5 Tips to Beat the Winter Blues

5 Tips to Beat the Winter Blues

by | Nov 17, 2022 | Brain Health, Mindfulness, Stress Management

While it's not yet officially winter, it's certainly starting to feel like it with the leaves off of the trees, frost on the ground, darkness, and cold to the bone weather upon us. Many have started to feel the impact of this change on their moods, which is known as seasonal affective disorder (SAD). Common symptoms include: depression, overeating, sleep changes, irritability, and self isolating. The sun lifts us up so much and sometimes we don't realize how much until we see her less! So in this newsletter I offer up a 5 tips (or reminders) on how to beat back these winter blues. 

1) Thanksgiving, an expression of gratitude, is a great elixir for the blues. I am daily thankful to be in alignment with my calling to support people on their health and healing journeys and grateful for you, my amazing patients and for the practice that I have been able to build with all of your support! When I am having a challenging day or drop into a pattern of "stinking thinking" I like to remind myself of three good things that happened that day that I am grateful to God for. The simple three good things practice is easy to implement and a surprisingly effective way to get back into a state of peaceful alignment.

2) Light! Specifically shining a 10,000 Lux white light box toward ones face, so the light is hitting the eyes from the side, for 10 to 30 minutes every morning is a wonderful, natural way to increase those mood boosting neurotransmitters, serotonin and dopamine. Some of my patients find using a sunrise alarm clock, which is a type of light that is connected to an alarm clock and stimulates the sunrise to help wake you up, also helpful.

3) Keep it Moving. With it being so dark out many of us literally might arrive to work when it's dark and then leave when it's dark. If you can carve out time for a walk, even a short 15 minute walk outside at mid-day has been shown to be as effective as light therapy for seasonal mood support. Aiming for regular cardiovascular exercise and strength training also has significant benefits for the mood and overall health. 

4) Build Community! Many people are suffering from loneliness, an epidemic that was only made worse during the pandemic. Faith communities, gym/ sporting groups, dance groups, coral groups, and Meet-up groups all can provide opportunities to build community. Volunteering can also be a great way to build meaningful connections - Loudoun Cares is a local non-profit organization that helps to connect Loudoun County residents to volunteer opportunities. Additionally, this article from Green America offers several other suggestions on how to build community - including time banks - which is an interesting, modernized version of the barter system, where members receive and exchange each others time and talents.

5) Have a Cup of Tea. My favorite mood boosting tea is tulsi or holy basil. But there are many others such as chamomile, lavender, and lemon balm that can help calm the nervous system and boost our moods. The ritual of having a cup of tea is calming in and of itself.

If your symptoms are so severe that they are impacting your ability to live a normal life, please seek out care from your primary care provider. I am here to help too. Naturopathic and East Asian Medicine - including herbal medicine and acupuncture - have so much to offer for support! Reach out to me on the form below to learn more about my healing practice.

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Alcohol, Immune Health and More: A Holiday PSA

Alcohol, Immune Health and More: A Holiday PSA

by | Nov 30, 2020 | Brain Health, Cardiovascular Health, Endocrine/Hormone Health, Immune Health, Mindfulness, Stress Management, Women's Health

The holiday season is a particularly stressful time for many people – and this year has been extra, as the kids say. One theme I often see in my patients is a tendency to use alcohol to relax. Most do not realize they are consuming a moderate or heavy amount of alcohol and many are not aware of the various health effects associated with each. Especially during this season and with alcohol sales soaring in Virginia, I feel compelled to provide a public service announcement. On September 3rd, the Washington Post wrote: “The Virginia Alcohol Beverage Control Authority brought in $1.2 billion in revenue during the 2020 fiscal year in a nearly $120 million increase from the previous year, even as the coronavirus pandemic left restaurants and bars shuttered for months.” As a health care provider, while not shocking, this is concerning, especially given the known, deleterious health effects of alcohol on the immune system.

When we talk about alcohol and its effect on the body positive or negative, we really need to consider the amount we are talking about. A standard alcohol drink is 14 grams of alcohol which equals 12 ounces of beer (~5% alcohol), 8.5 ounces of malt liquor (~9% alcohol), 5 ounces of wine (~12% alcohol), 3.5 ounces of fortified wine (ie sherry or port), or 1.5 ounces of liquor (distilled spirits, 40% alcohol). Moderate alcohol consumption for women is, as considered by the USDA, to be no more than one standard alcoholic drink per day and for men no more than two standard alcoholic drinks/day. Heavy alcohol consumption for women is considered, by the USDA more than 7 standard alcoholic drinks per week or more than 3 standard alcoholic drinks in one day and for men more than 14 standard alcoholic drinks per week or more than 4 standard alcoholic drinks in a day.

 

Light to moderate alcohol consumption has some likely effect in cardiovascular disease, where it has been shown to reduce risk of plaque build-up and heart attack and deaths from heart disease. One to two alcoholic drinks/day increases protective HDL and Apo A1 cholesterol, decreases LDL, triglycerides and ApoB (an inflammatory cholesterol fraction), decreases factors that influence blood clotting, may decrease systolic blood pressure, has been shown to reduces inflammatory marker blood biomarker, hsCRP. However, light to moderate consumption does not seem to have any effect in men with already established coronary heart disease. This is a major caveat to be aware of as many people in the US already have evidence of established heart disease and with the obesity epidemic we are seeing heart disease in children. About half of all Americans are at risk for heart disease and heart disease is the leading cause of death in the United States. 

Although red wine has been touted as ‘better’ than other forms of alcohol there is no conclusive evidence from clinical studies. Often people point to the polyphenol resveratrol that is in red wine as a reason to drink. However, you would have to consume a TON of red wine to get any benefit from the resveratrol in it. Most of the resveratrol in supplements is not from grapes, but from Japanese knotweed - an herb that grows like a weed in the US. Also, most of the research on the single ingredient resveratrol is insufficient. However, Japanese knotweed with all of its many phytochemicals is a wonderful herb that has been used in Traditional Chinese Medicine for centuries for its properties that have immune supportive effects and anti-inflammatory effects. 

Additionally, fruits and veggies generally have more polyphenols than wine. Most people would do better to focus on getting 5-10 servings of veggies and a few fruits per day and herbals teas and avoid drinking alcohol. One of my absolute favorite herbals teas of late is Holy Basil or Tulsi – as it has both a calming and gentle energy boosting or stress managing effects as an adaptogen herb.

I have a lot of patients with estrogen dominance, which is having too much estrogen in ratio to progesterone which contributes to many common PMS and other female health concerns. Alcohol only exacerbates these symptoms. Additionally, I have many patients at increased risk for breast cancer, sleep disturbances and symptomatic menopause. I generally advise limiting alcohol in these populations. 

While many people use alcohol to help relax before bed, the medical evidence shows alcohol to be disruptive to the sleep cycle. Magnesium chelates, Epson salt baths, meditation area some examples of more effective and less harmful choices to help get relaxed before bed or to get relaxed in general. Stress cannot be drunk away, as a culture the research shows that we all may benefit even when a small group of individuals takes some time daily to meditate. No time for meditation? Consider tapping or the Emotional Freedom Technique, which is a simple and often effective method for helping to relieve mild stress and worry. 

Known risks of over consumption or dependence include: central nervous system effects (kills your brain cells, as alcohol is a cellular toxin), cirrhosis (liver inflammation and damage), malnutrition, and mouth/esophageal/ laryngeal/liver cancer. More than two drinks per day can increase the risk of cardiovascular disease and overall mortality. Light to moderate consumption can increase risk of hemorrhagic stroke. In women, one or more alcoholic drinks per day might increase risk of breast cancer by 2 to 15% and increase mortality from breast cancer as much as 30% (especially if daily intake of folate is 300 mcg or less). Alcohol consumption can also increase asthma and migraines in those sensitive to sulfites/ yeast. 

I have many patients with acid reflux who are drinking 1-2 drinks every night, possibly along with caffeine, and often soda. While it is no surprise to me, they are often pleasantly surprised when their acid reflux resolves after eliminating these known triggers. 

Because alcohol increases your liver’s detoxification pathway alcohol consumption, it can disrupt the metabolism of many medications. Birth control is a good example of this, it is not as effective when drinking alcohol, so using a second method of birth control during these times is particularly important if trying to prevent pregnancy. There are many other medications affected by alcohol consumption and if you take medications you should be sure to check with your doctor or pharmacist to see if any can be consumed with alcohol. 

If you have pre-diabetes or diabetes, you might consider reducing your alcohol consumption. While light drinking can contribute to low blood glucose, heavy drinking can cause insulin resistance, which leads to the development of type II diabetes. Heavy drinking can cause inflammation of the pancreas and destroy the pancreas’ ability to make insulin, leading to diabetes. Alcohol is nutrient light and high caloric. “One pint of lager can be equivalent to a slice of pizza.” Over-consumption can contribute to weight gain and obesity, an independent risk factor for many diseases.

A final note during this season is that alcohol consumption weakens the body’s immune system making it more susceptible to disease and infection. Drinking more than 3-4 drinks on a single occasion will suppress the immune system even up to 24 hours later. Chronic drinkers have higher rates of diseases like pneumonia and tuberculosis.

For further reading on this topic, Harvard’s Nutrition Source has a thorough summary of the research on alcohol and its effect on the body: http://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/

Dr. Sarah is passionate about educating patients and getting to the root cause of their chronic, troubling symptoms; often alcohol is often a culprit that has not been thoughtfully considered. Dr. Sarah is honored to be a collaborative partner in her patient’s health at her practice Collective Health Center, in downtown Leesburg, Virginia. As the saying goes, ‘it takes a village’ – particularly when sensitive issues, such as dependence are involved, the primary care provider, the behavioral health specialist, the naturopathic doctor and others may need to work together to help get patients back on the road to wellness.

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Gratitude – Three Good Things

Gratitude – Three Good Things

by | Nov 19, 2020 | Mindfulness, Stress Management

It goes really without saying that 2020 has stretched many of us to our mental limits. Yet, how resilient our bodies are, such that positive emotions have been demonstrated to promote enhanced self-regulation, resilience, and stress levels! Gratitude is an important component of positivity and mental health. Not surprisingly, research studies have shown an attitude of gratitude promotes a positive mindset and reduces stress levels. Gratitude has also been associated with a lower risk for psychiatric disorders, higher life satisfaction, and even wisdom.

In my 2019 Thanksgiving blog post, I wrote about the concept of gratitude in Traditional Chinese Medicine (TCM):

While in Traditional Chinese Medicine literature, the concept of gratitude isn’t  necessarily spelled out, the opposite of gratitude, ingratitude, which might manifest as self-absorption, entitlement, jealously, and resentment are considered. A colleague of mine summed up this idea of ingratitude as “wanting things to be other than how they are.”

Wanting things to be other than how they are; I think many of us want this right now in these uncertain times. However, when we are busy hoping and praying for a different future, the tension the uncertainty causes against the hopes we have, can lead to frustration and unsettledness. This friction can lead to an energetic pattern of disharmony in the body known in TCM as liver qi stagnation. If you are feeling demotivated, stuck, and unable to get things done, you might be in this type of pattern. While physical movement, therapeutic nutrition, acupuncture and herbal medicine can all help us rebalance – so can our own minds. Our own mind is one of the most powerful tools to optimize our health! And when we purposefully set our intention to ‘flip the switch’ from hoping for better to being grateful for the present, we can get to gratitude and begin reaping the benefits; the present becomes a gift.

An excellent white paper (2018) detailing the science of gratitude from the Greater Good Science Center at UC Berkley can be found HERE. This white paper summarizes the many researched benefits of gratitude:

  • Improved health
  • Improved self-motivation
  • Easier adaption healthier habits
  • Improved emotional regulation
  • Improved relationships
  • Increased positivity
  • Increased generosity
  • Decreased inflammation (inflammatory blood markers actual decreased in cardiac patients who practiced a gratitude exercise!)
  • Improved sleep
  • Less fatigue
  • Reduced stress
  • Lower risk of psychiatric disorders
  • Improved life satisfaction
  • Increased humility, patience, and wisdom
  • Lower heart rate

The emotional opposite of gratitude, resentment, seems to reverse some of the health benefits.

A simple and easy exercise to promote gratitude is the three good things. At the end of each day you can do an assessment about three positive things that happened in your day and express gratitude for these. Doing this may not change your current circumstances, but it just might help make it little easier for you to deal with them. Personally, I’ve incorporated the three good things during a difficult and extended period of life difficulty and stress and I do credit this practice as one of the things that helped me to get through that period of time more easily. I am grateful for my family. I am grateful for my vocation and practice, Collective Health Center. I am grateful for my patients. Wishing you a peaceful and Happy Thanksgiving.

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Stress Management with the Emotional Freedom Technique (EFT)

Stress Management with the Emotional Freedom Technique (EFT)

by | Apr 29, 2020 | Mindfulness, Naturopathic Medicine, Stress Management

Stress, we all have it! Be it positive or negative, from global pandemic, to work, relationships, family, finances, world politics - stress is ever present. Although stress has a negative connotation, stress triggers necessary physiologic reactions that protect us from danger. One common example of why the stress response is important is being able to run from a tiger.

Research has well demonstrated the varied effects of stress upon our internal milieu. Our ability to cope actually begins as infants and is impacted, at a genetic level, by how we are reared and the nurturing we are given. Our environments impact our genetic expression which in turn lends some of us predisposed to have reduced stress responses and others to have enhanced stress responses. Again, the stress response in itself is important for helping us react appropriately to short term threats. However, chronic stressors cause a varied range of adverse health effects and the connection between chronic disease and stress is known, demonstrated, and complex. A large study published in the Journal of Epidemiology and Community Health suggested that even mild stress can lead to long-term disability that prevents people from working. The authors conclude, “Mild psychological distress may be associated with more long-term disability than previously acknowledged and its public health importance may be underestimated.”

One common example of how stress affects our health that I frequently educate my patients on is digestion. Digestive function is regulated by the parasympathetic nervous system, the part of the nervous system responsible for calming us down. Digestive function is inhibited by the sympathetic nervous system. A common phrase used by medical community to coin these functions is “rest and digest” or “fight or flight”. Indeed when we are stressed, as while running from a tiger, adrenaline is released into the bloodstream and increases strength by releasing sugar for fuel. During this sympathetic activity blood and oxygen is shifted away from non-essential systems such as the digestive and immune systems, and more blood goes to the brain and muscles. Again, while this is important on a short term basis, chronic stress can disturb digestive and immune functions over the long term. Chronic stress also increases the amount of cortisol secreted by the adrenal glands. Cortisol helps to modulate inflammation in the body produced by the body’s response to the stress. However, cortisol also helps to control protein, carbohydrate, and fat metabolism. Chronic stress shunts cortisol away from digestive functions and this can lead to incomplete digestion, which leads to irritation and imbalance of the gut flora. What a vicious cycle chronic stress can create!

We all know that stress is part of life and have probably heard or thought many times, “I’ve got to figure out a way to handle my stress better!” There are many ways to reduce or manage chronic stress that are highly effective, such as exercise, acupuncture, massage, bathing, meditation, deep breathing, and qi gong to make it easier to hypothetically “bathe with tigers”. The research is even demonstrating that some of these activities can even change our genetic expression, which is good news to those of us who may have been born with or acquired genetic expression that increases our stress response!

One unique technique that can be used to cope with stress is called the “Emotional Freedom Technique” or EFT. This is a psychological acupressure technique that helps to remove negative emotions, food cravings, reduce pain, and enforces a positive outlook and involves a series of tapping over acupuncture points and positive affirmations. The tapping is gentle, but firm, but not so hard to bruise or hurt. Of course glasses should be removed. Taping is with the finger tips of the middle three fingers of both hands and involves 5-7 taps at each of the following points, in sequence:

1) Top of the head
2) Eyebrow- at the beginning of each eyebrow
3) Side of the eye- over the bone that boarders the outside of each eye
4) Under the eye- over the bone that is about 1 inch below each pupil
5) Under the nose- in the small area below the nose and above the upper lip
6) Chin- in the crease below the bottom lip
7) Collar bone- at the junction where the collar bone and first rib meet
8) Under the arm- about 4 inches or a 4 fingers below the armpit
9) Wrists- where they bend, use the side of the hand to tap each wrist

During the tapping the following affirmations are to be stated aloud, passionately, and repeatedly:

a) “Even though I have this _____________, I deeply and completely accept myself.” Alternatively, the second part of the phrase can be substituted with “I deeply and completely love and accept myself.” Variations of this phrase can be used instead, such as: “I accept myself even though I have this _________.” Often when we get stuck in a pattern of negative emotion and can be difficult to emerge from. The affirmations can be helpful even in these cases where we may not believe them, and I have seen these help patients shift out of these stuck emotional patterns. This technique can be used to help shift limiting beliefs, fears, anxieties, and negative thought patterns. The more specific the affirmation, the more effective it becomes. Focused intention is important for the Emotional Freedom Technique to be most effective. This is an easy and safe technique; however, a person should be cautious not to enter into emotional areas that seem threatening and should only do what feels right to them. This technique does not replace any professional help that may be warranted.

While it may seem a little esoteric, this technique is simple and can be quite calming. Sometimes it is the simple that can be most effective and this is the rational approach that Dr. Sarah Giardenelli takes as a naturopathic doctor and acupuncturist at her Collective Health Center; empowering her patients to optimize their health with natural medicine through an evidence informed approach.

New Year: 3 Mindful Steps to Close Off 2018

New Year: 3 Mindful Steps to Close Off 2018

by | Dec 5, 2018 | Mindfulness, Stress Management

The new year is almost here! Let's talk about three steps that will help you end 2018 and better prepare yourself for the new year. From gratitude to planning for success and remembering the importance of self-care, the Collective Health Center will give you the tools necessary to live a happier and healthier life in 2019.

1) Gratitude

What went well for you in 2018? What are the top three things in your life for which you grateful every day? Keeping in mind what is going right in your world brings perspective for what we value and can help us in creating goals for the new year with these in the forefront. If you are interested in learning more about gratitude from a Traditional Chinese Medicine perspective and how you can implant these practices into your life during the new year, click here.

2) Planning for success

Often what gets in the way of us achieving our goals is the lack of preparedness or scheduling. For example, the transition from warm weather to frigid can discourage continued outdoor exercise for some of us to the point we might fall off the exercise bandwagon all together or not making the time to do the all-important food preparation, can lead to more eating out and unhealthy food choices. These are a few common life examples I often hear from my patients that are obstacles to them achieving their health goals. During the new year, if you have a lifestyle change goal in mind, what can you do with your schedule to help you achieve this goal? Is this something you can commit to putting on your calendar now? If not, what is getting in the way? If you commit and schedule yourself, then you are much more likely to succeed. What can you commit to and schedule now, so that in January you are prepared and ready to move forward with your goals? I’ve listed some ideas below:

  • Schedule time for meal planning, weekly or monthly, maybe using a helpful recipe and grocery list tool like: https://realplans.com/. Ensure there are always homemade frozen meals on hand for weeks where you get too busy and skip food prep. Daily Harvest meals are a good option, if you prefer to purchase for the convenience.
  • Schedule fitness class(es) or gym times so as not to let the cold weather impede your movement. Shop for some warm walking gear so that you can walk outside, even in the cold, if a gym may not be an option for you.
  • Schedule regular, weekly time to engage in your community. Whether it’s connecting with a spiritual family, or with people in group exercise classes, club sports, book club, or volunteering our time in the services of others, the less isolated we are and the more connect we are with people, the more we ourselves feel better and we actually can help prevent most of the chronic disease by avoiding loneliness and isolation.

3) Self-care

We cannot take care of others if we are not taking care of ourselves. Selfcare takes many forms for different people.This new year, make it an important everyday practice. Some selfcare, like exercise, we do because it’s good for us, but some of us don’t love doing it. The type of self-care I am referring to here is the enjoyable type that nourishes and restores the soul. However, for most of us, if we don’t schedule this it’s not going to happen, so planning and scheduling for success, is essential!

  • When we feel good on the outside this truly helps us feel good on the inside. Make time for skin, hair and more natural nail care
  • 10 to 20 minutes of meditation, breathing, yoga, and/ or prayer that can easily be done as part of a daily practice. This is a vital way to protect your mental health from everyday stress.
  • Schedule regular acupuncture, naturopathic care, massage, counselling, health or life coaching… It is beyond time to break the sickness model that encourages us to wait until we are fully broken to get some support. Most of us believe in prevention and so we should put this into practice for ourselves, families and communities – when we thrive, all benefit.

Dr. Sarah Giardenelli is a Naturopathic Doctor & Acupuncturist at her private practice, Collective Health Center, in Leesburg, Virginia. She partners with patients to optimize their health using a personalized natural medicine approach. Are you struggling with chronic disease and looking to get help from a different perspective or are in good health already and looking to optimize? Regardless of where you are on the journey towards health and wellness, Dr. Sarah is happy to partner with you. More information on Dr. Sarah’s practice can be found at www.collectivehealthcenter.com.

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