Tuesday, January 22, 2013

Is it time to be SAD?

By: Dusten Nelson

I recently had a request to put out some information on Seasonal Affective Disorder or SAD – The clinical term for “winter blues”. SAD (which can happen in any season, but is more commonly diagnosed as  “Depression” when it occurs during spring and summer) was first validated by the medical community in 1984 by Norman Rosenthal at the National Institute of Mental health. Seasonal Affective Disorder was determined to be a form of depression that occurs at the same time every year (fall or winter) and is more likely to occur in women than in men. – Lending more clinical credibility to my wife’s claim that it is in fact more difficult to be a woman.

What does SAD look like?
How do you test for it? Here’s the problem…there are no definitive tests for SAD thus it becomes a diagnosis of exclusion, meaning it’s a diagnosis reached by a health care provider if after performing an evaluation or testing they cannot determine a differential diagnosis.

How can you treat it? Since we don’t know exactly what causes SAD, we cannot definitively determine a successful treatment strategy. Despite not knowing the exact cause of SAD, several treatment strategies have proven successful in the past 25 years.
Possible Causes and Treatments: 
Sunlight – Though SAD can be diagnosed in any season, more cases seem to be reported in winter months in cold weather climates. As the days get shorter, the amount of sunlight we receive decreases. This not only has an affect on our “tan”, it also has a significant effect on our hormones. Melatonin (which plays a major role in our sleep/wake cycles) increases as exposure to sunlight decreases. Elevated levels of melatonin can improve sleep quality but when melatonin levels increase too much it in can also result in feelings of lethargy and excessive affinity for beanbag chairs, lava lamps and Pink Floyd music – you know what I mean? – “I’d be a lot cooler if you did” – Dazed and Confused reference for you Matthew McConaughey movie buffs.

Back to the point- in the same way Melatonin INCREASES with decreased exposure to sunlight, Serotonin levels DECREASE with decreased exposure to sunlight. This is a big problem since Serotonin levels are directly related to your “mood”. Adequate levels of Serotonin are crucial to elevating mood and can play a big part in alleviating the depressive symptoms associated with SAD. It may sound crazy but sunlight directly affects our serotonin levels and thus, our mood. So what do you do when you live in an area with long, cold, dark winters? Move.  But if that’s not an option – try installing full spectrum lighting in your house.

Full spectrum light contains infrared (IR) and ultraviolet (UV) wavelengths, which despite popular belief are necessary for optimal health. Problems begin when people get too much UV exposure - which is probably not the case if you are living in a northern climate and suffering from SAD. Full spectrum bulbs range widely in quality and can be expensive to purchase (I have seen high quality full spectrum bulbs sell for $30-$40 each).  Though they are typically more energy efficient, which will reduce your energy costs, full spectrum bulbs can have significant effect on the winter blues.

If changing light bulbs doesn’t seem like your cup of tea, try changing your diet.

Proper nutrition plays a crucial role in the production of neurotransmitters and hormones – which in turn directly affect the symptoms of SAD.

Vitamin D  Sunlight plays a key role in our ability to maintain adequate serum levels of vitamin D. Direct sunlight facilitates Vitamin D production in the skin. Research suggests that if you live north of 40 degrees of latitude (or south of 40 degrees in the southern hemisphere) it is difficult to maintain adequate Vitamin D levels year round, creating a window for a drop in Vitamin D levels and an increase in the occurrence of SAD symptoms. Supplementation of Vitamin D can be effective in raising serum levels quickly and thus is should be monitored closely by a qualified health care practitioner.

Carbohydrate Cravings  - Decreased levels of serotonin can also result in the carbohydrate cravings commonly described in the list of SAD symptoms.

Nutritional interventions can be successful at alleviating these symptoms. Since Tryptophan (an amino acid) is a precursor of Serotonin, consuming Tryptophan rich foods can increase Serotonin production and help alleviate symptoms.  To this point I have not been able to find significant research to support the Tryptophan-SAD link though empirically I have found that increasing Tryptophan in the diet (in food and supplement form) can help alleviate symptoms associated with SAD.  

Where can you find Tryptophan?  The first food everyone mentions is Turkey, and yes, Turkey does contain Tryptophan, but really all meat and seafood caries significant levels of Tryptophan – thus eating meat is important.

I also like a Magnesium and Tryptophan supplement that includes Magnesium Taurate, Glycinate, Fumarate, Orotate and 300 mg of Tryptophan to supplement the diet in some situations.

Beyond Tryptophan, steps can also be taken to increase the consumption of foods to boost Serotonin. Basmati rice (more so than other varieties of rice do to its less damaging effects on blood sugar levels), apricots, apples, pears, grapes, plums, grapefruits and oranges, when combined with adequate levels of omega-3 fatty acids, can improve Serotonin levels. If that doesn’t work, you could try a Using a 5-HTP supplement which have been shown to increase Serotonin levels quickly, though it is best to have this monitored by a qualified health care professional.

Weight Training:  Research has long suggested the correlations between weight training and resolution of depression symptoms. I am not aware of any research to support direct link between SAD and weight training, however, there is research to support a negative relationship between cardio training (especially late in the day) and an increased occurrence of SAD symptoms. This is not said to discourage people from running but rather recommending the inclusion of significant weight training to reduce symptoms of SAD.  And no, “band training” doesn’t count.

Here is what you should take away from this discussion: 

  • Seasonal Affective Disorder or SAD is a classification for depression occurring the same time every year.
  • It is more common in women than men.
  • It is more common in northern climates (north of 40 degree latitude) in the fall and winter.
  • There is no definitive cause or test for SAD.
  •  SAD may be linked to low sunlight exposure, low levels of Vitamin D, low serotonin levels and elevated levels of Melatonin

This is a list of steps you could take at home to improve SAD symptoms.

  • Install full spectrum lights in your home (and office if you can)
  • Consume 3g of pure epa/dha omega-3 fatty acids per day.
  • Take a Vitamin D3 supplement (consult with a qualified health care practitioner for an appropriate dosage)
  • Take Magnesium with Tryptophan supplement.
  • Eat meat with every meal (Doesn’t have to be turkey to work)
  • Consume certain foods to raise Serotonin levels.
  • Take a 5-HTP supplement to increase Serotonin levels.
  • Weight training for one-hour at least 3 times per week.
  • Hydrate – every process in the body is improved with hydration.

In addition to adding full spectrum bulbs, eating meat with each meal and weight training at least 3-hours per week, if you are interested in trying a supplement program, one recommendation might look something like this:
Vitamin D3- 2,000- 10,000 IU per day (again dosages range greatly and should be adjusted for you by a qualified health care professional)
Omega-3 – 1-2g of pure EPA/DHA oil per meal.
Magnesium with Tryptophan – 250 mg – 1,000mg in the evening
5-HTP – 50mg -600 mg per day can have an effect though it may be best to take 100-200 mg three times per day.

As always, Statements on this blog are intended for educational awareness and do not replace the recommendation of your personal medical professional. Before beginning any exercise, nutrition or supplementation programs always speak with a qualified medical professional and decide which programs are right for you.

Friday, January 11, 2013

Headache - what your body is trying to tell you

By Dusten Nelson

Headaches are like a crying baby - no one really likes to hear a baby cry - but it’s the only way a baby can tell us something is wrong. When a baby cries, we don’t view the baby crying as the problem (unless we are sitting next to it on a flight), no we ask ourselves “What does the baby need? Is it hungry? Is it tired? Does it need a diaper change?” - Incidentally if you crapped yourself in public you might cry too so lets pump the breaks on judgment here. The point is we try to figure out WHY the baby is crying, so we can fix the problem and put an end to the crying. Yet when we have a headache we use a different approach – we try to kill the pain with the most available form of analgesia – asprin, ibuprofen, tylenol etc. This approach w it will only mask the problem. The headache is NOT caused by a lack painkillers in the system, there is something else going on here.  The body is trying to tell us something is wrong. Its time to unmask the real cause behind headaches.

We reach for the painkillers because we don’t know what else to do, until now, consider this a crash course in learning to speak headache. The goal is to walk you through a 3-step process to prepare you so that the next time you feel a headache coming on you can stop it in its tracks.

Step 1: Determine the type of headache you are experiencing: 
The first step in fixing a problem is identifying what the problem is, in this case, you have a headache, but what type of headache do you have?

3 -Main Types of headaches:

  • Tension headache- Also known as a “hat-band headache” because the pain pattern presents like a hatband, is the most common type of head ache. The pain associated with a tension headache is thought to be caused by prolonged muscle contraction in the face, scalp and neck.
  • Cluster headache- Less common, but characterized by clusters of pain in and around the eye, these headaches are often mistaken for sinus or dental pain.
  • Migraine- The big daddy of the headache world, migraines split into two main categories: Migraine with Aura and Migraine without Aura. Both carry ipsilateral, pulsating characteristics.
  • Migraine without an aura – described as a recurrent headache manifesting in attacks lasting between 4 and 72 hours. Typical characteristics of this type of migraine include: unilateral location, pulsating quality, nausea and photophobia with symptoms aggravated with activity.
  • Migraine with an aura - Consist of an alteration in visual, sensory and/or speech that develop gradually but last less than an hour. People often feel the “aura” coming on before the other symptoms of the migraine present. Migraine headaches are complex entities take a little more refinement. Migraines can be caused

Step 2: Determine the cause of the headache - This is a short list of potential causes.

#1. Dehydration – Is a MAJOR cause of headaches and is fairly easy to avoid – drink water. But how much should you drink? General rule of thumb to avoid dehydration is to drink “half your body weight in oz” of water per day. i.e.: a 100lb human should drink 50 oz of water per day. That may or may not be true based on your ability to metabolize water and the quality of water you are drinking. For more explanation about how dehydration can cause a headache, visit the water section on our earlier post about hangovers – “Hair of the Dog”.

#2. Muscle Tension – Obviously, tension associated with headaches involves constriction of muscle and fascia contributes to the pain associated with tension headaches therefore, stretching is a useful weapon in the fight against tension headaches. Its about to get technical, muscle The most common cause of muscle tension headache (MTH) results from inflammatory changes at the site of muscular attachment on the occipital ridge.  In the adult, this occurs most often at the attachment of the Splenius Capitis and Semispinalis Capitis Muscles.  As inflammation develops, irritation of the Greater Occipital Nerve occurs and headache precipitates.

#3. Food sensitivity – Food sensitivities will almost certainly cause a headache, try eliminating grains from your diet and adopting a rotating food schedule to see if it impacts the headaches. If you want to take things a step further, speak with a health care provider about doing a Mediator Release Test (MRT) to help identify foods that may be causing you problems. Here is a short list of foods that have been linked to headaches:

  • All grains except rice, very rarely is rice associated with headaches or allergies.
  • All breads
  • Peanuts, peanut butter - Few issues reported with raw varieties of other nuts and seeds which most likely results from the elevated levels of Aflatoxin (dangerous fungus found in peanuts)
  • Potato chip products
  • Smoked or dried fish
  • Bread, crackers, and desserts containing cheese
  • Dried fruits (figs, raisins, dates)
  • Cultured dairy products, sour cream, buttermilk, yogurt
  • Chocolate, coffee, tea and colas and wine. – These have particular implications for estrogen.
  • Aspartame and ALL other artificial sweetener

#4. Hormonal fluctuations –Commonly associated with migraine headaches, the hormone most commonly blamed for headaches is estrogen. Estrogen driven headaches can occur in both men and women. (Though is it more common in women, and men that look like “Bitch Tit Bob” – watch fight club if you don’t get the reference.) This may explain why women, especially before and during their menses report a higher incidence of migraine headache. If you suspect a hormonal cause, it would not be a bad idea to talk with your health care professional about testing your hormonal balance. So how do hormonal fluctuations cause headaches? Dr. B.W. Somerville published a study in the early 1970s, showing a direct correlation between migraine headaches in women and a drop in estrogen (in particular estradiol –the primary type of estrogen made by the ovary). Estrogen along with progesterone, beta-endorphin, and serotonin levels, decreases dramatically from the last few days of the menstrual cycle to the first few days of menses resulting in headaches. There are several other common hormone causes for headaches, particularly women: Thyroid hormone, specifically T3, progesterone and DHEA have all been linked to headaches.

#5. Medication side effect – If you are on ANY medications, read the list of side effects. The first step in resolving a problem is identifying it, so start with the most likely culprit and work your way down. To quote one of my mentors who happens to be a brilliant physician “When in doubt, blame the pharmaceutical, it’s the most likely culprit” This does not mean that all pharmaceuticals are bad. There are a number of situations in which pharmaceuticals are needed, but they can also do a lot of damage and must be watched closely.

#6. Poor diet- chemicals: Eating a diet rich in foods that are packaged and/or claim to be “Diet, fat free, sugar free, or reduced in any way”, is most likely to contain a fair amount of chemicals and thus is unfit for human consumption. These foods include but are not limited to: most candy, chewing gums, mints, sodas and ALL “diet foods or diet food services”. They will not aid you in fat loss nor will they contribute positively to your health. Chemicals in processed foods can include aspartame, caffeine monosodium glutamate (MSG), nitrates, sulfites, Tyamine etc each of which can cause a laundry list of issues; headaches are just a pimple on the ass of the elephant here

#7. Magnesium decencies:
Magnesium is on of the four most common nutritional deficiencies and typically presents in the form of muscle cramping or cramp like headaches, muscle twitching, constipation (or dark and hard to pass stool), forms of insomnia and irritability.

#8 People: If you live in the world you will interact with people- some of these people will cause pains in head and other orifices - None of the remedies listed below will help, that is what vacation and training sessions are for.

Step 3: Pick a Remedy: If you have a headache, here is a short list of potential remedies.

  • Drink water
  • Take magnesium – (provided you do not suffer from hypermagneisa) magnesium glucinate, citrate and asparate can relieve symptoms. A magnesium supplement that includes several forms of magnesium would be best.
  • Remove grains, dairy and processed food from your diet.
  • Stretch your head, neck and shoulders and exercise regularly. (Stay tuned for an upcoming post on stretching)
  • Consult with an acupuncturist – acupuncture in credibly successful in resolving headaches.
  • Use an herbal remedy.

Herbal Remedies for headaches:
The type of herbal remedy used to treat a headache depends on the type of headache that presents. There are probably hundreds herbal formulas that can be used to treat a headache, often addressing your personal “constitution” or “make-up” and trying to restore balance. For this type of treatment I would recommend speaking with a licensed herbalist to design an herbal formula specifically for you. That being said, here is a quick list of herbal remedies that may help your headache. 

Cluster & Tension headaches:
One-Sided Headache, Occipital headache, Headache behind the eyes, or Pain at the Vertex (top of the head) often described in Traditional Chinese Medicine (TCM) as Liver & Gall Bladder Heat Rising)
Useful Herbal Formulas: Tian Ma Gou Teng Wan and Xiao Yao Wan

Frontal or Occipital Headaches: Often described as Sinus or rhinitis headaches.
Useful herbal formulas: Bi Yan Wan

Headache Behind the Eyes:
Useful herbal formulas: Ming Mu Di Huang Wan

Whole head headache & headache following menstrual period:
Useful herbal formulas: Tian Ma Gou Teng Yin

The statements in the blog are intended to be educational in nature and create awareness for potential causes and solutions to a headache. If you have persistent headaches, it is always best to meet with a qualified health care professional and discuss treatment options. 

Tuesday, January 1, 2013

Recipe: Grass Fed Beef Stew & Gluten Free Buttermilk Biscuits

Recipe by – Dusten & Stephanie Nelson

Grass Fed Beef Stew Ingredients:
3.5-4 lbs of grass fed stew meat (I typically use a London broil)
2 large sweet potatoes
1 lb of parsnip
1 large white onion
½ lb thick cut bacon
Stew Ingredients
60 oz of chicken broth

Rosemary (handful of sprigs)
Thyme (handful of sprigs)
Garlic powder (appx 1 tbsp)
Chili powder (appx 1 tbsp)
Sea salt (to taste)
Cracked black pepper (to taste)
Cayenne Pepper (pinch)
Pots & Pans:
Large sauté pan
Le Creuset Dutch Oven

Dice bacon and render in large sauté pan until crispy.
Pour excess bacon fat into a coffee mug of empty can, leaving enough fat in the pan to sauté the diced onion.

Finished Product
Sauté the diced white onion in the pan until tender, season with salt and pepper.
Once tender, place onions into a bowl.

After trimming the beef and cutting into 1 inch cubes, brown the beef in the same pan as the onions and bacon for approximately 5 min on medium-high to high heat. Season with salt and pepper.

While the meat is browning, pour the chicken broth into the Dutch oven, with the rosemary and thyme and cook over medium high heat until it is about to boil.

Once the beef is browned, strain the beef and put it in the Dutch oven along with the cooked onions and the raw sweet potatoes and parsnips (which have been peeled and cut into half to one inch cubes.)

Season the stew with garlic powder, chili powder, salt and pepper; I also add a pinch of cayenne pepper for some heat.

Let the stew work on the stove for 45-60 min at a rolling boil until the meat and veggies are tender.

While the stew is cooking, start the biscuits.

Gluten Free Buttermilk Biscuits:
Finished Product
10 oz all-purpose gluten free flour (one without xanthan gum already added)
1 tbsp xanthan gum
¼ teaspoon baking soda
1 tbsp baking powder
½ teaspoon sea salt
1 stick of organic butter (cold)
6 oz organic buttermilk

Mix all dry ingredients in a bowl with a standing or hand mixer.

Cut cold butter into small pieces and add to the dry mixture.  Incorporate butter (using hands works best!) into the dry mixture until blended well and no large pieces of butter remain.  Add the buttermilk and mix to form dough.

Roll out the dough on a lightly floured surface or on parchment paper into a ½ inch disk.  Cut biscuits with a 2 inch cookie cutter.

Place biscuits on baking sheet lined with a silpat mat or parchment paper.  Very lightly salt the top of each biscuit.

Bake at 375 for 15 minutes, makes 10 biscuits.  Be sure to eat them while they are still warm!