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Could Your Anxiety Be Genetic?

Could your anxiety be genetic?

There is a simple to challenge to find out.

There are many known factors that contribute to anxiety, but one that is rarely discussed is a genetic variant that can inhibit traditional care. You may wonder, “how can I make a change if my problem is genetic?” In fact knowing your anxiety stems from a genetic variant will empower you to possibly find a more appropriate path to feeling better.

Let me explain:

Your brain is influenced by a number of chemicals called neurotransmitters, chemicals which pass messages from one nerve cell to another.Two of the most influential neurotransmitters are Glutamate and GABA.

•    Glutamate excites the brain

•    GABA slows the brain

As you may have guessed, an imbalance between glutamate and GABA may have an adverse effect on your mental state. Too much glutamate may equal more anxiety.


Glutamate turns into GABA in the brain. A number of things influence this process, including your genes. If you happen to have the gene variant that inhibits the process, you may be expressing it in the form of anxiety.

Take the Alpha-ketoglutaric acid challenge

When taken as a supplement, the body should turn Alpha-Ketoglutaric Acid(AKG) into glutamate and then GABA. If you have this genetic variant, the body can’t convert glutamate into GABA, in essence temporarily creating too much glutamate and the resulting symptoms.

The test: Take 1000 to 1500 mg of Alpha-Ketoglutaric Acid. You will be symptom-free if your body successfully converts it to GABA. But if you have the genetic variant your body will have a problem completing the conversion, and you may notice excitability, nervousness, anxiety, insomnia, or gut disturbances. You might have to do this challenge for a few days to notice any changes.

What to do if the result is positive?

 If this is positive you will want to develop a strategy to increase GABA through supplementation. You can also add supplements that support GABA, such as l-theanine, l-taurine, vitamin b-6, Valerian, and lithium orotate.

What else can you do?

 •    With your prescribing doctor, you may want to readdress some of your medications. Benzodiazepines, such as Valium and Xanax, may be difficult to withdraw from because of the resistance you build up over time.

•    Avoid MSG. This is one of the largest contributing factors on raising unnatural Glutamate levels in the body and brain. This may cause what is called the Chinese food syndrome.  MSG raises glutamate and if your body can’t convert it to GABA, it may lead to hyper-excitable symptoms like a racing heart rate, headaches, stomach problems, among others. By the way, MSG goes by many different names. Get educated on other names MSG goes by.

•    Exercise has also been shown to restore neurotransmitters to a healthy level.

•    Organic Acid Tests and genetic tests can zero in on a cellular and genetic level to see what influençable markers you have and to develop more powerful strategies to overcome your anxieties.

If you experience thoughts of doing harm to yourself or others, seek help from a mental health professional.

Anxiety may be expressed in many ways, and there are many causes. If there is an influenceable cause, wouldn’t you want to know? I hope this article helps.

5 Tips to Help You Eat Healthy During the Holidays

The holiday season can be a real test to eating healthy for all of us. You do not have to completely sabotage your healthy routine. Yes, you may be tempted and you should be able to enjoy yourself without feeling all the guilt. Still take the time to nourish your body with the following tips to help you navigate through all the holiday temptation.

  1. Keep Hydrated! Did you know that keeping yourself hydrated will help with any cravings and can also assist with any over eating? Drinking plenty of water and keeping yourself hydrated will help you re-assess your craving. 
  2. Bring something to the party. There’s nothing like bringing a covered dish or your favorite desert to the holiday party. This allows you to make something on the healthy side or for you to create those dishes that are a fit for any stomach or intolerances you may have. Think of some healthy holiday trail mixes or low-calorie side dishes. Try making some healthy versions of your favorite holiday treats. There are lots of wonderful recipes online that can help. 
  3. Eat the good stuff during the day and before you go to the party. Eating well during the day and then eating prior to going to your holiday function will help you make better choices when you arrive. Look to fill up your plate at the party with the healthy choices first. 
  4. Watch your drinks. Alcohol does a few things, it can be loaded with calories but it also can assist you in making bad choices when eating. Pace yourself and make drink choices that aren’t loaded with sugar and mixers. 
  5. It’s a mindset. If you have a routine the holidays shouldn’t give you a pass to veer off course. Stick to the routines you’re used to and know that you may stumble but you have to get back into the groove of that routine. Don’t make the holidays your excuse for bad decisions. 

Enjoy the holidays with your family and friends. Savor all the wonderful foods that you will have and don’t feel too guilty about it. This holiday eat well and be merry!

Top 5 Reasons To Eat a Ketogenic Diet

The Ketogenic Diet is a high-fat, adequate-protein, low-carbohydrate diet. The diet forces the body to burn fats rather than carbohydrates. So let’s put down the bread and increase your brain power!

The “Keto” in Ketogenic comes from “Ketones,” the small fuel molecules produced when you eat very few carbs and only moderate amounts of proteins.

The goal of a Ketogenic diet is for your body to switch its fuel supply to run entirely on fat. 

  1. Losing the Pounds: Transforming your body into a fat-burning machine makes it a weight loss machine. Revving up  fat burning puts the breaks on the production of insulin – the fat storing hormone, creating ideal circumstances in which fat loss can occur, without hunger.
  2. Jedi Knight Mental Focus: Ketosis provides a steady flow of fuel (ketones) to the brain, unlike the big energy swings that occur from burning sugar (glycolysis), often resulting in the experience of increased focus and improved concentration.
  3. Let’s get Physical: Ketogenic diets can vastly increase your physical endurance by giving you access to the energy available in your fat stores. When your body primarily burns carbohydrates your fat stores are not easily available and they can’t fuel your brain. Burning sugar makes you hangry (hungry and angry). Burning fat makes you heppy (happy and energetic).
  4. Settle the Stomach: It’s common to experience fewer stomach ailments and complaints on a Ketogenic diet. You may produce less gas, be less nausea, experience less cramping and have fewer bouts of diarrhea. You may even get relief from constant heartburn, allowing you to shelve the antacids.
  5. Less Acne: Many people experience less acne and fewer breakouts. A low glycemic diet, often in combination with the elimination of dairy products and the addition of fruits and vegetables has been shown to reduce acne, decrease body mass index and the risk of type2 diabetes.

Before making dietary changes be sure to check with your physician or health care provider.

The Role of Food in Your IBS

We are constantly being barraged with plates and pyramids dictating what makes up a healthy diet. Low-fat, moderate fat, only a little protein or a protein portion the size of your palm; lots of fruits and vegetables or lots of grains; none is the perfect answer for everyone. As a matter of fact, some of those guidelines may actually cause your IBS symptoms to flare up. There is no one size fits all answer when it comes to relieving IBS symptoms, but we will say that over the years we have found some common threads with our patients. 

Fiber – Yeah we know it should be good for you. Fiber is the thing that adds healthy bulk to your diet.  Buzz words like “whole grains” may be appealing, but they may not always be a good choice. Fiber can aggravate your symptoms, especially your diarrhea. Your best bet is to look for soluble fibers like vegetables and fruits. For those with a more sensitive system we often recommend cooking vegetables for easier digestion.

Grains – As discussed above, grains are known to aggravate IBS symptoms. Because of their inflammatory nature we often have patients steer clear of ALL grains, at least until symptoms calm down. Some patients are able to reintroduce grains successfully over time; however, patients with Celiac Disease or non-Celiac Gluten Sensitivity are often limited to grains that do not contain   rye, wheat, barley, or other grains known to induce a cross-sensitive reaction. 

Foods that are Fried – We all love french fries, but fried foods are really hard on your gut, especially for those struggling with IBS. 

Beans and Coffee – IBS can appear as diarrhea or constipation, or alternate between the two. Either way it’s unpleasant. We often hear about things like beans and coffee “helping things along” but we also hear how they can overshoot the mark and have a bad result. Your best bet: if you already know a food bothers you, don’t eat it.

Milk – Like grains, dairy products are known to be inflammatory. For you, this may mean typical IBS symptoms like constipation or diarrhea, in others it may cause joint pain, bloating, or skin problems. Like grains, we often have patients eliminate all dairy until symptoms go away, then we add it back into your diet, one product at a time for a fews day to see how you feel. 

There is no cookie cutter solution for each person suffering from IBS even though we often see identical symptoms in those suffering with it. Everyone has a different underlying cause. Keep a journal and list what you eat and when you have problems.  These suggestions should be a good starting point for relieving your pain. 

Come to one of our FREE Workshops where Dr. Kirshner will answer all your questions about your IBS.

Listen To Your Mother

Listen To Your Mother, She Knows What She’s Talking About.

Remember when you were a kid rushing out the door and your mother’s voice would float through the air encouraging you: “Take a jacket; it’s going to be cold outside.” Maybe you paused for a second to consider her suggestion or, like most of us, without skipping a beat; you went on your merry way only to be cold later. Of course you never admitted that once again your mother was right!

When it comes to living a long, healthy, vibrant life three pieces of mom’s advice are continually supported by science, not just her uncanny intuition:

Number 1 – Eat your vegetables! Yes, it is really that simple. Although mom may not have had a degree in nutrition, she instinctively knew vegetables are a secret health weapon. Add a variety of vegetables that are rich in color to every meal. Spice up those boring scrambled eggs with sautéed spinach and salsa. At lunchtime, ditch the bread and wrap your grilled chicken and veggies in a dark green lettuce leaf. Dinner is a great time to try a vegetable you have been shying away from. Roasting Brussels Sprouts brings out their natural sweetness and tames the bitter cabbage flavor. Snacking on celery filled with peanut butter satisfies the desire for “crunch” while providing fiber and protein to keep you full until the next meal.

Number 2 – “Turn off that darn machine.” The old adage “move it or lose” is true. It doesn’t take long to lose muscle strength, flexibility, and balance. Physical prowess is not the only thing sacrificed by being a couch potato – your emotional wellbeing and brain health will also be challenged. After dinner, go for a walk around the block. Ride your bike to the store. If you must watch Dancing with the Stars get up and test your moves.

Number 3- Learn something new. Studies have shown one of the key components to maintaining brain health is to learn a new skill. Planning a trip abroad? Learn the native language, what better way is there to find the best local sites? Have you been thinking about picking up some knitting needles? Many charities appreciate knitted blankets and caps for newborns in need? Want to make mom really proud? Fulfill all three of her favorite suggestions by planting a vegetable garden, learn about soil and sunlight, and maintain rows of proliferating vines then sit down to a meal of freshly grown vegetables.

This Mother’s Day before you rush out the door to brunch or the kid’s soccer game, take a moment and connect with mom, maybe say thanks for her wisdom, and don’t forget your sweater.  Listen to your mother, you may be suprised. 

You want fabulous hair, skin and strong nails? You can have them!

Admit it, you want to look your best but sometimes no matter what you do you’re just not happy when you look in the mirror. Let’s put away the pretense of not being shallow and get to work on looking good.

You’re after strong nails that won’t split and flake with the slightest bump. Thick, radiant hair and luminous skin round out the picture. But how do you make this happen?

First you owe it to yourself to read the labels on the products you are using. Can you pronounce the ingredients without having a master’s degree in chemistry? Find a knowledgeable professional who uses high quality ingredients that don’t create more of a toxic load to stress your system.

About that toxic load: why isn’t your body able to eliminate it without your hair, skin and nails suffering? Innately all your body was created to do was survive, so it will prioritize which organs get fed first in order to achieve that goal. Highest on the priority list are you brain and heart. Guess what is at the bottom? That’s right, your hair, skin and nails; these will be robbed of nutrients for more essential body functions.

Your skin, the largest external elimination organ of the body is susceptible to a barrage of invaders, from free radical damage to oxidative stress, your skin doesn’t stand a chance if it’s not given the proper support. Free radical damage can be reduced by eliminating smoking, excess sugar and chemicals found in processed foods. Eating a diet rich in antioxidants, including berries, dark leafy greens, bell peppers and more will help protect against oxidative stress.

imagesYour liver is your largest internal elimination organ, and as you may have guessed it works hand in hand with your skin. Don’t believe it? Try this experiment: cut an onion then massage the exposed portion into the bottom of your foot, wait a few minutes then see what you taste in your mouth. What you put on your body affects what happens in your body!  Treat you liver kindly with cruciferous vegetables like kale and broccoli and your skin and hair will thank you.

Healthy protein from whole eggs, free range and cage free animal sources are also essential to health inside and out. Healthy oils like coconut and olive will feed your brain and hair, skin and nails. You can also find healthy oils in avocados and raw nuts. You have probably been told these foods are high in calories, and that is true but they are also high in essential nutrients. Besides, if you are counting calories you are probably eating the wrong ones.

Try these tips for a few weeks and see if it helps. If you continue to have skin issues or if you want to have a more in depth evaluation please feel free to call the office at 610-435-1777.


Why is Vitamin D Important?

Why is Vitamin D Important?

Hearing the words unrecognized pandemic can elicit fear in the most even tempered person. However; learning that you may have control over your exposure to this so called pandemic should come as some relief. To protect yourself you don’t need to get a shot, have your home debugged, or limit your travel. You probably don’t even need any special lotions or potions, you just need to have a simple understanding of why vitamin D is important.

Vitamin D, the “sunshine vitamin,” has a receptor site on every cell in your body, which means every cell in your body needs vitamin D for some function. A healthy level of vitamin D is needed to “maintain bone health throughout life, but also plays an important role in reducing risk of many chronic diseases including type I diabetes, multiple sclerosis, rheumatoid arthritis, deadly cancers, heart disease and infectious diseases.” 1

Symptoms of vitamin D deficiency may include:

  • Fatigue
  • General muscle pain and weakness
  • Muscle cramps
  • Joint pain
  • Chronic pain
  • Weight gain
  • High blood pressure
  • Restless sleep
  • Poor concentration
  • Headaches
  • Bladder problems
  • Constipation or diarrhea

Would you take action if protecting yourself from this global scourge required having fun and eating foods you like?

After having a breakfast containing whole eggs (yolks are a significant source of dietary vitamin D), go play outside for 15 or 20 minutes and you will be well on your way to satisfying your body’s daily need for vitamin D, and you will have done your part to protect yourself from a pandemic.

In truth, maintaining a healthy vitamin D level may be that simple. Because of a concern about skin cancer many people have done themselves a disservice by shying away from daily sun exposure by not going into the sun at all, using excessive amounts of sunscreen, or completely covering their skin when they are outside, thus becoming part of the pandemic. Although some vitamin D is found in food, it is not enough to maintain a healthy level. Moderate sun exposure is still the most effective way to ward off the ill effects of vitamin D deficiency.

Evaluation by a qualified professional is an important step in determining if you have a vitamin D deficiency, if it is the cause of your health concerns or the effect.

To learn more about why vitamin D is important, what is considered an optimal level, and the risks of not maintaining healthy levels click the links below:

1 The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action.

Holick, MF-Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, MA, USA.

What is Your Poop Telling You?

What is Your Poop Telling You?

We may all be adults here but there are some subjects we still feel embarrassed talking about, and bowel movements is one of them. The list of funny names we call our excrement is nearly as long as the things about us it may reveal. Some equate examining our poop to the ancient art of reading tea leaves. So, pull up a stool, have a seat and let’s get down to business.

Important stuff you need to know:

Stool color is important and can be an indicator of serious health conditions that may need immediate attention. For instance, if your stool is bright red or black this may indicate the presence of blood. Please seek medical attention.  Your stool reflects what you eat and the color will change accordingly, but not all colors or changes are normal.  Yellow means something different than green, which means something different than brown. Admit it, you peek in the bowl; please share the information with your health care provider. It’s significant.
It is not normal to not poop every day, after all, you eat every day. If you aren’t regular – and daily is regular- where is the poop hiding? You only have so many feet of intestines. The perfect poop is a well formed, golden brown stool and should make an appearance about 3 hours after a meal, but if you have a successful visit once per day most doctors would consider that to be in the normal range too. Ongoing constipation or diarrhea may be a sign of a more serious condition. Surprisingly, there are many non-gastrointestinal conditions related to irregular bowel movements. A common complaint of thyroid patients is digestive distress.
Shape matters. There is even an “official” identification chart used by practitioners called The Bristol Stool Chart. Pooping pebbles? Sounds like you may be constipated. The question you need to ask is why. Is it because of illness or are you eating an unhealthy diet? Pooping fluffy pieces or something closer to brown pee equals diarrhea. Again, the important question is why. Unfortunately,  IBS patients suffer frequent bouts of diarrhea and are often afraid to engage in life because of the constant fear of embarrassing accidents.                                                                                         
Using the expression “I feel like crap” can actually be fairly accurate. Your brain and digestive tract are intimately related. As a matter of fact, the gut is often called the second brain. So when your emotional health is in the can it may very well have everything to do with your poopy poop process. By creating a sort of electrical circuit between your brain base and gut, your Vagus Nerve, the longest of your cranial nerves, tells your brain when food has been ingested and digested. Any interruption in this circuitry can cause serious problems like a loss of muscular function in the stomach and intestines, sending you running or doubled over in pain.
Although your body has many subtle ways of giving you signs about your health, your stool carries perhaps the biggest load of information. Color, consistency, sinking or swimming, all attributes are important. So, what is your poop telling you?

Should I Take Probiotics?

Probiotics are live bacteria and yeasts that are called “good” microorganisms because they benefit the body, specifically the digestive system. Your gut has more bacteria then total human cells in the body. There are over 500 different strains, or types of bacteria in your gut and each of these live strains, just like you, wants to survive, thrive and multiply. So, should you take probiotics? How does your Gut Health Affect Your Brain Health?

Think of all the bacteria in your gut as being embattled in a world war. Many of these strains are fighting for your benefit by making vitamins, detoxifying, and repairing cells. Some bacteria even create healthy neurotransmitters, the brain chemicals that communicate information throughout your brain and body, hence the term “Gut-Brain Connection.” This explains studies showing that an improvement of good bacteria often results in a positive emotional benefit. Because your gut and brain have this connection, the opposite will also hold true – bad bacteria may create negative emotional and neurologic effects. Therefore, supporting our allies, the beneficial bacterial is critical.

The Power of Sauerkraut

Across enemy lines lie those bacteria that have little benefit and in fact may cause harm. These bad strains are known to create bloating, inflammation, depression, reduction of healthy vitamins, and reduction of healthy neurotransmitters. This may sound familiar to you as the symptoms of Irritable Bowel Syndrome. For you to win the war, it is important to send in reinforcements to support the healthy troops. This is the role of probiotics. It is also just as important to feed the troops. This is done by taking prebiotics. The stuff that healthy bacteria feed off of, prebiotics are non-digestible foods that make their way through our digestive system and help good bacteria grow and flourish. One of the healthiest categories of prebiotics can be found in fermented foods like sauerkraut, and kimchee.

One thing that all bacteria have in common, both good and bad, is their food source; carbohydrates. Carbohydrates can be classified loosely into two groups: Simple Carbohydrates which are found in unhealthy forms like refined sugar, and candy, and healthy forms like those in fruits. Complex Carbohydrates, also called starches can be found in less healthy refined forms like pasta, bagels, and bread or their healthier forms found in vegetables, beans and legumes. By eliminating specific carbohydrates you are limiting the fuel source for bacteria. This is the premise of many so called gut health diets like FODMAP, SCD and GAPS. But…

“A diet that significantly reduces carbohydrates can reduce the number of BOTH good and bad bacteria.”

A recent study found that low-carbohydrate weight loss diets reduced the number of certain kinds of bacteria in your intestines. One kind of beneficial bacteria, bifidobacteria, were particularly affected. This is a problem because beneficial bacteria in your gut produce butyrate. Butyrate is a short chain fatty acid that serves as an anti-inflammatory and “fuel of choice” for the cells lining the colon. It is vital for your intestinal health and helps prevent colon cancer. Doctors are concerned that people on low-carb diets may not have enough good bacteria in their intestines to produce protective butyrate, possibly putting them at risk for cancer.

An effective tool to deduce the health of your gut bacteria is a Functional Stool Test. This 3 day test will check gut bacteria count, it will look for an overgrowth of bad bacteria, and check for imbalances between good and bad bacteria. The findings from this test help determine the necessity of taking probiotics.

Why do you want to take Probiotics?

Should I take probiotics? Let’s answer that question with a question. Why would you take them to begin with? What problem are you trying to solve? The answer is, you are hoping to improve gut health; your health. Given this answer taking probiotics may be an important component for improving gut health but to improve overall health it is often prudent to defend your assets using all the forces available in your arsenal.

If you are trying to improve health, taking probiotics along with other strategies may be a good course of action. If you are suffering from the results of your internal bacterial war, then your best chance of success is consulting with someone who is familiar with the intricacies of this problem and how best to navigate your way to better health.

Should I Take Iodine?

This is a question I am frequently asked by thyroid patients. As with most questions of this nature the answer isn’t a simple yes or no, additional questions need to be addressed.


3 most important questions to ask before taking any supplement:

What problem are you trying to solve?
Can the “solution” actually make the problem worse?
Why would you be deficient in iodine and need to consider supplementation?
What are thyroid hormones T4 and T3 and why are they significant?

First a little background. Your thyroid makes many hormones but the two most commonly talked about are T4 and T3. The numbers 4 and 3 refer to how many iodine molecules are on the thyroid hormone. T4 means there are four iodine molecules, T3 means there are 3 molecules.
Your body has roughly 100 trillion cells, all vying for hormones and to be metabolically active. Cells have receptor sites which are specific to the hormones needed like T4 and T3. Metabolic activity occurs when T4 and T3 successfully enter the cell. If the cells are not functioning well, tissues, organs, your whole body in fact begins to degrade. You may feel this as thyroid symptoms including: fatigue, weight gain, hair loss, brain fog, depression, constipation, and infertility to name a few.

When you are healthy and your thyroid is functioning properly it will predominantly produce T4, then the T4 will travel through the body on a mission to be converted to T3 to maintain the correct hormonal balance. Some T4 will be converted to T3 in the liver, more will be converted in the small intestines, and yet more T4 will be converted to T3 by tissue it passes along the way. This conversion process is critical; remember the thyroid predominantly produces T4 but the more active form of thyroid hormone is T3.    

And one more important consideration before I discuss iodine and the need for iodine:

“70% to 90% of hypothyroid patients are actually suffering from an autoimmune condition called Hashimoto’s.”
This is a condition where the body is destroying its own thyroid gland. The point is, even though you might be suffering from the results of a hormonal (endocrinological) issue, the underlying cause may actually be an immunological issue.

4 Groups of people who usually consider taking iodine supplements.

1)    People with no known thyroid problem who “just want to supplement.” For this group adding foods to the diet with naturally occurring iodine, like fish, some dairy products, sea vegetables, kelp, dark leafy greens like Swiss chard, mustard greens and spinach should be more than adequate to maintain health.

2)    People who have developed or are at risk for developing goiters because of an iodine deficiency. The deficiency may cause the thyroid to enlarge and in turn develop nodules. Many people with goiters will have an enlarged thyroid with few “thyroid” symptoms and should consider taking iodine in combination with Selenium to mitigate adverse reactions to the iodine.

3)    People with hypothyroid conditions not related to an autoimmune condition often consider supplementing with iodine, but this can become complicated. Your thyroid condition may be the result of underactive thyroid, problems with converting T4 to T3 including stress induced under-conversion of T4 to T3, hormonal imbalances which  will down regulate conversion of T4 to T3 or will deregulate transportation of T4 and T3 through the body. Just taking iodine may not be the answer to your problem. But once again should you decide to supplement with iodine a healthy suggestion would be to include a selenium supplement to mitigate adverse reactions to iodine.

4)    If you have an active autoimmune condition like Hashimoto’s Thyroiditis, taking iodine will create more activity in the thyroid gland. The body may see this increased activity as an increased attack on the body.  The body’s response will be to increase an immune reaction thereby causing more inflammation.  Even though you might be deficient in iodine, the supplementation may cause more harm than the iodine deficiency alone. Once again, if you consider taking iodine, a healthy addition might be to add selenium. But an even healthier alternative would be to investigate a whole body approach that looks for the cause of your iodine deficiency.  Do you have Intestinal Permeability? Do you suffer from food sensitivities? Are you reacting to other triggers that might be the cause of an autoimmune condition?

There is no simple answer to the question “Should I take iodine if I have a thyroid problem?” All aspects of your health should be taken into consideration before taking any supplement. A truly heathy diet should be sufficient to maintain health; however a body in crisis needs to be addressed using different criteria that should include consideration of all systems of the body.