting an adrenal fatigue or cortisol test. This test measures the level of cortisol in your blood or saliva. Cortisol is typically higher in the mornings to give you energy to tackle your day and lower in the evening, so you can sleep. If you have adrenal fatigue, your body is not producing enough cortisol which can lead to limiting symptoms like constantly feeling tired or anxious, or other health issues.

If you think you might have adrenal fatigue, talk to your doctor or functional medicine doctor about obtaining an adrenal fatigue test. 

What are the treatment options?^3,5

• Improve your diet – Your diet affects your energy level and sleep quality. By focusing on a diet full of healthy fats like monounsaturated and polyunsaturated, vegetables, and grass-fed or wild-caught meat. Healthy fats include nuts, fish, avocado, seeds, olive and oil. Try limiting your intake of inflammatory foods like processed snacks, sugar, and alcohol. This diet decreases inflammation that may be affecting your symptoms, so try to incorporate a few of these foods into your daily meals.
• Stress management – This is one of the most important ways to promote adrenal health – fix the problem at the main source! Lowering your stress calms you and promotes your well-being. You could try mediating a few minutes a day, yoga, or listening to a podcast on an afternoon walk. Really, just whatever makes you calm and relieves your worries.
• Get quality sleep – If you do not have good sleep, it is definitely difficult to concentrate and go about your day. When your cortisol levels are irregular, this makes it even more difficult to sleep and adds to your stress. Aim for at least 7 to 8 hours of sleep per night, but quality sleep is more important than the quantity of sleep.
• Decrease caffeine intake – This includes your daily cups of coffee! Coffee boosts cortisol levels which adds to your already abnormal levels. It is recommended to avoid coffee if you drink it every now and then, but if you already drink it daily, you are already tolerant of this ability. Try limiting your intake after 2 pm to avoid more sleep problems since caffeine can keep you awake.
• Nutritional supplements – Supplements like magnesium, inositol, L-theanine, and ashwagandha promote stress reduction and improving mood. If you need more muscle pain, magnesium may be a better choice while L-theanine can easily be found in green tea to help relaxation. Choosing a supplement can be overwhelming, but you should not select a product alone. Josefs Pharmacy offers a variety of quality and affordable supplements. A pharmacist would be happy to help choose the safe and effective supplement for you.

Could it be something else?^3,7

If you think something is wrong with your adrenal glands, think, is there a stressor in your life? What could be causing it? Even if you do not have adrenal fatigue, stress management is key for prevention and lowering your risk of health diseases like heart disease.

If you have any of those symptoms mentioned earlier, it could be something else. The symptoms of anxiety and depression mirror these symptoms which can be treated with antidepressants and counseling. Other possible conditions include anemia; sleep apnea; menopause; autoimmune diseases; and heart, kidney, or liver problems. 

If you think you have adrenal fatigue or want to learn more about natural and pharmacological treatments, talk with your doctor or pharmacist today.

References:

1. Anderson, P. Adrenal functional medicine. ZRT Lab website. https://www.zrtlab.com/resources/provider-webinars-on-demand/adrenal-function-assessment/?_hsmi=184085093&_hsenc=p2ANqtz-_dBdyYL3d4DTb9jr18NHmKZc3e1ah0eAkkceZKnqS_7PLSYqYDUcRmgDuCTCRQiLl-qRoNbQg3SNHyr1xxvEKLkN7GVA. Accessed November 23, 2021.
2. Adrenal fatigue: What causes it? Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/addisons-disease/expert-answers/adrenal-fatigue/faq-20057906. Accessed November 23, 2021.
3. You might have adrenal fatigue, here’s how to treat it naturally. Dave Asprey website. https://daveasprey.com/adrenal-fatigue-treatment-symptoms/. Accessed November 23, 2021.
4. Adrenal fatigue symptoms and treatment. Enjoy Natural Health website. https://www.enjoynaturalhealth.com/adrenal-fatigue-symptoms-and-treatment/. Accessed November 23, 2021.
5. Adrenal fatigue: Tired, wired, foggy & fat. Arbor Health website. https://www.arbor-health.com/blog/adrenal-fatigue. Accessed November 23, 2021.
6. Adrenal fatigue: Is it real? WebMD website. https://www.webmd.com/a-to-z-guides/adrenal-fatigue-is-it-real. Accessed November 23, 2021.
7. Is ‘adrenal fatigue’ real? Harvard Health website. https://www.health.harvard.edu/blog/is-adrenal-fatigue-real-2018022813344. Accessed November 23, 2021.

Since before COVID-19 vaccines were made available, there has been speculation on if initial vaccination would be sufficient or if there would be recommendations for yearly vaccination, like the flu shot. As the vaccines continue to be studied and more information about COVID-19 becomes available, every effort is being made to ensure that you have the information and tools necessary to protect yourself from COVID-19 infection. Based on the data available, the FDA has recently authorized an additional dose or booster dose of certain COVID-19 vaccines for patients meeting specific criteria. At this time, only one COVID-19 booster dose is recommended. 

WHAT DOES “BOOSTER” MEAN?

The term “booster” is used to describe an additional dose of a vaccine that is given to boost your immune system. The booster shot helps you to maintain immunity and keep you protected against COVID-19 after the immunity from the first two doses begins to naturally decrease over time.¹

WHY IS A BOOSTER DOSE NEEDED?

Studies have shown that COVID-19 vaccines are effective at preventing severe disease and reducing the risk of hospitalization, but protection against the virus may decrease over time. This is due to natural waning of immunity, which is why a booster dose is needed.² Other routine vaccinations, such as the tetanus shot, require booster doses for the same reason. A booster dose triggers a memory response within your immune system so that your immune system is able to respond quickly if you are ever exposed to the virus.¹ With the emergence of COVID-19 variants that are highly infectious, such as the Delta variant, it is extremely important to maintain immunity, which can be done through a booster dose. One study on the Pfizer-BioNTech vaccine showed that a booster dose increased patients’ immune response, which provides increased protection against COVID-19, including variants.²

WHEN CAN THE BOOSTER DOSE BE GIVEN?

The FDA has authorized the Pfizer booster dose for those meeting certain eligibility criteria as listed in the next section. For patients meeting this criteria, the booster dose can be given at least 6 months after the second dose. ²  

For patients with moderate to severe immunocompromising conditions, such as those listed in the next section, the FDA has authorized a third dose of Pfizer and Moderna. For these patients, the third dose can be given at least 28 days after the second dose. This additional dose is given sooner because patients with weakened immune systems are more likely to have severe illness if infected with COVID-19 and are less likely to develop sufficient immunity after only two doses of the vaccine.³

Currently, an additional dose of Moderna is only authorized for immunocompromised patients and not yet available for others. The Johnson & Johnson COVID-19 vaccine has not not been authorized for booster doses.

The FDA is consistently reviewing data on COVID-19 vaccines, and booster doses that are not currently available for patients who do not meet the following criteria may become available at a later date. 

WHO IS ELIGIBLE?

According to the CDC, you should get the Pfizer booster dose if you have completed the 2-dose Pfizer series at least 6 months ago and fall into one of the categories below:

• 65 years of age or older
• 50-64 years old with underlying medical conditions (obesity, asthma, heart disease, high blood pressure, diabetes)
•  A resident of a long-term care facility and at least 18 years old

If you do not meet the above criteria but would like to get a booster dose, you may get the Pfizer booster dose at least 6 months after completing the 2-dose Pfizer series if you fall into one of the categories below:

• 18-49 years old with underlying medical conditions (obesity, asthma, heart disease, high blood pressure, diabetes)
• 18-64 years old and working in a high-risk setting where you may be exposed to COVID-19 (healthcare workers, first responders, teachers, retail and restaurant workers, public transportation workers, etc.)
• 18-64 years old and living in a high-risk setting where you may be exposed to COVID-19 (correctional facilities, homeless shelters, college dorms, any group living setting).^2,4

If you have one of the following immunocompromising conditions, you should get a third dose of Pfizer or Modera at least 28 days after completing the 2-dose series:

• Active cancer
• Organ transplant and taking medication to suppress the immune system
• Stem cell transplant within past 2 years or currently taking medication to suppress the immune system
• Advanced or untreated HIV
• Active treatment with medications that suppress the immune system.^3,4

DOES IT MATTER IF I GET A DIFFERENT MANUFACTURER FOR MY BOOSTER?

The CDC currently recommends that any additional dose match the vaccine that you initially received. This means that if you completed the 2-dose Pfizer series, your next dose should be the Pfizer vaccine, but if you completed the 2-dose Moderna series, your next dose should be the Moderna vaccine. Some exceptions do exist where your next dose could be different than what you previously received. If you are unsure of which vaccine you should be getting for your booster dose, please contact your doctor or pharmacist.³  

WHAT IF I AM NOT ELIGIBLE FOR A BOOSTER DOSE? WHAT DO I DO? 

At this time not everyone has been made eligible for a booster dose of the COVID-19 vaccine. However, it is important to stay alert to changes in eligibility as new information is made available often. If you have any questions about eligibility or updates in the media, reach out to your doctor or pharmacist to get the most accurate information. In the meantime, it is important to continue safe practices as recommended by the CDC which include wearing a mask, frequent hand washing, avoiding crowds, and practicing social distancing.⁵    

REFERENCES

1. Will you need a COVID-19 booster? What we know so far. yalemedicine.org. https://www.yalemedicine.org/news/covid-19-booster. Published July 27, 2021. Updated September 24, 2021. Accessed October 4, 2021. 
2. Who is eligible for a COVID-19 vaccine booster shot? cdc.gov. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html#HighRisk. Updated September 30, 2021. Accessed October 4, 2021. 
3. COVID-19 vaccines for moderately to severely immunocompromised people. cdc.gov. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html. Updated September 2, 2021. Accessed October 4, 2021. 
4. COVID-19 vaccine boosters and additional doses. ncdhhs.gov. https://covid19.ncdhhs.gov/vaccines/boosters. Accessed October 4, 2021.
5. COVID-19 and your health. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Updated 2021. Accessed September 30, 2021.

Everyday in the United States, 41 people lose their lives due to opioid prescription overdose.¹ National Pain Awareness Month is not only a time to bring awareness that chronic pain is real and that it can affect you emotionally, physically, and mentally, but that opioid abuse and misuse exists. Opioids are often prescribed after surgeries and trauma events like car accidents and to treat chronic pain, but they can have dangerous side effects. How can this be prevented? These effects can be avoided by using innovative, non-drug treatments that are safer!

What are opioids?²

Opioids are related to the opium poppy that comes from the opium plant that has pain relieving effects. Opioids act centrally at opioid receptors to affect your brain and spinal nerves by blocking pain signals from reaching your brain. They reduce the release of painful chemical signals, so pain is not felt. However, they come with risks of abuse, dependence, addiction, respiratory depression, confusion, restlessness, and euphoria or extreme pleasure. Opioids change how your brain functions, so they can lead to tolerance where you will need more of the drug to reach the same level of effect or dependence which is when you start to feel sick if you do not take them regularly. You do not know how opioids will affect your brain before you take them and not everyone on them becomes addicted. Addiction can even result from taking them as prescribed. 

Addiction or Opioid Use Disorder is associated with compulsive behaviors to continue getting and taking opioids. You continue to take them even when you know they hurt your relationships and damage your ability to perform your work, school, and home tasks. It is treatable through the use of recovery programs and medication-assisted treatments to reduce your cravings and withdrawal effects. Since opioids affect the part of the brain that is responsible for controlling your respirations, they can slow your breathing or cause death if a dose is too high. Since they can make you sleepy or sedated, they should not be combined with alcohol and other sedating medications like sleeping medications. Another limiting side effect of opioids is constipation, so if they are prescribed long-term, they are often taken with medications to stimulate your bowel movements. 

What is the opioid epidemic?^1-3

The opioid epidemic is a result of the increased opioid prescriptions that occurred during the 1990s when pharmaceutical companies reassured providers that they were not addictive. As they began to be misused, both prescription and non-prescription opioids, it was clear these drugs had dangerous effects like leading to addiction. Opioids are effective for treating pain, but they can result in misuse, overdose, and addiction if used for long periods of time or at high doses. 

According to the Centers for Disease Control and Prevention, about $78.5 billion is the “economic burden” of opioid misuse in the United States. The economic effects of opioid misuse include healthcare costs, loss of productivity, addiction treatment, and criminal justice involvement. It is estimated that over 650,000 opioid prescriptions are filled, but are not being used for medical purposes like moderate to severe pain relief. For people that are using opioids for long-term pain relief, about 1 out of 4 struggle with opioid addiction. Even during the COVID-19 pandemic, opioid-related overdoses and deaths continue to increase which could be related to mental health and financial issues. This really shows how big of a harmful impact opioids have!

How big of an issue is pain?^1-5

Over 30% of Americans live with chronic pain and it is the most common disability that affects daily activities and relationships in the United States. A 17-year study found that the prevalence of pain in adults of all ages is increasing in the United States. Joint pain cases have increased by 21%, neck pain cases have increased by 16%, and low back pain cases have increased by 15%. As pain continues to be an issue and opioid-related overdoses and addiction across the United States continue to rise, it is important that alternative and safe pain treatments are considered. 

What are other non-drug treatment options?^1,6

Continuous peripheral nerve block (cPNB) – cPNB utilizes a catheter to place at the target nerve that is causing pain, so it reduces the pain impulses that go to your brain for you to feel pain. It works by providing pain relief locally to the area by using non-opioid drugs that decrease the pain at that area. This treatment can be used during and after surgery to reduce the severity of post-surgical pain and the need for opioids. By reducing the need for opioids, this protects you from their addicting, dangerous, and unwanted side effects.

Peripheral Nerve Stimulation (PNS) – PNS is a unique way to provide pain relief because it occurs by using an electrical device. The small device is a wire that is implanted next to a peripheral nerve or a nerve that reaches beyond your brain and spinal cord. The device sends quick electrical pulses to your nerves to block pain signaling from reaching your brain. It is a quick and simple procedure that is likely painless due to the small size of the device. PNS is commonly used for diabetic peripheral neuropathy, and pain in the neck, back, and face. 

Deep Transcranial Magnetic Stimulation (TMS) – Deep TMS is a non-invasive procedure that involves using magnetic technology. Magnetic fields are created by a coil that is placed on your head to stimulate your brain to block pain signals from reaching your brain. As a result, your brain will not begin the process for you to feel the pain you are having. It only requires a few 20 minute sessions each week over six weeks to reach its full effects. Deep TMS has also been used for treating depression and obsessive compulsive disorder.

Pulsed Electromagnetic Field (PEMF) Therapy – PEMF therapy works by using electric and magnetic energy to stimulate your body to increase its pain relief mechanisms while decreasing the pain and swelling mechanisms. It flushes out toxic cells that cause inflammation while increasing the delivery of nutrients to your tissues. It is commonly used for neuropathic pain that is created within nerves, not from an injury like stomping your toe. This therapy is also non-invasive and can even be used at home.

Cryotherapy – Cryotherapy or cold therapy is typically used for treating warts and some cancers, but it has been shown to reduce pain for osteoarthritis and rheumatoid arthritis. Cryotherapy stimulates your body’s response to extremely cold temperatures which increases cell survival and strengthens your immune system. This results in decreased inflammation and swelling that can cause pain. The cold therapy is delivered to your peripheral nerves through a small, handheld device which reduces nerve activity of transmitting painful signals. It also reduces the use of opioids after surgery while increasing your body’s ability to reduce inflammation and promote healing. 

Botox – You may think of this as only for a cosmetic procedure or for treating migraines, but it can be used for pain too. Botox is a weak form of botulinum toxin type A that is produced from bacteria to block muscle contraction. For pain, it blocks the release of chemical signals and messengers that stimulate your brain to respond to pain. Research is still on-going with this therapy, but it has been shown to be useful in providing temporary pain relief for nerve and back pain.

If you currently take opioids, talk with your provider or pharmacist if you have questions or concerns about their effects. If you or someone close to you needs help for a substance use disorder, talk to your doctor or call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services Locator.

References:

1. Pain awareness month: Innovations in Pain. A4M blog website. https://blog.a4m.com/pain-awareness-month-innovations-in-pain-management-and-care/. Accessed September 27, 2021.
2. Opioids. Centers for Disease Control and Prevention website. https://www.cdc.gov/opioids/patients/materials.html. Accessed September 27, 2021.
3. Opioid overdose crisis. NIH website. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis. Accessed September 27, 2021.
4. 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
5. Americans in pain. McShane Welding website. https://www.mcshanemetalproducts.com/blog/americans-in-pain. Accessed September 27, 2021.
6. Botox for pain relief. Regional Neurological website. https://www.regionalneurological.com/botox-for-pain-relief-how-it-works/. Accessed September 27, 2021.

It may seem odd that September is National Pain Awareness Month since you know when you are in pain. This is a time to bring awareness to not ignore your pain, accept it as a valid problem, and seek treatment to maximize your quality-of-life. Pain is the most common cause of disability in the United States, that is more than cancer and heart disease combined!¹ Over 100 million people in the United States experience chronic pain or pain that does not completely go away and can result from other chronic diseases like diabetes and arthritis.¹ Chronic pain not only affects you physically and can limit your activities, but it affects you emotionally, behaviorally, and mentally. The pain is real and not an attempt to get powerful medications like opioids. Let’s bring the stigma associated with chronic pain!

What is pain?^2-4

When you stomp your toe or pull a muscle, your pain receptors in that area send a message to your central nervous system. This message acts as a signal to warn your body of danger. The central nervous system includes the brain and spinal cord. The message is delivered to your spinal cord through many nerves until it reaches your brain. Your brain interprets the signal and sends a message to that area to make you feel pain. This pathway typically ends when the pain is resolved such as when your wound has healed. With chronic pain, your nerves continue to fire to make you feel pain even when the injury is not present.

Acute pain is sudden and results from an illness or injury like cutting your finger or a mild headache. It typically lasts no more than a few weeks and the pain resolves with healing. Sub-acute pain lasts between six weeks and three months. 

Chronic pain is persistent and recurring pain that lasts over three months. It can result from an illness like cancer or injury with the pain still being felt in “on” and “off” episodes or continuous long after it. Other examples or conditions that can cause pain include migraines, headaches, nerve damage, arthritis, shingles, osteoporosis, peripheral vascular disease or poor blood flow, and back pain. Back pain is one of the most common health problems that greatly affects everyday functioning. It can also be caused without an illness or injury in the form of its own syndrome. It affects 28% of people between the ages of 46 to 64 years old, and over 65% of those over 65 years old and older. Unlike the other types of pain, chronic pain affects you from your daily activities to your social life. Pain is real and there is a need to bring awareness to its effects on the mind and body!

How does chronic pain affect me?^2,5

Chronic pain can make you feel frustrated, depressed, anxious, and stop you from completing your daily activities or things you enjoy like traveling. It is a continuous cycle of pain and uneasy feelings, so it can do more harm than just physical pain. When you feel pain, you may feel depressed or anxious that you are not able to complete your activities as easily. Performing these activities can even make your pain worse. You may feel stressed as you focus on your problem and have trouble sleeping which increase your pain. As you limit your activities, you may feel more depressed and anxious that you can not perform as well or do what you want to do. The pain continues which starts the cycle all over again.

What are the treatment options?^1,2,4-6

Acute pain is normally treated with rest, time, and over-the-counter pain medications while chronic pain requires an approach to treat the body, mind, and spirit. Acute pain is resolved upon healing while the pain never completely goes away with chronic pain. Therapies for chronic pain aim to improve you mentally, socially, emotionally, and physically, just minimizing the pain you feel for you to carry out your daily activities. The treatments include self-care, mental health, and pharmacological treatments. The encouraged treatment for chronic pain is self-care which include the following: 

Activity and stretching – Participating in workout classes, strength building, physical therapy, or even simply walking helps strengthen your muscles and lowers your pain. If you experience pain during your activities, the activities may be too intense. Just stop before it gets worse and build your way to doing more advanced activities.

Ice/heat – Ice and heat help relieve stiffness and pain, especially with arthritis and other joint conditions. Alternate sessions with ice or heat by applying for 20 minutes, then 20 minutes off a few times a day. 

Mindfulness and relaxation – Taking time for yourself to practice mindful meditation requires slowing your thoughts, taking deep breaths, and destroying your negative thoughts. This calms your body and mind down, so you can relax. Yoga is another technique that is used to reduce your stress levels which eases your pain.

Sleep – A lack of sleep affects your mood, relationships, and ability to function. Creating a sleep routine to get a good night’s rest, about seven hours a night consistently can help reduce your stress and pain. This will also make you feel more empowered to tackle your day!

Nutrition – A nutritious diet full of whole grains, fruits, vegetables, and lean meats while limiting your intake of processed/sugary foods, white bread, red meat, and salt gives your body more nutrients that can fight off inflammation and help your pain flares. Some key vitamins include iron, folic acid, and vitamins A, B6, C, and E. These are commonly found in nuts, leafy greens like spinach, berries, and whole grains.

Smoking cessation – Research has shown that smoking increases your risk of back pain and can increase the intensity of neck pain. Those that are smokers have reported that their pain is more intense than those that have never smoked.

Weight management – If you are overweight or obese, gradually losing about 5 to 10% of your weight can lower the amount of pain you are feeling. This is especially true if you have knee or hip pain since more weight adds pressure to the joints and stimulates pain.

Engaging in meaningful activities – Do not let chronic pain stop you – performing activities you enjoy increases your body’s natural painkillers while boosting your overall mood!

Family/friends support – Not only having the support of your family is helpful, but also sharing your experiences and learning from others in group or rehab programs. It may provide you comfort knowing that other people understand your experiences, fears, and discussing your worries. 

If these are not enough for pain relief, pharmacological treatments can be started or along with self-care measures. Pharmacological treatments include over-the-counter and prescription medications depending on the type of pain. Opioids are not a first-line treatment. Transcutaneous electrical nerve stimulation (TENS) is an alternative option that involves sending tiny electrical impulses to the painful area, so less pain signals are sent to your brain to make you feel pain. Regardless of the approach, self-care measures should be started to enhance your quality of life and limit the need for medications.

The Dangers of Alcohol For Pain Relief⁷

From the damaging effects of chronic pain on the mind, body, and relationships, about 28% of people use alcohol as a way to ease their pain. Mixing alcohol with pain medications can increase your risk of liver toxicity, gastrointestinal bleeding, or sedation. Alcohol does not treat the pain. Alcohol only depresses you from feeling the pain temporarily while it actually makes the condition worse. The Dietary Guidelines (2020-2025) recommend that females drink no more than one drink and males drink no more than two drinks daily, regardless of health conditions. Depressing your mind to interpret the pain requires a greater intake, so over time, your body becomes tolerant and requires more to lessen the pain. This increases your risk of developing dependence and experiencing withdrawal when you do not drink. If you misuse alcohol, this can cause peripheral neuropathy. Peripheral neuropathy is a painful neurological condition that causes chronic pain, tingling in the limbs, and disability. 

If you are experiencing pain and it does not get better, contact your physician or pharmacist today. 

References:

1. 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
2. About chronic pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_2. Accessed September 19, 2021.
3. Chronic pain. NHS inform website. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain. Accessed September 19, 2021.
4. September is national pain awareness month. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_1. Accessed September 19, 2021.
5. Chronic pain conditions. Metropolitan institute of pain website. https://mipainchicago.com/chronic-pain-conditions/. Accessed September 19, 2021.
6. Can diet heal chronic pain? Harvard website. https://www.health.harvard.edu/pain/can-diet-heal-chronic-pain. Accessed September 19, 2021.
7. Dangers of using alcohol to dull the pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_5. Accessed September 19, 2021.

Did you know 100 calories of broccoli has more protein, vitamins, minerals, and less fat than 100 calories of steak? But which protein source is better – animal or plant? Does it matter? Does animal protein increase the risk of cardiovascular disease? Is plant protein a poor source? There is conflicting research and information on this topic, but like how your body uses protein, we break down all the nutritious facts here!

What is protein?^1,2

Protein is a macronutrient that is involved in many of your body’s functional processes such as muscle and tissue repair, enzymatic reactions, hormone production, and transport of molecules like oxygen. Over 20% of your body is made of protein. Protein is made up of amino acids, but they are not stored in the body. Instead, amino acids are either made by your body or obtained from your food. The following nine amino acids are only obtained from your food: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

Protein is a component of the three macronutrients, along with carbohydrates and fat, that are essential in a healthy diet. Although the optimal diet type differs for everyone, diets should include a variety of whole foods like vegetables, fruits, whole grains, dairy, beans, seafood, lean meat, and nuts/seeds with minimally-processed foods like hot dogs, bacon, and ice cream. This method is called the Healthy Eating Plate. For more information on incorporating nutritious foods into your diet, servings, and meal examples, click here.

How much protein do I need?²

Without enough protein, your body becomes weaker and you lose muscle mass. This makes it harder to carry out normal functions like growth and breathing. Too much protein becomes stored as fat which can make you gain weight. According to the National Academy of Medicine, for every 20 lbs of body weight, you need 7 grams of protein. If you are more physically active, you may require higher amounts of protein. Protein is found in a variety of foods, but not all sources are equal. 

How are animal and plant protein sources different?^1,3,4

Animal protein sources are known as complete while plant sources are incomplete. This means that animal sources have the nine essential amino acids we mentioned earlier, unlike the plant sources. The chart below displays examples of each type, along with some of their key points to remember when selecting a protein. Most sources of protein are from animals, but be careful because some animal sources may be packaged with higher amounts of saturated fat, cholesterol, calories, and poor fiber. Plant sources have many other nutrients like plenty of fiber, antioxidants, vitamins, and minerals! 

Risk vs. Benefit^1-3,5

You may have heard that plant protein sources are higher in nutrients and can lower your risk of diseases while animal protein sources may increase your risk of diseases. Yet, this is not exactly true. Plant sources include more fiber, minerals, antioxidants, and vitamins. Animal sources can include more zinc, vitamin D, vitamin B12, heme-iron, and docosahexaenoic acid (DHA) which is important for brain health. They also add some protection against diseases, but it is all about the specific food. Foods contain other components like fat, calories, and cholesterol. Like getting the right amount of protein, it is important you are getting it from a nutritious source.

When considering the risk of certain diseases like diabetes and cancer, the section below indicates how your risk is affected by your selected protein sources.

• Diabetes – Research has shown that a diet higher in red-meat increases your risk of type 2 diabetes while your risk can be lowered by eating more nuts and legumes. One study found that those who ate more red-meat had a higher risk of type 2 diabetes than those that rarely ate red or processed meat. The risk increased about 20% for each additional daily serving of red or processed meat. However, the risk lowered by 10% if a serving of nuts, whole grains, or low-fat dairy was consumed instead. Those that consume more plant protein sources tend to be less overweight which is another risk factor for type 2 diabetes.
• Cardiovascular disease – In the 20 year-long Nurses’ Health Study and Health Professionals Follow-Up Study, the risk of dying from cardiovascular disease such as heart disease, stroke, or heart attack increased by 13% for each additional daily 3 oz serving of red-meat the participants consumed. With each additional 1.5 oz serving of processed meat, the risk increased to 20%. However, this study did find that eating poultry, fish, and low-fat dairy was associated with a lower risk of cardiovascular disease. These results were mirrored by a meta-analysis with data from over 38 trials and 1,803 participants. Higher blood pressure, and levels of cholesterol, low density lipoprotein (LDL) or ‘bad’ cholesterol, and triglycerides were higher in those that consumed larger diets of red-meat than chicken, fish, or plant proteins.
• Cancer – Plant protein sources like vegetables and seeds contain phytochemicals which are chemicals that may protect you against cancer. A study conducted by the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) stated that processed meat is ‘carcinogenic to humans’ based on data from over 800 studies. These studies mainly showed an increased risk of colorectal cancer, but there were also associations with prostate, pancreatic, and stomach cancers. Even how the meat is cooked can affect the risk of cancer since grilling at high temperatures can release cancer-causing compounds.
• Premature death – From the Nurses’ Health Study and Health Professionals Follow-Up Study, the researchers found that a greater intake of red or processed meat like deli meats, sausage, and bacon was associated with a higher risk of death than plant protein sources. Eating processed or red-meat increased the risk of death by 13% to 20% in a study with data from over 21 countries.
• Weight control – After performing a 20 year-long study with 120,000 participants, the Harvard Chan School of Public Health found that those who ate more nuts lost about half a pound more weight every four years than those who ate more red and processed meats. Those that ate more red and processed meats gained an extra pound every four years. This study also found that eating more yogurt, chicken without skin, low-fat cheese, and peanut butter was associated with less weight gain than chicken with skin, regular cheese, and red-meat. Another study reported that by eating a daily serving of legumes, peas, or beans, this can increase fullness which may help with weight loss. Even eating eggs for breakfast has been shown to make you feel fuller.

What about vegans and vegetarians?^1,3

If you are vegan or vegetarian, it’s possible to have a nutritious diet with all of your protein from plants. However, be sure you are consuming enough protein by calculating your protein intake with the formula discussed earlier. It is unclear if a higher protein intake is needed due to the lower digestibility of plant proteins, but it can be improved by boiling, fementing, or soaking them. Research also shows that combining incomplete protein sources to equal a complete protein is not necessary. As long as you consume enough variety of plant protein throughout the day, you do not need to combine incomplete sources at your meal.

Plant sources of protein can be poor in zinc, vitamin D, vitamin B12, heme-iron, DHA, and calcium. Try to eat dairy, leafy greens and drink plant milk to increase your vitamin D and calcium intake. To increase your zinc, eat more whole grains and beans in your diet. Lentils, spinach, and tofu are great sources of heme-iron. To increase your DHA, this can be done through eating algae or dietary supplements.

Do animal proteins really affect the environment?¹

Greenhouse gases are those that are able to trap heat and radiation from Earth’s surface, creating a ‘greenhouse effect.’ About 17% of those gases come from nitrous oxide of fertilizers and irrigations, cutting down large areas of trees to make room for livestock, and methane from the manure of cattle, sheep, goats, and deer. As these effects increase, this contributes to climate change and destruction of ecosystems. It may seem like there is not much you can do to help this issue, but just by opting to eat less animal protein or eat more fish and chicken can make a difference!

Key Takeaways

Incorporating a variety of animal and plant protein sources are key for a nutritious diet. If you are vegan or vegetarian, be sure you eat a variety of plant protein sources to maximize your health. If you consume mostly animal, red-meat, or processed protein sources, try replacing some of those foods with plant proteins like beans, spinach, or nuts to lower your chance of diseases. You could even simply start with ‘Meatless Mondays!’ Before you make big changes to your diet or your protein intake, contact your health care provider or pharmacist today to ensure you are meeting your dietary needs.

References:

1. Best protein sources: Comparing animal and plant-based protein. Fullscript website. https://fullscript.com/blog/best-protein-sources. Accessed September 1, 2021.
2. Protein. Harvard University website. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/. Accessed September 1, 2021.
3. Animal vs plant protein – What’s the difference? Healthline website. https://www.healthline.com/nutrition/animal-vs-plant-protein. Accessed September 1, 2021.
4. Nutrition – Plant vs animal protein. Dr. Hillel Harris website. https://drhillelharris.com/nutrition-plant-vs-animal-protein/. Accessed September 1, 2021.
5. The difference between animal protein and plant protein. WebMD website. https://www.webmd.com/diet/difference-between-animal-protein-plant-protein#1. Accessed September 1, 2021.

What’s the body’s largest organ that offers protection and is your first defense against harm? If you said your skin, you’re correct! The skin is made up of about a trillion cells and gets its strength from a protein called collagen.¹ It is important that it is well taken care of. You may be familiar with collagen’s ability to slow down the process of aging skin or reduce wrinkles. Maybe you have lotions or shampoo with collagen. But what exactly is collagen and what does it do? This article gives you a quick overview of collagen and its benefits.

What is collagen?^1-4

Collagen, a protein highly produced by the skin, makes up a third of the protein in your body and is responsible for the skin’s flexibility and strength. Collagen is also found in your bones, muscles, tendons, teeth, and blood. Think of it like this, collagen is like a glue. It is strong and provides structure and support to your body’s tissues. 

The skin is made up of the outer epidermis, dermis, and inner hypodermis or the fat layer. Collagen is found on the outer layer of your cells and is greatly involved in the skin’s process of protecting, healing, and regenerating itself within the dermis. You may already know that your skin goes through a cycle to get rid of its old cells and make new ones, but did you know it happens every 27 days? To undergo this process effectively, it is important that collagen and its amino acids or building blocks are available.

Like glue, collagen comes in several types. Type I includes over 90% of your collagen. It is made of densely packed fibers to strengthen your skin, bones, teeth, and connective tissue. Type II is made of loosely packed fibers to provide support to your joints. Type III is found in your muscles, organs, and arteries while Type IV is located in the layers of your skin.

As you age, your body reduces its production of collagen and your skin may start to become more fragile and less firm. This can lead to wrinkles, sagging skin, and aching joints. Without enough collagen in your joints and muscles, your joints may be less flexible and your muscles may weaken. Even your hair can become thinner and start to go slower. That is why it is important that you are getting enough collagen in your life. The benefits of collagen extend well beyond protecting your skin!

What are the benefits?^1,2,5,6

1. Skin elasticity and hydration – As you enter your mid-20s, you begin to lose some of your collagen. For women in the first few years of menopause, they can lose over 30% of their collagen. This explains why collagen is often marketed as an anti-aging supplement. A recent meta-analysis with data from 19 studies and 1,100 patients determined that collagen supplements improved the skin’s hydration and elasticity. There was also improvement in their wrinkles after taking the supplements for four weeks and even four weeks afterwards.
2. Osteoarthritis – Since collagen makes up your joints and bones to provide support and function, collagen can be used to improve joint function and reduce pain. This was shown in a study with 81 patients that took collagen tablets for two months.
3. Strong bones – It is no surprise that as we age, our bones become more brittle that can lead to a higher fracture risk. Research has shown that by taking collagen supplements, this makes your bones more dense and stronger. 
4. Increase muscle mass – Are you trying to gain muscle? A study with physically active men found that taking collagen supplements with a strength training regime increased muscle mass more than men that did not take collagen. 
5. Healthier nails and hair – You may notice your nails are more brittle than your friend’s or that your hair is thinning. This may mean your body needs more collagen. One study found that collagen improved nail growth and strength, and hair thickness and growth by taking supplements for just a month.

What damages collagen?^2,3

• Sunlight – Excess ultraviolet radiation from the sun can damage collagen and cause it to break down faster. This causes collagen production to decrease, so the skin incorrectly rebuilds itself, causing wrinkles. Be sure to wear sunscreen and proper clothing when going outdoors to reduce your risk of skin damage.
• Smoking – Harmful chemicals in tobacco products like nicotine destroy your body’s collagen which can also lead to wrinkles. Nicotine causes your blood vessels to constrict, so less oxygen and nutrients is delivered to your skin. This affects your skin’s flexibility and protection from harm.
• High sugar and refined carbohydrate consumption – A diet high in sugar and refined carbohydrates can come from sodas, potatoes, and cookies can affect your body’s ability to use collagen. When too much sugar is consumed, the sugar begins to stick to your proteins to make advanced glycation end products (AGEs). The sugar affects the function of proteins like collagen, so they become weaker. One way to minimize the production of AGEs is by consuming less foods high in sugar, refined carbs, and processed foods like sugary cereals, white rice, white bread, and sweet manufactured treats. AGEs have been linked to increasing your risk of cardiovascular disease and type 2 diabetes.
• Autoimmune disorders – Lupus is a common inflammatory disorder where the body mistakenly attacks its own tissues and organs like the skin and joints. This damages your layer of collagen that can lead to fatigue, joint pain, and rashes. Rheumatoid arthritis typically causes inflammation in the joints of the hands and feet because of the body thinking your own cells are harmful. There can be painful swelling and joint stiffness since the protective collagen layer has been destroyed.

How do I increase my intake of collagen?^1-3

One of the easiest ways is to consume foods with collagen, its amino acids, or other precursors. You may already be obtaining collagen in your diet! Bone broth is a great source of collagen because it makes up most of the tissues of animals like chicken. Plus it has the extra benefit of hydrating your skin because it is water-based. Other high impact sources can be obtained from foods that directly increase the amount of collagen made by the body including: 

• Vitamin C – found in strawberries, kiwis, oranges, bell peppers, and broccoli
• Vitamin A – found in mangos, apricots, carrots, spinach, and sweet potatoes
  • Sources of vitamins, while fun in color, also have the extra benefit of reducing inflammation and harmful chemicals from your body’s regular processes!
• Proline – found in egg whites, meat, dairy, and cabbage
• Glycine –  found in chicken, turkey, seafood, peanuts, spinach, and asparagus
• Leucine – found in eggs, dairy, chicken, pork, pumpkin seeds, oats, and beans
• Zinc – found in beans, pork, beef, nuts, and seafood
• Copper – found in nuts, red meat, seafood, cocoa powder, and dark leafy greens

What kind of supplements are available?²

If you are not consuming enough collagen in your diet, then this easy option is for you! Collagen is available in capsule, powder, liquid, and topical forms. The most popular way it is consumed is by the powder form. Many of the powders are tasteless, so they can be simply added to foods and drinks like smoothies, coffee, tea, soups, oatmeal, and cookies. However, caution should be used with the topical creams because they may not work as well. Since collagen is a large protein, it is unlikely its benefits other than being a moisturizer are able to get absorbed through the tiny barriers of the skin. 

Some supplements may be called ‘collagen peptides’ or ‘hydrolyzed collagen.’ This just means that they are smaller strands of amino acids that make it easier for your body to absorb them and use for its strengthening and support benefits. These collagen supplements mainly come from animal skin and bones, so if you are vegan or vegetarian, they may not be suitable for you.

Since supplements like collagen are not Food and Drug Administration (FDA) approved, there are few ways you can make sure you pick a safe collagen. When selecting a collagen, make sure it has the NSF or United States Pharmacopeia (USP) seal on the product. This means the company has done its job to make sure the product is of high quality and safe for your use.

If you have any questions about collagen supplementation or wonder if it is right for you, contact your healthcare provider or pharmacist today.

References:

1. Greer J. Collagen for your skin. Thorne website. https://www.thorne.com/take-5-daily/article/collagen-for-your-skin?utm_source=Akreto&utm_medium=email&utm_campaign=Take%205%20Daily&utm_content=T5D%20Consumer%20-%20Aug%2018%202021&tid=611d542fd270895f839e8c6f. Accessed August 29, 2021. 
2. Collagen – What is it and what is it good for? https://www.healthline.com/nutrition/collagen#nutrients-that-increase-collagen. Accessed August 29, 2021. 
3. Collagen: What is it and what are its uses? Medical news today website. https://www.medicalnewstoday.com/articles/262881#roles. Accessed August 29, 2021.
4. Can collagen supplements really reduce signs of aging? Health matters website. https://healthmatters.nyp.org/can-collagen-supplements-really-reduce-signs-of-aging/. Accessed August 29, 2021.
5. Health benefits of collagen: Pros and cons, nutrition, and more. Webmd website. https://www.webmd.com/diet/collagen-health-benefits#1. Accessed August 29, 2021.
6. Collagen. Versus arthritis website. https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/collagen/. Accessed August 29, 2021.

The thyroid gland is the primary regulator of cholesterol, blood sugar, temperature, reproductive health, growth, and weight. Hypothyroidism or underactive thyroid affects over 30 million females and 15 million males in the United States.¹ No wonder this highly affects the population since it is common to have lifestyles with high stress, poor sleep, minimal exercise, and diets high in processed foods.² The most common type of hypothyroidism is Hashimoto’s thyroiditis. Hashimoto’s thyroiditis is an autoimmune condition where your body wrongly attacks your thyroid cells, resulting in cell death and improper thyroid hormone regulation.³ Lifelong pharmaceutical treatments are available to boost your thyroid, but can it be healed naturally through diet or lifestyle changes? The good news is that by identifying the culprit, you can incorporate the needed foods, vitamins, and wellness approaches into your lifestyle to support your thyroid naturally via functional medicine! 

The Functional Medicine Approach

Are you a fan of optimizing your lifestyle to promote your health? If so, a functional medicine approach is right for you in treating your thyroid! Once you determine your cause of hypothyroidism, take the necessary steps to modify your diet and lifestyle. This will increase your metabolism and overall thyroid wellbeing. This approach is different from conventional pharmacological therapy because it considers your disease-causing, lifestyle, and diet factors. The diagram below displays the main differences between the two approaches for hypothyroidism.⁴

Foods

Did you know that nutrient-dense foods can boost your thyroid’s health while processed, inflammatory foods promote harmful effects? Listed below are a few diet changes you can make to benefit your thyroid.

1. Remove gluten – Foods with gluten like bread, cookies, and crackers may be contributing to your thyroid issue if you have a gluten sensitivity.⁵ A gluten sensitivity blood test can be performed by your doctor to see if an inflammatory reaction occurs when you consume those foods, resulting in weight gain, fatigue, and headaches. You could also remove the foods with gluten for three weeks to see if any symptoms go away.⁵ If they do, this could indicate a diet lacking gluten may be right for you.
2. Increase anti-inflammatory and nutrient-dense food intake – Anti-inflammatory foods like leafy green vegetables, fruits, and healthy monounsaturated and polyunsaturated fats are beneficial for lowering your risk of heart disease and decreasing inflammatory reactions.⁶ Furthermore, these foods include vitamins that help make your thyroid hormones active to carry out metabolism. Healthy fats can be found in avocados, olive oil, cheeses, eggs, nuts, seeds, and peanut butter.⁶ Foods with refined sugar, refined vegetable oil, cow’s milk, and unhealthy trans and saturated fats should be avoided in your diet because they promote inflammatory processes.² These unhealthy fats are found in many processed foods, fried foods, red meats, ice cream, whole milk, and butter.

Vitamins

If you find it difficult to consume foods with crucial vitamins for thyroid functioning or your vitamin levels are still low, you may consider adding nutritional supplements to your diet. However, it is best to start with increasing your intake of nutritious foods to limit excess supplementation side effects. 

1. Iodine – You may recall that too much iodine damages your thyroid, but too little iodine inhibits the hormonal conversion of inactive thyroxine (T4) to active triiodothyronine (T3).⁷ Without T3, your thyroid is unable to regulate your temperature, weight, growth, and energy. Iodine is highly found in seaweed, shellfish, and eggs. It can be dangerous to increase your iodine intake, so be sure your iodine blood levels are monitored by your doctor.
2. Selenium – Selenium is vital to kick-starting the conversion of T4 to T3 and decreasing inflammation. The best options for selenium-dense foods include salmon, turkey, grass-fed beef, shrimp, and Brazil nuts. Yet, too much selenium is damaging because it causes upset stomach, fatigue, and nerve damage.⁷

3. Magnesium – Magnesium is needed to increase your T3 levels. If you experience constipation which is a common symptom of hypothyroidism, asthma, or muscle pain, you may have poor magnesium intake.⁷ The following foods are high in magnesium: nuts, dark chocolate, avocados, and spinach.
4. Omega-3 fatty acids – Like iodine and magnesium, omega-3 fatty acids are needed for active thyroid hormone production. Omega-3 fatty acids are polyunsaturated fats that decrease inflammation and relieve fatigue.⁶ Key foods include flax seeds; walnuts; and fish like salmon, sardines, and trout. Remember, you want to avoid fish that are high in mercury content because it can damage your thyroid’s ability to function.⁶
5. Vitamin A – Without enough Vitamin A, T3 is unable to be produced. The best foods for increasing this vitamin include liver, carrots, sweet potatoes, and kale. Keep in mind that too much Vitamin A can lead to stomach problems.⁷
6. Vitamin D – Low Vitamin D levels are associated with Hashimoto’s thyroiditis.^6,7 Vitamin D helps make T3, reduces inflammation, and relieves muscle pain. Even spending more time in natural sunlight can increase your levels. If your schedule does not allow for more outdoor time, you could increase your intake of dairy products, mushrooms, eggs, and salmon.

Wellness Approaches

Like treating many health conditions, lifestyle modifications play a role in stimulating your health and reducing risk of further complications. 

1. Stress relief – In today’s fast-paced world, you may find it hard to limit stressful situations or find stress relief. Increasing cortisol or the body’s stress hormone suppresses your thyroid hormones and promotes inflammation. You are at a higher risk of infection if you have chronic stress, so managing your stress and following-up with your doctor are beneficial.⁵ However, there are a few ways you can learn to manage your reaction to stress like joining a stress management program or finding things to do that make you calm. Some activities that can lower your stress include walking, working-out, drawing, journaling, and baking. The options are limitless, so find what works for you!

2. Activity – By participating in activities that stimulate movement like walking, running, playing with your pets, or participating in sports, this encourages your thyroid to function properly and makes it easier for your hormones to work.⁵ The activity does not have to be performed all at once or be a strenuous activity. If you are not used to exercising, try walking 10 minutes a day for three days a week. Gradually increase your time each week to work towards a goal of 150 minutes a week.²

3. Adequate sleep – By establishing a sleeping routine to get quality sleep, this can help your overall health and thyroid functioning. According to the Centers for Disease Controls and Prevention (CDC), adults should get at least seven hours of sleep per night.⁸ If you are having trouble falling or staying asleep, you may find it helpful to meditate, read, or drink a cup of hot tea to relax your mind for a good night’s sleep.

4. Minimize toxin exposure – Excess exposure to toxins not only increases inflammation and your risk of health conditions, but it harms the thyroid. Limiting your exposure to radiation, contrast dyes, and pesticides can keep your thyroid hormones intact.⁵ Mercury, a common metal found in saltwater sea creatures, is highly toxic and affects your body’s regulation and development processes.² Therefore, you may need to reduce your intake of high mercury-containing foods like king mackerel and bigeye tuna.⁶ Other changes include avoiding tobacco products, eating organic foods, and using natural cleaners. One way that both reduces stress and toxins is using a sauna because it removes toxins from your fat cells while you relax.⁵

Insteading of solely treating you based on your hormone levels, signs, and symptoms, a functional medicine approach considers your physical, social, environmental, and nutritional needs. Assessing you fully helps to identify the primary cause of your thyroid disorder that may be a mystery if only conventional treatments are used. For more information on the functional medicine approach to hypothyroidism, talk with your doctor or functional medicine specialist. 

References: 

1. Hyman M. A 7-step plan to boost your low thyroid and metabolism. Dr. Hyman website. https://drhyman.com/blog/2010/05/20/a-7-step-plan-to-boost-your-low-thyroid-and-metabolis/#close. Accessed August 3, 2021.
2. Klimenko E. Functional medicine approach to autoimmune thyroid disease. Dr. Klimenko website. https://www.drelenaklimenko.com/autoimmune-thyroid-disease/. Accessed August 3, 2021.
3. Hypothyroidism (underactive thyroid). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed August 3, 2021.
4. Los angeles functional medicine doctors of holistic and integrative medicine. Southern california center for anti-aging website. https://socalbhrt.com/functional-medicine-doctor-los-angeles/. Accessed August 3, 2021.
5. Hyman M. 6-Steps to heal your thyroid. Dr. Hyman website. https://drhyman.com/blog/2015/06/10/a-comprehensive-6-step-strategy-to-heal-your-thyroid/. Accessed August 3, 2021.
6. Hyman M. The functional medicine approach to hypothyroidism and hashimoto’s disease. The doctor’s farmacy. 2021. https://drhyman.com/blog/2021/03/11/podcast-hc47/. Accessed August 2, 2021.
7. Drecher L. Supporting the thyroid: Food as medicine. https://www.ultrawellnesscenter.com/2018/03/15/supporting-thyroid-food-medicine/. Ultrawellness center website. Accessed August 3, 2021.
8. Are you getting enough sleep? CDC website. https://www.cdc.gov/sleep/features/getting-enough-sleep.html. Accessed August 3, 2021.