Of all the health conditions that we routinely see, hypertension is one of the most common and thankfully one of the easiest to improve. Once you know where to look, it responds extremely quickly to simple dietary changes.

It’s an unfortunate thing about western medicine that the treatment of a symptom often results in a worsening of the overall health of the patient. While blood pressure medications reduce high blood pressure, many also result in negative impacts on other body systems and the whole person suffers.

Addressing hypertension through diet change however, reduces the severity of that single symptom while elevating the overall health of the patient. Most of our patients who follow this protocol for hypertension end up being able to come off of their blood pressure medication within between 2 and 6 months.

You should never stop a prescribed medication without first consulting with your doctor. For many medications there are establish dosing reductions that need to take place. Whenever my patients come off of their medications, it is always in coordination with their doctor’s office.

Here’s one patient’s experience:
L.M. had blood pressure that was routinely above 180 systolic. She was a former nurse so she knew how important it was to get her blood pressure under control and she diligently did everything her doctors told her. Unfortunately, her doctor wasn’t able to control it. He referred her to a Cardiologist. Her Cardiologist tried multiple medications with no change. He tried combining medications but still her blood pressure wasn’t changing. With all the usual mainstream options exhausted, she came to see me at the suggestion of her son who was also a patient. We made this simple intervention in her diet and within weeks her blood pressure was under control and remains there today. Her Cardiologist was in disbelief and actually angry with how quickly her hypertension resolved. I suppose that’s understandable after all his effort. It’s simple nutrition but surprisingly very few western doctors, Cardiologists included, receive comprehensive training in nutrition.
The good news is that this protocol can easily and safely be done for most patients. (As with most dietary interventions please consult your health care provider prior to starting. This is especially true if you suffer from a kidney or heart condition.)

Step One:
Write down everything you eat and drink in a normal day.

Step Two:
Calculate the amount of potassium you get in that standard day. (Click the button below to download a form to help you find and track those numbers)

Download Form Here

Here’s another resource to find more potassium contents for different foods: https://nutritiondata.self.com).

Okay, let’s take a moment and talk about the science.
Sodium and potassium operate as a ratio. If sodium is too high relative to potassium, you’ll get hypertension, if your potassium is too low relative to sodium, you’ll also get hypertension. What’s important is the ratio between the two. When patients track their potassium at the start of this protocol I typically see numbers between 1,000 and 2,000 mg per day. That’s a big problem. The recommended daily allowance is between 3,500mg and 4,700mg. Not only are most people deficient, they are getting less than half of what is recommended! Since we don’t get nearly enough potassium to start with, in order to get the ratio of sodium to potassium to the point where it will reduce blood pressure we’d need to eat so little sodium that it would actually cause new problems.

A National Academies of Science meta-analysis found exactly this. The sodium intake recommended for years by the American Medical Association was not only not helping hypertension, but was actually making people worse by causing increased triglycerides and increased inflammation.)

The obvious solution is to increase the potassium intake in order to normalize that sodium/potassium ratio (ideally, restoring it closer to what we are intended to get, what we’ve been getting in our diets going back millennia.) Once you increase your potassium your blood pressure responds rapidly. Studies have repeatedly shown this to be an effective strategy.

(I wrote about this subject at length in 2017 click here to read the entire article.
Okay, time for step three, but first, a crucial note:

Do not take potassium supplements!
There are two reasons for this, but most importantly, taking potassium in a supplement makes it possible, and even easy, to take too much. That can and will result in dangerous, possibly fatal heart arrhythmias for many people. Get your potassium only from food unless specifically recommended by your doctor!

The other reason is a little more complicated. Think about it this way: If you are that deficient in potassium, do you think there are other nutrients that you are also deficient in? Americans are notoriously deficient in magnesium, zinc, fiber and vitamin C just to name a few. When you get your potassium from whole foods, you will be increasing your intake those other nutrients as well. A lot of them (like magnesium and naturally occurring Nitric Oxide precursors) will also help to lower your blood pressure and protect your cardiovascular system.
Okay, ready for the fun part?

Step Three:
Now, using the form, shoot for between 3,500 and 4,700 mg per day. You’ll notice that a lot of the foods that are highest in potassium are fruits and vegetables. What’s helped a lot of patients navigate this is to buy as many single serving fruits and vegetables as will fit into the vegetable drawer of their fridge, think carrots, oranges, bananas, celery, pears, apples, bell peppers, plums, and peaches. Whenever you’re hungry for a snack just grab another piece of fruit. Shoot for having 4 servings of fruits and vegetables as snacks each day then have a serving with each meal. That will bring you to 7 servings for the day. Not bad, and on average you’ll be up to between 2,500-3,500mg of potassium already. Add in the starches with your meals - (especially good sources are quinoa and potatoes) and you’ll be right around your target.

Follow this protocol exactly as described and within between 2-5 days you should already notice a change and within 2-4 weeks you should be able to easily maintain your blood pressure in the normal range.
​
Enjoy watching your blood pressure drop, and enjoy the feeling of being in charge of your own health!

When something is off about your health, what does your doctor do? Most doctors (thankfully not all), will prescribe a medication based on the symptoms you are having: lisinipril for your blood pressure, a statin for your cholesterol, maxalt to prevent your monthly migraines, metformin for your elevating blood sugars, ambien for your sleep and, just for good measure, some prozac for your depression and fatigue. That’s an awful lot, but surprisingly, it’s not uncommon. 

This system of medicine doesn’t view you as a person with a complex physiology. You’re a list of symptoms. It isn’t healthcare because that would be focussed on improving your health. This is management of your illness. It should be called sick-care. 

Functional Medicine approaches it differently. It doesn’t look to treat your symptoms. It looks for an underlying common root that connects your symptoms. This takes careful investigation. Your practitioner needs to untie the knots that have been formed from poor diet, genetics, emotions, exposure to toxins, and other factors. We may order additional blood tests beyond what your doctor orders so we can identify not just what’s wrong, but why. The myriad symptoms can usually be traced back to a few basic root causes. 

A situation like that described above can occur when poor diet and lack of exercise cause sugars to accumulate in the body. The biological systems within our bodies are interrelated and delicate. Everything’s connected. When one system is damaged that spreads dysfunction into other systems. The rising sugars damage the machinery of energy production. Cholesterol and triglycerides also increase as the body looks for places to store all the extra energy. As enzymatic function is impacted by excessive blood sugars, inflammation starts increasing too. Nutritional deficiencies from poor diet drive inflammation even higher.  As your blood sugars are driven up and down throughout the day by sugar rich snacks, your stress hormones are pushed up and down too. You start to experience alternating cranky periods followed by energy crashes. The rest of the hormones get thrown off by this roller coaster of stress hormones. As a result you feel exhausted all day, but can’t sleep at night. Menstrual cycles can be affected, causing menstrual migraines. Even though these are all different symptoms, you can see that they all can be traced back to a few issues in the fundamental functioning of your body. 

Your Functional Medicine practitioner will get you eating foods that will supply steady energy through the day so your metabolism can stabilize. A relaxation program and an adrenal support supplement can help to bring your wild stress hormone swings back to normal. Adding a high quality multi-vitamin will replace the nutrients that have been lost through poor diet. Lifestyle support such as relaxation techniques and refining your sleep habits would round out a successful functional medicine program for a patient like this. 

All of your body’s systems are interrelated. If you don’t address these root causes of illness and disease then you are just covering up symptoms while the underlying health continues to erode. 

I hope this finds you all healthy and whole.
I've never in my life experienced anything like this. I've never seen a situation in which there is such risk for loss of life, or felt so powerless to do anything to help. I've worked to find a way in which our clinic can help in a real way, and our current effort is the result. 

As you all likely know, we have been closed to all but those patients who, without our care, may end up requiring advanced medical care, encumbering an already overworked medical system. That seems the only way in which our services can be delivered without the possibility of doing more harm than good. 

However, there are still a lot of services that we can deliver without patients coming into the office. We have been sending out a lot of herb orders the past few weeks, consulting with patients on new symptoms and sending out exercise and meal plans.

We are also adding a new service for our patients who are at the most risk of having a serious illness related to Covid 19. Chinese Medicine absolutely does have a place in the treatment of Covid-19. Our medicine has incredible nuance and sensitivity. Chinese Medicine can treat patients at the earliest signs of illness, long before it would be safe or appropriate to take western prescription medications. In fact, multiple stages of Covid-19 development can be treated before the patient has even reached the point where Western Medicine can take them on. Because our medicine is safe and generally without side effects, and because our diagnostic techniques are so refined and nuanced, we can treat patients before they've reached the point at which a Western doctor can treat them. The key to capitalizing on this potential is catching any developing Covid-19 cases early enough that we are able to intervene in a meaningful way while the condition is still mild. So, we have added a portal to our website where our at risk patients can send a regular update on their symptoms. That portal will send a message directly to your practitioner informing them of your status in real time, allowing them to identify any worrisome changes right away and get the appropriate treatment in place before the situation is able to worsen. 

For our patients in at risk populations (those older than 60, immunocompromised, or with associated illnesses that increase vulnerability to Covid-19), we will be sending out prompts with links to the form to fill out at regular intervals. If you are not in that population, but would like to get regular prompts in your inbox as well, contact our office or reply to this email, and we'll add you to the list. If you choose not to be part of our prompts for this service, but develop symptoms at a later time and feel that you'd benefit from a rapid response, you are welcome to complete the form at that later date and and we'll get in touch with you right away. You can find the form here. If in depth assessment becomes warranted for your symptoms a consultation appointment may be scheduled and that appointment fee may apply. 

It is still our feeling that a patient should notify their doctor of any emerging symptoms right away, and our support should in no way replace or supersede you communicating with your regular doctor. 
Hang in there folks. We'll come out of this stronger. 

Warm regards,
Kieran

In Today's Newsletter:

• Our Holiday Schedule
• QiGong in the Park​

 
The office will be closed from Monday Christmas Eve through Tuesday New Years day to allow for some much deserved down time with family. Appointments will be available on an on call basis however for any emergencies that arise. Although our time to recuperate and recharge is important, so too is our service to you, the community. Don't hesitate to call if you urgently need care. Kieran will have all calls forwarded and will be screening messages over the break. 

QiGong in the Park

This has been a long time coming. I am passionate about QiGong. A regular practice can have immense positive impacts on your health. I've prescribed QiGong exercises for many of my patients, and I do a set of QiGong exercises daily to keep my mind clear, my energy up, and my abilities for healing honed throughout the day. These classes will be free of charge and will occur on Wednesday afternoons at 1:00pm at Kotate Park in Cotati (just a short walk from our other office!) If you're interested in participating please respond to this email letting us know, that way we can reach out if inclement weather forces a cancellation. Our first class is scheduled for Wednesday January 9th. I hope to see you there. It will be an ongoing and informal class, so feel free to drop in when it's convenient.

As always, it is with the deepest gratitude and honor that I place myself at the service of your health, 

-Kieran Jones L.Ac. MTCM

There is one key thing about nutrition that modern Western Medicine gets wrong over and over and over. 
I call it the "all or nothing" approach to nutrition. Basically, every food group, ingredient, or nutrient is either good for you (eat it all the time!) or bad for you (never, ever, ever eat that!). When the medical research seems to indicate a connection between a particular food item and a health condition, the response is to reduce the intake of that food down to as close to zero as possible. There have been many vilified foods: saturated fat in the recent past, carbohydrates currently, and for many people, ever since a high blood pressure reading at the doctor's office, salt. For a long time the recommendation has been to reduce intake of sodium as low as possible, with a maximum of 1,500mg/day for those with hypertension or cardiovascular disease. The problem is that nutrients don't work like that. Nutrients work in a  way that has been described by many as "The Goldilock's Principle".


In 2013 the National Academies of Science's Institute of Medicine undertook a massive evaluation of all the available evidence. They combed through hundreds of studies on the relationship between sodium intake and cardiovascular disease, kidney health, blood pressure and blood lipid levels. What they found should change how we think about salt intake. (here's a link to the study)

Just right...What they found is that reducing your sodium intake down to 1,500mg/day doesn't provide additional benefits to blood pressure. It also increases the risk of adverse effects. It leads to an increase in triglyceride levels, negatively impacts insulin levels, and increases the risk of chronic heart disease when compared to those consuming a more moderate level of sodium. Reducing sodium intake IS an appropriate intervention only IF your sodium intake is extremely high, (say 5,000mg/day or more) but if you are getting the typical amount for an American (2,900-4,200mg/day) you are unlikely to gain additional benefits by further reducing your sodium intake. That's because optimal sodium intake, like most nutrients, is defined by "the Goldilock's principle" (you thought I'd never come back and explain that, didn't you?) Basically, you could draw the optimal intake for sodium as a bell curve with an optimal range somewhere in the middle. Get a lot more, or a lot less than that optimal range and symptoms start to pop up. You want it to be "just right.". (there are a few genetic variants for which sodium restriction will have a more pronounced effect, the bell curve moves to the left for people with these genetic variants. These "salt-sensitive" people are identified by our genetic consultations.) When you do consume salt, it's a good idea to move around the world (Himalayan sea salt this month, Mediterranean sea salt next month) as each region will produce salt with slightly different trace mineral content; mixing it up will optimize your intake of these trace minerals.

*A Little Aside: To Iodize or not to iodize? 
The presence of iodine in the absence of sufficient selenium (rampant in America) can trigger autoimmune thyroid disease. Iodization of our salt coincided with a 4 fold increase in auto-immune thyroid disease. However, Americans are often also iodine deficient. What to do? My recommendation to my patients is to get your iodine by regularly consuming seafood and seaweed (sources that contain both iodine and selenium), and to avoid iodized salt. 

So, what is the optimal Nutritional Approach to High Blood Pressure
There is, however, a large body of evidence supporting increasing potassium intake to improve blood pressure. (Here's a massive meta-analysis) This isn't surprising as sodium and potassium work in a push-pull relationship, controlling cell membrane gradients, and influencing kidney excretion of one another. Adequate intake for potassium is 4,700mg/day for adults. In addressing high blood pressure in patients, I've often had them track their daily potassium intake. The majority of my patients found they were consuming in the neighborhood of 2,000mg/day, or less than half of the recommended daily intake. Once they bring their potassium intake up, blood pressure drops. It is a great intervention because it is rapid, reliable, and simple to implement. Track your potassium intake for 1 week and maintain at least 4,700mg/day. By the end of the week you can expect your blood pressure to be down by around 15 points (seriously).

Two other important nutrients for blood pressure control are magnesium, and soluble fiber. You can get potassium, magnesium, and soluble fiber in plentiful amounts with a single intervention: eat more fruits and veggies. Aim for at least 6 servings per day. It's easy: reach for a fruit or veggie instead of potato chips or a granola bar when you want a snack. Have a fruit or veggie with each meal. 

Just a few short years ago, everyone was taking Fish Oil. 
Now it doesn't seem nearly as popular, and for good reason. The studies are not consistent on the impact Fish Oil has on the body. We'll cover what happens when Fish Oil goes in the body and why too much may be a bad thing. 
Here's why we take it: 
Fish Oil provides Omega 3 fatty acids (so termed because they have a double bond located 3 carbons from the end of the molecule.) You may have heard of Omega 6 fatty acids? Yep, you guessed it, 6 carbons from the end in that case. This fairly simple difference changes how easily these molecules bend, The Omega 3s are more flexible, and make structures built out of them more flexible The Omega 6s are stiffer and make structures more stiff. 

Ok, so? Omega 3 and Omega 6 fatty acids have very different impacts on the body. They integrate into the cell membranes and influence the viscosity of the cell wall. They also become the precursors for hormones called prostaglandins. If there are more Omega 3s, then it will be more likely that an anti-inflammatory prostaglandin will be formed. If there are more Omega 6s, then the prostaglandins that are made are more likely to induce inflammation. 

It's all about the ratio.Our evolutionary ancestors consumed between 1:1 and 3:1 omega 6s to 3s. The typical American diet, because of its reliance on certain types of oils and grains, runs closer to 20:1. Now you know why that's a bad thing, and means a lot more inflammation.  

Omega Fats are fragileOkay, so omega 3s are good for you. But only up to a point. They are also very fragile molecules. If not sourced from from high quality fish oil, omega 3s can actually cause some harm. Not only that, but your total intake should be pretty low. (they should only make up about 1% of your total caloric intake, about 1 teaspoon) Chris Masterjohn (PhD in lipid biochemistry) likens Omega 3s to wine glasses. They are fragile, so you'd rather not have them all over your house. A few is good, more is not better.  
Okay, so what should you do?Quick and simple, here's the take home: 

1. Try to influence your omega 3 to omega 6 ratio by reducing your omega 6 intake rather than increasing your omega 3 intake. Avoid using industrial oils (Canola, vegetable oil, corn oil, etc) and use coconut oil, butter and ghee instead whenever possible. Increase your intake of grass fed meat and wild fish, fruits and vegetables and reduce your intake of grains.
2. If you do take Fish Oil, say to reduce blood pressure, reduce inflammation, lower your triglycerides, or improve mental/emotional health (all good uses backed up by solid research!) make sure you TAKE HIGH QUALITY FISH OIL! Do not buy it at the drug store or Costco. Instead, get it from a practitioner or a reputable store. Bad or sloppy manufacturing processes result in oxidized omega 3 molecules that damage your health. 
3. Store your Fish Oil in the fridge, not on the counter and definitely not in the cabinet above your stove.
4. Or better yet, take Fermented Cod Liver Oil instead of Fish Oil 

Do you have a favorite brand? 
I'd love to hear about your experience, questions or comments.

All the best, 

Sometimes surgery is a necessary step in healing. What can you do to help make sure it is successful?There are some dietary and supplement strategies you can use prior to surgery to improve the success rate and reduce the risk of complications. Here's a step by step guide.

It's all about building your reserves. Surgeons are understandably a little wary about their patients taking supplements prior to surgery. Vitamins, supplements and herbal products can alter the way the liver breaks down medications, impact clotting ability, or create synergistic effects with anesthesia drugs. You should always follow the recommendations of your surgeon regarding avoiding supplements prior to your surgery. However, the few months leading up to your surgery are all yours. It's during these few months that you want to build up your stores and support the cell-level availability of these nutrients. 

ZincZinc deficiency is especially common in America (I covered this topic earlier in this newsletter). Take 30mg per day for 6-8 weeks leading up to your surgery. Zinc is helpful prior to surgery because: 

• It is essential for wound healing
• It helps regulate post surgical hypoglycemia to speed recovery
• It supports healthy immune response to reduce your risk of infection

Fish OilThe omega 3 fatty acids derived from fish oil incorporate first into your cell membranes where they are then utilized as needed to synthesize important hormones in the body called prostaglandins. The more omega 3 fatty acids you have stored up in your cell membranes the more your prostaglandins will reduce inflammation. Think of it like stacking the deck for health. Start about 3 months before your surgery and take 2,000 mg/day. If you are curious about how well set up your system is with omega 3s already, there is a simple blood test that most alternative medicine practitioners can do to see what your omega 3 to omega 6 ratio is. Fish Oil is a tricky supplement to buy, because while good fish oil protects you, bad fish isn't just neutral, it is actually really bad for you. You want to make sure your fish oil is high quality, and you want to store it in your refrigerator. Here’s the product that I use for my patients. I have a newsletter article coming up on selecting good fish oil so stay tuned. 

• Helps the body respond correctly to the trauma of surgery
• Reduces inflammation
• Helps manage blood pressure

Vitamin DVitamin D is crucial for both infection reduction and to support healing. Vitamin D has been shown in studies to reduce the risk of antibiotic resistant hospital acquired infections such as MRSA. An optimal approach would be to do blood work to identify your vitamin D level, then supplement based on your needs. If blood testing isn't an option for you, take 4,000iu per day for a month before your surgery. 

• Reduces risk of MRSA and other infections
• Speeds healing

SeleniumTopical iodine wash is still used in the majority of surgical preparations. Enough iodine is absorbed through the skin by pre-surgical antiseptic wipes that iodine excretion in urine is 7 times higher the day after surgery. (study)  Iodine is a benign mineral in many people, but in those with inadequate selenium stores, a sudden increase in iodine can exacerbate or trigger an autoimmune attack against the thyroid gland. Selenium is also a cofactor in the synthesis of the body's main antioxidant, glutathione (study). Take 200mcg per day for a month leading up to surgery. I prefer this product for its bioavailability. Brazil nuts are also very high in selenium.

• Safeguards the body against iodine damage to thyroid
• Supports antioxidant function

Magnesium Magnesium improves perfusion by regulating blood vessel dilation. It supports healthy muscle contractions, helps to maintain regular heart rhythm, and is depleted by physical stressors (such as surgery)

• Supports healthy heart rhythm
• Supports a healthy recovery
• Reduces post surgical muscle cramping

ProbioticsPost surgical infection is one of the most common complications impacting patient recovery and surgical outcomes. Because of this risk, the importance of antibiotics in surgery is hard to overstate. However, those antibiotics can result in their own side effects. The most serious concern from antibiotic use is infection by an opportunistic pathogen called Clostridium Difficile. When the healthy bacteria in the gut are wiped out by antibiotics this unhealthy bacteria can take over resulting in long lasting and serious complications following surgery. Prior to surgery a product such as Ultra Flora Balance would be best to build up numbers of healthy bacteria. Following surgery, a stronger formulation such as Ultra Flora Intensive Care is more appropriate. 

• Helps to support gut health
• Reduces the risk of developing post-surgical complications such as C. Difficile infection. 

CollagenThis one is more appropriate after surgery, although, most people would benefit from adding collagen to their general supplement line-up as well. Collagen powder provides the building blocks to repair tissue. Collagen figures into the structure of most of our tissues: bones, skin, hair and, of course, cartilage. The main amino acids found in collage are proline and glycine, which are non-essential amino acids (meaning your body can make them from other amino acids.) However, the demand for these building blocks is so high during surgical recovery that it is likely that demand outstrips supply. Adding collagen speeds healing, and ensures scars heal more smoothly. Glycine (one of the amino acids found in collagen) also figures prominently in other body systems including neurotransmitter function and synthesis. When it is deficient, adding it back in usually has a calming effect. 

• Speed healing of tissue
• Helps to supplement post surgical protein intake 

Carb-LoadingBecause surgery is a physiologically stressful event for the body, there are several natural responses that take place. Stress hormones shoot up in response to surgery. These stress hormones mediate various effects, one of them is the rapid increase in blood glucose. Remember that glucose isn't all bad. It is a problem when it is elevated for a prolonged period of time, such as in diabetes or metabolic syndrome, but in the short term this increase in glucose is valuable. Glucose is the fuel the body uses to power the machinery of healing. The glucose is converted into ATP in the cells. The more healing that needs to take place, the more glucose and ATP is needed. When athletes carb load they are trying to fill the glycogen stores (where glucose is squirreled away for future use.) It's a good idea to spend the day before your surgery filling these storage sites as well. In fact many surgeons are beginning to relax their recommendations on fasting prior to surgery, sometimes suggesting a clear, sugar containing drink in the 6 hours prior to surgery. (Please ask your surgeon before adding this to your preparation) There have been several studies (study, study, study) examining the benefits of pre-surgery carb loading. Some of the benefits include:

• Faster healing
• Shortened post surgical hospital stays
• Improved inflammatory response

RelaxationStarting off your surgery in a mentally relaxed state improves both short term and long term outcomes. Cardiac surgery patients have poorer outcomes if they were exposed to high stress prior to their surgery (study). Mental and emotional stress also reduce both immunological function and the healing response (study). Stress is associated with an increased risk of post-surgical complications, and poorer pain control. The clear take-home message is to stay relaxed prior to your surgery. Bring some headphones with your favorite music to get ready for your surgery. Bring along the people that calm you down. Take a nice walk the morning of your operation. Of course, staying calm before a surgery is easier said than done. However, the ability to relax at will is something that can be cultivated. Engaging in a regular, daily relaxation practice (prayer, meditation, etc.) for a month or two prior to your surgery will help to improve your ability to keep your cool when it counts. 

​Happy to help.
I hope you find this information useful.  Feel free to hit the reply button and let me know about your experience, or any additional questions you have. 

PS: Here's a link to an exercise you can do after your surgery if you (like many people) experience post surgical ileus (a common surgical complication where the intestines don't immediately start moving again). It was a great help to me after surgery. ​

How Nutrigenomics can Optimize Diet for Bone HealthIn the July issue of Jama (Journal of the American Medical Association) there was an article outlining the results of a huge meta-analysis of genes related to calcium absorption, use and excretion.

The study looked at hundreds of thousands of patients and compared their genetic data to their blood calcium levels. They found that there were several genes that influenced calcium levels, and 6 genes that had a significant impact on the circulating calcium levels. 

In this week's article we look at why this is important in the treatment of osteoporosis and more importantly in protecting patients against cardiovascular disease. 

Read the Abstract in Jama

Calcium is a double edged swordStudies are mixed on calcium supplementation. Although it has been recommended for osteoporosis prevention for decades, many studies have found that supplementing calcium increases the risk of cardiovascular disease. (Study, study). Calcium supplementation in women with existing cardiovascular disease has also been associated with an increased risk of dementia (study). In this current study those participants who had the genetic variants associated with higher blood calcium levels also had increased risk of heart attacks and strokes as well. Not all studies have been consistent on this topic. Many studies failed to find any significant connection between calcium supplementation and cardiovascular disease. These genetic variants influencing calcium absorption, utilization and excretion may provide the missing piece of the puzzle that explains these discrepancies.

It bears stating that this doesn't change the basic tenet of nutrition, namely, that nutrients exist and operate within the fabric of a complex diet consisting of various nutrients. You can't provide a single concentrated nutrient as a supplement and expect it to behave as it does in a healthy diet. Calcium is no different than any other nutrient in this regard, and depends on other nutrients for proper use. The best approach is, as always, a complex, nutrient dense diet rich in whole, unprocessed foods.
Vitamins D and K influence the function and absorption of CalciumIn those with sufficient vitamin D, calcium is less likely to end up plastered to the blood vessel walls. Sufficient vitamin D stores also seem to help regulate absorption. In order to provide adequate Vitamin D through sun exposure, a minimum of about 10 minutes in full sun, exposing arms and legs is needed 2-3 times per week. (study) Vitamin K2 also helps to protect blood vessel walls from calcification by supporting the proteins that clean calcium out of the blood vessels. (article)

So what about your Genes?Genetic consultations at The Parani Clinic consist of 3 one hour sessions where we dive deep into your genes. We evaluate genes like the ones appearing in this study as well as hundreds of others. Our goal through these sessions is to give you a detailed template for the best practices for your health; from the best diet for you to the most effective exercise approaches, and specific lifestyle strategies. We can often identify environmental toxins that your system is especially sensitive to and help you to form strategies to avoid exposure to them. As in the case of calcium for the participants in this study, there are nutrients you will need in smaller amounts and some you will need in larger amounts based on your genes. The capacity for personalized genetic medicine to optimize your health through uncovering all the specific fine adjustments about how your body functions is exciting and promising. It allows us to identify and treat disease long before it appears. 

In the context of osteoporosis, if a person has multiple genes that increase circulating calcium levels, then attempting to address osteoporosis by adding a calcium supplement is not only ill advised, it should be avoided as it will likely increase their risk of heart attack or stroke without offering much benefit in terms of bone strength. 

For those with genetic variants increasing calcium levels, here are a few simple interventions that are likely to be helpful:

• Make sure to consume vitamin K2 regularly (it activates a protein that removes calcium from the blood vessel walls and helps it to get back into the bones). 
• Avoid calcium supplements
• Test your vitamin D levels yearly and take supplemental vitamin D if needed to keep your 25 hydroxy vitamin D above 40
• In patients requiring blood thinner treatment, Vitamin K antagonists (such as warfarin, and Coumadin) may not be the best option. Because patients taking these medication need to limit their vitamin K intake, they open themselves up for additional cardiovascular damage. Consider consulting with your doctor to find a suitable replacement. 

You Can Sign up for a Genetic Consult Here

​Did you enjoy this material? 
Comment and let us know what other subjects you'd like us to cover. 

Who should take CoQ10 and Why?​
I've had numerous conversations about this subject in the past few weeks so I thought it would be a good time to do an article on it.

First of all, What is CoQ10?It stands for Coenzyme Q10. It is a compound that is naturally made inside the body. It performs various functions in the body including providing antioxidant support for blood vessels, helping to utilize energy in the cells, protecting cell membranes from damage and assisting in the production of other useful compounds and enzyme functions. 

It protects the blood vessels
​Coenzyme Q10 is one of the main fat soluble antioxidants that the body uses to protect the blood vessels from damage. Oxidative damage cause body tissues to break down and attracts inflammation. When this happens in the blood vessel walls it leads to arteriosclerosis, high blood pressure, and cardiovascular disease. CoQ10 protects the blood vessels from oxidative damage. ​

It helps make energy 
Inside the cells there are small structures called mitochondria that convert sugar and fat into energy, CoQ10 helps this conversion to occur. For this reason it often helps to alleviate fatigue (study). In some kinds of migraine headaches where energy utilization contributes to the onset of migraines, CoQ10 has been found to be effective.

It lowers blood pressure 
​Coenzyme Q10 is effective and safe for the treatment of high blood pressure. As CoQ10 makes the blood vessel walls healthier they also become more flexible, reducing blood pressure. In a meta-analysis CoQ10 was found to lower blood pressure by as much as 18 points. 


So who should take CoQ10?First of all, anyone taking a Statin should be taking CoQ10 because statins inhibit the body's ability to make CoQ10. (study) Especially those who experience adverse effects from statins such as muscle pain or brain fog (study). For these symptoms try 100mg/day for 4 days then increase by 50mg per day until your symptoms are reduced, up to 500mg/day. 

Second, if you have high blood pressure you can use CoQ10 to reduce it. Try 200-300mg/day. (By the way, there are a lot of dietary interventions that are especially effective for blood pressure, here's a video I did on it.)

Lastly, if you are experiencing fatigue (or fatigue that triggers migraines) try CoQ10 200mg/day. This is more likely to be effective for you if you also suffer from fibromyalgia symptoms like muscle pain, mental fatigue, and metabolic dysfunction. 

A Final Notes
CoQ10 is available in two forms (ubiquinone and ubiquinol). The research is unclear on which is better. Most studies seem to indicate they work equally well (although ubiquinol is much more expensive!). In our clinic we use ubiquinone and have only had good results with it. 

Sinus symptoms have been especially frequent lately.

They are common this time of year. But here are some steps you can take to prevent, and treat them...

1. Start with DietFortunately for you there are quite a few easy steps you can take that have a big impact: 

Consume a wide variety of fruits and vegetables. As excellent sources of the mast cell stabilizer, Quercitin, fruit and vegetables can reduce the frequency and severity of allergies that may precipitate sinus congestion or infections.

Also, by boosting the immune system fruits and vegetables can also reduce the frequency and duration of colds and viral infections affecting the sinuses. For the best results, emphasize capers, citrus, fresh herbs, and leafy greens. If you have a hard time getting enough fruits and vegetables in, download our daily tally card to keep you on track.

Unknown food allergies can also be a big contributing factor. Foods that irritate your digestive system stimulate the production of phlegm and mucus. If you feel increased mucus in your throat after consuming a particular food, chances are good that it is contributing to your sinus congestion. If dairy is an issue for you, check out our article on A2 milk. 

2. Fix your PostureIncreased muscle tension in the shoulders, neck, upper back and pec muscles can trigger referral pain patterns that result in pain in the sinuses. More importantly, muscle tension in these areas also reduces lymphatic circulation resulting in a slower immune response to pathogens in the sinuses, making infections more frequent. Lastly, circulation and drainage of the sinuses can be impeded by structural problems associated with muscle tension in the upper neck and facial muscles, resulting in more congestion and more pressure.

Here's a good exercise for relaxing the neck, head and upper back:

-Imagine a string drawn from the top of the head up to ceiling is suspending you. Stretch up towards the ceiling from the top of your head. 
-Now lift your shoulders up towards your ears and inhale. 
-Roll your shoulders back, exhale, and let your shoulders drop.
-Roll your hips side to side feeling for any tension or asymmetries, relax into a neutral position in the hip. 
-Carefully hold this position and take large, yawning breaths. If you did it right you may feel your ears pop. Nice job!

3. Hydrate!Your body needs fluids to support healthy circulation through the sinuses. The best fluids are warm liquids such as tea and broths. Sweet drinks, and dairy are likely to increase your congestion. Ideally, you should have water available to you all day. If you keep it next to you at your desk or work, and in your vehicle, chances are you'll drink enough without even trying. 

4. Practice the Ancient Technique of Guasha. In Traditional Chinese Medicine, guasha is a technique done to increase circulation and reduce inflammation in a specific region, meridian or tissue. In the case of sinus congestion, you want to perform the Guasha on the upper back, on either side of the spine.

To perform guasha, you'll need a flat tool with a blunt edge, the ceramic soup spoons you get at a Chinese Restaurant are an ideal implement, but you can also use a ladle, the rim of a coffee mug, or the handle of a comb. Apply some lotion of oil to the skin, then scrap down the skin from top to bottom, applying a little bit of pressure. It shouldn't be painful, but you should use enough pressure to turn the skin red. 

This opens up the lymphatic drainage from the throat and sinuses to help drain the fluid, but also transport antigens from the bacteria or virus present in the sinus cavity to the rest of the immune system so that antibodies can be formed to respond to the infection. 

Work with a Professional!Acupuncture, Herbal Medicine, and Targeted Nutritional Recommendations can take treatment to the next level, and treat the root causes of your sinus congestion.Often, there is an underlying cause for frequent sinus congestion. Often stemming from issues in the digestive system. Working with a practitioner for these symptoms can speed up recovery, as well as prevent future illness manifesting from the same cause. 

We'd love to hear from you. What works for you when you get sinus congestion? Any questions about treatment or management?