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Fighting The Mid-Day Blahs!

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Are you feeling fit at the beginning of the day, but find you’re soon running out of gas? You may have the mid-day blahs, and it may be because of what you are eating.

An image of sleeping at work because of the blahs

The blahs. They can strike any time, but are most commonly seen around 10:30 in the morning, or in mid-afternoon. On night shifts, the worst time seems to be between 4 and 7 in the morning. Part of the reason for this is the body's own internal clock, which regulates the flow of insulin, and thus blood sugars.

Exactly what is blood sugar (also known as blood glucose)? This is the level of glucose (sugar) available in your blood stream and is the primary source of energy for your body's cells. Low blood sugar is known to make us tired, and naturally tends to happen at about 3:30 in the afternoon. However, often the problem is induced simply by eating the wrong foods. A breakfast of sweet juice, a Danish, a muffin, or toast with jam may help us wake up by quickly elevating our blood sugars. But, after a couple of hours these simple carbohydrates have dissolved from the stomach and have been burned off in the blood stream, meaning that, in automotive terms, our tank is empty. Because hunger levels are high, the temptation is great to reach for sweets instead of protein during the coffee-break and at lunch time. Once in the bloodstream, the sugars and starches in these foods cause the pancreas to secrete extra insulin.

This makes the blood sugars swing low again, and making a person feel tired, thus perpetuating the desire for a quick fix from the cafeteria or restaurant. On the other hand, one need not be a slave to the donut truck or the muffin trolley. Simply by changing the order of foods ingested, we have the power to stabilize our energy levels.

Here's an action tip:

For breakfast and lunch eat lots of protein, while reducing the amount of sugar and simple carbohydrates consumed. At breakfast, replace the jams with peanut butter, and the white starchy breads with the high fiber variety. Have a bran cereal or oatmeal, as the fiber helps to moderate the rate of absorption of sugars into the bloodstream. Drink milk, tomato juice, or grapefruit juice to lessen sugar loads. For snack time, have an apple instead of a honey-bun. At lunch, reach for protein foods such as beans, cottage cheese, fish, chicken breast, or lean beef. Avoid sweet desserts. For dinner, you can go easier on the protein, have lots of vegetables, and have your desserts with a clear conscience.

Remember, you are what you eat, so fight the blahs with the cordon bleus.

Bon appétit!


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Fiber: The Stress Fighter

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Fiber.  I know it's good for me, doc, but how do I get enough of it?  Do I have to eat the wrapper off my bran muffin?  Perhaps bark chips and kitty litter? 

Luckily, its a lot easier than you thought. More importantly, if you do eat enough fiber you can help make yourself a lot more bullet-proof to stress.

Fiber: A Stress Defense


Fiber is the non-digestible part of the cell wall found in all plant materials, such as fruit, grains, and vegetables.  It cannot be found in any animal products, such as meat, milk, or eggs.  Fiber is inert, and has no caloric value, and thus could be said to do nothing.  In fact, fiber never even enters the body in the sense of getting into the blood stream.  Not unlike a swallowed plastic button, fiber leaves the bowels largely unaffected by the stomach’s attempts to digest it.  But fiber is also one of the most powerful, if often underrated tools we have to defend our bodies from stress.

In the stomach, fiber makes the digestive juices work harder.  The stomach acid burns itself out on the inert fiber, and the stomach takes several hours to empty.  As a result, you are more ulcer-proof, and will feel fuller longer.  In the bowels, fiber, as long as it is taken with sufficient water, will prevent constipation, and help protect you from inflammations such as colitis and diverticulitis. The U.S. and Canadian Cancer Societies have recommended we eat more fiber, to reduce the incidence of cancers of the digestive system.  The Heart associations have endorsed fibers such as found in oat bran as a means to reduce circulating cholesterol, which is of course implicated in heart disease. 

Fiber also makes the body work harder and longer to extract sugars out of our foods, meaning that blood sugar levels tend not to have such high and low swings.  Not only does this reduce the hypoglycaemic urgency of a quick sugar fix a couple of hours after a meal, but it helps diabetics reduce their intake of insulin by a few units a day. I have even seen borderline adult diabetics come off their pills when they switched over to a diet with exactly the same number of calories, but with a high fiber load. 

The overweight dieter also benefits from increasing dietary fiber.  Because the stomach stays full for about four hours after a high fiber meal, there is less room to accommodate post-prandial nibblers.  After all, if one lived next to a field of sugar cane, one could eat endless sugar and not get fat, because the sugar comes with such a high natural fiber content.  When that fiber is refined out of the sugar, and put into candies, then huge quantities of sugar can be crammed into the same space, and dissolves almost instantly into the bloodstream, causing obesity.  As an added bonus to help the obese lose weight, a high fiber diet will carry out about 150 calories of undigested food each day, which helps fiber fans stay slim.

Fiber is a great help in fighting stress, as well as many other conditions.  Try to have at least 35 grams of it per day, or more if you can.  Remember you can get the whole regimen of fiber from your favorite foods: Bran cereal, oatmeal, baked beans in tomato sauce, corn, peas, potatoes, apples and bananas are all foods people enjoy, but are often avoided by people who are trying to lose weight.  Think again.  As long as you don't garnish these foods with butter, margarine, or fattening sauces they will actually help you stay full, and lose weight.  Remember, you needn't eat grated pine cones to win against stress. 

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How to take the knee stress out of running

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Here are some good tips for reducing the stress on your knees. 
an image of a woman jogging


One of the more common stress relievers is exercise, and simple running leads the pack. In large part, running has become so popular because of several features:

  1. It takes no time to coordinate. Just go when you are ready, with or without friends. No teammates are needed, you don’t need to book time on the court or field, and, with minor modifications in equipment, you can run day or night, summer or winter.
  2. It doesn’t require lessons. Although there are certainly very good lessons to be had, most people can just take off. Not true of skiing, tennis, and, least of all, golf.
  3. It is cheap. An old t-shirt and shorts, and a good pair of running shoes gets you started. No need for pads, helmets, uniforms, or equipment.
  4. It is a great way to burn off calories, and counteract the lack of movement incumbent in the modern work station.

The down-side of running is really just two-fold:

  1. Running can be boring, if you are not into the zen of it. Remedy: try running on a treadmill, and tune in to a video screen, or read a magazine while you trot. If you are an outdoor person, consider the ipod or other portable sources of sound. However, it is best to only plug into one ear, so the other one is left free to alert you to impending traffic warnings, or the sounds of an upcoming biker or dog.
  2. Running can hurt. Not every body is built for running. Some people have knock-knees or arthritis in feet, ankles, knees, or hips. Others have scoliosis or just poor posture, and find they get back pains if they run on hard surfaces. Others have unrealistic goals, and try to run too far before they get fit. (One tip from running coaches for beginners is to walk for a minute, then run for a minute. Repeat. Then gradually build up the minutes of running, still with a minute of walking between each set)


However, in medicine it is never that hard to figure out what kind of an injury a person has. The real question is what kind of a person does the injury have. I see runners every week in my office, often with the same pains, for example in the knees. Some are looking for an excuse to get off the compulsory running team at school, and want a note to join the swim team. Others are devoted to running, and nothing else will do as an option. It is in the latter group that we focus on in this article.

While running can cause pains in many body parts, let’s focus on the knee for now. One of the most common complaints is “runner’s knee”, otherwise called the “patella-femoral” syndrome. If you suffer from this, please read this article:  “patella-femoral” syndrome

In severe cases, we may need to have the patient lay off all running for a while, and switch to other “cross-training” exercises that don’t cause pain. The list of these could include such things as blading or skating, biking, or using the elliptical machine, or yoga. As a home treatment, it is good to follow the RICE principle after activity (Rest, ice, compression, elevation above the heart). Also remember that you may be making your knees hurt while you are NOT moving during desk duties all day. Set your computer to alert you every fifteen minutes, so you can flex/extend your knee regularly. See your doctor for specific guidance, and for customized strategies that might include orthotics, physiotherapy, massage, acupuncture, a trainer in the gym, or even a running coach.


For more info on coaching for beginners, read this link:

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Iron Surplus: Too Much Of A Good Thing?

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Nothing causes stress more than the unknown.  We should all be working with our doctors to rule out hidden dangers to our health, especially ones that are easily treated.

Iron Horse or Iron Surplus? Too little blood iron can cause fatigue, but too much can also be harmful!

an iron horse - metaphor for surplus blood iron

In a previous post, we discussed the common problem of iron deficiency, as determined by a low level of ferritin.  As we test for the “silent signals” during a regular physical exam, we are also looking for problems of iron surplus.  While some of us are a bit stressed by needles, this is another example of the merits of looking beneath the surface for health clues.

To begin, we check the blood for its levels of ferritin, a protein found in the liver, spleen, muscles, and marrow of our bodies.   Shaped like a hollow sphere, it stores iron inside, which can be released if needed, as in the case of blood loss from heavy periods or from colon polyps.  In the case of too much iron in the body, the ferritin will absorb the excess.

If ferritin is found to be high on screening, (levels should be 80-300 mcg/L, and are considered serious if over 1,000 mcg/L) a repeat test should be ordered, to include the serum iron, saturation levels, and Total Iron Binding Capacity.   Also tests for viral hepatitis and other inflammatory conditions should be considered.  Remember that these tests can be influenced by recent food intake, so are best done fasting.   Usually the only way to make this diagnosis is through early routine testing, as most cases of excess iron (hemochromatosis) start with no symptoms until age 40 or 50 in men.  Women have an advantage of 15 years later onset of symptoms, due to their iron loss in menstruation.  The consequences of high iron levels are alarming.  Deposits in the pancreas can result in Diabetes; in the testicles and pituitary gland: impotence.   In the liver, excessive iron can cause cirrhosis and even an increased risk of cancer.  The heart responds to iron deposits in its muscle by going into irregular rhythms or even heart failure.

If your doctor finds you have high levels of ferritin, further tests can be arranged, which may include genetic testing, and liver tests including scans or even needle-biopsies. 

In treating this condition,  we first make sure the patient is not taking iron supplements, which are sold without prescription, and sometimes included in multipl-vitamin pills. Secondly, we suggest reducing the intake of iron rich foods, such as red meats.  But the definitive treatment is to draw blood, usually at the rate of one unit (which contains 250 mg of iron) every one or two weeks, depending on the levels.  Tests of ferritin and transferrin saturation are checked every couple of months.  Until tests return to normal, vitamin C supplements should be avoided due to problems with heart rhythms, and alcohol should be avoided.

The good news is that early detection of iron overload works wonders.  Simply by drawing blood, the dangers can be avoided, and no other drug therapies are needed.

In all, another good reason to see your doctor regularly.  We all hate surprises!

For more info:

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Probiotics: A New Role for an Old Bug!

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Whenever we are under stress, our imune system comes under attack.  When stresses are continuous, we need to get all the help we can.  That's why we are taking a new look at an old ally: bacteria.

For over a century we have known that bacteria live normally in and on our bodies, but when out of balance, many of them can take over and cause disease or fatalities.  Not unlike the plant world, where one rogue weed can take over a whole field, choking out all competitors.

 As an example, our mouths contain many organisms like strep and staph bacteria every day, as we can demonstrate with throat cultures.  But if one gets the upper hand, it can take over, causing systemic  diseases like septicaemia, bacterial colitis (with c. difficile the usual culprit), or MRSA (the flesh eating disease).  Other complications develop if our normal flora is out of balance.  For example if we take antibiotics to kill an infection (for example earache) then all the bacteria will be subject to being wiped out, including the “good” ones.  So that’s why other opportunistic organisms like thrush can develop during treatments, as seen with white oral patches, or with vaginal discharge.  Many of my patients will note these side effects of ANTI-biotics, and have come to appreciate the good effects of “PRO-biotics”. 

In the old days, before dairy products were pasteurized (done to get rid of “bad” bacteria), lactobacilli lived normally in milk, cheeses, and yogurt.  Civilizations that consumed these had good health benefits.  In fact this was their only defense against infectious diseases prior to modern antibiotics.  But now that foods are sanitized, most of these bacteria are rendered inert, so a strategy is needed to replace the good bacteria.  In doing so we also booster our whole immune systems, not just the gut.

That’s why a daily dose of probiotics can make a lot of sense.  Certain foods like Miso soup are a good source.   If you like cheeses or yogurt, try some of the unpasteurized kinds if you can find them.  If not, try the pill route, usually a single capsule daily.  The contents of one capsule are billions of live cultures of acidophilus, but none  actually enters the body.  It only rests in the lining of the gut, in particular the colon, and never crosses into the blood stream.  Research shows its salutary effects on lowering risks of colon cancer or colitis to improving our defense against recurring colds or chest infections. 

While probiotics are not essential, there are a few conditions that would be a good fit for them:

1.       If your doctor has prescribed antibiotics to kill a bad bacteria, remember that the good ones also are going to be decimated; so take probiotics for the duration of treatment. Just don’t put them both in the stomach at the same time; the probiotics will survive better if the antibiotics have been given at least three hours earlier, and will have cleared out of the stomach by then.    

2.       If you are prone to repeated infections, whether vaginal, or common colds or bowel disorders, consider taking probiotics for longer term use. 

3.       If you are at risk for infections, such as beginning a new job with exposure to children or to the general public, then probiotics would be good for the duration of your exposure, eg the school year, or the flu season etc.  Ask your doctor or pediatrician for advice about your children as they begin daycare or school.

4.       For hospitalized or elder-care patients where serious infections can break out at any time, daily probiotics would be very sensible.

Ask your doctor or your naturopath for specific brand advice; but remember that live bacteria are more likely to survive in the refrigerator, just like the milk or yougurt they come from; so look for them in the refrigerated section of your vitamin or grocery store.  For more info, check the following:


For more on the dangers of MRSA:


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Stress Advice: How to be a good yourself!

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The most important job that any of us can have is that of manager…of our own department of one.  And nobody ever wants to work for a bad boss.  So let’s take a look at some of the working conditions that we place upon ourselves, and see if we would tolerate any of them being imposed by anyone else.

1.       Exercise deprivation:  Out of a standard 168 hour week, this boss only allows 3 hours for any exercise. image of a bad work environment


2.       Food rationing: The foods that will prevent disease and promote good health will be locked away.  The only ones served will be those with empty calories, hormones, chemical additives, and known dangers to our health.  The results will be illness and premature death from obesity, diabetes, and heart disease.


3.       Time rationing: The maximum time allowed to speak to our spouse/significant-other in private is no more than 15 minutes a day.  For those with young children, no more  than 9 minutes a day of solo conversation.  The rest of our time away from work will be consumed with talking or thinking “shop”, otherwise known as "unpaid overtime".  New stresses will result: one in two marriages will fail, and friction between kids and their parents will rise.


4.       Air contamination:  The work environment will be polluted by carbon monoxide and other chemicals, in doses enough to cause illness, and early death. 

Certainly none of us would put up with these horrible work conditions.  And yet, if we are stressed out, and join most of the general public in the above parameters, we are being the worst possible boss to ourselves.  Let’s take a look at the above parameters:

1.  Most people do not allow themselves 3 hours of exercise a week. If they did, they would instantly improve their cardiac health, muscle tone, their mood, and even their resistance to diseases. 

2.  Most choose the wrong foods, making an epidemic of type 2 Diabetes.  Poor nutrients, high calories, and quick eating make for fattening “fast” foods.  Doctors' offices are filled with people complaining of the resulting ill health.

 3.  National averages for meaningful conversation within families are very disappointing.  With the intrusion of 5 hours a day of “tube time”, most children are too engrossed in the internet, video games or television to have a real interaction.  Parents too are watching their own diversions on different screens, either their own laptops or live television.  With the decline of the dinner hour, family opportunities for conversation dwindle.  Not much interaction occurs when one family member at a time reheats their dinner on the microwave, then eats in their room or in front of their laptop.  

4. Smokers are poisoning themselves with carbon monoxide, among other heinous dangers.  While none would allow anyone else to pollute their air,  smokers are completely blocking out their own laws of cause and effect.     

To turn the tables, try to imagine what a great boss would offer.  Healthy nutrition, time away from work for friends and family, and clean air to breathe.  Then commit yourself to being that great boss.  Your stress levels may be the same at work, but your health and performance will improve! 





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Stress and Constipation: How to Move Things Along

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Constipation, or passing stool with difficulty less than three times a week,  is a common reaction to modern stress.  This is at first glance curious, because our bodies were hard-wired for centuries for the exact opposite response.  In primitive times, stress consisted of an acute attack, such as from a wild animal in the forest. 


The body was (and still is) programmed to immediately eject the contents of our bowels, to lighten our load for "fight or flight".  An excellent modification if one is being chased by an enraged predator, or is cornered and forced to summon Herculean strength in self defense.  When the blood supply is urgently needed in the limbs for strength and speed, there is no blood to spare languishing around the digestive tract, so it shuts down for business.

However, in the modern workplace, stresses are chronic and innocuous, and our hard-wired reflexes have become useless.  While we are still set for "Fight or Flight", there is nobody to hit, and nowhere to run.  Even worse, our busy schedules make good bowel habits even more challenging.  We are programmed to have a gastro-colic "dumping" reflex about a half-hour after stretching the stomache with a huge meal.  Problem is, we are now rushing of to work, so that breakfast stimulation creates the wrong reflex for the bus trip, or traffic jam.  As a result, we hold back that urge, then try to pass stool a few hours later, when the body is offering no help at all.  So lets take a look at some ways to help the modern battle for regularity:

1. Drink plenty of water.  Most people, like car engines, are down a quart.  More water at the top end will help soften the stool at the bottom end.  A good time to drink that extra water is after a big meal, to further generate that "dumping" reflex soon thereafter.

2. Eat more fiber.  There is no fiber in refined sugars, or refined flours, or, for that matter, refined anything.  Fiber should best come from multiple sources, such as bran, fruits, nuts, and vegetables.  There is no fiber in anything that comes from an animal.  Not in meats, fish, chicken, and not in milk, cheese or eggs.  That means an Atkins Diet of high protein provides no fiber until you get to the part with the green vegetables.  Fiber cannot be found in processed foods either.  Read the fine print, and you will note that Aerosol Spray-Cheese is devoid of any fiber.

3.  Tone those abdominal muscles.  The six feet of colon contents need to be propelled along the way, and this propulsion is inhibited by a sloppy abdominal wall.  While sit-ups can lead to low back pain if not done correctly, crunches can help, or many of the abdominal work done in Pilates and Yoga. 

Belly dancing is an excellent example of another way to ripple the abldominal muscles, and encourage the bowel tone as well.

4.  Watch the time.  Remember your gastro-colic dumping reflex will strike a half hour after your big meal.  So make plans to be sitting on the toilet, not on the bus when this happens.

5. Be wary of drugs as a frequent response.  If one uses non-prescriptive suppositories, pills, or enemas too often, the results are often worse.  Lazy bowels can be the unintended consequence of too much "help".

6. If you truly cannot get your bowels back on track, please see your doctor for proper investigation. 

This may include Xrays, ultrasounds, or MRI's of the abdomen, and can even include colonoscopies to rule out other underlying conditions. 

 For more reading, consider:.




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Stress and your Blood Pressure: How to Read the Numbers!

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One of the top ten ways that stress can influence your health is via your blood pressure.I commonly have patients present with a surprisingly elevated pressure, and suggest that we consider the context before rushing to medicate. This is just one example of silent signals that your doctor can help you identify, as we discussed in another post.
Blood pressure is expressed in mm of mercury, in a “fraction” format, eg 120/80.This is not really a fraction, just a listing of two pressures; the upper number reflects the pressure inside the heart during contraction, while the lower number measures the resting pressure between beats.
In young athletes, the pressures might be around 120/80. As we age, we can easily cope with ten more mm on each number.With exercise or anxiety the upper number will rise as the heart beats faster.The lower number should stay below 90.
Usually not.A single episode of an elevated set of numbers usually means the patient is anxious about seeing the doctor (white coat hypertension), and this simply indicates that more data is needed.Your pressures are going to increase with exercise, stress, anger, frustration, and overeating.They can be lowered with rest, meditation, deep breathing exercises, and eating a good diet.Because medication is often a lifetime option (never without some chance of side-effects) I always suggest a BP diary so the patient can show me the range of highs and lows during a couple of weeks.
By encircling the limb, the inflated balloon compresses the underlying artery, shutting off all blood supply. With the stethoscope (or built-in microphone) listening over the artery beyond the blockage, the pressurein the balloon is slowly released.When the first sounds are heard (always at the rate of the pulse) the upper or systolic BP number is known.When the beats become inaudible as the pressure keeps dropping, then the lower diastolic BP number is known.One of the limitations of the upper arm cuff is that it takes a lot more pressure to squeeze the underlying artery in the arm if the muscles are toned from recent weight lifting, for example, or if the whole arm is encased in layers of fat, as in the morbidly obese.
Usually they are pretty accurate.The only limitation is that you have to be walking by the store to get the reading, so we are missing many of the rest of the highs and lows of your day.Also, some do not have super-sized cuffs to get around an extra large arm.
Actually yes, and, due to the absence of white coats, these numbers are usually more accurate than those taken in our medical offices.If you can, try one of the new wrist units, as the arm cuffs are not as accurate.
Take your readings along to your doctor for assessment.Also take along a diary of your food intake and exercise output.In the case of obesity, a proper weight loss can often take the spike out of the blood pressure, and obviate the need for any drugs.In the case of extremely high pressures, your doctor may have no choice but to start you on medications.In general, eat good natural foods, and stay away from “white death”, ie white sugar, flour, and salt.If you have weight to lose, then please get serious about doing so.We find that bringing our obese patients in for a weekly “health check” works wonders; we have our nurse record the weight and BP readings each week. I don’t need to see the patient unless their numbers are climbing!A good example of audience participation, this results in an impressive number of cases being able to get back to safe BP numbers, and dodge the drugs entirely.If not, then a carefully monitored course of medications can make life a lot easier.
Here is some extra reading you may find useful:

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A new wrinkle on fatigue: Flat Iron

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As part of the complete physical exam we do on our patients in the office, we routinely do blood tests.  Even in asymptomatic patients we often can find hidden clues to their health (see our post on Stress Alarms).  In reviewing our recent patients, we note that a great number have low levels of ferritin, in other words low iron.

Iron is one of the key building blocks of your next batch of red blood cells.  These cells last only about three months, and are constantly needing replacement by the marrow.  If our iron levels fall, then we can end up anemic, and, commonly, fatigued.

While most iron deficiencies have been seen in women of menstruating age, it can occur in men as well.

Here are some considerations if you have low iron in your blood test:

1. INTAKE:  Iron is found in foods that are green (like fresh vegetables, including Popeye's famous spinach), and also in foods that have red blood (meat, fish, chicken).  If you are vegan and don't eat green veggies or beans, then it is easy to be deficient in your intake.  If you are a junk food fan, remember that most of these high carb processed foods are useless for iron. Check this link for more info:

2. ABSORPTION:  Certain kinds of stomache or intestinal conditions make it difficult to absorb iron, even if enough is presented in one's diet.  This can be seen in cases of malabsorption, including patients with surgically shortened intestines.

3. OUTFLOW: Two major sources of blood loss to consider;

    a)  Vaginal loss: heavy periods, or constant slow leaks throughout the menstrual cycle can lose more blood than the body can produce. If this is the case, it is not something to put up with, it should be investigated by your doctor.

     b) Rectal loss:

          -Visible loss of blood is an obvious cause of low serum iron for men or women.  Remember that blood can be black if it comes from higher up in the stomache or upper intestines, or it could be bright red, if it comes from a hemorrhoid .  These are very important to investigate.

          -Invisible loss of blood:  A slow daily leaking of trace amounts of blood in the stool can indicate important problems inside the colon. One way to screen for this is with the home kits for Fecal Occult Blood, which comes with a stick, and a fold-over place to put the stool sample.  To read more about this test, click this link: .  If any hidden blood is detected, then colonoscopy comes next.  This gives the doctor a clear view of any bleeding polyps, which are often fixable on the spot.  Through the colonoscope, it is also possible to biopsy and photograph any other pathology, such as inflammatory diseases like colitis or diverticulitis.  

Once the cause has been determined, then a solution becomes clear.  In cases where the problem lies in low intake, one needs more iron in the diet, or an iron supplement from your doctor.  In cases where there is an excessive loss, one must plug the leak, or at least have one's doctors solve this. In all cases, remember to recheck your blood after three months, to make sure your body is back on track.

In any case, this is just another reason to check the silent signals in your body, to make sure you stay as bulletproof as possible.  Its a stressful world out there, and we all need to be in our best shape!

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Cholesterol too high? Try some simple tips:

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One of the most common complaints I see in the office is that of an elevated cholesterol.  Not just in middle aged male executives, but even in otherwise fit twenty and thirty year old men and women.  Is your cholesterol too high? Here are a few tips that can help As part of today's routine medical exam, one of the "silent signals" we look for is the level of cholesterol in the blood stream. Let's take a better look at this potential enemy.

Levels of cholesterol are measured differently in US units and in metric ( for the rest of the world).  They can even be different from one lab to another across town.  So the best thing to do is to talk to your doctor, and review your own cholesterol panel.  This includes the key elements of:



  • HDL (or High Density Lipoproteins): the good cholesterol.
  • LDL (or Low Density Lipoproteins): the bad cholesterol
  • Total Cholesterol (the sum of the above two)
  • Triglycerides
  • Visible Cholesterol:  If you stand naked in front of a mirror, start with your arms extended out to the sides at a 90 degree angle.  Then slowly lower your arms to your sides.  If they come to rest at 45 degrees, then you are wearing too much cholesterol.  Even if your blood levels are normal, don't kid yourself that visible cholesterol or excess fat is ok.  It is not!


Your doctor can review your own results with you, including the ratio of the good/bad kinds of cholesterol.  But before you assume that all elevated levels need a drug and a "cholesterol-free" cookie, let's take a look at some caveats with these two options.

1. Drugs: Lipitor and Crestor are good drugs for their purpose, and indeed are perfectly suited to some cases of high cholesterols that are refractory to diet and exercise, or in cases where  a serious family history of early heart attacks prevails.  But take a look at their side effects before taking the plunge, and even then, make sure your doctor monitors your liver for its vital functions. (Probably for a lifetime).  For more info, visit


2. "Cholesterol-Free" Foods: Usually, this means "full of white sugar" foods.   All disease is based on cellular inflamation, and white sugar and white flour are the worst kinds of starches to cause inflamation throughout the body.  When this inflamation involves the lining of the arteries, then the body tries to help by laying down a protective coating, same as the oyster does to create a pearl around an irritating grain of sand.  Problem is in humans: we lay down cholesterol over the raw artery walls, not pearls.  So beware the lure of "cholesterol free ice-creams, pastries, and fast foods.  They can be a disaster.

 When I see my patients for a review of their blood-work as part of their physical exam, I like to start with a simple protocol whenever we find abnormal levels of cholesterol.

1. Work on the visible fat, if any.  Moderate overall fuel intake to match your calories burned.  For this, the best measurement is actually the tape: follow your waist and hip measurements every week to see if you are truly slimming down properly.  No point in losing a few pounds if all that happens is your rings and watches fall off, but your belt stays the same.

2. Fish: Omega 3 fatty acids are commonly found in Salmon, your new best friend at the table. (Note to beauty fans: Sophia Loren credits her daily few bites of salmon for keeping her skin young, in spite of no surgery!).   If you are allergic to fish, or on days when you are not eating any, try capsules of fish oil from the vitamin shelves.

3. Flax: a natural plant, flax seeds are found pulverized as a powder, or made into tasty oil.

  I often put the flax powder on oatmeal (another good cholesterol-fighting food) and top with a drizzle of flax oil.  Also a good combo on natural applesauce, instead of a richer dessert.  Again if you don't have access to the oil or the powder, try the capsules, readily available at most drug stores and grocery stores.

4. Shop the periphery, not the center; fresh produce is always found around the edges of a grocery store.  The center is usually where the junk foods are kept.  The profits are also generated mainly from the center, because junk food doesn't have much of a stale date...who ever heard of Twinkies and Oreos going stale?

5.  Learn to cook, even a little bit.  First of all, you will save money.  Secondly, you will feel involved with your health, and certainly more in control.  Don't be shy about watching chefs on the internet, or asking your grocer or butcher how to prepare their foods.  Often a simple treatment with a healthy oil in a frying pan, or a bit of water in the steamer will create an amazing meal that is far healthier than processed or fast foods.

6.  Retest: cholesterol levels should improve after four months of the above.  If not, a full consideration should then be given to medications.

So don't rush to the pills, before trying the above.  You may be surprised you can control a lot more of your health than you think.


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