Author Archives: sararodgers

Heart Health

2 Questions:

  1. Why is it so important to be aware of heart health?
  2. What can one do to improve heart health?

Answers:

#1. Why is it so important to be aware of heart health? Because heart disease is deadly and costly!

  • Heart Disease is the leading cause of death for all people in the United States, contributing to 1 in 3 deaths.
  • In 2023, 919,032 people died from cardiovascular disease.
  • High Cost: between 2021 and 2022, $168 billion was spent on medications and health care cost addressing heart disease.

#2. What can one do to improve heart health? As usual, the answer to prevent heart disease is simple, but not always easy. It is not easy because the foundation for heart health starts with diet and lifestyle. The following simple suggestions may may reduce the cost and grief that comes with a stroke, heart attack or heart failure.

Eat fiber. Fiber is found in whole grains, nuts, seeds, fruits, and vegetables. It is convenient that many of the same foods contain both types of fiber: insoluble and soluble fiber.

Insoluble fiber is non-digestible and provides bulk to stools to improve transit time, and thus reducing constipation. Insoluble fiber increases satiety thus reducing desire for sugary foods and finally resulting in weight loss.

Soluble fiber mixes with water to create a gel-like substance. It binds to toxins and dietary cholesterol, thus preventing absorption into the blood stream. Some soluble fiber is now categorized at pre-biotic fiber because it feeds the beneficial bacteria in our intestines. The by-products of bacterial digestion produce fatty acid molecules that provide anti-inflammatory signals for our cells. Inflammation is reduced in the cardiovascular system and the body as a whole.

A target goal of daily fiber intake should ideally be ~30-35 grams, with at least 10 grams of soluble fiber.

The added benefit of focusing on eating the fruits and vegetables is also obtaining the important nutrients associated with a healthy cardiovascular system: Bioflavonoids and Vitamin C. Bioflavonoids are the beneficial chemical compounds found in plants that reduce inflammation and provide anti-oxidation support. The cardiovascular system benefits from these compounds greatly. Vitamin C, best known as an antioxidant, is also part of our connective tissue matrix, supporting the tissues surrounding our blood vessels.

Exercise is also a key component to cardiovascular health. What is the best form of exercise? Answer: the one that you will do consistently. Ideally, exercise should include both cardio (ie, moving), and weight lifting (moving against gravity). Suggested frequency includes at least 150 minutes moderate or 75 minutes intense activity weekly. Short burst of high intensity activity are also beneficial.

Low impact activities such as yoga, tai chi, and pilates are also helpful for strength, flexibility, and mental wellness.

Breathing. Lastly, a simple technique to reduce blood pressure is to breathe. It sounds so simple. Of course you are breathing, but are you belly breathing? Relaxation breathing techniques such as belly breathing can reduce your stress response and blood pressure in a very short period of time. Find your favorite technique and practice daily.

https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html

Dias MC, Pinto DCGA, Silva AMS. Plant Flavonoids: Chemical Characteristics and Biological Activity. Molecules. 2021;26(17):5377. Published 2021 Sep 4. doi:10.3390/molecules26175377

Beating Insomnia

Have you ever experienced not being able to get to sleep or waking up in the middle of night without getting back to sleep?  You are not alone, 30-50% of adults report insomnia symptoms and 10% of adults are diagnosed with chronic insomnia[1].

Insomnia includes difficulty falling asleep, staying asleep, or poor sleep quality that may impact the quality of your waking life.  Insomnia can be very frustrating as Dr. Rodgers can attest from personal experience.

Not only is Insomnia annoying, but it may contribute to numerous health effects including cardiovascular disease and diabetes[2],[3]. 

There are many causes of insomnia including, but not limited to:

  • Stress
  • Blood sugar dysregulation
  • Hormone insufficiency
  • Genetic disposition
  • Dietary choices, including use of alcohol and stimulants
  • Pain
  • Digestive issues
  • Brain health
  • Environmental influences 

Can sleep medications help?

According to the CDC, 8.4% of adults in the US took sleep aids in 2020[4].

Most sleep medications are initially helpful, but lose their efficacy after a few weeks, leading to the need to increase dosages as the brain adapts to the medication. Discontinuing the drug(s) also leads to rebound insomnia, leading to a vicious cycle of not sleeping.  There are also studies suggesting sleep medication’s contribution to cognitive decline or Alzheimer’s disease[5],[6].

Additionally, daytime drowsiness with the use of sleep medication increases the risk of motor vehicle accidents[7] and loss of social interactions[8].

Watch Dr. Rodgers’ interview with pharmacist Jeremy Crowfoot of Saint Alphonsus Geriatrics Clinic and Memory Center in Boise, Idaho discussing the efficacy of sleep medications.  Watch the interview HERE.

How to get to sleep without sleep medication.

The sleep foundation (https://www.sleepfoundation.org/sleep-hygiene) has a wonderful list of sleep hygiene techniques which can be tried prior to initiating sleep medication.  Techniques include:

  • Go to bed at the same time daily.
  • Remove all electronic devices from bedroom.
  • Turn off Wi-Fi at night.
  • It is ok to read or listen to calming music or mediations, but do not use screens in bedroom.
  • Complete all work or discussions prior to entering bedroom.
  • Dust bedroom regularly.
  • Use black out curtains, to create a dark room.
  • Cognitive Behavioral Therapy for insomnia (CBTi) to re tune the body and brain towards healthy sleep[9].

Sleepwell (mysleepwell.ca) is a CBTi educational program of Dalhousie University of Canada.  The website is an excellent starting point to learn how to retrain your brain to achieve quality sleep. Supported by research, the Sleepwell program can be used for anyone with sleep difficulty and offers guidelines for safely weaning off sleep medications.

Although insomnia can be a challenging condition to treat, finding a physician who listens to your story may be the first step towards a good night’s sleep.  Dr. Rodgers is one such physician. She takes the time to understand each patient’s current medical condition, lifestyle, diet, supplement/medication use, and past medical history and then creates a plan for you to achieve quality sleep.

[1] Benca RM, Bertisch SM, Ahuja A, Mandelbaum R, Krystal AD. Wake Up America: National Survey of Patients’ and Physicians’ Views and Attitudes on Insomnia Care. J Clin Med. 2023;12(7):2498. Published 2023 Mar 25. doi:10.3390/jcm12072498

[2] Fernandez-Mendoza J, Vgontzas AN. Insomnia and its impact on physical and mental health. Curr Psychiatry Rep. 2013;15(12):418. doi:10.1007/s11920-013-0418-8

[3] Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci. 2023;7(5):457-466. doi:10.1042/ETLS20230111

[4] https://www.cdc.gov/nchs/products/databriefs/db462.htm

[5] Puustinen J, Nurminen J, Kukola M, Vahlberg T, Laine K, Kivelä SL. Associations between use of benzodiazepines or related drugs and health, physical abilities and cognitive function: a non-randomised clinical study in the elderly. Drugs Aging. 2007;24(12):1045-1059. doi:10.2165/00002512-200724120-00007

[6] Wilt TJ, MacDonald R, Brasure M, et al. Pharmacologic Treatment of Insomnia Disorder: An Evidence Report for a Clinical Practice Guideline by the American College of Physicians. Ann Intern Med. 2016;165(2):103-112. doi:10.7326/M15-1781

[7] Hansen RN, Boudreau DM, Ebel BE, Grossman DC, Sullivan SD. Sedative Hypnotic Medication Use and the Risk of Motor Vehicle Crash. Am J Public Health. 2015;105(8):e64-e69. doi:10.2105/AJPH.2015.302723

[8] Fitzgerald T, Vietri J. Residual Effects of Sleep Medications Are Commonly Reported and Associated with Impaired Patient-Reported Outcomes among Insomnia Patients in the United States. Sleep Disord. 2015;2015:607148. doi:10.1155/2015/607148

[9] https://mysleepwell.ca/cbti/cbti-research/

Why does acupuncture work?

A simple answer is that acupuncture helps the energy “highways” in your body flow better.

Meridians (channels) are the energy superhighways in your body. There are 12 main and 8 extra meridians (also known as channels) described in the practice of Traditional Chinese Medicine (TCM). Each meridian is the pathway for energy flow related to an organ system within the body.

Perceptive physicians many years ago mapped out these channels and found associations with organ systems including the Lungs, Large Intestine, Stomach, Spleen, Heart, Small Intestines, Urinary Bladder, Kidneys, Pericardium, Triple Burner*, Gall Bladder and Liver.  Although there is some overlap with western medicine’s understanding on how these systems work, TCM treatments and philosophy do not always translate into western medicine. When I was in medical school, I felt that I needed a passport to travel between my medical and acupuncture classes.  *The Triple Burner is a 3 tier system enclosing the entire body cavity and ensuring unity and harmony of the organs.

Treating points along the meridians can help tap into the channels and help improve the flow of energy by supporting a weak channel or reducing an over stimulated channel. For example, if energy is blocked within a meridian, certain acupuncture points can help unblock the channel. Much like how a snowplow clears snow from the roads, acupuncture reduces congestion and pain.  At the same time, other points may strengthen a channel, much like repairing potholes.

Acupuncture, when practiced as a system of medicine, can help reduce suffering at a specific area and help the body as a whole.  This is different from dry needling that is used to address pain at the site of pain only. 

Acupuncture can help to balance mood and hormones, reduce pain, improve sleep, promote relaxation, and much more. 

Dr. Rodgers provides acupuncture at her Payette, Idaho office.

Thyroid questions and answers

Lately, I’ve been getting the same couple of questions about thyroid medications.

Question #1: Are there herbs I can use instead of my thyroid medication?

Question #2: I only want to use natural thyroid hormone. Can I switch my medication to be only natural thyroid?

These are great questions.

The answer to Question #1:  No, there are no herbs that can substitute for thyroid hormone if you are already taking thyroid hormones. 

You MAY be able to correct a thyroid imbalance before you start thyroid medication, but the trial should have a stop date if unsuccessful. Lifestyle, diet, herbal or nutritional support, cortisol balancing, and/or homeopathy may all help to correct a thyroid imbalance.  However, because thyroid hormone is so important to your overall wellness, thyroid levels need to be monitored during these interventions. If no improvement occurs, herbal trials need to stop, and hormone replacement needs to start.

Thyroid hormone medication is not just a medication, it is the replacement of a very important hormone that is no longer being produced.  Thyroid hormone turns on the signals for metabolism (aka, life) such as:

  • making proteins for skin, hair, nails, and wound repair
  • making energy to move the body
  • making the brain work
  • making the digestive system work
  • making bones and muscles
  • making babies
  • and much more

In my opinion, thyroid function is too important to neglect and should be tested regularly to ensure optimal levels. 

Regarding Question #2:  Choosing natural thyroid.

It is important to first understand what hormones we are discussing.  Human thyroid hormones produced in the thyroid gland include T4  (Thyroxine) and T3 (Triiodothyronine).

Triiodothyronine (T3) is about 4 times more potent than Thyroxine (T4).  Thyroxine is more abundantly produced in the thyroid and converts to T3 in other tissues such as the intestines (by bacteria), in the liver, and the kidneys with the help of certain nutrients such as Vitamin B12, selenium, and zinc. 

There are naturally derived thyroid medication, but all thyroid  medications on the market are bio-identical to human hormones. See below for pictures of these hormones.

Medical supplementation of T4 is provided as levothyroxine and under brand name such as Synthroid, Euthyrox, Tirosint, Levoxyl, and Unithroid. 

Replacement of T3 is provided as  liothyronine, and under brand names such as Cytomel and Triostat.   All of these drugs are virtually identical to human produced thyroid hormone.

Additionally, some products (Armour, NP thyroid, or compounded thyroid) combine T3 and T4 in a 1:4 ratio to match the natural ratio of T3 and T4 produced in the thyroid gland. 

The most natural source of combined thyroid hormone medication is derived from animal thyroid, such as from pigs or cows. These products also contain the other nutrients found in thyroid glands. Many people benefit from glandular products, but some people react adversely to glandular thyroid products.   

It is important to understand that thyroid medication needs to be chosen to provide the best therapy for each patient. Some people may do well with only T4 or may only need T3 or may do very well with glandular products.

Laboratory analysis every 6 weeks needs to be obtained every time there is a change in thyroid dosing. This allows time for the body to adjust to the dose and to evaluate if the dose and medication type is correct. 

The take home message to answer Question #2:  Although naturally derived thyroid hormone is available, it may not be the best fit for every patient.

T3 and its medication counterpart
T4 and its medication counterpart

Cortisol: good or bad?

Cortisol has hit the social media airwaves with a bad reputation, especially about weight loss.  As usual, social media took something right and made it wrong.

Before I can comment about cortisol’s relationship to weight gain, it is important to understand cortisol.

Cortisol is a glucocorticoid hormone secreted from the adrenal glands and is a vital hormone for the stress response system. Cortisol helps increase blood sugar and blood pressure during stress events.

Without an adequate amount of cortisol, the body is unable to respond to stress and results in numerous symptoms, including:

  • Fatigue
  • Dizziness, fainting
  • Low blood pressure
  • Low blood sugar
  • Digestive upset such as vomiting, diarrhea
  • Muscle pain, cramping, fatigue
  • Joint pain
  • Depression
  • Loss of body hair
  • Salt cravings
  • Abdominal weight gain
  • Inappropriate responses to stress

Severe depletion of cortisol may lead to coma or death, but this occurs when the adrenal glands are damaged, such as with Addison’s disease.  Most people do not suffer from Addison’s disease, but it highlights the importance of cortisol.  

Much more common is cortisol insufficiency resulting from a living a lifestyle colloquially known as “burning the candle at both ends.” In this scenario, cortisol levels initially rise, to address stress, but over time may become depleted. Fatigue, abdominal weight gain, poor ability to manage stress, salt/sugar/fat cravings, repetitive colds, and an inability to respond to stress with grace are common symptoms of insufficient cortisol levels.

For many, regular consumption of sugary foods will result in cortisol depletion.  This occurs due to the following (simplified) mechanism:

  • Blood sugars rise steeply after eating sugar.
  • Insulin takes the sugar out of the blood stream and puts it into the cells.
  • Subsequently, there is a lack of blood sugar to support the next need for cellular energy. This is felt like a blood sugar “crash.”
  • Cortisol rises to raise blood sugar. I call this inappropriate release of cortisol due to dietary choices. Remember, cortisol is a stress hormone, so stress responses also occur with the rise of cortisol, including a rise in blood pressure.
  • If this blood sugar is not needed immediately by cells, it is converted into fat.   

Blood sugar yo-yo-ing may result in weight gain, fatigue, and insufficient cortisol.

The adrenal glands also produce other hormones, including:

  • Sex hormones: Progesterone, DHEA, Testosterone, Estrogens
  • Mineralocorticoids: Aldosterone (a blood pressure regulator)
  • Catecholamines: epinephrine, norepinephrine (adrenalins).

In order to maintain cortisol levels, the adrenal glands may preferentially support cortisol production over these over hormones. For peri/menopausal women, hot flashes and night sweats may worsen if hormone production needs to favor cortisol production rather than sex hormones.

So, yes, cortisol is a contributor to belly fat due to blood sugar dysregulation, but cortisol is not the culprit. Lifestyle, diet, nutritional insufficiencies, and a lack of allowing oneself to relax is path to cortisol insufficiency. It is possible to regain cortisol balance with lifestyle,  nutritional changes, and if needed, targeted nutraceutical therapy. Weight loss is also only possible when cortisol and other hormones are balanced.

Not sure if cortisol insufficiency contributes to your symptoms?  Dr. Rodgers offers testing for cortisol and sex hormone levels.  She can also counsel you on how to maintain healthy blood sugars to preserve your cortisol stores.

USE YOUR MEDICAL DOLLARS WISELY

Health Savings and Flexible Spending Accounts: Did you know that you can use your Health Saving Account (HSA) for your appointments with Dr. Rodgers, lab expenses, prescribed supplements from Fullscript, and prescribed medications?

A Health Savings Account (HSA) allows you to use untaxed income for medical expenses not covered by your medical insurance and is available for those with a high deductible health insurance plan and for those who are not enrolled in Medicare. If you think you qualify, ask your employer, financial advisor, or bank about applying for an HSA.

A Flexible Spending Account (FSA) is available from some employers. Like an HSA, health expenses can be paid with income prior to taxes. 

Check with your FSA and HSA to understand what services are covered. If eligible, consider using these pre-tax income accounts to help pay for your naturopathic and acupuncture services, Fullscript supplements, or laboratory expenses.

Insurance Billing: Submit your receipts!

Dr. Rodgers does not bill insurance and patients are responsible for the full cost of services provided at the time of visit. However, because Dr. Rodgers is a licensed physician and acupuncturist, you may be able to obtain reimbursement for your visits with Dr. Rodgers from your health insurance company or medical sharing group. 

If you do not pay for your visit with a Health Savings Account or Flexible Spending Account, (or are not using Medicare), your insurance company may reimburse your visit and/or laboratory fees, or apply the fees towards your deductible.  Dr. Rodgers provides a superbill receipt for each visit containing all the information you need to share with your insurance provider for possible reimbursement.

Contact your insurance provider or medical sharing group to determine if they recognize out of network naturopathic or acupuncture visits.

Liver Health

The liver is a fascinating organ. Not only does it manufacture proteins, glucose, and blood clotting factors;  stores energy as glycogen; makes bile for digestion, it also gets rid of metabolic waste, old blood cells, toxins, and drugs. Additionally, if given the opportunity and time, liver tissue can regenerate, making it a unique visceral organ.  It behooves us to take care of this amazing organ. 

A few simple techniques help us honor and protect the liver.

  • Avoid or minimize alcohol. Alcohol is metabolized into aldehydes which cause cellular toxicity. Drunkenness sensation is caused by the effects of aldehyde toxicity.
  • Reduce or eliminate sugar. Sugar is very inflammatory and may increase fat deposition in the liver leading to fatty liver disease (NASH), strains pancreatic insulin production, and causes cortisol (a stress hormone) disruption.
  • Get adequate sleep to support your regenerative ability.
  • Consider the following nutrients to protect the liver:
    • N-acetyl cysteine (NAC). NAC is the only nutraceutical that is approved by the FDA for liver failure treatment.  NAC helps build glutathione, our biggest antioxidant. It is also great for thinning mucous if you have sinus or lung congestion.
    • Silymarin derived from Milk Thistle seeds is highly beneficial for liver health and supports detoxification systems.   Remember to grind the seeds before use.
    • Curcumin. This compound found in turmeric has been shown to be highly beneficial for the liver.
    • L-carnitine. This molecule helps to transport fat into the mitochondria, the energy producing center of cells.
    • SAM-e.  This methylation support nutrient has been found to support the liver detoxification.
    • Licorice. It is best in the deglycyrrhizinated form to reduce hypertension effects.  Licorice also fights viruses and supports adrenal health. 
    • Vitamin C. This vitamin needs to be ingested daily as humans are one a few mammals that don’t manufacture it on our own.
  • Avoid known toxins.
    •  Eat organic foods as much as possible. See HERE for the annual dirty dozen list from EWG to determine what foods to prioritize as organic.
    • If smoking, consider a quit smoking program. Even organic tobacco contains toxic metals such as arsenic, cadmium, and lead. If vaping, consider quitting. Dr. Rodgers offers an acupuncture protocol to help wean off addictive substances.
    • Avoid synthetic fragrances as they may contain neurotoxins and endocrine disrupters.  Manufacturer labels do not disclose everything that in these complex products. Avoid fragrance in lotions, shampoo, laundry cleaning products, scented plugins, scented candles, etc.
    • If you are doing a project that involves solvents, metals or other toxins, use the personal protection suggested on labels (e.g. nitrile gloves, a respirator) even if you can’t see or smell the toxins.
    • If you work in an environment with hazardous fumes or materials, ensure that your employer is offering personal protection devices or provides industrial grade air purification.

MicroNeedling – Healing damaged skin

Reasons to consider Microneedling

  • Any inflammatory reaction usually resolves the day after treatment.
  • There is a reduced incidence of keloid (over scaring) creation
  • Lightens sunspots
  • Scar repair from acne and burns. [1],[2],[3],[4],[5],[6]
  • Supports hair re-growth, especially if when added to drug therapy such as Rogaine / Minoxidil.[7],[8],[9]
  • Creates tighter, firmer, more radiant skin

Reduced Acne Scaring.

Hair re-growth. 40 year old man who was not satisfied with conventional treatment. Images below follow progress with addition of Microneedling at 1 month (a), 3 months (b), and 6 months (c).

References: Acne Scars

[1] https://www.dermatologytimes.com/view/microneedling-may-provide-alternative-lasers

[2] Gozali MV, Zhou B. Effective treatments of atrophic acne scars. J Clin Aesthet Dermatol. 2015;8(5):33-40.

[3] El-Domyati M, Barakat M, Awad S, Medhat W, El-Fakahany H, Farag H. Microneedling Therapy for Atrophic Acne Scars: An Objective Evaluation. J Clin Aesthet Dermatol. 2015;8(7):36-42.

[4] Chilicka K, Rusztowicz M, Szygu?a R, Nowicka D. Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review. J Clin Med. 2022;11(10):2744. Published 2022 May 12. doi:10.3390/jcm11102744

[5] Tirmizi SS, Iqbal T, Mansoor M, et al. Role of Microneedling in Atrophic Post-Acne Scars: An Experience from a Tertiary Care Hospital. Cureus. 2021;13(1):e12578. Published 2021 Jan 8. doi:10.7759/cureus.12578

[6] Busch KH, Aliu A, Walezko N, Aust M. Medical Needling: Effect on Skin Erythema of Hypertrophic Burn Scars. Cureus. 2018;10(9):e3260. Published 2018 Sep 6. doi:10.7759/cureus.3260

References: Hair Loss

[7] Dhurat R, Mathapati S. Response to Microneedling Treatment in Men with Androgenetic Alopecia Who Failed to Respond to Conventional Therapy. Indian J Dermatol. 2015;60(3):260-263. doi:10.4103/0019-5154.156361

[8] Kumar MK, Inamadar AC, Palit A. A Randomized Controlled, Single-Observer Blinded Study to Determine the Efficacy of Topical Minoxidil plus Microneedling versus Topical Minoxidil Alone in the Treatment of Androgenetic Alopecia. J Cutan Aesthet Surg. 2018;11(4):211-216. doi:10.4103/JCAS.JCAS_130_17

[9] Wall D, Meah N, Fagan N, York K, Sinclair R. Advances in hair growth. Fac Rev. 2022;11:1. Published 2022 Jan 12. doi:10.12703/r/11-1

Its cold and flu season- don’t participate!

It is very apparent that the cold, flu and Covid season is upon us.  Here are 5 tips to staying healthy and what to do if you get sick.  For those who have read many of my older articles, you may find the links below a reminder of what to do.

Wet Sock Therapy. This simple technique works to improve the immune system as a preventative and treatment. Read instructions HERE.

If you get sick, see what Viral Fighting products Dr. Rodgers suggests.  See my handout HERE  (includes the Wet Sock protocol)

We all hate them, including me, BUT wearing a Mask over the mouth and nose may reduce inhalation of air droplets carrying viruses. Personally, I am grateful for a mask when the stranger next to me in the grocery store sneezes or coughs.

Washing hands frequently and avoiding touching your face also reduces transmission of viruses.

Air purification.  Ultra HEPA air purifyers trap viruses and other particles. Choose a product that has replaceable pre-filters, HEPA or Ultra Hepa filters, and filter to remove noxious gases.  Avoid products that produce ozone or other ions.

Lastly, if you have a naturopathic appointment, but are not feeling well, consider a Telehealth visit instead. Telehealth hours have been extended during December and January.