Naturally Speaking

Understanding Weightloss: Leptin

drmaynd — Sun, 31 Jan 2010 04:13:49 +0000

Sorry it’s been a while since my last post. Who would have thought starting a new practice would be time consuming?! I’m back (for now) and have several great topics I want to share with you. On the topic of weightloss, I’ll be addressing leptin today. In the past few years, it’s received a lot of attention in regards to weightloss (or lack thereof). Hopefully, I can clear up any confusion you may have about it. I look forward to any comments or questions you may have afterwards.

Leptin is a hormone that is produced by your fat cells (among other cells). It’s a hormone we are just starting to really understand, however, we do realize it plays a large part in the establishment of a person’s set point weight. Unsure of all that is in play to trigger fat cells to produce it, we do know that it signals to your brain that you are satisfied and to stop eating. This signal takes a few minutes (up to 20 minutes by some estimations) to occur after ingesting food. That’s why it’s so important, especially in today’s rush-rush society, that you slow down and take your time eating. This is the first thing I tell patients whose problem is overeating. Give your body time to tell itself it’s full. Another problem that can exist for those who are overweight or obese is that their fat cells are producing leptin, but their brain’s are not getting the signal. The current thought on this is that the signal to your brain from your fat cells has been too strong for too long, so your brain becomes desensitized to the signal. It’s like type 2 diabetes (insulin-resistance). Blood sugar goes up and triggers the pancrease to produce insulin. Insulin transports sugar to the cells. Insulin attaches to receptors on cells and this allows the sugar to go into the cell for energy. If insulin levels stay too high for too long (blood sugar too high for too long), the receptors on the cells become desensitized to the insulin and won’t let it attach (thus not allowing the sugar to get into the cell). In this analogy, insulin is leptin. It’s being produced at too high a level for too long, your brain becomes less sensitive to the signal, resulting in less signal to tell you to stop eating. This explains why you can gain weight and still have the ability to overeat. Your body is unable to establish its set point due to the leptin insensitivity. So…what are you to do? Unfortunately, that’s not so clear at this point. There have been some studies strongly correlating eating fish/fish oil with lower leptin levels. I think it’s a great approach because fish oil is great for so many other problems like: inflammation, arthritis, chronic inflammatory disease, diabetes, etc. These are often associated with increase body fat and obesity. Also, the use of this “good” fat often displaces calories usually reserved for foods high in sugar and saturated fat. So, regardless if it helps lower leptin, it will get you closer to your overall goal of becoming healthy. Also, I’d suggest trying curcumin. It’s the active ingredient in curry and used by many naturopathic doctors to treat inflammation (especially arthritis and tendonitis) and for liver support. In looking at some literature suggesting the potential causes of the overproduction of leptin by fat cells, it seems curcumin could address one of these potential causes (blocking/regulating the production of NF Kappa B). Like fish oil, even if this doesn’t work specifically for lowering leptin levels, it can be very beneficial otherwise. As with either of these (fish oil and curcumin), be sure to consult your naturopathic doctor before starting a regimen. There are some contraindications for each that should be addressed as well as appropriate dosing strategies. In addition, several books about leptin have come out in recent years. Educate yourself about it more. One of the more popular books is “The Leptin Diet” by Byron J. Richards.

This is definitely a complicated aspect of weightloss, one that we’re just beginning to understand. I’m sure this will not be the only time I address it. Stay tuned for more updates.

REMEMBER…it’s YOUR health. No one can be held responsible for it but YOU. Educate yourself.

Until next time…

Dr. May

Endurance Exercise Slows Aging

drmaynd — Fri, 04 Dec 2009 07:17:19 +0000

Researchers reported online in Circulation: Journal of the American Heart Association on Monday that exercise (specifically endurance exercise) may slow telomere shortening. Telomeres are little DNA structures found on the end of chromosomes. Think of them like the caps at the end of shoelaces. They protect the ends of the chromosomes from genetically unraveling, which could lead to disease. As we get older, cells divide, telomeres shorten with each division, and eventually cells die. Some research has linked shortened telomeres to higher rates of death from heart disease and infections, cognitive dysfunction, and certain cancers.

This study compared telomere length in white blood cells of middle-aged lifelong runners, healthy middle-aged people who did not exercise, and younger distance runners. There’s no surprise, the researchers found the exercisers had less loss of telomere length than the non-exercisers. The exercisers also had substantially higher amounts of proteins that help preserve telomeres.

This information reaffirms a study published last year that involved 2,400 twins. Researchers split the twins up, one group exercised, one group was sedentary. The twins that exercised had longer telomeres. One the flip side, a couple of other studies have shown an association between smoking and obesity and shorter telomeres.

My first thought when reading these studies was how much exercise do I have to do in order to gain this benefit. The short answer is they don’t know. The subjects in the most recent study were endurance runners averaging 50 miles a week since they were young. That discourages me a bit because I’m not much of a runner. I doubt I run 50 miles a year. No worries though. I’m sure other forms of endurance exercise should have similar benefits…I hope.

In relation to diet, preliminary research has shown resveratrol increased the life span of the animals in the studies, likely due to its affect on telomeres. Resveratrol is found in the skin of red grapes and is a constituent of red wine. It’s produced by the plant in response to attack by bacteria or fungi. Note: bromelain enhances resveratrol absorption, while quercitin competes with it (and wins).

Maybe the French are onto something. Ride your bike and drink lots of wine. Cut out the cheese, coffee, and pastries though, of course.

In pursuit of health,

Dr. May

Understanding Weightloss: Serotonin

drmaynd — Tue, 24 Nov 2009 00:58:54 +0000

You’ve heard the statistics before…two-thirds of Americans are overweight and almost one-third are obese…at any one point in time, 30-40% of men and 50-60% of women are dieting…the list goes on and on. If I had to make up a statistic, I’d say 98% of us all have been on some sort of diet at some point in time (the remaining 2% are anomalies and probably aren’t reading this blog anyway). So, what’s the deal? Why do people jump from weight-loss program to weight-loss program with varying success? Being in the health and fitness industry, before medicine, I’ve concluded it’s partially due to being uneducated about our bodies. Even as a personal trainer, putting people through dozens of different programs, I didn’t truly understand how weight-loss worked. I was first taught that it was a simple equation: burn more calories than you consume and you’ll lose weight. Simple, right? Maybe in theory, however, reality was a totally different story. It wasn’t until medical school that I started putting more of the pieces of the weight-loss puzzle together. This blog entry will be the first of a series that will address different aspects of weight-loss and how to make you more successful at it.

First I’ll start with serotonin. Serotonin is a neurotransmitter that influences regulation of mood, appetite, sleep, muscle contraction, and some cognitive functions including memory and learning. Our bodies make serotonin from the amino acid tryptophan. When people go on low-carb diets (which are low in tryptophan), their serotonin levels drop and the brain interprets this as starvation. So, the natural thing to do is for the brain to signal that it needs more carbs (thus the craving for a large pizza all to yourself). My approach to this dilemma is to slowly drop the grams of carbohydrates one takes in, while at the same time slowly titrating up a dosage of 5-hydroxy-L-tryptophan (5HTP). 5HTP is a precursor to serotonin. It sits in between L-tryptophan and serotonin in the serotonin metabolic pathway. Therefore, it’s a great way to keep your serotonin levels up (carb cravings down) while you’re learning to diminish the amount of carbs (simple carbs especially) in your diet.

Some patients have asked why they couldn’t just take L-tryptophan instead of 5HTP (L-tryptophan tends to be a cheaper supplement than 5HTP) since it’s on the same pathway. The short answer is that you add more variables to the equation. L-tryptophan can’t cross the blood-brain barrier without a transport molecule. Once it does get across, it must be converted to 5HTP using an enzyme (tryptophan hydrolase) that can be inhibited by stress, insulin resistance, vitamin B deficiency, magnesium insufficiency, and oxidation associated with age. So, it’s just easier and more effective to use 5HTP.

Remember: let your doctor titrate your dosage! It can be tricky and optimal doses for weight-loss are on the high-end, so it should take a while to get your dosage up to that optimal area. Also, 5HTP in combination with selective serotonin reuptake inhibitors (SSRIs) like Prozac, Paxil, Zoloft, etc., could potentially (though never documented) cause serotonin syndrome. This can manifest as agitation, confusion, delirium, fast heart rate, sweating, and blood pressure fluctuations. Just because you can buy it over-the-counter doesn’t mean it can’t harm you if used improperly. Be safe.

In pursuit of health,

Dr. May

Is a crib the safest place for your baby?

drmaynd — Sat, 21 Nov 2009 23:13:58 +0000

My wife and I were just talking about this a couple of nights ago. How did the “norm” in our society become babies sleeping away from mothers, alone in their cribs? This thought was triggered by a commercial (for what I can’t recall) where a baby is crying and the wife nudges the husband out of bed to feed the baby. At first glance, this appears normal and slightly comical. However, after actually giving it some thought, I felt a little confused. How did we get here? When did we start thinking separating a baby, who can’t regulate its own body temperature and breathing rate well and needs to be fed every couple of hours, from its source of food and heat? Coincidentally, the next day, I unintentionally stumbled onto a blog by a renowned pediatrician, Dr. Jay Gordon, M.D., on this very issue. In his blog, entitled Peaceful Parenting, he defends c0-sleeping of parents and babies and provides some very strong evidence. He states, “Babies sleeping on a safe surface with sober, nonsmoking parents respond to their parents, and the parents respond to them. The chance of SIDS (sudden infant death syndrome) occurring in this situation is as close to zero as we can measure.” Now, I’m sure there are some out there that are instantly thinking of someone they know or have heard of that co-slept with their baby and mistakenly rolled over on the baby and suffocated it. Although I’ve never known anyone who this has dreadfully happened to, I have heard of a friend of a friend of a friend who has. I think that’s how urban legends get started, right? Well, the fact of the matter is that many more babies have suffocated in cribs than in beds shared with their parents. For more information about this, check out James McKenna’s work at the University of Notre Dame’s Mother-Baby Sleep Laboratory. To wrap this up, Dr. Gordon explains that in his 23 years of practice, the families that do co-sleep are more successful at breastfeeding and the babies have fewer episodes of ear infections, pneumonia, and other illnesses than those families that don’t.

Granted, I am a male with no experience in breastfeeding or the stresses that go along with mothering a baby. I have to gather my information from my wife and patients. However, she and patients alike (despite the difficulties) agree co-sleeping has strengthened the bond between themselves and their babies as well as enhanced their abilities to know what their babies need. Also, being a father of two young boys (co-sleeping with both), I can appreciate the challenges of co-sleeping (especially with my oldest son who flipped and flopped every five minutes). But, I would not trade that bonding experience for all the hours of sleep I missed because of it.

I would love to hear your thoughts on this subject. Please feel free to comment.

In pursuit of health,

Dr. May

A bit about Dr. May

drmaynd — Sat, 21 Nov 2009 00:06:41 +0000

Hi, my name is Dr. May. I practice in Fairbanks, Alaska, at the Alaska Center for Natural Medicine. I am a naturopathic doctor who practices family medicine and specializes in physical medicine, pain management, weight loss, men’s health, and chronic disease. Many of my patients have been passed from doctor to doctor, their health concerns poorly managed, and have slipped through the cracks of our healthcare system. I am invested in each patient that comes through my door. I am dedicated to using every resource at my disposal to help bring them back to health and a life they are excited about living. That’s what it’s all about…living this life to its fullest!

Here’s a favorite quote of mine by Henry David Thoreau:

“I did not want to live what was not life. I wanted to live deep and suck out all the marrow of life. To put to rout all that was not life and not when I had come to die, discover that I had not lived.”

As a naturopathic doctor, I try to always consider six principles:

1. The healing power of nature: I believe our maker designed our bodies to be ordered and intelligent, giving it the ability to heal itself. Many times, there are obstacles that need to be removed in order to allow the body to do so. That’s the first thing I try to identify and eliminate.

2. Identify and treat the cause: Too many times, we (doctors) treat our patients’ symptoms and not the source. This palliative care makes the patient feel better, however, they are not able to achieve wellness because there still remains an underlying dysfunction. This is one of the reasons chronic disease, especially in America, is rising at an alarming rate.

3. First do no harm: This includes prescribing medicines that are effective with minimal side effects. Did you know the #3 cause of preventable deaths in America is PROPERLY prescribed pharmaceuticals?! Also included in “do no harm” is not suppressing symptoms. What comes to mind here is fevers, especially in children. We’re inundated with commercials sympathetically displaying sick children with fevers and if you want to be a parent that doesn’t want their child to suffer, you must give them an antipyretic (Tylenol). This is SUPPRESSION! There’s a reason for the fever. By suppressing the fever, the immune system is disabled in its ability to work effectively.

4. Doctor as teacher: This is one of the principles I love most and I think patients appreciate the most. I love being able to help my patients and provide medicine or therapies that allow them to heal. However, I take the greatest pleasure in educating patients about their disease or illness so they are able to be successful, longterm, in treating the disease or preventing the illness.

5. Treat the whole person: Rarely is there ever an illness, disease, or disorder that is one-dimensional. Most have physical, emotional, spiritual, and environmental aspects that must be addressed.

6. Prevention: I always emphasize disease prevention, assess for risk factors and hereditary susceptibility to disease, and then make the appropriate intervention to prevent illness. This is the most difficult aspect of modern medicine. We’re all inundated everyday with unhealthy lifestyle choices that look more appealing and are more convenient. This is hard to compete with, as a doctor trying to steer someone back onto the right path. Add this to the nomadic nature of our society, it becomes almost impossible to track, monitor, and encourage patients to do the things necessary for them to prevent disease and illness. Of course that’s not going to stop me from trying .

This blog is intended to be a resource for my patients and general public. I aim to educate readers on difficult issues and to keep them updated on new developments in research and news that may affect their health. Enjoy

In the pursuit of health,

Dr. Ashley D. May, ND

The following are my credentials:

Doctorate in Naturopathic Medicine- Bastyr University, Seattle, WA

10+ years in the health and fitness profession (working as a personal trainer, athletic trainer, program director, fitness director, instructor). Certifications as a Master Fitness Trainer, Health Promotion Director, Basic Pilates, and Indoor Cycling.

Internship at the world-renowned Cooper Institute for Aerobic Research & Cooper Fitness Center founded by the “father of aerobics” Kenneth Cooper- Dallas, TX

Bachelor of Science in Kinesiology, with minors in Athletic Training and Biology- East Texas Baptist University, Marshall, TX