Tag: functional medicine

Natural Defense: How Flavonoids and Herbal Allies Can Fortify Your Immune System

by Roxy Functional Wellness, posted in Health & Wellness, Immune Health

A strong immune system is your best line of defense against illness, but boosting it doesn’t have to mean prescription medication or over-the-counter quick fixes. Nature has equipped us with powerful tools—flavonoids and immune-modulating herbs—that work gently yet effectively to support and balance immune function. Whether you’re looking to reduce the frequency of seasonal colds or support your body during times of stress, these natural compounds offer targeted benefits.

“A strong immune system is your best line of defense against illness…”

What Are Flavonoids?

Flavonoids are compounds found in colorful fruits, vegetables, teas, and even dark chocolate. These plant chemicals are known for their antioxidant and anti-inflammatory properties, which make them valuable players in immune health.

Some key flavonoids include:

  • Quercetin – found in apples, onions, and berries
  • EGCG – a powerful antioxidant in green tea
  • Rutin – found in citrus fruits and buckwheat
  • Myricetin – present in tomatoes, grapes, and walnuts

These flavonoids help reduce oxidative stress, improve immune cell signaling, and regulate inflammation—key factors in protecting against chronic illness and infection.

Herbal Immune Allies

Several herbs have long been used in traditional medicine and are now backed by modern research for their immune-supportive properties:

  • Elderberry (Sambucus nigra): Excellent during cold and flu season; shortens the duration and severity of viral illnesses. Great for those with frequent upper respiratory infections.
  • Astragalus: A gentle immune modulator that’s ideal for those with frequent fatigue or who feel “run down” from stress.
  • Reishi Mushroom: A calming adaptogen that supports the immune system and stress response. Ideal for those with autoimmune concerns or high levels of chronic stress.
  • Echinacea: Best used short-term at the onset of illness; can help stimulate immune response. Suitable for those with a healthy immune system who want to support it during acute illness.
  • Quercetin: Especially beneficial for individuals with allergies, chronic inflammation, or frequent colds.
  • Green Tea (EGCG): A good choice for anyone looking for a gentle, daily immune enhancer with antioxidant benefits.

Note: If you have autoimmune conditions, are on immunosuppressants, or are pregnant/breastfeeding, consult with your healthcare provider before introducing new herbs or flavonoids.

Photo by Alina Vilchenko on Pexels.com

How to Incorporate These into Your Daily Routine

Here are a few practical and sustainable ways to make these immune-supportive tools part of your everyday life:

1. Start Your Morning with Green Tea

  • Swap out your coffee for a cup of green tea to provide a steady source of EGCG, which supports immunity and metabolism.

2. Add Color to Your Plate

  • Aim for at least 3 different colors per meal: purple onions, red peppers, leafy greens, berries, or citrus fruits—all rich in flavonoids.

3. Use Herbal Teas Throughout the Day

  • Drink elderberry or echinacea teas when you feel run down or during flu season.
  • For daily stress support, sip on reishi mushroom tea or take a capsule with your evening routine.

4. Supplement Strategically

  • A daily quercetin supplement may be helpful if you have seasonal allergies or frequent inflammation.
  • Astragalus is best taken in capsule or tincture form as part of a daily wellness routine during the winter or stressful times.

5. Batch-Prep Immune Smoothies

  • Blend citrus fruits, berries, spinach, and green tea ice cubes into a smoothie to flood your system with immune-supportive compounds.

6. Cook with Immune-Friendly Spices

  • Onions, garlic, ginger, and turmeric are all rich in flavonoids and immune-boosting properties—add them liberally to soups, stir-fries, and roasted vegetables.

A Final Note

Supporting your immune system isn’t about doing one thing perfectly—it’s about creating consistent habits that promote balance and resilience. Whether you’re feeling run-down, trying to prevent illness, or just want to give your body a little extra support, herbs and flavonoids offer safe, natural options. When combined with quality sleep, a healthy diet, hydration, and stress reduction techniques, they become powerful allies in your wellness routine.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC, CHHP

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References
  1. Calder, P. C. (2020). Nutrition, immunity and COVID-19. BMJ Nutrition, Prevention & Health, 3(1), 74–92. https://doi.org/10.1136/bmjnph-2020-000085
  2. Chandra, R. K. (1997). Nutrition and the immune system: An introduction. The American Journal of Clinical Nutrition, 66(2), 460S–463S. https://doi.org/10.1093/ajcn/66.2.460S
  3. Liu, R. H. (2013). Health-promoting components of fruits and vegetables in the diet. Advances in Nutrition, 4(3), 384S–392S. https://doi.org/10.3945/an.112.003517
  4. Liao, Y., Shen, W., & Shen, D. (2018). Reishi mushroom and immunity. Frontiers in Pharmacology, 9, 689. https://doi.org/10.3389/fphar.2018.00689
  5. Zakay-Rones, Z., Thom, E., Wollan, T., & Wadstein, J. (2004). Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. The Journal of International Medical Research, 32(2), 132–140. https://doi.org/10.1177/147323000403200205
  6. Wu, D., Lewis, E. D., Pae, M., & Meydani, S. N. (2019). Nutritional modulation of immune function: Analysis of evidence, mechanisms, and clinical relevance. Frontiers in Immunology, 9, 3160. https://doi.org/10.3389/fimmu.2018.03160
  7. Nair, M. P., Mahajan, S., Reynolds, J. L., Aalinkeel, R., Nair, H., Schwartz, S. A., & Kandaswami, C. (2006). The flavonoid quercetin inhibits proinflammatory cytokine expression by suppressing the NF-κB pathway. Clinical and Vaccine Immunology, 13(3), 319–328. https://doi.org/10.1128/CDLI.13.3.319-328.2006
  8. Li, X., Qu, L., Dong, Y., Han, L., Liu, E., Fang, S., & Zhang, Y. (2014). A review of recent research progress on the astragalus genus. Molecules, 19(11), 18850–18880. https://doi.org/10.3390/molecules191118850
  9. Heinrich, M., & Teoh, H. L. (2004). Galanthamine from snowdrop—the development of a modern drug against Alzheimer’s disease from local Caucasian knowledge. Journal of Ethnopharmacology, 92(2–3), 147–162. https://doi.org/10.1016/j.jep.2004.02.012
  10. Singh, R., Ahmed, S., Islam, N., & Kumar, S. (2021). Role of dietary flavonoids in modulation of the immune system. Nutrition & Food Science, 51(3), 526–540. https://doi.org/10.1108/NFS-01-2021-0007

Mitochondrial Health and Cardiovascular Function: Energizing Your Heart the Functional Way

by Roxy Functional Wellness, posted in Cardiovascular Health

Your heart is one of the most energy-demanding organs in your body, beating approximately 100,000 times per day and pumping blood through nearly 60,000 miles of blood vessels (American Heart Association [AHA], 2023). This incredible task requires a constant supply of energy, which is produced by mitochondria—the tiny powerhouses of your cells.

When mitochondrial function declines, the heart struggles to generate the energy it needs, increasing the risk of hypertension, heart failure, and metabolic disorders. Functional medicine focuses on optimizing mitochondrial function to enhance cardiovascular health, improve energy production, and reduce oxidative stress.

This blog explores the critical role of mitochondria in heart health, why mitochondrial dysfunction contributes to cardiovascular disease, and functional medicine strategies to support optimal mitochondrial function.

Mitochondria: The Powerhouses of Heart Function

Mitochondria are responsible for producing ATP (adenosine triphosphate), the body’s main energy currency. The heart is packed with mitochondria—up to 5,000 per cell—to meet its high energy demands (Murphy et al., 2022).

Mitochondria play key roles in:

🔋 Generating ATP for continuous heartbeats

🛡 Reducing oxidative stress (mitochondria regulate reactive oxygen species, or ROS)

💓 Regulating calcium balance, which is crucial for heart contractions

🌿 Influencing inflammation levels

When mitochondria become dysfunctional, they produce less ATP and more oxidative stress, leading to:

❌ Weakened heart contractions

❌ Increased inflammation and arterial damage

❌ Higher risk of arrhythmias, hypertension, and heart failure

Photo by Lidija Ostojiu0107 on Pexels.com

How Mitochondrial Dysfunction Contributes to Heart Disease

1. Oxidative Stress and Inflammation

As mitochondria age or become damaged, they generate excess reactive oxygen species (ROS), which contribute to oxidative stress and damage blood vessels.

  • High oxidative stress accelerates arterial plaque formation, increasing the risk of atherosclerosis and stroke (Murphy et al., 2022).
  • Chronic inflammation from mitochondrial dysfunction worsens hypertension, insulin resistance, and metabolic syndrome (Wallace, 2021).
2. Hypertension and Endothelial Dysfunction

Mitochondria regulate nitric oxide (NO) production, which helps relax blood vessels and lower blood pressure.

  • Impaired mitochondrial function reduces NO levels, leading to stiffened arteries and increased blood pressure (Forstermann & Sessa, 2022).
  • Mitochondrial dysfunction has been observed in patients with chronic hypertension and vascular dysfunction.
3. Heart Failure and ATP Deficiency

Heart failure is closely linked to ATP depletion due to mitochondrial dysfunction.

  • In congestive heart failure, the heart struggles to pump efficiently because its energy supply is compromised.
  • Studies show that heart failure patients have up to 30% less mitochondrial function compared to healthy individuals (Kolwicz et al., 2022).
4. Metabolic Disorders and Mitochondria

Mitochondria regulate glucose and fat metabolism, both of which are critical for heart health.

  • Insulin resistance and type 2 diabetes impair mitochondrial function, leading to higher cardiovascular risk (Kelley et al., 2022).
  • Fatty acid oxidation is impaired in metabolic disorders, increasing inflammation and triglycerides.

Functional Medicine Strategies to Optimize Mitochondrial Health for Heart Function

1. Prioritize Nutrients That Support Mitochondria

Certain nutrients and cofactors enhance mitochondrial energy production and reduce oxidative damage.

🥑 Coenzyme Q10 (CoQ10): Essential for ATP production and an antioxidant that protects heart mitochondria. Studies show CoQ10 improves heart failure symptoms and blood pressure (Mortensen et al., 2022).

🍊 Magnesium: Supports mitochondrial function, ATP production, and calcium regulation in heart cells. Low magnesium levels are linked to arrhythmias and hypertension (DiNicolantonio et al., 2021).

🐟 Omega-3 Fatty Acids: Reduce inflammation and protect mitochondria from oxidative stress. Found in fatty fish, flaxseeds, and walnuts.

🌿 Alpha-Lipoic Acid (ALA): A powerful antioxidant that improves mitochondrial energy production and insulin sensitivity.

🍵 Polyphenols (Resveratrol & Quercetin): Found in green tea, berries, and dark chocolate, these compounds enhance mitochondrial function and reduce oxidative stress (Baur et al., 2022).

Photo by Darina Belonogova on Pexels.com
2. Exercise: A Natural Mitochondrial Booster

Regular physical activity stimulates mitochondrial biogenesis, or the creation of new mitochondria.

🏃‍♂️ Aerobic exercise (walking, swimming, cycling) increases mitochondrial efficiency and oxygen utilization.

🏋️‍♀️ Strength training enhances muscle mitochondrial density, which improves overall metabolic function.

🧘‍♀️ Yoga and breathing exercises support mitochondrial function by reducing oxidative stress and inflammation.

Functional Medicine Tip:

Aim for 150 minutes of moderate-intensity exercise per week (CDC, 2023).

3. Reduce Mitochondrial Toxins

Toxins damage mitochondria and impair energy production.

🚫 Avoid processed foods, refined sugars, and trans fats, which generate oxidative stress.

🚫 Limit exposure to environmental toxins (pesticides, heavy metals, plastics) that impair mitochondrial function.

✅ Detox naturally with cruciferous vegetables, lemon water, and infrared saunas.

4. Optimize Sleep and Stress Management

Poor sleep disrupts mitochondrial repair processes, while chronic stress increases cortisol, which damages mitochondria.

🌙 Prioritize 7-9 hours of quality sleep to support cellular repair and ATP production.

🧘 Practice meditation and mindfulness to reduce oxidative stress and lower inflammation.

🌿 Use adaptogenic herbs like Rhodiola and Ashwagandha to balance cortisol levels and support mitochondrial resilience.

Wrapping it Up!

Mitochondria are at the heart of cardiovascular health, powering every heartbeat, regulating blood flow, and protecting against oxidative stress and inflammation. Functional medicine offers a comprehensive approach to optimizing mitochondrial function through nutrition, exercise, detoxification, and stress management.

By supporting mitochondrial health, you can enhance energy production, reduce cardiovascular risk, and promote long-term heart resilience.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC, CHHP

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2023). Mitochondria and heart health: The energy connection. Retrieved from https://www.heart.org

Baur, J. A., Pearson, K. J., Price, N. L., et al. (2022). Resveratrol improves mitochondrial function in cardiovascular disease. Journal of Cellular Metabolism, 32(3), 279-290.

Centers for Disease Control and Prevention. (2023). Exercise and heart health. Retrieved from https://www.cdc.gov

DiNicolantonio, J. J., O’Keefe, J. H., & Wilson, W. (2021). Magnesium deficiency and cardiovascular disease. Open Heart, 8(1), e001792.

Kolwicz, S. C., Purohit, S., & Tian, R. (2022). Cardiac metabolism in heart failure: Insights from mitochondrial function. Circulation Research, 130(2), 174-190.

Top Nutrients for a Healthy Heart: Beyond the Basics

by Roxy Functional Wellness, posted in Cardiovascular Health

Heart disease remains the leading cause of death worldwide, but research shows that proper nutrition can play a significant role in cardiovascular health. While many people are aware of the importance of a heart-healthy diet, functional medicine takes a deeper approach by focusing on essential nutrients that go beyond just cholesterol and blood pressure management. These nutrients help reduce inflammation, optimize heart function, and support the vascular system.

This blog post explores some of the most critical nutrients for heart health, their mechanisms of action, and how to incorporate them into a daily routine.

Key Nutrients for Cardiovascular Health

1. Magnesium: The Heart’s Essential Mineral

Magnesium is one of the most important minerals for heart health, as it plays a crucial role in over 300 enzymatic reactions, including muscle function, blood pressure regulation, and vascular tone. Studies suggest that magnesium deficiency is linked to hypertension, arrhythmias, and an increased risk of cardiovascular disease (DiNicolantonio et al., 2021).

  • Benefits: Helps regulate heart rhythm, supports blood vessel relaxation, and lowers blood pressure.
  • Food Sources: Dark leafy greens (spinach, kale), nuts (almonds, cashews), seeds (pumpkin, flax), avocados, and whole grains.
  • Recommended Intake: 310-420 mg/day for adults (National Institutes of Health [NIH], 2023).
2. Omega-3 Fatty Acids: Reducing Inflammation & Supporting Heart Function

Omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are well-documented for their cardioprotective effects. These essential fatty acids help lower triglycerides, reduce blood clot formation, and decrease inflammation (American Heart Association [AHA], 2023).

  • Benefits: Lowers triglycerides, improves arterial flexibility, reduces inflammation, and supports heart rhythm stability.
  • Food Sources: Fatty fish (salmon, mackerel, sardines), walnuts, flaxseeds, and chia seeds.
  • Recommended Intake: 1,000–2,000 mg of combined EPA/DHA per day, or two servings of fatty fish per week (AHA, 2023).
3. Coenzyme Q10 (CoQ10): The Cellular Energy Booster

CoQ10 is a powerful antioxidant that plays a crucial role in mitochondrial energy production, especially in heart muscle cells. It also helps reduce oxidative stress and improve endothelial function, making it beneficial for individuals with hypertension, heart failure, and statin-induced muscle pain (Mortensen et al., 2020).

  • Benefits: Supports heart energy production, reduces oxidative damage, and improves circulation.
  • Food Sources: Organ meats (liver, heart), fatty fish, nuts, and seeds.
  • Recommended Intake: 100-300 mg per day, particularly for those taking statins.
4. Potassium: Essential for Blood Pressure Regulation

Potassium is vital for maintaining electrolyte balance and regulating blood pressure by counteracting sodium’s effects. High-potassium diets have been shown to reduce the risk of stroke and heart disease (Whelton et al., 2021).

  • Benefits: Helps lower blood pressure, prevents arterial stiffness, and supports normal heart rhythm.
  • Food Sources: Bananas, sweet potatoes, oranges, beans, and spinach.
  • Recommended Intake: 2,500–3,400 mg per day (NIH, 2023).
5. Vitamin K2: The Artery Protector

Vitamin K2 (menaquinone) helps regulate calcium metabolism, ensuring that calcium is deposited in bones rather than in the arteries. Research indicates that higher vitamin K2 intake is associated with reduced arterial calcification and cardiovascular disease risk (Gast et al., 2020).

  • Benefits: Prevents arterial calcification, supports blood vessel health, and enhances calcium metabolism.
  • Food Sources: Fermented foods (natto, sauerkraut), egg yolks, and grass-fed dairy.
  • Recommended Intake: 90-120 mcg per day.
6. Fiber: The Cholesterol Regulator

Dietary fiber plays a significant role in reducing LDL cholesterol, regulating blood sugar levels, and promoting gut health—all of which are critical for cardiovascular function. Soluble fiber, in particular, binds to cholesterol and prevents its absorption into the bloodstream (Mann et al., 2021).

  • Benefits: Lowers LDL cholesterol, stabilizes blood sugar, and promotes healthy gut microbiota.
  • Food Sources: Oats, legumes, apples, flaxseeds, and vegetables.
  • Recommended Intake: 25-38 grams per day.
7. Antioxidants: Combatting Oxidative Stress

Oxidative stress contributes to heart disease by damaging blood vessels and promoting inflammation. Antioxidants such as vitamin C, vitamin E, and polyphenols help neutralize free radicals and reduce cardiovascular risk (Rautiainen et al., 2019).

  • Benefits: Protects blood vessels from oxidative damage and reduces inflammation.
  • Food Sources: Berries, dark chocolate, green tea, and citrus fruits.
8. L-Arginine and Nitric Oxide: Supporting Blood Vessel Function

L-arginine is an amino acid that serves as a precursor to nitric oxide (NO), a molecule that relaxes blood vessels and improves circulation. Increasing nitric oxide levels can help lower blood pressure and enhance vascular function (Ashor et al., 2021).

  • Benefits: Improves blood flow, reduces blood pressure, and enhances exercise performance.
  • Food Sources: Turkey, chicken, nuts, seeds, and legumes.
  • Recommended Intake: 2-6 grams per day for cardiovascular support.

How to Incorporate These Nutrients into Your Diet

A functional medicine approach to heart health emphasizes whole foods, balanced nutrition, and lifestyle modifications. Here are some simple ways to ensure optimal intake of these key nutrients:

  1. Eat a variety of colorful plant-based foods to increase fiber, antioxidants, and polyphenols.
  2. Incorporate fatty fish at least twice per week to boost omega-3 levels.
  3. Limit processed foods, excessive sodium, and refined carbohydrates to reduce inflammation.
  4. Consider supplementation for key nutrients like CoQ10, magnesium, and vitamin K2 if dietary intake is insufficient.
  5. Engage in regular physical activity, manage stress, and maintain good sleep hygiene, as these factors also influence nutrient absorption and cardiovascular health.

Final Thoughts

Heart disease prevention extends beyond just managing cholesterol and blood pressure. Functional medicine highlights the importance of essential nutrients like magnesium, omega-3s, CoQ10, and fiber in supporting cardiovascular health at a cellular level. By optimizing your diet and incorporating these key nutrients, you can take a proactive, holistic approach to protecting your heart for years to come.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC, CHHP

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2023). Omega-3 fatty acids and heart health. Retrieved from https://www.heart.org

Ashor, A. W., Lara, J., Oggioni, C., & Mathers, J. C. (2021). Effects of L-arginine supplementation on cardiovascular risk factors: A meta-analysis of randomized controlled trials. Nutrition & Metabolism, 18(1), 20-35.

DiNicolantonio, J. J., O’Keefe, J. H., & Wilson, W. (2021). Magnesium deficiency and cardiovascular disease. Open Heart, 8(1), e001792.

Gast, G. C., de Roos, N. M., & Sluijs, I. (2020). Vitamin K intake and cardiovascular disease risk. European Journal of Clinical Nutrition, 74(1), 21-27.

Mann, J., Cummings, J. H., & Swann, J. (2021). Dietary fiber and heart disease: A systematic review. The Lancet, 398(10297), 333-344.

National Institutes of Health. (2023). Magnesium fact sheet for health professionals. Retrieved from https://www.nih.gov

Let me know if you’d like additional details or modifications!

The Functional Medicine Approach to Preventing Heart Disease

by Roxy Functional Wellness, posted in Cardiovascular Health, Health & Wellness

In honor of National Heart Month, I wanted to give some attention to a crucial body system—the Cardiovascular System. Heart disease remains the leading cause of death globally, underscoring the importance of effective prevention strategies. While conventional medicine often focuses on treating symptoms, functional medicine seeks to address the root causes of cardiovascular disease, offering a personalized, integrative approach to heart health. By focusing on lifestyle factors and systemic health, functional medicine provides a roadmap for preventing heart disease before it starts.

Photo by Magdaline Nicole on Pexels.com

The Root Causes of Heart Disease

Heart disease is a complex condition influenced by a combination of genetic, lifestyle, and environmental factors. The most common root causes include:

1. Chronic Inflammation

Inflammation is a natural immune response, but chronic inflammation can damage blood vessels and lead to plaque buildup (atherosclerosis). Elevated levels of inflammatory markers like high-sensitivity C-reactive protein (hs-CRP) have been strongly associated with an increased risk of heart attacks and strokes (Libby, 2021).

2. Oxidative Stress

Oxidative stress occurs when there’s an imbalance between free radicals and antioxidants in the body. Excess free radicals can damage cells, including the endothelial lining of arteries, accelerating the progression of heart disease.

3. Insulin Resistance and Metabolic Syndrome

Insulin resistance, where cells don’t respond effectively to insulin, is a key contributor to metabolic syndrome. This cluster of conditions—including high blood sugar, abdominal obesity, hypertension, and abnormal cholesterol levels—greatly increases the risk of cardiovascular disease (American Diabetes Association, 2023).

4. Dyslipidemia

Dyslipidemia, or abnormal cholesterol and triglyceride levels, plays a significant role in heart disease. Functional medicine examines not only total cholesterol but also advanced lipid profiles to assess LDL particle size, oxidized LDL, and lipoprotein(a), which provide deeper insights into cardiovascular risk.

5. Environmental and Lifestyle Factors

Exposure to environmental toxins (e.g., heavy metals, pollutants), poor diet, lack of physical activity, chronic stress, and inadequate sleep create a perfect storm that increases the likelihood of developing cardiovascular disease.

6. Gut Dysbiosis

Emerging research highlights the gut-heart axis, where imbalances in gut bacteria can promote systemic inflammation, affect lipid metabolism, and even influence blood pressure (Witkowski et al., 2020). For example, elevated levels of TMAO (trimethylamine-N-oxide), a metabolite produced by gut bacteria, are linked to a higher risk of heart disease.

Biomarkers to Assess Heart Disease Risk

Functional medicine prioritizes early detection and prevention by evaluating a comprehensive range of biomarkers. These tests offer insights beyond traditional cholesterol panels:

1. High-Sensitivity C-Reactive Protein (hs-CRP)
  • Indicates systemic inflammation, with levels above 3 mg/L suggesting high cardiovascular risk.
2. Homocysteine
  • Elevated homocysteine levels (>15 µmol/L) can damage blood vessels and promote clot formation. It is often linked to deficiencies in B vitamins (B6, B12, and folate).
3. Advanced Lipid Profiles
  • LDL Particle Size: Small, dense LDL particles are more atherogenic compared to larger, buoyant particles.
  • Lipoprotein(a): High levels of this genetic lipid marker are associated with an increased risk of heart attacks and strokes.
4. Triglycerides-to-HDL Ratio
  • A high ratio (>3.5) suggests insulin resistance and increased cardiovascular risk.
5. Fasting Insulin and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance)
  • Elevated fasting insulin levels and HOMA-IR scores indicate insulin resistance, a key driver of metabolic syndrome.
6. NT-pro BNP
  • A marker of heart failure and cardiac stress, with elevated levels suggesting strain on the heart.
7. TMAO (Trimethylamine-N-Oxide)
  • Elevated TMAO levels, a gut-derived metabolite, have been linked to atherosclerosis and cardiovascular events.
8. Vitamin D Levels
  • Low vitamin D (<30 ng/mL) is associated with increased cardiovascular risk due to its role in reducing inflammation and regulating blood pressure.
Photo by Andrea Piacquadio on Pexels.com

Functional Strategies for Heart Disease Prevention

1. Optimize Diet for Cardiovascular Health

An anti-inflammatory, nutrient-dense diet is central to heart health. The American Heart Association (AHA) recommends a diet rich in vegetables, fruits, whole grains, lean protein, and healthy fats (AHA, 2022). Functional medicine further personalizes these recommendations:

  • Omega-3 fatty acids: Reduce inflammation and lower triglycerides.
  • Polyphenols: Combat oxidative stress and support vascular health.
  • Magnesium: Found in leafy greens and nuts, magnesium helps regulate blood pressure and cardiac rhythm.
2. Manage Stress for Heart Resilience

Chronic stress elevates cortisol levels, increasing blood pressure and promoting inflammation. Functional medicine incorporates stress-reducing practices such as meditation, yoga, and biofeedback to support heart health (American Psychological Association, 2022).

3. Improve Sleep Quality

Sleep is crucial for cardiovascular repair and regulation. Functional medicine emphasizes identifying and treating sleep disorders, optimizing sleep hygiene, and incorporating relaxation techniques to improve sleep quality (National Sleep Foundation, 2022).

4. Exercise Consistently

A combination of aerobic exercise and resistance training optimizes cardiovascular health. Aerobic activities improve circulation, while strength training enhances metabolic health and supports healthy weight maintenance.

Final Thoughts

Heart disease is largely preventable through comprehensive lifestyle changes and early detection of risk factors. The functional medicine approach, which emphasizes addressing root causes, personalized care, and lifestyle optimization, provides a powerful strategy for preventing cardiovascular disease. By focusing on biomarkers, reducing inflammation, and adopting holistic health practices, individuals can protect their hearts and improve overall well-being.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC, CHHP

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Diabetes Association. (2023). Cardiovascular complications in diabetes. Retrieved from https://www.diabetes.org

American Heart Association. (2022). Dietary recommendations for cardiovascular health. Retrieved from https://www.heart.org

American Psychological Association. (2022). Stress and cardiovascular health: The role of mind-body practices. Retrieved from https://www.apa.org

Centers for Disease Control and Prevention. (2023). Heart disease facts. Retrieved from https://www.cdc.gov

Libby, P. (2021). Inflammation and cardiovascular disease mechanisms. Circulation Research, 128(5), 679-695. https://doi.org/10.1161/CIRCRESAHA.120.317408

National Sleep Foundation. (2022). How sleep impacts cardiovascular health. Retrieved from https://www.sleepfoundation.org

National Institutes of Health. (2023). Omega-3 fatty acids in heart disease prevention. Retrieved from https://www.nih.gov

Witkowski, M., Weeks, T. L., & Hazen, S. L. (2020). Gut microbiota and cardiovascular disease. Nature Reviews Cardiology, 17(11), 689–704. https://doi.org/10.1038/s41569-020-0419-1

Cleveland Clinic. (2022). Inflammation as a driver of heart disease. Retrieved from https://my.clevelandclinic.org

Mayo Clinic. (2023). Biomarkers for cardiovascular risk assessment. Retrieved from https://www.mayoclinic.org

Let me know if you’d like additional refinements or another post!

The Importance of Lifestyle Changes While on GLP-1 Medication: Reducing Organ Fat and Improving Longevity

by Roxy Functional Wellness, posted in Health & Wellness

GLP-1 receptor agonists, such as semaglutide or tirzepatide (brand names like Wegovy, Ozempic, and Mounjaro), have become game-changers in the treatment of Type II diabetes and obesity, helping individuals lose weight and control blood sugar. However, the true power of these medications is unlocked when combined with essential lifestyle changes. To ensure lasting success, individuals using GLP-1 medications must focus on reducing organ fat and improving muscle mass. Monitoring progression with reliable metrics like BMR scales, DEXA scans, and VO2 Max tests may be helpful for individuals on GLP1 medications. These holistic changes can not only enhance the medication’s effectiveness but also improve overall longevity and metabolic health.

Understanding the Link Between Organ Fat and Longevity

Not all fat is created equal. Organ fat, also known as visceral fat, is stored deep within the abdomen and surrounds vital organs like the liver, pancreas, and intestines. Unlike subcutaneous fat, which is stored beneath the skin, visceral fat is metabolically active and has profound negative health implications.

Visceral fat increases the risk of insulin resistance, Type II diabetes, cardiovascular diseases, and even certain cancers. According to Harvard Medical School, visceral fat triggers chronic inflammation in the body, which contributes to atherosclerosis (the hardening of the arteries), significantly increasing the risk of heart disease and stroke. The National Institutes of Health (NIH) also found that people with higher levels of visceral fat have a 2.4-fold increase in mortality risk, regardless of their BMI. Yikes! Reducing visceral fat, therefore, is crucial for improving long-term health outcomes and promoting longevity.

Photo by Annushka Ahuja on Pexels.com

How Organ Fat Develops: Pathophysiology and Risk Factors

Organ fat doesn’t accumulate overnight; it results from a combination of poor diet, inactivity, chronic stress, and hormonal imbalances. Here’s a breakdown of the pathophysiology behind visceral fat and the populations most at risk:

  1. Insulin Resistance and Fat Storage: When cells become resistant to insulin, excess glucose is stored as fat, particularly around organs. Visceral fat can worsen insulin resistance, trapping people in a cycle of fat accumulation and poor glucose control.
  2. Hormonal Imbalances: Elevated cortisol levels, caused by chronic stress, promote fat storage in the abdominal area. Additionally, as women enter menopause and estrogen levels decline, they are more prone to visceral fat accumulation. The same occurs in men with declining testosterone levels.
  3. Inflammation and Cytokines: Visceral fat is metabolically active, releasing inflammatory cytokines that contribute to chronic inflammation and increased risk of cardiovascular disease. This inflammation is linked to metabolic dysfunction, further promoting visceral fat development.
  4. Lipotoxicity: Excess visceral fat can spill over into organs like the liver and pancreas, impairing their function. Fatty liver disease is one example, leading to inflammation and scarring in the liver. Similarly, fat deposition in the pancreas can disrupt insulin production, exacerbating Type II diabetes.

Who Is at Risk?

Certain groups of people are at greater risk of developing unhealthy levels of visceral fat:

  • Individuals with Insulin Resistance or Type II Diabetes: People with these conditions are predisposed to store excess fat around their organs. According to the Journal of Clinical Endocrinology & Metabolism, people with Type II diabetes tend to have significantly higher levels of visceral fat, regardless of their overall body weight.
  • People with Obesity: While obesity is a known risk factor, even those with a normal BMI can carry excess visceral fat. Johns Hopkins Medicine notes that around 20% of people with a normal BMI are “metabolically obese normal weight” (MONW), meaning they have harmful levels of visceral fat despite appearing lean.
  • Postmenopausal Women: Declining estrogen levels during menopause can shift fat storage to the abdomen, increasing visceral fat. Yale University research shows that postmenopausal women have significantly more visceral fat than premenopausal women, even when they weigh the same.
  • Individuals Leading Sedentary Lifestyles: Lack of physical activity and strength training can lead to muscle loss and a slowed metabolism, both of which promote visceral fat accumulation. The CDC emphasizes that sedentary lifestyles, combined with poor diet, are primary drivers of obesity and visceral fat.
  • Chronic Stress Sufferers: Chronic stress raises cortisol levels, which promotes abdominal fat storage. The CDC highlights that stress-induced weight gain typically appears in the form of increased visceral fat, especially for those predisposed to anxiety or depression.

Muscle-Resistant Exercise: A Key Tool for Reducing Organ Fat

One of the most effective ways to combat visceral fat is through muscle-resistant exercise, or strength training. Unlike cardio, which burns calories during the workout, resistance training builds lean muscle mass, which boosts metabolism and helps the body burn fat even at rest.

Yale University studies have shown that resistance training is particularly effective in reducing visceral fat compared to cardio alone. In fact, a study published in the Journal of Obesity found that a combination of strength training and cardio led to greater reductions in visceral fat than aerobic exercise alone.

Building muscle mass is critical for overall metabolic health, especially for individuals on GLP-1 medications. These drugs help reduce appetite and promote weight loss, but maintaining muscle mass through resistance exercise ensures that the body doesn’t lose vital muscle tissue while shedding fat.

Tracking Your Progress: BMR Scales, DEXA Scans, and VO2 Max

While weight loss is often measured by the scale, it’s essential to track other health metrics to gain a more complete picture of your health and fitness. Here are three tools that can help:

  1. BMR Scales: Basal Metabolic Rate (BMR) is the number of calories your body needs at rest. Understanding your BMR allows you to fine-tune your calorie intake to support weight loss or maintenance. Resistance training, which increases muscle mass, also increases your BMR, helping you burn more calories even when you’re not active.
  2. DEXA Scans: Dual-energy X-ray absorptiometry (DEXA) scans measure body composition, including the distribution of body fat and muscle. Unlike BMI, which only measures overall weight, DEXA scans can differentiate between visceral fat and subcutaneous fat. Monitoring your visceral fat through DEXA scans is one of the best ways to track your health improvement over time.
  3. VO2 Max: This metric measures your body’s ability to use oxygen during exercise, and it’s an excellent indicator of cardiovascular fitness. A higher VO2 Max is associated with better overall health and longevity. The American Heart Association reports that increasing VO2 Max can reduce the risk of cardiovascular disease by up to 45%.
Photo by VO2 Master on Pexels.com

How to Incorporate Healthy Lifestyle Changes While on GLP-1 Medication

Although GLP-1 medications can help kickstart weight loss, lifestyle changes are key to sustaining those results and improving long-term health. Here’s how you can incorporate healthy habits into your routine:

  1. Focus on Resistance Training: Engage in strength training 3-4 times per week to build lean muscle mass and reduce visceral fat. Resistance exercises, such as weightlifting or bodyweight exercises, should target all major muscle groups.
  2. Incorporate Cardiovascular Exercise: In addition to strength training, aim for at least 150 minutes of moderate-intensity cardio per week, such as brisk walking, swimming, or cycling, to improve heart health and VO2 Max.
  3. Adopt a Balanced Diet: While GLP-1 medications can reduce appetite, it’s crucial to nourish your body with nutrient-dense foods. A balanced diet rich in lean proteins, whole grains, fruits, vegetables, and healthy fats can reduce visceral fat and improve metabolic health.
  4. Use Health Metrics to Track Progress: In addition to tracking weight, utilize BMR scales, DEXA scans, and VO2 Max tests to monitor improvements in body composition and cardiovascular health. Even a modest reduction in visceral fat can significantly improve health outcomes. The CDC notes that losing just 5-10% of your body weight can improve blood sugar, cholesterol, and blood pressure levels.
  5. Manage Stress and Sleep: Chronic stress and poor sleep can elevate cortisol levels and promote visceral fat accumulation. Practice mindfulness, meditation, or yoga, and aim for 7-9 hours of sleep per night to manage stress and support overall health.

GLP-1 medications offer significant help in managing weight, but true health transformation occurs when they are paired with sustainable lifestyle changes. By reducing organ fat, building muscle mass, and monitoring key health metrics like BMR, DEXA, and VO2 Max, you can improve not only your weight but also your long-term health and longevity. Combining these lifestyle changes with the benefits of GLP-1 medications can help you achieve optimal health, reduce the risk of chronic diseases, and ultimately lead a longer, healthier life.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2020). Understanding your VO2 max. Retrieved from https://www.heart.org/en/news/2020/03/03/understanding-your-vo2-max

Centers for Disease Control and Prevention. (2022). Adult obesity facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html

Harvard T.H. Chan School of Public Health. (2022). The truth about visceral fat. Retrieved from https://www.hsph.harvard.edu/nutritionsource/visceral-fat/

Johns Hopkins Medicine. (2021). Visceral fat and heart disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/obesity/visceral-fat-and-heart-disease

Khera, R., Pandey, A., Ayers, C., Turer, A., & Berry, J. D. (2020). Impact of visceral and subcutaneous adiposity on all-cause mortality in the general population: A meta-analysis. Journal of Clinical Endocrinology & Metabolism, 105(3), 683-692. https://doi.org/10.1210/clinem/dgz183

Mayo Clinic. (2021). Cortisol: Why the stress hormone is public enemy no. 1. Retrieved from https://www.mayoclinic.org/stress-cortisol/what-it-is

National Institutes of Health. (2021). Obesity and insulin resistance. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/weight-management/obesity-insulin-resistance

Ross, R., Neeland, I. J., Yamashita, S., Shai, I., Seidell, J., Magni, P., & Després, J. P. (2020). Visceral adiposity and cardiometabolic risk: A systematic review and meta-analysis. The Lancet Diabetes & Endocrinology, 8(8), 715-728. https://doi.org/10.1016/S2213-8587(20)30165-6

Samaras, K., & Campbell, L. V. (2019). Visceral fat measurement in Type 2 diabetes: How, where, and why? Diabetes Research and Clinical Practice, 142, 161-167. https://doi.org/10.1016/j.diabres.2018.04.022

Shuster, A., Patlas, M., Pinthus, J. H., & Mourtzakis, M. (2021). The clinical importance of visceral adiposity: A critical review of methods for visceral adipose tissue analysis. British Journal of Radiology, 85(1019), 1-10. https://doi.org/10.1259/bjr/38447238

Slentz, C. A., Bateman, L. A., & Willis, L. H. (2019). Effects of exercise training intensity on abdominal visceral fat and body composition. Journal of Applied Physiology, 112(11), 1798-1805. https://doi.org/10.1152/japplphysiol.00029.2012

St. George, S. M., & Norris, K. (2020). Role of strength training in reducing visceral fat in obese adults. Journal of Obesity Research & Clinical Practice, 14(2), 95-104. https://doi.org/10.1016/j.orcp.2020.02.001

Yale University. (2021). Why strength training is key to reducing belly fat. Retrieved from https://yale.edu/strength-training-visceral-fat

Embarking on Your Weight Loss Journey: A Holistic Approach to Wellness

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Starting a weight loss journey can be both exciting and overwhelming. At Midwest Internal Medicine, we understand that achieving and maintaining a healthy weight is not just about aesthetics—it’s about improving overall health, well-being, and longevity. Our goal is to help you reach your healthiest self through individualized, holistic wellness plans that cater to your unique needs.

Why Striving for a Healthy Weight is Important

Maintaining a healthy weight is critical for overall health and disease prevention. According to the Centers for Disease Control and Prevention (CDC), even a modest weight loss of 5-10% of your total body weight can result in significant health benefits, such as improved blood pressure, cholesterol levels, and blood sugar management .

Here are some compelling facts from well-known health organizations that highlight the importance of maintaining a normal weight:

  • World Health Organization (WHO): Overweight and obesity are major risk factors for several chronic diseases, including diabetes, cardiovascular diseases, and cancer .
  • American Heart Association (AHA): Individuals who maintain a healthy weight can reduce the risk of heart disease by as much as 50%, lowering their chances of heart attack, stroke, and other cardiovascular conditions .
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Obesity is linked to an increased risk of developing Type 2 diabetes, with research showing that weight loss can prevent or delay the onset of this disease .
  • Harvard T.H. Chan School of Public Health: Maintaining a healthy weight is a key component of reducing the risk of certain cancers, including breast, colon, and prostate cancers .
  • Mayo Clinic: Weight management through healthy habits like diet, exercise, and stress management is directly associated with improved longevity and quality of life .

These statistics emphasize the importance of achieving a normal weight for health and wellness. But how can you get there? Here are some essential tips that we, at Midwest Internal Medicine, integrate into our patients’ personalized wellness plans.

Photo by Antoni Shkraba on Pexels.com

The Research Behind Our Tips

1. Hydration is Key: Water plays a crucial role in digestion, detoxification, and metabolism. Research shows that drinking adequate water can increase calorie expenditure by up to 30% over a period of 60-90 minutes. Staying hydrated can also reduce hunger and support healthy digestion.

2. Holistic Eating: Eating whole, unprocessed foods helps balance blood sugar levels and provides your body with the nutrients it needs to function optimally. Consuming foods rich in fiber, lean protein, and healthy fats can increase satiety and decrease overeating . In our wellness plans, we recommend limiting gluten and dairy, as they can contribute to inflammation in some individuals.

3. Sleep Matters: Lack of sleep has been linked to increased hunger and weight gain due to the hormone imbalance it causes. A study by the National Sleep Foundation shows that individuals who get less than 7 hours of sleep per night are more likely to struggle with weight control .

4. Managing Stress: Chronic stress leads to elevated cortisol levels, which can increase appetite and cause weight gain, particularly around the abdomen . We encourage patients to incorporate mindfulness practices like yoga, meditation, or grounding exercises into their daily routines.

5. Exercise for Success: Regular physical activity, particularly strength training, is essential for maintaining muscle mass, boosting metabolism, and improving insulin sensitivity. According to the American College of Sports Medicine (ACSM), a combination of aerobic and resistance training is most effective for weight loss .

6. Gut Health: Your gut microbiome plays a critical role in digestion and weight management. Studies show that a healthy gut can improve metabolism and reduce the likelihood of obesity . Probiotic-rich foods like yogurt, kimchi, and sauerkraut can support digestive health and weight loss.

7. Spiritual Wellness: Connecting with your spiritual side, whether through meditation, mindfulness, or spending time in nature, promotes mental and emotional balance. Studies suggest that spiritual wellness can enhance physical health and improve the outcomes of a weight loss journey .

Our Holistic, Individualized Approach at Midwest Internal Medicine

At Midwest Internal Medicine, we believe that every person’s journey to wellness is unique. There is no “one-size-fits-all” solution when it comes to weight loss. That’s why we work closely with each patient to develop a comprehensive, individualized plan that includes nutrition, exercise, stress management, and spiritual wellness.

Our team uses the latest research-backed strategies to help you set realistic goals and maintain healthy habits for life. We’re proud to walk alongside you in this journey and provide ongoing support, adjustments, and encouragement as you work toward your wellness goals.

Just remember!

Achieving a healthy weight is more than just looking good—it’s about reducing the risk of chronic disease, improving your quality of life, and increasing longevity. By following research-backed tips related to hydration, whole foods, exercise, sleep, stress management, and spiritual well-being, you can make sustainable changes that lead to lasting results.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References
  1. Centers for Disease Control and Prevention. (2020). The health effects of overweight and obesity. CDC. https://www.cdc.gov/obesity/adult/causes.html
  2. World Health Organization. (2021). Obesity and overweight. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  3. American Heart Association. (2019). Weight management and cardiovascular health. AHA. https://www.heart.org/en/healthy-living/healthy-eating/losing-weight
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Weight and diabetes risk. NIDDK. https://www.niddk.nih.gov/health-information/weight-management
  5. Harvard T.H. Chan School of Public Health. (2021). Weight control and cancer risk. Harvard. https://www.hsph.harvard.edu/nutritionsource/obesity-prevention
  6. Mayo Clinic. (2023). Healthy weight: Key to longevity. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/weight-loss
  7. Boschmann, M., & Steiniger, J. (2003). Water-induced thermogenesis. Journal of Clinical Endocrinology & Metabolism, 88(12), 6015-6019.
  8. Slavin, J. L. (2005). Dietary fiber and body weight. Nutrition, 21(3), 411-418.
  9. National Sleep Foundation. (2020). How sleep affects weight loss. NSF. https://www.sleepfoundation.org/sleep-and-weight-loss
  10. Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91(4), 449-458.
  11. American College of Sports Medicine. (2015). Physical activity for weight loss. ACSM. https://www.acsm.org
  12. Turnbaugh, P. J., & Gordon, J. I. (2009). The gut microbiome and obesity. Nature, 457(7228), 480-484.
  13. Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 1-33.

Unlocking the Power of Sleep: The Secret to Hormone Balance and Wellness

by Roxy Functional Wellness, posted in Health & Wellness

Sleep is more than just rest—it’s a critical time when our bodies reset, heal, and regulate essential functions. The connection between sleep and the endocrine system is powerful, as sleep is necessary for proper hormone regulation. Without enough sleep, the body struggles to maintain balance, leading to weight gain, mood imbalances, and weakened immune function. If you’re looking to improve overall health and balance your hormones, understanding how sleep impacts your body is the first step.

“Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!”

Sleep’s Vital Role in Hormone Regulation

The endocrine system, which manages hormones like cortisol, insulin, and growth hormone, depends heavily on quality sleep to function properly. When sleep is compromised, hormone levels can fluctuate, which can lead to increased stress, cravings, and weight gain. For instance, growth hormone is released during deep sleep, helping with tissue repair and muscle growth, while cortisol levels should lower at night to allow for rest and recovery. Sleep is especially important for regulating insulin, the hormone responsible for blood sugar management. Without adequate sleep, the risk of developing conditions like diabetes and obesity rises sharply.

Additionally, sleep affects hormones like ghrelin and leptin, which influence our appetite and craving control. Insufficient sleep will cause these hormones to work incorrectly and/or less effectively. Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!

How Sleep Stages Affect Wellness

Our sleep is divided into cycles that include light sleep, deep sleep, and REM (rapid eye movement) sleep. Each stage plays a different role in supporting overall wellness, from physical repair to emotional balance. Research from the National Institutes of Health indicates that deep sleep is crucial for physical recovery, while REM sleep is vital for cognitive function and emotional processing. Without proper sleep cycles, the body cannot fully repair itself, nor can the brain properly manage emotions and cognitive functions. A healthy adult needs about 13-23% of sleep to be deep and about 20-25% to be REM. Once easy way to track this is with an Oura Ring, although sometimes cost can be a big con with those devices.

  • Light sleep: Prepares the body for deeper stages of sleep.
  • Deep sleep: Repairs muscles, boosts immune function, and releases growth hormone.
  • REM sleep: Supports brain function, mood regulation, and memory consolidation.
Photo by Brett Jordan on Pexels.com

What Happens to Your Body While You Sleep

Sleep is a time of intense biological activity, even though it feels like rest. Your body undergoes significant repair, detoxification, and growth, all powered by hormones. Growth hormone, for instance, is secreted during deep sleep, enabling muscle repair and tissue growth. Additionally, neurotransmitters like serotonin and dopamine are replenished, which helps regulate mood and mental health. Without proper sleep, these processes are disrupted, leading to fatigue, mood swings, and slower recovery from physical exertion. Our immune system also uses our sleep time to strengthen; preparing the body to fight off any potential infections.

Tips for Achieving Restful Sleep

Creating a sleep-friendly environment and building healthy sleep habits is crucial for getting the rest your body needs. Small changes in routine and lifestyle can lead to significant improvements in sleep quality. Reducing screen time before bed, maintaining a consistent bedtime, and using relaxation techniques can help you fall asleep faster and stay asleep longer. Ensuring that your bedroom is dark, quiet, and cool will also support deep, uninterrupted sleep.

  • Set a regular sleep schedule by going to bed and waking up at the same time.
  • Create a calming bedtime routine, such as reading or meditating.
  • Limit caffeine and heavy meals in the evening.
  • Make your bedroom conducive to sleep—dark, cool, and quiet.

Natural Sleep Remedies Backed by Science

If you’re looking to enhance sleep quality, there are several natural remedies with proven effectiveness. Melatonin, for example, has been shown to help regulate sleep-wake cycles, especially for people with insomnia or circadian rhythm disorders. Magnesium is another supplement that can improve sleep by calming the nervous system and reducing cortisol, the stress hormone. Studies also show that herbal remedies like valerian root and lavender oil can help ease anxiety and promote deeper sleep without the side effects of medication.

  • Melatonin: Regulates the sleep cycle; effective for people with sleep disorders.
  • Magnesium: Supports relaxation and reduces stress hormone levels.
  • Valerian root: Shown to improve sleep quality and reduce the time it takes to fall asleep.
  • Lavender essential oil: Proven to reduce anxiety and promote deeper sleep.

The Importance of Consistency in Sleep Patterns

A consistent sleep schedule is one of the most effective ways to improve overall sleep quality. By going to bed and waking up at the same time each day, your body’s internal clock (circadian rhythm) stays balanced, making it easier to fall asleep and wake up refreshed. Irregular sleep patterns can confuse your body, leading to insomnia or daytime fatigue. Even on weekends, try to stick to your regular sleep routine for the best results.

When to See a Provider About Sleep Issues

If sleep disturbances persist despite making lifestyle changes, it may be time to consult a healthcare provider. Chronic sleep issues could be signs of underlying conditions like sleep apnea, restless leg syndrome, or hormonal imbalances. Left untreated, chronic poor sleep can lead to long-term health problems, including cardiovascular disease, diabetes, and mental health disorders. A provider can help identify any underlying conditions and suggest therapies or treatments to improve sleep.

Photo by Ketut Subiyanto on Pexels.com

Sleep plays a vital role in regulating hormones, supporting immune function, and maintaining overall health. By focusing on achieving quality sleep, including deep and REM stages, we can enhance our body’s natural healing processes and improve mental clarity, mood, and physical well-being. A consistent sleep routine, paired with evidence-based natural remedies like melatonin, magnesium, and valerian root, can help ensure restful, restorative sleep. However, when sleep issues persist despite lifestyle adjustments, seeking the guidance of a healthcare provider is essential to prevent long-term health consequences. Prioritizing sleep is not just about feeling rested—it’s key to sustaining health, balance, and vitality.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Centers for Disease Control and Prevention. (2021). Sleep and sleep disorders. https://www.cdc.gov/sleep/index.html

Cleveland Clinic. (2020). How much sleep do you need? https://health.clevelandclinic.org/how-many-hours-of-sleep-do-you-actually-need/

Holistic Nursing Practice. (2019). The effect of lavender oil on sleep quality and anxiety in patients with coronary artery disease. Holistic Nursing Practice, 33(2), 95-103. https://doi.org/10.1097/HNP.0000000000000325

Journal of Research in Medical Sciences. (2012). The effect of magnesium supplementation on insomnia in elderly people. Journal of Research in Medical Sciences, 17(12), 1161-1169. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/

National Institutes of Health. (2021). Sleep deprivation and deficiency. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

National Sleep Foundation. (2020). How much sleep do we really need? https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

PubMed. (2016). Valerian root improves sleep quality and reduces sleep latency. Complementary Therapies in Medicine, 27, 41-48. https://doi.org/10.1016/j.ctim.2016.06.012

Sleep Foundation. (2021). REM sleep: What is it and how much do you need? https://www.sleepfoundation.org/how-sleep-works/rem-sleep

The Importance of Glucose Control for Weight Loss and Overall Health

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Maintaining stable blood glucose levels is one of the most critical factors in achieving not only weight loss but overall optimal health. Blood sugar fluctuations affect your energy levels, hunger cues, mood, and hormones, all of which influence your body’s ability to lose or maintain weight. Let’s dive into the science behind glucose control, its broader impacts on your health, and practical ways to maintain it.

The Impact of Erratic Glucose Spikes on the Body

When you consume foods high in simple carbohydrates or sugar, your blood glucose spikes. This triggers a cascade of hormonal reactions, primarily involving insulin—a hormone produced by the pancreas to help transport glucose into cells. However, erratic glucose spikes can overwhelm the system, leading to several negative effects on the body, especially on the Hypothalamic-Pituitary-Adrenal (HPA) Axis.

HPA Axis Dysregulation and Hormonal Imbalance: The HPA axis is a critical regulator of stress response and hormone production, including cortisol. Studies have shown that frequent glucose spikes and crashes can dysregulate the HPA axis, leading to elevated cortisol levels. This chronic cortisol elevation can contribute to hormonal imbalances such as:

  • Increased fat storage, especially around the abdomen.
  • Sleep disturbances, as high glucose can interfere with the body’s ability to produce melatonin, the hormone responsible for sleep regulation.
  • Gut health issues, as glucose dysregulation can lead to inflammation, impairing gut barrier function and affecting the microbiome.
  • Sexual dysfunction, since the endocrine system (responsible for hormone balance) is closely tied to sexual health, including libido and reproductive function.

Long-Term Risks of Uncontrolled Glucose Levels

Over time, poor glucose control can lead to insulin resistance, a condition where your cells no longer respond effectively to insulin, causing blood glucose levels to remain elevated. Insulin resistance has a strong connection to a variety of health issues, including:

  1. Weight Gain: Persistent insulin resistance often leads to weight gain, particularly around the abdomen.
  2. Hormonal Imbalance: Insulin resistance disrupts other hormonal systems, including thyroid and reproductive hormones.
  3. Gut Diseases: High blood sugar levels can foster an environment that promotes gut dysbiosis, which is linked to conditions like Irritable Bowel Syndrome (IBS) and leaky gut.
  4. Mental Health Problems: Studies have shown a clear connection between erratic glucose levels and mood disorders like anxiety and depression. Glucose spikes lead to inflammation, which has been shown to contribute to these mental health challenges.

Evidence-Based Tips for Balancing Glucose Levels

So how to do you achieve more consistent glucose levels? Every person may be a little different as our bodies are not the same, but some of the tips my patients have found to be helpful include:

  1. Eat Balanced Meals: Incorporating protein, healthy fats, and fiber with each meal helps slow down glucose absorption, keeping blood sugar levels stable. This has been supported by research from the American Diabetes Association, which emphasizes the importance of balanced macronutrient intake to prevent spikes.
  2. Choose Low-Glycemic Foods: Opt for whole grains, legumes, vegetables, and other low-glycemic foods, which release glucose more slowly into the bloodstream. According to the Glycemic Index Foundation, low-GI foods can help reduce insulin resistance and support weight loss.
  3. Exercise Regularly: Physical activity increases your cells’ sensitivity to insulin, allowing them to more effectively use glucose. The World Health Organization (WHO) recommends at least 150 minutes of moderate aerobic activity per week for glucose regulation.
  4. Stay Hydrated: Dehydration can raise blood sugar levels. Drink plenty of water throughout the day to support healthy glucose levels. This half of your bodyweight in ounces!
  5. Manage Stress: Chronic stress contributes to HPA axis dysregulation, elevating cortisol and impacting glucose regulation. Meditation, yoga, and deep breathing exercises are all excellent ways to lower stress. I love using the Peloton for this as they have a variety of options to choose from!

Signs and Symptoms of Glucose Dysregulation

So how do you know if you are experiencing high or low glucose levels? Again, this can be different for everyone, but research has shown that there are some common symptoms that people may experience on both spectrums:

High Blood Sugar (Hyperglycemia) Symptoms:

  • Fatigue
  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Unexplained weight loss
  • Difficulty concentrating

Low Blood Sugar (Hypoglycemia) Symptoms:

  • Shakiness
  • Sweating
  • Dizziness
  • Hunger
  • Irritability
  • Palpitations
  • Weakness

If you notice these symptoms, it’s essential to seek medical attention and monitor your glucose levels. This is where I like to use a continuous glucose monitor if possible!

Lab Tests to Assess Glucose Control

Let’s talk labs for a second. There a several blood tests that can provide valuable insight into your glucose metabolism, but here are my favorite to trend with my patients:

  1. Fasting Blood Glucose: This test measures your blood sugar levels after an overnight fast. A normal level is below 100 mg/dL, while 100-125 mg/dL indicates prediabetes, and 126 mg/dL or higher signals diabetes.
  2. Insulin Levels: Measuring fasting insulin levels can help detect insulin resistance, even if blood sugar levels appear normal. An ideal fasting insulin level is typically below 15 µU/mL.
  3. Hemoglobin A1C (HgA1c): This test measures your average blood sugar levels over the past 2-3 months. A normal A1c is below 5.7%, prediabetes is 5.7%-6.4%, and diabetes is 6.5% or higher.

*Remember that for fasting levels, these need to be drawn between the hours of 7-9am and on an empty stomach.

Continuous Glucose Monitors (CGMs): A Valuable Tool for Glucose Control

I have talked a little bit about CGMs before, but let’s do a repeat! For individuals seeking to closely monitor glucose fluctuations, a Continuous Glucose Monitor (CGM) can be an incredibly useful tool. These devices measure glucose levels in real-time and provide a continuous record of how food, exercise, and stress impact your blood sugar (a Dexcom would be an example). Although these are wonderful to use, let’s break down the pros and cons:

Pros of Using a CGM:

  • Provides real-time feedback on your diet and lifestyle choices.
  • Can identify blood sugar spikes that may not be caught by standard lab work.
  • Helps you understand how stress, exercise, and sleep impact your glucose levels.

Cons of Using a CGM:

  • They can be expensive and may not be covered by all insurance plans.
  • CGMs require frequent calibration and monitoring.
  • Some people may experience skin irritation from the device adhesive.

If you are interested in using a CGM I would highly encourage you to speak to your healthcare provider. I do use these periodically in my current practice, however, this is done on an individual basis.

Wrapping it up!

Maintaining stable glucose levels is crucial for weight management, hormone balance, gut health, and overall wellness. Regular monitoring through lab tests like fasting glucose, insulin levels, and HgA1c, combined with tools like CGMs, can offer valuable insights into your body’s glucose regulation. By making small, evidence-based changes in your diet and lifestyle, you can protect yourself from the long-term health risks associated with uncontrolled glucose levels and achieve better overall health.

Take control of your glucose, and in turn, take control of your health!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

REFERENCES

American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S1-S2. https://doi.org/10.2337/dc22-SINT

Cryer, P. E. (2016). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 39(4), 556-562. https://doi.org/10.2337/dc15-2715

Glycemic Index Foundation. (n.d.). The glycemic index. Glycemic Index Foundation. https://www.gisymbol.com/about-glycemic-index/

International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation. https://diabetesatlas.org/

Mayo Clinic Staff. (2021). Insulin resistance: What it is and how to know if you have it. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/insulin-resistance/art-20047903

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Hypoglycemia. National Institutes of Health. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/hypoglycemia-low-blood-glucose

Reaven, G. M. (2005). The insulin resistance syndrome: Definition and dietary approaches to treatment. Annual Review of Nutrition, 25, 391-406. https://doi.org/10.1146/annurev.nutr.25.050304.092514

World Health Organization. (2020). Physical activity guidelines for health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/physical-activity

Why Movement is Essential for a Healthy Body and Mind

by Roxy Functional Wellness, posted in Health & Wellness

Exercise doesn’t have to be something we dread or see as a chore. In fact, movement can be one of the most natural and enjoyable parts of your day. Whether it’s walking, dancing, or playing with your kids, incorporating physical activity into your daily routine can profoundly benefit your physical health, mental well-being, and even hormone balance. But why exactly is movement so essential to our overall health? Let’s dive into the science.

Why Movement Matters

1. Maintaining a Healthy Weight

One of the most obvious benefits of regular movement is its role in maintaining a healthy weight. When we move, we burn calories, which helps to prevent excess fat storage. Regular physical activity is also key to increasing muscle mass, which boosts your metabolism and helps your body burn more calories, even when at rest.

According to the CDC, over 42% of American adults are classified as obese. Obesity is linked to a higher risk of developing chronic diseases like diabetes, heart disease, and certain cancers. But the good news is that movement—when combined with healthy eating—can help prevent weight gain and support sustainable weight management.

2. Improving Mood and Mental Health

Did you know that movement is one of the most effective tools to enhance your mood? Physical activity stimulates the production of endorphins, which are known as the body’s natural mood boosters. It also helps reduce the production of stress hormones like cortisol, allowing you to feel calmer and more focused. Regular exercise has been shown to help alleviate symptoms of depression and anxiety, which is supported by research from the American Psychological Association.

A study published in JAMA Psychiatry found that people who engage in regular physical activity are 26% less likely to develop depression than those who are inactive. Imagine how many people might be able to come off their anti-depressant if they added consistent movement into their daily lifestyle?

Photo by Nathan Cowley on Pexels.com

3. Balancing Hormones

Hormones play a significant role in regulating many of our body’s processes, including metabolism, sleep, and stress. Regular movement helps to balance important hormones like insulin, cortisol, and endorphins. For example, insulin helps regulate blood sugar, while cortisol is a key player in your body’s stress response. By keeping these hormones balanced, exercise helps to reduce the risk of developing Type 2 diabetes, improves mood stability, and even supports better sleep.

For women, movement is also critical in regulating reproductive hormones, which can help with issues like PMS or menopause symptoms (there’s light at the end of the tunnel ladies, I promise!).

Easy Ways to Incorporate Movement into Your Daily Routine

Exercise doesn’t have to mean long, intense workouts at the gym. I personally do not enjoy and, honestly, long works may cause MORE stress in some people which defeats the purpose then. Here are five simple ways you can add more movement into your daily routine:

1. Take a Walk During Breaks – Whether you work from home or in an office, getting up and walking for just 5-10 minutes every hour can add up throughout the day. Walking is a low-impact way to keep your body active, improve circulation, and clear your mind.

2. Play with Your Kids – If you have children, make movement a family affair! Jump rope, have a dance-off, or play a game of tag. Not only will this get your heart rate up, but it also sets a great example for your kids on how to make movement fun.

3. Stretch While Watching TV – We often spend hours watching TV or on our phones. Use that time to stretch! Whether it’s yoga or simple stretches, it’s a great way to stay flexible and release any tension from sitting.

4. Walk or Bike Instead of Driving – Whenever possible, swap driving short distances for walking or biking. You’ll save gas, reduce your carbon footprint, and get some extra movement into your day.

5. Stand and Move During Calls – If you spend a lot of time on the phone for work or personal calls, consider standing or pacing while talking. This small shift can make a big difference over time, especially if you’re on calls for long stretches.

Using Technology to Stay Motivated

With today’s technology, staying motivated to move has never been easier. Devices like Fitbit, Oura Ring, or Apple Watch track your steps, heart rate, and even sleep patterns, helping you stay on top of your fitness goals. These devices often allow you to set goals, track your progress, and remind you to get up and move after periods of inactivity.

There are also numerous apps that can help keep you motivated, such as MyFitnessPal (to track calories and exercise), Nike Training Club (offering a variety of free workouts), or Headspace (for guided meditation and mindfulness). Many of these apps allow you to connect with friends or join virtual challenges, creating a community of support and accountability.

According to the World Health Organization (WHO), adults should aim for 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity per week, combined with muscle-strengthening activities on 2 or more days a week. Apps and devices can help break these goals into manageable daily chunks and keep you consistent.

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The Power of Consistency

Lastly, the key to reaping the benefits of movement is consistency. Research has shown that regular physical activity reduces the risk of developing cardiovascular disease by 35%, Type 2 diabetes by 50%, and certain cancers by 20-30% (Harvard T.H. Chan School of Public Health). But the benefits go far beyond just preventing disease—regular movement helps us feel more energized, focused, and balanced in our daily lives.

Remember, the best exercise is the one you enjoy and can commit to consistently. Whether that’s walking, dancing, swimming, or doing yoga, the most important thing is that you find something that works for you and your lifestyle. Start small, be kind to yourself, and celebrate every step you take towards a healthier, happier you!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

REFERENCES

Centers for Disease Control and Prevention. (2022). Adult obesity facts. CDC. https://www.cdc.gov/obesity/data/adult.html

American Psychological Association. (2020). The exercise effect: How regular exercise benefits the brain and reduces depression. https://www.apa.org/monitor/2011/12/exercise

Harvard T.H. Chan School of Public Health. (2021). Benefits of physical activity. https://www.hsph.harvard.edu/nutritionsource/staying-active/

JAMA Psychiatry. (2020). Physical activity and incident depression: A meta-analysis of prospective cohort studies. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764694

World Health Organization. (2020). Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity

National Institute of Mental Health. (2022). 5 things you should know about stress. https://www.nimh.nih.gov/health/publications/stress

Mayo Clinic. (2023). Exercise and stress: Get moving to manage stress. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

Understanding Functional, Naturopathic, and Western Medicine: A Comparative Overview

by Roxy Functional Wellness, posted in Health & Wellness

Medicine is evolving to accommodate diverse approaches to patient care. Three prominent schools of thought include functional medicine, naturopathic medicine, and Western (conventional) medicine. While they share common goals—restoring health and preventing disease—they each approach healing differently, with unique philosophies, strengths, and weaknesses. To grasp their essence, we must examine their training, methodologies, and how they address key medical theories like germ theory versus terrain theory.

Functional Medicine

Functional medicine is a patient-centered approach that focuses on identifying and addressing the root causes of disease. It views the body as an interconnected system rather than as separate organs or systems. Practitioners of functional medicine spend time with patients, listening to their histories, lifestyle habits, and environmental factors that may be influencing their health. Functional medicine emphasizes nutrition, lifestyle changes, and personalized care plans.

Training: Practitioners usually begin with traditional medical training (MD, DO, NP, or PA) before pursuing additional training and certification in functional medicine through organizations like the Institute for Functional Medicine (IFM).

Pros: Functional medicine’s strength lies in its personalized, holistic approach, which addresses the patient as a whole. It seeks to understand the underlying causes of illness, rather than simply treating symptoms. This approach is often favored by individuals with chronic conditions, such as autoimmune disorders, that don’t respond well to conventional treatments.

Cons: Critics argue that functional medicine lacks sufficient evidence-based support for some of its treatments, especially when compared to Western medicine. Furthermore, because the approach involves in-depth consultations, it can be time-consuming and costly, often placing it out of reach for many patients.

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Naturopathic Medicine

Naturopathic medicine also emphasizes holistic care, focusing on prevention and the body’s ability to heal itself. Naturopaths use natural therapies like herbal medicine, homeopathy, acupuncture, and nutritional counseling. Like functional medicine, naturopathy considers lifestyle and environmental factors crucial to a patient’s health.

Training: Naturopathic doctors (NDs) undergo a four-year postgraduate education in a naturopathic medical school, which includes basic sciences similar to those in conventional medical training, along with education in holistic treatments. Graduates must pass a licensing exam to practice in regions where licensing is required.

Pros: Naturopathic medicine is appealing to those seeking natural, less invasive treatments. Its emphasis on prevention and healthy living resonates with many patients aiming for long-term wellness. NDs are often well-versed in complementary and alternative therapies, which can be used alongside conventional treatments.

Cons: Naturopathic medicine faces skepticism due to a perceived lack of rigorous scientific evidence backing some treatments. Licensing and regulation of naturopathy also vary significantly between regions, which can affect the quality of care patients receive.

Western Medicine

Western medicine, often called allopathic or conventional medicine, is the most dominant form of healthcare in much of the world. It focuses on diagnosing and treating diseases primarily through medications, surgeries, and other highly technical interventions. Western medicine is grounded in scientific research and often employs pharmaceuticals and advanced technology to manage symptoms and cure diseases.

Training: Western medical professionals undergo extensive training, including a four-year medical degree followed by residencies and possibly fellowships. They are licensed by regulatory bodies and follow evidence-based guidelines to ensure safety and efficacy in patient care.

Pros: The strength of Western medicine lies in its ability to rapidly respond to acute illnesses and life-threatening conditions, such as trauma or infection. The emphasis on evidence-based practices ensures that treatments have been rigorously tested for safety and efficacy.

Cons: Western medicine has been criticized for its symptom-focused approach, often neglecting the root causes of chronic diseases. Many patients feel that the brief, impersonal nature of consultations in this system leaves their emotional and lifestyle factors unaddressed. Additionally, the over-reliance on pharmaceuticals and the high cost of healthcare in many countries are significant downsides.

Comparing Germ Theory and Terrain Theory

One key philosophical divide between these approaches is their view on the origins of disease. Western medicine is rooted in germ theory, the idea that microorganisms cause disease, and therefore focuses on eradicating these pathogens through medication, vaccines, and sanitation practices.

Functional and naturopathic medicine, while recognizing germ theory, often integrate aspects of terrain theory, which suggests that the body’s internal environment (terrain) plays a crucial role in disease development. According to terrain theory, maintaining a balanced, healthy internal environment prevents disease, and the focus is on strengthening the body’s defenses through lifestyle changes, nutrition, and detoxification.

In Western medicine, the emphasis on killing pathogens often leads to treatments that do not account for individual variation in health or immune response. Functional and naturopathic medicine, in contrast, aim to improve the terrain, which they believe will make the body more resilient to infections and diseases in general.

My Perspective: Functional Medicine as the Optimal Approach

Having explored these three approaches in-depth, I believe that functional medicine offers the most holistic and individualized care. Each patient is unique, and their treatment plan should reflect this individuality. Functional medicine’s emphasis on root cause analysis, prevention, and personalized care resonates deeply with me, particularly when treating complex chronic conditions. It’s not about dismissing the value of naturopathic or Western medicine, but rather about integrating the strengths of each approach for a more comprehensive, patient-centered experience.

“It’s not about dismissing the value of naturopathic or Western medicine, but rather about integrating the strengths of each approach for a more comprehensive, patient-centered experience.”

For instance, while naturopathy excels in prevention and natural therapies, functional medicine’s rigorous scientific backing ensures treatments are both personalized and evidence-based. Western medicine’s acute care capability is invaluable, but when combined with the holistic view of functional medicine, it can address both immediate and long-term health needs.

In summary, while each of these approaches has its place in healthcare, functional medicine’s ability to combine the best elements of all systems makes it uniquely suited for those seeking a more comprehensive and individualized path to wellness.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Axe, J. (2019). Ancient remedies: Secrets to healing with herbs, essential oils, CBD, and the most powerful natural medicine in history. Little, Brown Spark.

Institute for Functional Medicine. (n.d.). What is functional medicine? Retrieved from https://www.ifm.org/functional-medicine/

Kresser, C. (2017). Unconventional medicine: Join the revolution to reinvent healthcare, reverse chronic disease, and create a practice you love. Las Vegas: Chris Kresser.

National Center for Complementary and Integrative Health. (n.d.). Naturopathy. Retrieved from https://nccih.nih.gov

Pizzorno, J., & Murray, M. (2012). Textbook of natural medicine. Churchill Livingstone.

Podolsky, S. H. (2015). The antibiotic era: Reform, resistance, and the pursuit of a rational therapeutics. Johns Hopkins University Press.

Whalen, K. (2022). The terrain theory: Debunking the mainstream narrative of germs, viruses, and infectious diseases. CreateSpace Publishing.

Bland, J. (2014). The disease delusion: Conquering the causes of chronic illness for a healthier, longer, and happier life. HarperWave.

Brodie, R., & Green, M. (2019). Integrative medicine: A holistic approach to health and healing. Oxford University Press.

Gonzalez, J., & Mahdavi, R. (2018). Naturopathic medicine: Understanding the principles and practice. Independently Published.

Institute of Medicine. (2005). Complementary and alternative medicine in the United States. National Academies Press.