Seasonal Resilience: Longevity Practices for Fall Immunity & Vitality

Seasonal Resilience: Longevity Practices for Fall Immunity & Vitality

by | Nov 5, 2025 | Immune Health, Naturopathic Medicine, Nutrition, Prevention, Respiratory Health

As the air turns crisp and the days grow shorter, our bodies begin to shift—mirroring the seasonal transition around us. Fall invites us to slow down, reflect, and prepare for the inward pull of winter. It’s also the ideal time to focus on fall immunity and longevity practices that strengthen resilience, balance mood, and support immune health through seasonal change.

This is the season where resilience matters most.

In my functional medicine practice, I often describe longevity not as a quest to “anti-age,” but as a commitment to vitality—supporting the body’s systems that help us feel clear, grounded, and well. Fall is the perfect time to lean into those restorative practices that build immunity, energy, and emotional balance.

🍂 Why Fall Is the Longevity Season

In Chinese medicine, fall is ruled by the Lung and Large Intestine—organs linked to immunity, detoxification, and emotional release. When these systems are supported, we’re better able to clear lingering pathogens, process emotional transitions, and build deep reserves for winter vitality.

You can explore this further in my post on supporting the lungs and internal ecosystem in fall—how the Metal Element governs this season and how to work with it rather than against it.

🌿 Longevity Practices to Strengthen Fall Immunity

1. Support Your Immune Terrain

Rather than just trying to “boost” immunity, focus on regulating inflammation, clearing lymph, and nourishing your body’s natural barriers. In Eastern medicine, this means supporting Lung Qi, which governs breath, immunity, and the boundary between your inner and outer world.

During the fall transition, aromatic kitchen herbs can help keep Lung Qi flowing smoothly:

  • Thyme & Oregano: dispersing and clearing; open the chest and sinuses, keep mucus moving.
  • Ginger & Garlic: warming and protective; dispel cold and dampness, strengthen digestion.
  • Sage: cooling and moistening; soothes dry throats and lungs.
  • Cinnamon: circulates Qi and provides grounding warmth.

Add these to soups, teas, and roasted dishes for simple, flavorful ways to nourish your immune system naturally.

2. Reset Your Nervous System

Seasonal transitions can heighten stress. Practices like acupuncture, breathwork, humming, or intentional rest help regulate your nervous system and shift you out of fight-or-flight mode. Even 10 minutes of stillness can make a meaningful difference in your stress resilience and sleep quality.

3. Eat With the Season

Choose warm, cooked foods—think squash, ginger, and bone broth—to strengthen digestion and immunity. Avoid cold, raw foods that can weaken your digestive fire during cooler months.

4. Honor Emotional Transitions

Fall often brings emotional release—grief, nostalgia, or restlessness. Gentle movement, journaling, and connecting with community help you process emotions and restore balance.

These simple fall immunity and longevity practices help strengthen the lungs, digestion, and emotional balance through the season’s transitions.

🍲 Nourish Yourself: Dr. Sarah’s Quick Immune-Supportive Soup

This simple, deeply nourishing soup is one of my favorite seasonal staples. It supports the immune, digestive, and nervous systems, helping the body adapt to the cooler, slower rhythm of fall. Nourishing foods like this soup are central to fall immunity and longevity practices, grounding the body while supporting immune resilience and vitality.

Choose the chicken version for warmth and recovery, or the vegan version for plant-based grounding energy.

🥄 Chicken Version

Ingredients:

  • 1 tbsp butter + 1 tbsp olive oil
  • 1 cup chopped onion
  • ½ cup chopped celery
  • ½ cup chopped carrot
  • 2 dried bay leaves
  • 1 tbsp dried astragalus root
  • 1 tbsp dried reishi mushroom
  • Optional: 1 tsp thyme or oregano
  • Optional: ½ tsp Herbes de Provence
  • 4 cups chicken bone broth
  • 1½ cups cooked jasmine, basmati, wild rice, or quinoa
  • 1–1½ cups cooked shredded chicken
  • Sea salt and black pepper to taste

Instructions:

  1. In a large pot, heat butter and olive oil over medium heat.
  2. Add onion, celery, and carrot. Sauté with bay leaves, astragalus, reishi, and optional herbs until onions are translucent (5–7 min).
  3. Add broth and bring to a gentle simmer. Cover and simmer 20–30 minutes.
  4. Remove astragalus and reishi slices.
  5. Stir in cooked grains and chicken. Simmer 5–10 minutes until warmed through.
  6. Season to taste and serve warm.

🥄 Vegan Version

Ingredients:

  • 1 tbsp olive oil + 1 tbsp vegan butter
  • 1 cup chopped onion
  • ½ cup chopped celery
  • ½ cup chopped carrot
  • 2 dried bay leaves
  • 1 tbsp dried astragalus root
  • 1 tbsp dried reishi mushroom
  • Optional: 1 tsp thyme or oregano
  • Optional: ½ tsp Herbes de Provence
  • 4 cups mushroom broth
  • 1½ cups cooked grains or root veggies (e.g., parsnip, sweet potato)
  • 1–1½ cups cooked beans
  • Sea salt and black pepper to taste

Instructions:

  1. In a large pot, heat olive oil and vegan butter over medium heat.
  2. Add onion, celery, and carrot. Sauté with bay leaves, astragalus, reishi, and optional herbs until onions are translucent (5–7 min).
  3. Add mushroom broth and bring to a gentle simmer. Cover and simmer 20–30 minutes.
  4. Remove astragalus and reishi slices.
  5. Stir in cooked grains or root veggies and beans. Simmer 5–10 minutes until warmed through.
  6. Season to taste and serve warm.

🌿 Herbal Energetics for Fall Wellness

  • Bay leaf: Warming and moving; supports Lung and Spleen Qi, clears dampness and stagnation.
  • Thyme: Warm and drying; transforms phlegm and supports bronchial health.
  • Oregano: Dispersing and cleansing; supports digestion and immunity.
  • Astragalus & Reishi: Adaptogens that enhance immune resilience and reduce stress.

🧘‍♀️ Experience Fall Vitality Firsthand

Sat, Nov 8 — Half-Day Longevity Intensive (Full Day or À-La-Carte Options)

Join me and Brian Wright, MS, CSCS at Method Health Club in Ashburn, VA, for a powerful, hands-on Longevity & Wellness Intensive focused on movement, recovery, and vitality.

🕗 Time: 8:00 AM–2:00 PM
🥗 Breakfast & lunch included for full-day attendees

Come for the full day or attend individual sessions:

  • 8:00–9:00 AM – Yoga & joint mobility + optional cold plunge
  • 9:00–10:00 AM – Self-defense workshop with national champion Kristen DeBrukyer
  • 10:00–11:00 AM – Physical therapy tendon-care essentials with Carrie Cothran, MS, DPT
  • 11:00 AM–12:00 PM – Train all three energy systems for longevity with Brian Wright
  • 12:00–1:00 PM – Recovery & testing block (acupuncture, massage, stretching, dry needling, and exercise testing)
  • 1:00–2:00 PM – Lunch + my talk on seasonal longevity and immune optimization

There are limited spots available—only about six remain!

👉 Register now on Eventbrite

About Me

I’m Dr. Sarah Giardenelli, founder of Collective Health Center in Leesburg, Virginia, where I serve patients across Loudoun County and beyond through a functional and integrative medicine approach. My work focuses on helping individuals build resilience, balance, and longevity—from improving immune health and hormonal harmony to supporting recovery from chronic stress and inflammation.

I believe wellness should feel attainable, intentional, and restorative, aligning both modern science and the wisdom of nature. Whether through acupuncture, functional nutrition, or personalized longevity programs, my goal is to help you feel grounded in your body and vibrant through every season of life.

 

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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Measles, Vitamin A, and Immune Health: What You Need to Know

Measles, Vitamin A, and Immune Health: What You Need to Know

by | Apr 19, 2025 | Immune Health, Naturopathic Medicine, Nutrition, Prevention

A recent confirmed case of measles at Dulles Airport has raised concerns among patients about how to protect themselves and their families. While measles is less common in the U.S. due to high vaccination rates, it can still spread in certain populations, particularly among unvaccinated individuals or those with weakened immunity.

Vaccination is undoubtedly a highly charged topic right now. This post isn’t here to dive into that debate. Instead, it’s intended to focus on the current evidence regarding immune support—specifically the role of vitamin A in measles outcomes—as several patients have reached out with questions in this area. My goal is to offer clarity, not controversy, and to highlight practical, well-supported steps you can take to support your health.

One critical factor in measles severity is vitamin A status. The World Health Organization (WHO) and the CDC recommend high-dose vitamin A supplementation in measles cases to help reduce complications and mortality, particularly in children. But what does this mean for people in the U.S., where vitamin A deficiency is considered uncommon? Let’s break it down.

Measles and Its Risks

Measles is a highly contagious viral illness that spreads through respiratory droplets and can remain airborne for up to two hours (CDC). Symptoms typically include:

  • High fever
  • Cough and runny nose
  • Red rash spreading from the face downward

While many people recover, complications can be serious, ranging from mild (ear infections, diarrhea) to severe (pneumonia, encephalitis, blindness, and even death) (WHO). Vitamin A supplementation has been shown to reduce the severity and mortality of measles, especially in children with vitamin A deficiency (CDC).

Vaccination Rates in the DMV Area

High vaccination rates are critical in preventing outbreaks. The MMR vaccine (measles, mumps, rubella) is typically administered in two doses during childhood. According to the CDC’s National Center for Health Statistics:

  • The national MMR vaccination coverage for children aged 19-35 months is around 90%.
  • Virginia and Maryland have vaccination rates close to this average.
  • Washington, D.C. has made significant efforts to maintain high coverage among school-aged children.

While these rates are relatively high, measles outbreaks still occur when unvaccinated individuals introduce the virus into a community, as seen in past U.S. measles outbreaks.

Historic Measles Outbreaks in the U.S.

Although measles was declared eliminated in 2000, outbreaks continue due to declining vaccination rates in certain communities and travel-related cases (CDC).

  • The most notable outbreak in recent years occurred in 2019, with over 1,200 cases, primarily affecting unvaccinated populations (CDC).
  • The current case at Dulles Airport serves as a reminder that measles can still spread even in highly vaccinated areas if exposure occurs.

Vitamin A and Measles: Why Is It Recommended?

Vitamin A plays a crucial role in immune function, reducing complications, and lowering mortality rates in measles infections.

How Does Vitamin A Help?

  1. Supports Immune Function – Essential for T-cell function, antibody production, and maintaining epithelial barriers, helping the body fight infections (NIH).
  2. Reduces Severity and Complications – Lowers the risk of pneumonia, diarrhea, and eye damage associated with measles (WHO).
  3. Lowers Mortality Rates – Significantly reduces measles-related deaths, particularly in malnourished children (American Journal of Clinical Nutrition).
  4. Prevents Measles-Associated Blindness – Deficiency increases the risk of keratomalacia (severe eye damage) in measles (WHO).
  5. Shortens Disease Duration – Some studies suggest vitamin A reduces hospital stay and speeds recovery from measles (SagePub).

WHO Guidelines for Measles Cases

🔹 Children over 12 months: 200,000 IU of vitamin A for two consecutive days
🔹 Infants (6-12 months): 100,000 IU over two days
🔹 If eye involvement or vitamin A deficiency is present, an additional dose is given 2–4 weeks later (WHO).

Vitamin A Deficiency in the U.S.: Who Is at Risk?

While severe vitamin A deficiency is said to be rare in the U.S., marginal or subclinical deficiency is more common than many realize. Up to 45% of the US Population were found to have marginal vitamin A levels based on reanalysis of 2005–2016 National Health and Nutrition Examination Surveys (NHANES) (Nutrients). In my clinical experience, I frequently see low vitamin A levels in patients with gut health issues and poor dietary intake.

Populations at Higher Risk

  • People with fat malabsorption disorders – Those with celiac disease, Crohn’s disease, small intestinal bacterial overgrowth (SIBO), or liver disease often struggle to absorb fat-soluble vitamins like vitamin A (National Library of Medicine StatPearls).
  • Individuals with low dietary intake – Those who eat low-fat, low-animal-product, or highly processed diets may not get enough vitamin A or its precursor, beta-carotene.
  • People who struggle to convert beta-carotene to vitamin A – Some individuals, due to genetic variations (like BCMO1 mutations), have trouble converting beta-carotene from plant foods into active vitamin A (retinol) (Front Nutr).
  • Those who wear glasses or have poor night vision – Vitamin A is essential for eye health, and some patients who require glasses or have night vision issues may have higher vitamin A needs.

Should You Supplement with Vitamin A?

While vitamin A is critical for immune function, vision, and overall health, high doses should not be taken without medical guidance (NIH).

Would you like guidance on how to assess your vitamin A status or the best food-based sources for your needs? Reach out for a consultation!

Dr. Sarah Giardenelli is a naturopathic doctor, acupuncturist, principle clinician and founder of Collective Health Center based in Leesburg, Virginia, with a deep passion for helping individuals and families build lasting health through thoughtful, evidence-informed care. In her practice, she emphasizes immune resilience, nutritional foundations—including the role of key nutrients like vitamin A—and personalized strategies tailored to each patient. Dr. Giardenelli approaches healthcare with curiosity and discernment, steering clear of dogma from any side of a debate. She is committed to critical thinking, careful evaluation of the research, and empowering her patients to make confident, informed decisions about their health.

Photo by CDC on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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Let’s Talk About Poop: A Thanksgiving Conversation Starter

Let’s Talk About Poop: A Thanksgiving Conversation Starter

by | Nov 28, 2024 | Digestion/GI Health, Naturopathic Medicine, Prevention

Ah, Thanksgiving. The season of gratitude, gravy, and gatherings. The table is set, the turkey’s carved, and just as Aunt Linda looks ready to dive into a heated debate about politics… why not steer the conversation to something truly universal and informative? Yes, I’m talking about poop!

Before you cringe, hear me out. Poop is a fantastic barometer of overall health. It’s like the awkward family member we all have- it doesn’t get enough credit but has a lot to say. So, in the spirit of Thanksgiving and family bonding, let’s dive into this not-so-taboo topic.

That Time I Embarrassed My Sister’s Boyfriend

Let me start with a story from one of my own family Thanksgivings. Picture this: my baby sister brought her new boyfriend to dinner. Poor guy had no idea what he was walking into. As a naturopathic doctor, I might have gone a little overboard with questions like:

  • “Do you go every day?”
  • “What’s the texture like? Pebbles? Pudding? Somewhere in between?”
  • “Ever noticed if corn shows up in your stool? It’s a great marker for transit time!”

Let’s just say, the poor guy turned beet red and didn’t touch the sweet potatoes after that. My sister still brings it up every Thanksgiving, but hey, poop is important!

The Bristol Stool Chart: A Poop Primer

Since we’re already here, let’s get technical for a moment. Have you heard of the Bristol Stool Chart? It’s a handy tool for classifying stool types. Here's a rundown:

Type

Description

What It Means

1

Separate hard lumps, like nuts (hard to pass)

Constipation city. You need more water and fiber!

2

Sausage-shaped but lumpy

Still constipated, but slightly better.

3

Like a sausage but with cracks on the surface

Normal-ish. Could use a bit more hydration.

4

Like a smooth, soft sausage or snake

Ideal! Celebrate this Thanksgiving miracle!

5

Soft blobs with clear-cut edges

Borderline diarrhea. Could be your microbiota signaling imbalance.

6

Fluffy pieces with ragged edges, a mushy stool

Diarrhea territory. Check your diet or stress levels.

7

Watery, no solid pieces

Full-on diarrhea. Might want to investigate further.

A good bowel movement is smooth, pain-free, and happens daily or even 2–3 times a day. Naturopathic doctors like me encourage this frequency because pooping is one of the main ways your body detoxifies hormones and environmental toxins. If you’re not going regularly, those toxins might get reabsorbed.

What's 'Normal' Anyway

When it comes to poop, the conventional definition of “normal” is pretty broad—anywhere from three times a day to three times a week, as long as your stools are smooth, well-formed (Bristol Types 3-4), and easy to pass without straining. But us naturopathic docs like to aim a bit higher (or more frequent, rather). We say the gold standard is 1-3 glorious BMs a day. Why? Because pooping regularly isn’t just about comfort—it’s one of the best ways your body detoxifies. Those daily poops help eliminate hormones, environmental toxins, and all the other stuff you really don’t want hanging around. So, while conventional medicine might call it fine if you’re pooping twice a week, naturopaths would argue that a happy gut—and a healthier you—deserves better!

Constipation: More Than Just “Not Going”

Constipation doesn’t just mean skipping days. It’s also about stool consistency and ease of passage. Ideally, stools should feel like Type 4 on the Bristol Stool Chart. If they’re hard, infrequent, or difficult to pass, it’s time to make some changes—starting with hydration, dietary fiber, and perhaps some Thanksgiving leftovers (more on that later).

Your Microbiota: The Gut’s Gossip Network

Your gut microbiota—those trillions of bacteria living in your digestive tract—play a starring role in your health. When they’re in balance, everything flows smoothly. When they’re out of whack, you might experience diarrhea, constipation, or both (hello, IBS!).

Conditions like SIBO (Small Intestinal Bacterial Overgrowth) and IMO (Intestinal Methanogen Overgrowth) can seriously disrupt digestion and require careful management. In my practice, I help patients identify and address these imbalances with diet, lifestyle changes, and sometimes targeted supplements.

Thanksgiving Dinner and Your Gut

Surprisingly, Thanksgiving dinner offers some gut-friendly options:

  • Sweet Potatoes: Packed with fiber, these help move things along.
  • Cranberries: Rich in polyphenols, they support gut bacteria diversity.
  • Turkey: A great source of tryptophan, which your gut bacteria can use to make beneficial compounds.
  • Green Beans: Full of prebiotic fibers that feed good gut bacteria.

However, too much indulgence in stuffing, gravy, and pie might lead to a Type 6 or 7 situation. Moderation is key!

Dietary Diversity and Gut Health

Research shows that a diverse diet is one of the best ways to support a healthy gut microbiota. Aim for a 'rainbow' on your plate—not just on Thanksgiving, but year-round. A diverse gut microbiota is linked to better digestion, immune function, and even mental health. In contrast, an imbalanced microbiota can lead to digestive issues like diarrhea and constipation. Research from the Microsetta Initiative at UC San Diego emphasizes that consuming at least 30 different plant foods per week is key to optimizing gut diversity. Learn more here: Microsetta Initiative.

Why Poop Should Be a Family Conversation

Discussing health topics like poop might feel awkward, but it can open the door to more meaningful conversations about wellness and family history. Sharing symptoms or experiences can even help identify hereditary conditions early. So, this Thanksgiving, while avoiding politics and awkward questions about relationships, why not talk about something that truly matters?

Final Thoughts

Poop isn’t just waste—it’s a window into your health. So, the next time you’re gathered around the Thanksgiving table, consider bringing up the Bristol Stool Chart instead of the latest political drama. Who knows? You might inspire someone to make a positive change.

Happy Thanksgiving, and may your Type 4s be ever in your favor!

 

Dr. Sarah Giardenelli, ND, MSOM, LAc, is a naturopathic doctor, acupuncturist, and the owner of Collective Health Center in Leesburg, Virginia. At her practice, you can always count on one thing: we'll talk about poop! Dr. Sarah fosters an open, supportive space where health discussions are never awkward (or maybe just a little), and a little humor makes everything easier—because good health starts with good digestion!

Photo by Megan Watson on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

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[UPDATED 2/5/24] Unlocking the Mystery: How a Newly Discovered Autoantibody Sheds Light on Chronic Fatigue and Hashimoto’s Thyroiditis

[UPDATED 2/5/24] Unlocking the Mystery: How a Newly Discovered Autoantibody Sheds Light on Chronic Fatigue and Hashimoto’s Thyroiditis

by | Sep 20, 2023 | Endocrine/Hormone Health, Prevention

Unrelenting fatigue in patients with Hashimoto’s thyroiditis, despite “normal” thyroid functions tests is an extremely common complaint in my patient population, many of whom have Chronic Fatigue Syndrome. Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a debilitating condition characterized by severe, unexplained fatigue that lasts for at least six months and is not improved by rest. It often comes with a myriad of other symptoms, including muscle pain, cognitive difficulties, and sleep disturbances. Despite its significant impact on the lives of those affected, CFS remains poorly understood and effective treatments are limited. However, recent research has shed light on a potential link between CFS, selenium, and thyroid hormones, opening new avenues for understanding and managing this enigmatic condition.

Yet Another Antibody that Affects Thyroid Function

I recently came across some research by Sun and colleagues that sheds light on why the fatigue for CFS patients with Hashimoto’s might be unrelenting. Interestingly, in 2021 Sun’s research group discovered a new autoantibody that affects thyroid function. Their research verified their hypotheses that the body has natural autoantibodies to the selenium transporter selenoprotein P (SELENOP) in thyroid patients which impair selenium transport and thus negatively affect glutathione production in the thyroid, which is so essential to help protect the thyroid from the oxidative stress that occurs in the thyroid with thyroid hormone production. Their most recent research from 2023 unveiled a fascinating connection between CFS and selenium in the form of autoantibodies targeting selenoprotein P (SELENOP-aAb). [CORRECTION] They discovered that there is a subset of patients with chronic fatigue syndrome with autoantibodies to selenoprotein P (SELENOP-aAb) which hinders normal transport of selenium to target tissues and causes reduced selenoprotein expression [in my originally blog I misstated that these patients not also had Hashimoto's thyroiditis, which the article does indicate - there was no mention if they screened or excluded participants with Hashimoto's]. This disruption had far-reaching consequences on the health of CFS patients.

Selenium Connection

To understand their findings, we need to understand the connection of selenium to thyroid function. Selenium is a trace element that plays a crucial role in various physiological processes within the body. It is an essential component of selenoproteins, a family of proteins that function as antioxidants and help regulate the immune system and thyroid hormones. Selenium helps to protect the thyroid from oxidative stress that occurs normally during thyroid hormone production. If selenium isn't able to be properly transported, oxidative stress and tissue damage ensues and thyroid (and body) cannot function optimally.

Thyroid Hormones and the Impact on Chronic Fatigue Syndrome (CFS)

To fully grasp the implications of SELENOP-aAb in CFS, researchers examined the interplay between selenium, selenoproteins, and thyroid hormones (TH). The thyroid gland produces TH, essential for regulating metabolism, energy production, and overall health. Thyroid hormones come in two primary forms: T4 (thyroxine) and T3 (triiodothyronine). T3 is an active thyroid hormone that has metabolic effects in our body and derives from T4 (inactive thyroid hormone) through a process known as deiodination 1 (DIO1) and deiodination 2 (DIO2). DIO1 occurs mostly in the thyroid, but also in the liver and kidneys, whereas DI02 activity has been detected in areas of the brain (pituitary and hypothalamus), ear (cochlea), brown adipose tissue, bones, muscles, heart, and central nervous system. The T3 produced by DIO2 in these peripheral tissues persists longer in the body for reasons that are not yet fully understood. We also have DIO3 which helps to protect fetal tissues and adult brains (central nervous system) from excessive TH production by converting T4 to inactive reverse T3 (rT3) and T3 to inactive 3,3’-diiodothyronine (T2).

Sun et al introduced two indices to evaluate thyroid gland activity and peripheral deiodination: the SPINA GT index (secretory capacity of the thyroid gland, indicates DIO1 activity) and the SPINA GD index (total deiodination activity, indicates peripheral tissue DIO2 activity). These indices offer valuable insights into how SELENOP-aAb impacted TH metabolism. Patients with SELENOP-aAb displayed lower SPINA GD values, indicating reduced TH activation as well as lower active thyroid hormone (fT3) levels and higher levels of inactive thyroid hormone (rT3). Furthermore, their 24-hour urinary iodine concentrations were significantly lower, pointing to suppressed TH deiodination. This collective evidence suggested that SELENOP-aAb disrupted regular selenium supply to target tissues, resulting in reduced selenoprotein expression, elevated oxidative stress, and impaired TH activation.

Sun et al’s 2023 study is frankly one of the most useful studies on thyroid function that I’ve come across. It sheds so much light onto several different and previously perplexing aspects of thyroid health. Clinically, I tend to recommend 24-hour urine iodine testing to my hypothyroid patients who upon dietary review have a low iodine diet. However, this study helps us understand that iodine levels can be low in patients even with adequate dietary intake because of the SELENOP antibodies making it so iodine cannot be freed from the tissue. Thus, 24-hour urinary iodine might be a helpful test for all patients with Hashimoto’s thyroiditis and if low in a patient with normal iodine consumption, may point towards SELENOP-aABs. Their findings also help to explain why supplementing with high dose iodine in patients with Hashimoto’s can go south for some patients. I’ve never had clinical success with this approach – iodine is very oxidizing to thyroid tissues, especially in the context of low selenium, and there is even more oxidative stress with SELENOP-aABs which creates a functional iodine deficiency. Iodine is like fuel to the fire in this situation. Furthermore, their study helps us better understand why selenium supplement is vital for patients with Hashimoto’s but is not a cure-all in this situation. Other studies have demonstrated that selenium supplementation helps to improve thyroid function and lower thyroid antibodies in patients with Hashimoto’s for several months but without significant improvements after this. Repletion of selenium helps to counter the oxidative stress from SELENOP-aAB, but may not resolve the SELENOP-aABs, this research hasn’t yet been done. Deficiencies of selenium and iodine we may see with SELENOP-aABs appear to be functional and related to these autoantibodies. Finally, this study helps us to better understand why some patients do so much better while on active thyroid replacement than others, particularly those with chronic fatigue syndrome, as their peripheral conversion of inactive (T4) to active thyroid (fT3) is impaired by SELENOP-aAB lending to more brain fog and bodily fatigue.

Implications and Future Directions

The discovery of SELENOP-aAb in a subset of CFS patients opens a promising avenue for understanding and managing this perplexing condition. It suggests that CFS may have an autoimmune component that affects selenium transport and thyroid hormone metabolism, leading to characteristic symptoms of fatigue, pain, and cognitive dysfunction. While naturopathic doctors have long appreciated the nuances of thyroid function in different patients, and that a personalized approach is needed, we didn’t understand all the whys. I was excited to see if SELENO-Abs and SPINA GD discussed in Sun et al’s study, were available through standard commercial medical labs, sadly they are not yet available. I expectantly await additional research with larger study groups and more longitudinal studies that will hopefully pave the way for additional commercially available tests that can help clinicians better understand the nuances of thyroid function in individual patients and more targeted approaches to underlying immune dysfunction.

An Aside - Bio-Energetic Testing!

As an aside, while I was writing this blog this week, another interesting study on chronic fatigue syndrome came across my newsfeed on a blood-cell based diagnostic test for chronic fatigue syndrome that appears to have extremely high accuracy.

These results demonstrate that Raman profiles of blood cells can distinguish between healthy individuals, disease controls, and ME/CFS patients with high accuracy (91%), and can further differentiate between mild, moderate, and severe ME/CFS patients (84%).

Given that so many patients with CFS go through the ringer prior to getting a diagnosis, often being told their symptoms are “all in their head”, obtaining access to an accurate diagnostic test would be a game changer for these patients. The method of testing, called single-cell Raman spectroscopy (SCRS), measures the vibrations of the cell providing a type of energetic fingerprinting of all the biomolecules in the cell. Vibrational energy is being found to help identify imbalances at a cellular level - amazing, right?! Different types of bio-energetic testing and balancing machines (ie EKG, heart rate variability, TENS, etc) have been available for some time, but this is the first time I’ve seen such technology aid in diagnosis so specifically and at a cellular level. As energetic beings, it makes so much sense that medical research is beginning to look at energetic vibrations to provide additional insights on underlying cell function and aid in the diagnosis, monitoring and potentially treatment of disease.

 

 

Dr. Sarah Giardenelli is a naturopathic doctor, herbalist, acupuncturist and the owner of Collective Health Center in Leesburg, Virginia. She loves diving into the medical literature in order to help patients get to the root causes of their troubling health conditions and getting them back with their health. She is grateful to all of the researchers who do the hard work that helps clinicians do better.

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Reverse Aging: Reanimating and Slaying Zombie Cells Naturally

Reverse Aging: Reanimating and Slaying Zombie Cells Naturally

by | Aug 28, 2023 | Brain Health, Healthy Aging, Herbal Medicine, Prevention

Time goes by so quickly, in a blink really! I felt this so much last week as my son, Vincent James, started his first day of second grade! We may feel like we are in a time warp, our cells don’t and as time marches on, our cells undergo a complex series of changes that lead to decreased functionality and increased vulnerability to diseases. One of the key players in this process is cellular senescence, a state in which cells lose their ability to divide and function properly, contributing to chronic inflammation, tissue dysfunction, and age-related diseases. Yes, time marches on and various stressors contribute to the aging process, however, one of the things that I get excited to see is the important role that lifestyle and natural medicine have in combating healing our bodies at a cellular level and helping to slow this aging-process, helping us to age well! Cellular senescence is one of the many topics I had the privilege  of learning more about this past spring at Medicines from the Earth in Ashville, North Carolina with the amazing naturopathic doctor and herbalist, Dr. Mary Bove. She shared some of the recent scientific research that have unveiled natural compounds, such as quercetin and fisetin, as powerful senotherapies capable of rejuvenating senescent cells and promoting healthier aging. She also discussed the so-called ‘hit-and-run’ dosing that seems to make these senolytics most effective. Hit and run dosing = less supplements to support well-aging. Interested to learn more, read on!

The Underlying Mechanisms of Cellular Senescence & Zombie Cells

Cellular senescence is a double-edged sword. While it serves as a protective mechanism against cancer by halting the growth of damaged cells, it also contributes to chronic inflammation and tissue deterioration. Senescent cells accumulate over time due to various factors including DNA damage, oxidative stress, and telomere shortening. These cells enter a state of persistent inflammation and release harmful molecules that can negatively impact neighboring cells and tissues, creating what is often referred to as the "senescence-associated secretory phenotype" (SASP). Because they are not yet dead, but not functional, and create havoc in the body, these senescent cells are also know as zombie cells.

Reanimating versus Slaying Zombies

SASP inhibitors (senomorphics) and senolytics are both approaches aimed at addressing aging-related cellular changes, but they work in different ways. Senomorphic agents morph the signals coming from the zombie cells, while senolytic agents directly target and eliminate these problematic aging cells. SASP inhibitors can be thought of agents that help to turn back zombie cells into healthy cells, like in science fiction zombies being reversed or reanimated back into healthy humans, whereas senolytic agents are the zombie slayers in this analogy. Another difference between SASP inhibitors and senolytics is related to how these agents are dosed. Daily dosing seems best for SASP inhibitors, while senolytic agents appear to work best with intermittent or ‘hit-and-run’ dosing.

Hit & Run Dosing

I know, know, zombie cells and ‘hit-and-run’ dosing, what is going on! While I didn’t come up with these terms, I cannot deny they are catchy and on-point. I was particularly excited to learn about how hit and run dosing seems to make these senolytic agents most effective. Hit and run dosing is exactly what it sounds like, using a higher dose of these agents for just a few days and repeating for at least several months in a row. I am always excited to learn about health supportive strategies that are relatively easy to implement and involve less pills!

Slaying the Zombie Cells with Lifestyle & Botanical Agents, Quercetin and Fisetin

Foundational lifestyle measures are pivotal for maintaining cellular health and combating cellular senescence. Regular exercise, a balanced diet, stress reduction, and other healthy practices play a crucial role. Intermittent fasting has garnered attention for its potential impact on cellular rejuvenation. By cycling between eating and fasting periods, intermittent fasting stimulates processes like autophagy, aiding in the removal of damaged cells. This approach shows promise in reducing the presence of senescent cells and supporting prolonged cellular vitality. Two natural compounds that have garnered significant attention as helping to improve cellular heath are quercetin and fisetin, through their actions as both SASP inhibitors and senolytics.

Quercetin

We’ve heard a ton about quercetin in recent years because of its immune supportive and anti-viral benefits. Quercetin is a plant compound called a flavonoid found abundantly in fruits and vegetables and some medicinal herbs (ie elderberry syrup and green tea), quercetin has been extensively studied for its antioxidant and anti-inflammatory properties. Recent research has highlighted its potential as a senolytic agent. By interfering with pathways that promote cell survival in senescent cells, quercetin helps induce apoptosis, or programmed cell death, in these cells. This remarkable action contributes to the removal of senescent cells from tissues, reducing inflammation and potentially delaying age-related diseases.

Fisetin

Another flavonoid and senolytic agent, found to help our bodies as well , not as well know by the general public is fisetin, found in foods like strawberries, apples, grapes, onions, cucumbers, and in higher amounts in the many trees such as various Morus species (Mulberry leaf), Cotinus coggygria (Smoke Tree) and Rhus succedanea fruit wax (the fruit of a sumac tree native to Japan). The fruit of North American species of sumac also contains fisetin, but have not been as well studied - yet. Fisetin, through its ability to modulate the senescence signaling pathways research suggests it can help our cellular ‘powerhouses’ or mitochondria function despite stress, combats aging in brain clean-up cells called microglia by increasing the production of the important antioxidant called glutathione and thus decreasing inflammation. All these actions work together to slow down age related changes in our aging bodies and brains!

The effects of quercetin and fisetin as senolytics are profound. Not only do these natural compounds aid in the elimination of senescent cells, but they also exhibit the potential to rejuvenate surrounding cells and tissues. As senescent cells are cleared away, inflammation decreases, and the tissue microenvironment becomes more conducive to healthy cellular function. What I find so exciting is that when dosed regularly in lower doses quercetin and fisetin can help to manage inflammation and cellular damage, but at when dosed intermittently and in higher doses the so called ‘hit-and-run’ dosing they act as senolytics, slaying the zombie cells that contribute to our aging.

Beyond Cellular Senescence

The implications of quercetin, fisetin and other botanical senolytics (ie gingerenone A from ginger and piperlongumine from black pepper) extend beyond their senolytic properties. Those of you who have worked with me for years, likely already know how much I appreciate natural therapeutics that are “multi-fers”, a term I’ve lovingly coined for natural agents that have multiple health promoting properties. I’ve long appreciated quercetin for being one of these agents. Both quercetin and fisetin have been studied for their potential in reducing the risk of chronic diseases such as cardiovascular disorders, neurodegenerative conditions, and cancer and research on botanically derived senotherapeutics is on the horizon. Their antioxidant and anti-inflammatory actions may contribute to overall wellness and longevity.

Conclusion

The discovery of natural senolytics such as quercetin and fisetin represents an important advancement in the field of aging research. By targeting and removing senescent cells, these compounds offer a unique opportunity to rejuvenate aging tissues and potentially delay the onset of age-related diseases and are with a relatively low side-effect profile compared to the pharmaceutically based senolytics. The potential for healthier aging through a well-aging lifestyle and the application of these natural therapeutics is good news for those of us who want to both optimize our health and age as well as we can.

 Dr. Sarah Giardenelli is a naturopathic doctor, acupuncturist, herbalist, owner of Collective Health Center. She is passionate about optimizing patients’ health, including strategies to age well. If you are interested in aging-well with lifestyle, natural medicine, and personalized supplements, including senotheropeutic and senolytic agents, please feel free to schedule or reach out to her office.

References

Bove, Mary. Sencescene, Senolytics, and Aging. Medicines from the Earth Herb Symposium Conference Proceeding Notes, 2023. https://www.botanicalmedicine.org/

Chaib S, Tchkonia T, Kirkland JL. Cellular senescence and senolytics: the path to the clinic. Nat Med. 2022 Aug;28(8):1556-1568. doi: 10.1038/s41591-022-01923-y. Epub 2022 Aug 11. PMID: 35953721; PMCID: PMC9599677.

Liu X, Wang Y, Zhang X, Gao Z, Zhang S, Shi P, Zhang X, Song L, Hendrickson H, Zhou D, Zheng G. Senolytic activity of piperlongumine analogues: Synthesis and biological evaluation. Bioorg Med Chem. 2018 Aug 7;26(14):3925-3938. doi: 10.1016/j.bmc.2018.06.013. Epub 2018 Jun 18. PMID: 29925484; PMCID: PMC6087492.

Moaddel R, Rossi M, Rodriguez S, Munk R, Khadeer M, Abdelmohsen K, Gorospe M, Ferrucci L. Identification of gingerenone A as a novel senolytic compound. PLoS One. 2022 Mar 29;17(3):e0266135. doi: 10.1371/journal.pone.0266135. PMID: 35349590; PMCID: PMC8963586.

Rayne S, Mazza G. Biological activities of extracts from sumac (Rhus spp.): a review. Plant Foods Hum Nutr. 2007 Dec;62(4):165-75. doi: 10.1007/s11130-007-0058-4. Epub 2007 Oct 2. PMID: 17909971.

Tsurudome N, Minami Y, Kajiya K. Fisetin, a major component derived from mulberry (Morus australis Poir.) leaves, prevents vascular abnormal contraction. Biofactors. 2022 Jan;48(1):56-66. doi: 10.1002/biof.1798. Epub 2021 Oct 23. PMID: 34687255; PMCID: PMC9298084.

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Breathing Easy: A Guide to Choosing Air Purifiers for a Healthier Home

Breathing Easy: A Guide to Choosing Air Purifiers for a Healthier Home

by | Jul 20, 2023 | Cardiovascular Health, Environmental Health, Naturopathic Medicine, Prevention, Respiratory Health

Weeks of on and off haze here in Northern Virginia have underscored the importance of clean air for everyone. While air purifiers serve as lifelines during hazardous pollution days, they are also effective in addressing common health concerns such as harmful gases, mold, pollen, dust, bacteria, and viruses. While it is unusual for us in Northern Virginia to experience air quality issues related to wildfires, it is not unlikely to be our last go around with this scenario. Most toxicity from our environment comes from what we breath. According to the National Institutes of Health, an estimated 60% of the health problems caused by environmental factors are due to long-term exposure to urban air pollution. Air purifiers are one proactive way to prevent poor indoor air quality, while optimizing your respiratory, cardiovascular, and cognitive health. If you’ve been procrastinating purchasing an air purifier, I urge you to take some action on this today.

Choosing the right air purifier involves three key steps: determining what you want to remove from your air, assessing the area you want to clean and the desired frequency, and considering the associated costs.

Step One: What do you want removed from your air?

Air purifiers employ different technologies to tackle particulates, gases, or both. Assess the issues you face, whether it's dust, smoke, mold, or chemical odors from paint, off gassing carpets, or car exhaust. The market offers a wide variety of air purifiers, making it crucial to explore all the available options to determine the best fit for your family's needs.

HEPA Air Filters

Advantages: HEPA, short for High-Efficiency Particulate Air, meets strict Department of Energy requirements by removing approximately 99% of airborne particulates larger than 0.3 microns. It effectively filters out mold spores, dust, pollen, pet dander, and flame retardants. For these pollutants, HEPA filters are a suitable choice. However, they might not effectively capture viruses, which are smaller than bacteria.

Disadvantages: HEPA filters may not be efficient in trapping gases, fumes, chemicals, or odors or the lung damaging ultrafine particulate. For comprehensive filtration of these pollutants, a disinfecting filtration system is a better option.

Activated Carbon

Advantages: Also known as activated charcoal, activated carbon is highly effective in adsorbing gases and fumes like formaldehyde and VOCs (Volatile Organic Compounds). It efficiently removes odors from the air, providing a fresher environment.

Disadvantages: Activated carbon filters do not remove particles or germs from indoor air. For comprehensive air purification, a combination system is necessary.

Disinfecting Filtration System

Advantages: The disinfecting filtration system is the most powerful on the market, surpassing HEPA technology by around 40 times in efficiency. It can effectively eliminate particles as tiny as .007 microns, including airborne viruses, molds, and bacteria.

Disadvantages: While highly effective, this system can be costly due to its advanced capabilities. However, the benefits justify the investment in cleaner and healthier air.

UV Filters (Ultra-Violet Filters)

Advantages: UV filters have the capability to eliminate bacteria and viruses by employing UV lights for sterilization.

Disadvantages: UV filters are inadequate for removing large particles like HEPA filters or gases and chemicals like formaldehyde, which can be effectively handled by activated carbon filters.

Ionic Filters

Advantages: Ionic filters release negatively charged ions to electrify dust and dander, making the particles attracted to a positively charged collection plate inside the machine.

Disadvantages: Ionic filters may not be effective as the particles can stick to walls, tabletops, and screens. Additionally, they do not absorb VOCs like formaldehyde, and the introduction of ozone into the home can interact with VOCs to create smog, so I do not recommend these.

Ozone Filters

Advantages: Ozone filters use electrostatic plates and ozone to remove odors and freshen the air.

Disadvantages: Ozone filters are hazardous and pose risks to humans and small pets. Even the Environmental Protection Agency (EPA) cautions against their use, making them unsuitable for anyone, so I do not recommend these.

Step Two: How finely do you need to filter particles?

Particulate matter, also known as particulates, is a major concern with wildfire smoke and a key factor in determining air quality. While larger particles can be seen and are easier to remove due to gravity, fine and ultrafine particles, constituting up to 90% of the story, pose a different challenge. These ultrafine particles can penetrate deep into our lungs and even travel through the bloodstream. Understanding the sizes of specific particulates, such as pollen, mold, bacteria, and viruses, helps determine the level of filtration required.

  • Mold Spores: Typically range from 1 to 100 micrometers in size.
  • Mycotoxins: Mycotoxins are produced by certain molds and are much smaller, usually less than 1 micrometer.
  • Viruses: Vary in size but can be as small as 0.02 micrometers.
  • Bacteria: Usually between 0.5 to 5 micrometers in size.
  • Coarser Particulate Matter (PM10): Particles with a diameter of 10 micrometers or smaller.
  • Fine Particulate Matter (PM2.5): Particles with a diameter of 2.5 micrometers or smaller.
  • Ultrafine Particulate Matter: Particles with a diameter of 0.1 micrometers or smaller.

 Ultrafine particulate matter comes from various sources, including combustion processes (e.g., vehicle exhaust, industrial emissions), wildfires, cooking, and certain indoor activities like smoking or using candles. These particles are so tiny that they can remain suspended in the air for longer periods and can penetrate deep into the respiratory system when inhaled, potentially causing health issues. 

Step Three: Evaluating cleaning capacity and costs

Consider the area you need to clean, factoring in both square footage and ceiling height. Understanding the volume of air in the room is crucial for selecting an appropriately sized air purifier. Additionally, assess the air exchange rate, or how often you want the air completely changed, particularly for asthma and allergy relief. It is generally recommended to achieve three to four air changes per hour.

It's important to note that air quality measurements, such as PM2.5, which quantifies fine and ultrafine particles, can vary across different sites. Consulting multiple sources, AQICN.org, AirNow.gov, PurpleAir, and IQAir, provides a more comprehensive understanding of outdoor air quality.

Cost considerations include the initial purchase price, ongoing power consumption, and filter replacement costs. HEPA units typically range from $200 to $900, with additional expenses for specialized units. Filter replacements costs vary depending on usage, fan speeds, and air quality, averaging between about $70 and $175 per year.

Wirecutter provides a thorough review of air filters that they’ve independently tested for quality, several which are excellent. Top of their list for several years running is the well-engineered Coway Airmega AP-1512HH Mighty, which is a more affordable option than some of the specialized units.

However, given my practice where many of the patients I see have compromised health, aggravated by mold, mycotoxins, and other allergens and ultrafine particulates, I’ve considered the following specialized, high quality air purifiers:

Excellent at filtering out ultrafine particles:

  • Intellipure (down to 0.007, has a unique Disinfecting Filtration System, which I appreciate especially for my patients with mold and mycotoxin illness)
  • IQAir (down to 0.003 microns)
  • AirDoctor (down to 0.003 microns)

Excellent at filtering out VOCs – due to heavy carbon filters:

  • AirPura (18 pounds of carbon)
  • AustinAir (15 pounds of carbon)
  • IQAir GC MultiGas (12 pounds of carbon)
  • IQAir Heath Pro Plus (5 points of carbon)

Clean air is a vital aspect of our well-being, especially during periods of heightened air pollution from wildfires. By selecting the right air purifier tailored to your needs, you can effectively address indoor air quality concerns. Don't delay in taking action to protect yourself and your loved ones. With the challenges posed by recurring smoke, prioritize proactive measures and embrace cleaner air for a healthier home. 

Meet Dr. Sarah Giardenelli, an experienced naturopathic doctor and acupuncturist in Leesburg, Virginia, with a specialization in environmental health. With her guidance, you can learn how to optimize both your indoor and internal environment, safeguarding yourself from air pollution. Take a breath of fresh air today and embark on a new journey towards better health! Let's create a cleaner and healthier living environment together.

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