The fresh beginning of a new year offers the opportunity to renew our dedication to become the people we want to be, the best versions of ourselves.  There are so many ways to go about this, and focusing on positive change often includes a new commitment to health by eating better, exercising more, and losing those extra pounds we’ve been carrying.  As a holistic health practitioner, I have observed that January often brings a surge of new patients coming in the door to seek support and guidance in meeting their personal health goals for the new year.  I’ve learned, both in my practice and more keenly in my own personal life, that commonly these goals and the language we use to define our resolutions are shaped by what we’ve learned about ‘self-improvement:’ that the path to change is to do better, to do more, and to focus on the numbers on a scale.

Merriam Webster defines resolution as the act of analyzing a complex notion into simpler parts, to move from dissonance to consonance.  Resolution is also the subsidence of a pathological state, a shift toward wellness.  I think of this as coming into balance, into alignment, into harmony.  Resolution is a sort of new sight, of making distinguishable the individual parts, like pixels in an image or a Seurat painting.  With resolution it’s possible to see one’s place in the world, to have perspective, and to break an otherwise overwhelming task or a goal into smaller, manageable pieces.  To have resolve is to make a firm decision and to deal with a problem successfully.  When one is in alignment, having resolve is effortless.  It stops being a struggle against inner resistance or inertia, and obstacles to achieving our goals become easier to identify and overcome.

So, how do we come into alignment?

This is the part of the equation that makes it impossible for any single diet plan, exercise program, well-meaning advice from highly trained and experienced medical professionals about how to live somewhat ineffective.  Because the shift is an internal one, and the answer for what each of us needs to come into balance and harmony in our lives so that we can effortlessly achieve our goals isn’t something that can be found by following the latest fad diet or medical weight loss program.  Thankfully, there are numerous ways to find true resolve, and a tremendously important element in maintaining resolve is support.  Without support, resolve is not sustainable.

I was moved to recently learn about documentary filmmaker Michael Moore’s ongoing commitment to ‘virtual walks’ with his Twitter followers, which he began doing nearly a year ago after a follower suggested that taking a brisk walk was an alternative to anti-depressant medication.  Since then, every evening Moore takes a walk and invites followers around the country to join him where they live and post their comments.  He posts this on his Facebook page:

 But the truth is, exercise does not work, diets do not work, feeling crummy does not work. Nothing works. My advice: Quit trying to be something you’re not, be happy with the life you’ve been given, and just go for a pleasant walk outside. With me. Wherever you are. Get off the treadmill, stop drinking diet Coke, throw out all the rules. It’s all a scam and it conspires to keep you miserable. If it says “low-fat” or “sugar-free” or “just 100 calories!” throw it out….I have no idea how much weight I’ve lost and I don’t care. I don’t care about that or diets or home gym equipment or rules about what I can or cannot eat or anything other than making sure I go on my walk today. That’s it. That’s the big secret. It costs nothing. I feel great. I can see my feet! There they are! Hello, feet! Wanna go for a walk? The feet say YES! Ask yours right now. And if you want, join me. But do NOT go on that walk with me if you are doing so to “get fit”, “be healthy”, or “lose weight”. You are fine just the way you are.

It seems that the slight shift in perception, the honing in of resolution on the fine point that we are enough just the way we are… this is the paradigm shift that is needed to come into balance, and the paradox of finding the resolve for a successful ‘self-improvement’ program: that it’s not about self-improvement at all, just about becoming more of who we are, because we are enough.

Please join me and Wellness Coach Deb Rhizal on Monday January 7th at 6 pm at Hygeia Center for Healing Arts for a free discussion of New Year Resolutions, finding inner balance and resolve, and suggestions for identifying and overcoming obstacles to achieving your health goals

A new study published in The Lancet, the ATLAS trial (Adjuvant Tamoxifen: Longer Against Shorter) found that women with breast cancer treated for ten years with the anti-estrogen drug Tamoxifen had reduced rate of recurrence and greater survivorship at 15 years than women who were treated for the standard five years.  Researchers concluded that extending the duration Tamoxifen treatment to ten years halved the incidence of mortality from breast cancer in the second decade following diagnosis. While the clinical implications of this study are yet to be determined, this is promising news in breast cancer research.

As we await further trials to determine whether doubling the duration of Tamoxifen treatment will become the new standard of care, it is timely to review the many integrative therapeutics for managing the side effects of this drug.  The most common side effects of Tamoxifen are hot flashes, night sweats, and joint or muscle aches.  Fortunately there are many natural medicine options for reducing these side effects.

A very effective nutrient to reduce the frequency and severity of hot flashes is hesperidin methyl chalcone[i].  Hesperidin is a bioflavonoid that has been shown to stabilize capillaries by increasing capillary resistance and reduce permeability.  It is a non-phytoestrogen useful for providing relief of menopausal hot flashes and those induced by medical and surgical interventions.  Because it does not affect estrogen levels, it is appropriate for use in breast cancer patients and survivors.


Another wonderful option for hot flashes is acupuncture.  In one landmark study, acupuncture was found to be as effective as the pharmaceutical treatment of choice, venlafaxine (Effexor).[ii]  In this randomized clinical trial, the subjects receiving acupuncture experienced relief of their hot flashes, and also reported secondary benefits such as better sleep, improved energy, and overall sense of well-being.  Additionally, these benefits all persisted beyond the course of treatment, and unlike the drug treatment, the acupuncture treatment carried no adverse effects.

Finally, vitamin D is a very important nutrient for reducing the joint and muscle aches common with Tamoxifen.  One study demonstrated that maintaing a baseline 25-hydroxyvitamin D level of at least 40 helped prevent these side effects.[ii]  Optimal levels of vitamin D are between 50-100, and it can require high dose supplementation to achieve this, especially if one is initially deficient.  Maintenance doses of vitamin D are between 2000-4000 IU, but between 6000-8000 IU daily may be needed to address a deficiency, with periodic testing to ensure safe blood levels.

At Hygeia Center for Healing Arts, acupuncture and naturopathic medicine provide adjunct support for cancer patients undergoing conventional treatment, to optimize the patient’s overall health, enhance immune function, and help reduce adverse effects of treatment.  For more information or to make an appointment, please call (734) 769-6100 or visit http://www.hygeiacenter.org.

[i] Prieto-Alhambra D et al.  Vitamin D threshold to prevent aromatase inhibor-induced arthralgia: a prospective cohort study.  Breast Cancer Res Treat 2011 Feb;125(3):869-78.

[ii] Walker et al.  Acupncture versus velnafaxine for the management of vasomotor symptoms in patients with hormone-receptor-positive breast cancer: a randomized clinical trial.  J Clin Oncol 28:634-640.

[iii] Bouskela E, Cyrino FZGA, Marcelon G, et al. Inhibitory effect of the Ruscus Extract and of the flavonoid hesperidin methylchalcone on increased microvascular permeability. J Cardiovasc Pharmacol 1993;22:225-230.

Naturopathic medicine has long espoused the connection between digestive health and overall wellness.  The  interior ‘terrain’ of the body affecting susceptibility to illness and the general state of health as described by traditional Naturopathic physicians is all about the ecosystem of the gut.  Terms like ‘dysbiosis’ and ‘toxemia’ refer to imbalance of this internal ecosystem, affecting microflora and chemical signaling having far-reaching effects from digestive function to mood and neurological disorders.

A growing body of evidence is demonstrating the mechanisms behind the environment in the gut and physical and psychological ailments.  The gut has long been referred to as the ‘second brain’ because it is rich with its own nerve supply called the enteric nervous system.  This intricate nervous system responds to changes in neurotransmitters like serotonin, a chemical that affects mood and sleep.  Although serotonin affects the mind, and is targeted by drugs like anti-depressants, the majority of circulating serotonin is produced in the gut and is essential for digestive function.  Hormones like cortisol, which generates a stress response, also affect the gut.

A naturopathic approach to any health concern, whether physical, mental or emotional, should include attention to nutrition and digestive health.  For many patients experiencing depression and anxiety, making dietary modifications and treating the health of the gut can make a profound impact on their mood.  Assessing digestive function, addressing overgrowth of unfavorable organisms in the gut, reinoculating with beneficial probiotic flora, and repairing damage to the gut mucosa are all components of healing the gut.

Evaluation of digestive function and the microbiology of the gut may be part of an assessment, using digestive stool analysis.  Such functional medicine tests are unique from routine colonoscopy or stool tests, and are available from Naturopathic physicians and other holistic doctors.  With this information, an individualized plan can be made to remove unfavorable organisms, such as overgrowth of unfriendly bacteria or yeast like Candida albicans — traditionally called ‘dysbiosis.’  Next, supplementation of high-potency, multi-strain probiotics containing Lactobaccili and Bifidobacterium replenish the presence of protective gut flora.  These organisms have many roles, from maintaining proper digestion and elimination to regulating immune function.  Addressing digestive impairments and modifying the diet to remove food sensitivities is crucial in the gut recovery process, and may require several months of strict avoidance of gut irritants like wheat and other gluten-containing grains.  Finally, repair of the gut lining using herbs and nutrients that rebuild the protective mucous membrane is the final phase of gut recovery.

Whether you suffer from depression and anxiety, digestive complaints, other chronic illness or simply want to improve your overall health, treating the gut is the foundation of wellness.  For more information, call Hygeia Center for Healing Arts at (734) 769-4981.

More info: A Gut Check For Many Ailments, Shirley Wang

Mind-Altering Microbes: Probiotic Bacteria May Lessen Anxiety and Depression, Science Daily

The Gut and Psychology Syndrome Diet


Seasonal Affective Disorder, or SAD, affects roughly 6% of adults in the US.  Defined as annual depression occuring the winter months and lifting with seasonal change, SAD is a more severe form of the “winter blues.”  Over 25% of Americans report some sensitivity to the decrease in light during the fall and winter.

The specific cause of SAD is not fully understood, but it is believed to be caused by a confluence of factors including: age, gender, genetics and individual brain chemistry.   SAD is more common in women, and in young adults to mid-life.  It is also more common in those living in northern states with reduced sunlight exposure in the fall and winter months.

The symptoms of SAD are due to a chemical imbalance marked by a decline in serotonin, a neurotransmitter that governs mood, and melatonin, the hormone responsible for sleep/wake cycles.  Production of both melatonin and serotonin depends on exposure to UV light, and the absense of light exposure is a key factor in the decline of levels.

The symptoms of SAD may include:

  • Mild to moderate depression in the fall and winter
  • Fear, worry, anxiety
  • Loss of energy
  • Social withdrawl
  • Oversleeping
  • Aggravation in the afternoon
  • Pain – fibromyalgia, TMJ, migraines
  • Difficulty concentrating
  • Appetite changes, cravings for sweets and carbs, especially in the afternoon and evening
  • Weight gain
  • Sleep problems, insomnia
  • If untreated can lead to serious problems including suicidal thoughts and behavior, school or work problems, social withdrawal and substance abuse

The most common treatment for SAD is light therapy with full-spectrum light bulbs or lightboxes.  Full-spectrum lightboxes come in a variety of designs, the Ott light and the Verilux products are two quality brands with affordable lamp options.  Medical research typically cites results from light therapy with 30 minutes of exposure to 10,000 lux daily.  Lux is a standard measurement of luminescence; on a typical overcast day one would be exposed to 10,000 -25,000 lux.

Because Vitamin D is produced in the skin cells upon contact with sunlight, many people in northern climates can be deficient or insufficient in Vitamin D and require supplementation.  This important nutrient helps maintain mood, immune function, and hormone balance.  Because Vitamin D is a fat-soluble nutrient that can accumulate in the body, it is recommended that one test blood levels of Vitamin D (a test known as 25-hydroxy-vitamin D) prior to supplementation.  This can help determine what dosage of supplementation would be ideal; in some cases of extreme deficiency, your doctor may recommend weekly megadoses to help bring the level up to the optimal range, then switch to a lower maintenance dose.

Other natural treatments for SAD are aimed at increasing serotonin and melatonin levels.  One option is the herb St. Johnswort, which has been extensively studied for the treatment of mild to moderate depression, and is useful for SAD.  St. Johnswort should not be used by patients who are already taking anti-depressants, as it works similarly to the medications and can potentiate their effects.  Another option might be 5HTP, a natural substance which is a precursor to both serotonin and melatonin.  This can help naturally increase serotonin levels and boost mood.

Lifestyle modification is also an important part of coping with SAD or other forms of depression.  Counseling or psychotherapy, stress management and mind-body techniques may all be helpful.  Additionally, a balanced whole-food diet high in vegetables, fruit, whole grains, beans, nuts, seeds and fish is optimal for maintaining overall health.  Avoiding sugar, alcohol and caffeine is key as these substances can aggravate a depressed mood.

Finally, exercise and time spent in nature are important ways to elevate mood and promote health.  Exercise naturally raises serotonin levels, helps improve sleep and maintains physical health.  Many studies demonstrate that time in nature also brings a sense of well-being, in addition to some sunlight exposure even during the winter months.  Dressing warmly and taking a brisk walk every day can help beat the winter blues.

For more information please see the following resources:

WebMD – Seasonal Affective Disorder

Mayo Clinic – Seasonal Affective Disorder

Dr. Julia Ross’ book The Mood Cure

The Environmental Working Group (EWG) has recently shed light on the dangers of sunscreen.  Most commercially available sunscreens contain two major toxic chemicals; Oxybenzone, a hormone-disrupting chemical, and retinyl palmitate, a form of vitamin A that has been shown to accelerate the growth of skin tumors.  The EWG recommends that consumers avoid sunscreens with vitamin A (look for “retinyl palmitate” or “retinol” on the label).  Unfortunately, many of the safer sunscreens recommended by EWG contain forms of zinc and titanium, which can have their own health risks in high doses. Most of the non-toxic sunscreens are all-natural or organic. 

Ultimately,  the EWG states that the best protection from the harmful UVA rays of the sun is a physical barrier  such as clothing or shade.

Below is a list of EWG-recommended sunscreen brands.  For the complete list of specific products and ratings visit the EWG website at: www.ewg.org/2010sunscreen.

Safe Sunscreens:  Avoid These:
Badger Coppertone
California Baby Hawaiian Tropic
Jason Kiss My Face
Loving Naturals Neutrogena
Soleo Organics No-Ad

Thanks to Anna Weaverdyk and Rachel Hasse for their contribution to this article.

Parenting Workshop:

Naturopathic Women’s HealthCare welcomes Sonja Knighton and her creative parenting workshops.  Sonja is a preschool teacher, and has dedicated fourteen years to crafting her own mothering and working with children and families professionally.  The Mother Wit perspective provides a medium for re-skilling in the art of creating family.

 Sunday July 18th, 3-5 pm

 Wit & Wisdom

During this workshop you will explore how developing the intuitive aspect of your parenting allows you to cultivate parenting tools that are uniquely aligned with your family’s needs.

To register email Sonja at momwit@gmail.com


Office Closure August 3-22

Naturopathic Women’s HealthCare will be closed from August 3rd through 22nd and will reopen on Monday August 23rd.  For supplement refills, please contact the office by Friday July 30th. 

Dr. Christoff Quinn will be out of contact by phone or email for the first week of August, and will periodically check messages prior to returning on August 23rd.  For urgent matters, her colleague Dr. Hallie Armstrong will be taking patient calls through Beaumont Integrative Medicine in Troy, at (248) 964-9200.  Extended telephone consultations with Dr. Armstrong will be billed at $35 for 15 minutes and $75 for 30 minutes.

In addition to a remote camping trip and family reunion, Dr. Christoff Quinn will be attending the annual convention of the American Association of Naturopathic Physicians in Portland, Oregon.   She looks forward to returning to the office with the latest updates in naturopathic medicine at the end of August.

Yesterday’s article in the New York Times on food allergies presents an opportunity to clarify the distinction between food allergies and food intolerances.  The article cites Dr. Marc Riedl, allergist and immunologist at UCLA who was recently commissioned to author a report on food allergies for the federal government.  Dr. Riedl accurately comments on the fairly low prevalence of true food allergy – roughly 5% for adults and 8% for children. 

By true food allergy is meant a Type I, acute immune hypersensitivity reaction mediated by a type of antibody called immunoglobulin E, or IgE.  Evaluation by allergy and immunology specialists for IgE food reactions are typically conducted via blood testing for IgE antibodies or by performing skin prick tests for food reactions.  True IgE-mediated food allergies are the type of hypersensitivity to foods causing severe responses including anaphylaxis and death.  This type of food allergy is relatively rare, and occasionally false-positive reactions to foods can occur on testing.

Other types of reactions to food, frequently mislabeled “food allergies,” are in fact food sensitivities.  These reactions may also present with an immunological reaction to foods and are mediated by immunoglobulins type A and G.  The presence of IgG or IgA antibodies to foods correlate to delayed hypersensitivity reactions and commonly present as chronic symptoms such as digestive complaints and skin rashes.  Evaluating for food sensitivities can be done by testing saliva or blood, or by performing an Elimination/Challenge diet.  Studies that assess testing methodology have demonstrated inconsistencies with salivary IgA and serum IgA and IgG testing, with unclear sensitivity and specificity and a good deal of variability between laboratories.  Today the “gold standard” for evaluating food sensitivities is considered to be the Elimination/Challenge Diet, in which select foods are eliminated for a minimum of three weeks and gradually reintroduced one at a time.  The findings of this test are empirical and subjective, and certainly more challenging for a patient that simply getting a blood test.  However, the clinical relevance of how much better one feels after eliminating reactive foods, confirmed with a return of the symptoms when the food is reintroduced, is significant. 

An important clarification regarding the Elimination/Challenge diet is that this assessment is appropriate for identifying food sensitivities, not food allergies.  It would be inappropriate and dangerous to attempt a “challenge” of foods suspected of causing acute hypersensitivity reactions, such as a peanut allergy, which can be life-threatening.  Unlike the incidence of true food allergy, the incidence of food sensitivities is very common.  As mentioned in the article, as much as 30% of the population believe that they have a food allergy  – a misnomer for food sensitivity or intolerance.  The actual prevalence of food sensitivity may be even higher than 30%, given the widespread use of prescribed and over the counter antacid medications for reflux and indigestion.

Which brings me to the most important point from a Naturopathic perspective of Identify and Treat the Cause: the food sensitivity, although often a hidden or overlooked aggravator of many chronic health problems, may be in fact merely a symptom of underlying maldigestion and not the causal factor itself.  The prevalence of food sensitivities correlates with rising incidence of GERD, maldigestion associated with greater consumption of refined food, a low-fiber diet, overeating, eating too quickly, elevated stress levels, and impaired digestive function.  While identifying and eliminating food sensitivities can greatly improve a patient’s chronic symptoms, digestive health must be addressed to fully resolve the underlying cause and prevent further sensitivities and greater dietary restrictions.

More information on food sensitivities can be found at Alletess, a laboratory specializing in food sensitivities (despite the incorrect usage of the term “food allergies” on their website), and from the following resources:

The Anti-Inflammation Diet and Recipe Book by Jessica Black, ND

Coping With Food Intolerances by Dick Thom, ND

Naturopathic Women’s HealthCare is pleased to present a new series of parenting workshops with Sonja Knighton. 

Sunday May 16th, 3:00-5:00 pm

“After the Snow Forts & Tea Parties.”  

In this workshop you will discover how to participate in play with your child(ren) in ways that nurture parent-child intimacy and reconnect you with the experience of whole hearted joy. 

Sunday  June 6th, 3:00-5:00 pm

“Shake It Off”

During this workshop you will learn to recognize opportunities to disengage funky energy & create a pool of strategies to help your family in challenging moments and difficult situations.

Sonja Knighton has dedicated fourteen years to crafting her own mothering and working with children and families professionally.  The Mother Wit perspective provides a medium for re-skilling in the art of creating family.   For more information or to register, email Sonja at: motherwit@selfaware.com

Chocolate l photo by ParsecTraveller

February is Heart Health Awareness Month, a great opportunity to explore preventive measures for maintaining cardiovascular health.  While hereditary risk factors are not modifiable in preventing heart disease, many lifestyle and nutritional choices have been shown to reduce risk and to strengthen the heart.  Fortunately, many of these options don’t require self-denial, and in fact some can be rather indulgent and may fit in well with your plans this Valentine’s Day: dark chocolate, red wine, and loving relationships.

Chocolate is cardioprotective is due to antioxidant, anti-inflammatory, and anti-atherogenic  compounds called polyphenols in cocoa .  Polyphenols in dark chocolate have been shown to reduce LDL cholesterol, the “bad” form that causes the cholesterol deposits in blood vessels and leads to atherosclerosis, and increase the “good” HDL cholesterol.  Chocolate was also found in one small study to inhibit platelet activity, reducing blood clotting.  It also appears to help lower high blood pressure by triggering the release of nitrous oxide in the blood, which relaxes blood vessels. 

The tradition use of cocoa originates in Mayan and Aztec culture in the form of a blended drink of fermented and crushed cocoa beans called xocoatl, which lacked the saturated fat and refined sugars of modern chocolate products that may do more harm than good.  The amount of cocoa used in clinical trials is roughly 100 g, which is a fairly high daily dose even for chocoholics.  The downside of obtaining this amount of cocoa daily is of course the increased caloric intake that comes from consuming chocolate bars containing sugar and cocoa butter, between 200-400 extra calories daily and containing over 1/3 of the daily recommended limit for saturated fat.  The “darkness” of the chocolate or cacao content doesn’t necessarily reflect the polyphenol content, although dark chocolate may have less added sugar and saturated fat than milk chocolate. 

Antioxidant polyphenols are found in many foods besides chocolate, of course, which brings me to our next indulgence, red wine.  The benefits of red wine have been known for quite some time and have been written about extensively in both medical literature and books on diet and health.  An 8 oz glass of red wine contains over 600 mcg of resveratrol, a potent antioxidant that supports blood vessel health.  The alcohol content of red wine is an unnecessary element of the beverage for conferring the health benefit, and many people choose to obtain the beneficial constituent resveratrol in supplement form rather than imbibe daily.  Alcohol can have an unfavorable effect on blood sugar, and again there are the extra calories.  Like chocolate, the benefit of red wine is probably best as an occasional indulgence.  Fortunately, many other foods that we can consume every day contain polyphenols and other beneficial nutrients, such as tea and fresh, brightly colored vegetables and fruits. 

Finally, an essential way to care for your heart is by managing stress and maintaining healthy relationships.  Many studies document the impact of stress on cardiovascular risk factors like high blood pressure and cholesterol.  Dr. Dean Ornish, a physician specializing in the reduction of coronary heart disease risk through lifestyle modification, emphasizes the need for love and intimacy in our lives. In his book Love and Survival, he writes: “I am not aware of any other factor in medicine – not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery – that has a greater impact on our quality of life, incidence of illness, and premature death from all causes.”

Wishing you a heart-healthy Valentine’s Day,

Diana Christoff Quinn, ND