EM Wave Personal Stress Reliever

Ok - I know what most people think of when they hear "Personal Stress Reliever" but in this case it's not a euphemism. It's the name of a product I highly recommend for people who are looking for a way to learn to manage stress better. It comes from the good people at Heartmath, an organization which promotes a form of biofeedback based on heart rhythms.

Specifically, research done by them, and others, has found a very strong link between the way the heart beats and our emotions. Of course, we all know how it feels when your adrenaline surges, like before giving a big speech (or in my case, playing into the wind with a 200 yard carry) - your heart races from the anxiety. Fewer people know that sometimes it can go the other way - physical sensations in our bodies, like a fluttering heart, can trigger anxiety. But the Heartmath research goes even further, finding a much more subtle connection between way our heart rate varies from beat to beat and feelings like appreciation, love, flow, as well as ones like fear, rage and depression. (If you want to know more, you can start with this summary, or check out my Amazon store for even more reading).

Even better, using this connection, researchers have found that working with the Heartmath EM Wave system can improve control of hypertension, asthma, and diabetes; relieve symptoms of insomnia, depression and fatigue; and help optimize performance for students, athletes and other who need to perform at their best.

I'm currently offering this to my patients with high blood pressure, anxiety, stress, depression, eating disorders, headaches, insomnia, etc. - and finding great results. If you are in the San Francisco bay area, you can come and see me at the Noe Valley Clinic for a consultation. Also, please feel free to send me an email with more questions, and consider the Personal Stress Reliever, which you can buy through my Amazon store or the Heartmath website.

Maca (Lepidium meyenii), coming to a health food store near you!

In accordance with my ongoing efforts to keep my patients and readers on the cutting edge of health and medicine, let me present Maca (Lepidium meyenii ), a plant grown high in the Andes mountains for over 2000 years. I only recently heard of it, and believe there is enough preliminary information to add it to the "one to watch" category.

Of course, the Peruvians would say it's been used medicinally for at least hundreds of years, for conditions related to male fertility and female menstual irregularities. It's also been used in Peru as a "vitality boosting" medicine, in atheletes to boost performance, and in people with depression or fatigue. In the last 5-10 yrs there has been a growing global interest in the plant for its medicinal properties, so much so that now you can find it at Whole Foods and many other natural markets.

So far the scientific evidence has been limited, finding only small effects on male libido, as well as in sperm quality, without affecting testosterone levels.  Studies in humans have looked at doses of 1500 and 3000mg daily and found no significant adverse effects. As always, it's a good idea to discuss any new medicine, plant or not, with your physician. Patients at risk for bleeding, or with hormone-senstivie cancers should be cautious when considering its use.

So is this a "natural Viagra"? Should everyone be using Maca? To help guide patients interested in using it, I've looked to Dr. Oz, who recommends the supplement to boost energy. I've also read Dr. Weil's take, and he feels there is insufficient evidence to supoprt using Maca medicinally at this time.

What about Dr. Blackman, you ask? While I do think the evidence is still too scant to make strong conclusions, I have recommended this to a few patients looking to conceive, and with fatigue. As I told them, it should be taken with food because it can cause heartburn. It may also cause insomnia, so pay attention to your sleep quality and if affected, cut back or stop completely.

For more info, please review the Bottom Line Monograph from NaturalStandard.com.

Evidence for Supplements

If you are looking for ideas on where to start with supplements, either for general health or for a specific problem, this website from and David McCandless and Andy Perkins, presents the best available evidence for a wide variety of herbs and nutritional supplements.

Using Pubmed and the Cochrane Collaboration databases, two widely used sources for cataloging and reviewing the biomedical literature, they've identified high quality studies that looked at the use of health supplements. Then they created a spreadsheet which gives "quality of evidence" and "popularity" scores to each supplement, as well as tags for specific conditions. Pretty simple, and very powerful.

Pregnancy and depression, new news.

I promise I'll have posts from other sources, but the New York Times just reported on a study done at Stanford in which women with depression who were pregnant saw significantly greater benefit from symptom-targeted acupuncture than from "generic" acupuncture or massage. Moreover, the amount of benefit these women received from the specific acupuncture was about the same as has been shown for antidepressant medications.

This is important because women who are taking antidepressants and become pregnant often face a difficult choice between continuing on an antidepressant, and taking a risk of harming the fetus, or of stopping the medication and suffering a relapse of their symptoms. (For more information, see the Mayo Clinic summary of risks/benefits of antidepressants during pregnancy.) This research suggests that focused acupuncture might be a great alternative.

It's also worth noting that the massage had a pretty good effect on the subjects' depression symptoms, so one might consider a combination of both anti-depression acupuncture and massage for depression in pregnancy.

Finally, I want to put in a plug for Jeannie Bianchi LAc, an excellent Chinese medicine and acupuncture practitioner whom I have been working with at the Noe Valley Clinic. She does a lot of work with pregnancy and post-partum care, and I've been learning a lot from her. If you are in the SF bay area and are looking for a good acupuncturist, she is great!

For thousands of years...

...The Greeks have been eating well. Here's a great article from the NY Times on delicious Greek vegetarian dishes.

Happy Birthday George!

Take a stand. Or a walk.

Here's an interesting article from the New York Times on the potential problems with sitting too much.

My first reaction was, well of course sitting too much, or a "sedentary lifestyle" as we doctors call it, is unhealthy. But then I reviewed some of the actual studies referenced at the bottom of the page, and it seems that the data are of good quality, which concerns me further. Specifically, it seems that, despite eating well and maintaining a good weight and exercising at least 2.5 hours per week (at least in Australian men), sitting a significant portion of the day is still harming us. How much sitting is too much? The Canadian study actually came up with some numbers to guide us, reporting that sitting 0-25% of the time is ok, but when you get to 50% and up your risks for having heart attack and dying start to go up significantly.  

So what can we do? Well, let's start by not freaking out. This is good information, not bad. It supports our intuitive, conventional wisdoms that tell us to try to be active, that sitting in front of the TV for hours at a time, even if we are on the treadmill 30 minutes a day, is not good for us. And these reports dovetail nicely with some other studies that suggest that beyond meeting the minimum weekly exercise requirements, more is actually better.

So yes, if you can put a treadmill in your office, I say do it. Take some calls on the phone. Switch out your chair for an execise ball, at least some of the time. Park far away from your destination. Take an hour walk with a friend or loved one after dinner. Just find ways to keep your body moving, and it will keep you moving longer.

Lifetimetv.com columns

I thought I'd post links to some of my articles for mylifetime.com:

H. pylori questions
http://www.mylifetime.com/lifestyle/health/tummy-troubles

Is coffee safe?
http://www.mylifetime.com/lifestyle/health/crazy-caffeine

How to be safe in the sun
http://www.mylifetime.com/lifestyle/health/save-your-skin-summer