Heavy Metal Testing and Detoxification

Weight Loss Management

Almost two-thirds—sixty-five percent—of Americans are overweight. Thirty years ago type 2 diabetes was an adult-onset disease; today we are seeing it diagnosed in elementary school children. There is increasing evidence that the American diet—highly processed and loaded with sugar—is a major factor in the rise of diabetes across all age groups. High fructose corn syrup, a cheap alternative sweetener widely used since the 70s, is ubiquitous throughout the processed food supply. Check your labels: high-fructose corn syrup is in bread, cereal, soft drinks, yogurt, condiments, and all kinds of fast food. Our development of a cheap food supply has made food plentiful, but not healthful.

From an evolutionary standpoint, our genes have evolved to protect us from starvation, so when we have an abundance of food, our body prepares for the inevitable "winter" by storing fat. In modern life,

however, that winter never comes. Our increasing lifespan, while beneficial, also contributes to weight gain in later years. Once our reproductive years have passed, we are no longer propagating the species, so Mother Nature has less need for us, and consequently our biological need for food declines. As we age, we need to eat less and move more to maintain healthy function. A successful weight loss program considers all these factors, and in addition to better nutrition addresses the metabolic and hormonal changes of aging.

An overweight body has developed its own biochemical system to maintain its fatty condition. In order to facilitate effective weight loss, that biochemical system has to be interrupted and reset. Environmental toxins are also stored in fatty tissue. We offer a range of nutritional and detoxification therapies to "reset" your system, and accomplish lasting weight loss.

Cardiovascular Disease

Cardiovascular disease (CVD) remains the number-one killer of Americans. It's being diagnosed in younger and younger people; we are now seeing heart attacks and strokes in people as young as 30 years old. More and more doctors are realizing that inflammation is a major underlying cause of CVD.

The source of this inflammation remains a topic of discussion but once again our highly processed,

Irritable Bowel Syndrome & Inflammatory Bowel Disease

It is estimated that greater than 50% of all visits to a doctor's office involve gastrointestinal complaints. I believe this statistic is a direct result of our Standard American Diet (SAD), which is high in processed grains, sugar, and chemical additives. By applying the "4R"

Autoimmune Disease

Autoimmune diseases like systemic lupus erythematosus, inflammatory bowel disease, and rheumatoid arthritis are the unfortunate result of an aggravated immune system. The body, in response to other stressors, works to fight some unseen invader, and ultimately attacks its own healthy tissue. Why would this happen? The body has an amazing capacity to heal itself, so immune disease presents a particularly confounding

Depression

Antidepressant medication is a billion dollar industry. They are among the most common drugs prescribed today. But are we really all that depressed? Many women in their 30s and 40s are prescribed antidepressants and/or oral contraceptives in response to depressive symptoms due to natural hormonal fluctuations associated with aging. Our stressful lives and compromised diet places increasing demands on our bodies and brains. Eventually, our body says: "Enough," and we find ourselves struggling to function.

Depending on genetics, lifestyle, and stress levels, abrupt hormonal shifts during perimenopause and

menopause can lead to disaster for some women. Every woman is different, though, and requires an assessment of her personal and unique situation to determine which treatment avenues will most effectively meet her needs.

In men, we are seeing lower testosterone levels—even in young men—and this may be due in part to xenoestrogens, which are compounds present in our chemical-laden environment. These compounds interfere with testosterone production and function. In both men and women, chronic stress, as well as poor diet and lifestyle, also contribute to these kinds of hormone imbalances.

Chronic Fatigue

There are different reasons for fatigue and different triggers for this confusing syndrome. Some people have chronic, difficult-to-diagnose infections; others have significant hormonal imbalances and/or overwhelming

Thyroid Function

Integrative Cancer Therapy

Ideally we aim for cancer prevention, but when a cancer diagnosis has been given, there are many supportive therapies that can benefit patients during every kind of cancer treatment. I will work with you to find every tool

Alternative Therapies

I maintain an extensive network of reputable practitioners offering alternative therapies like stress management, acupuncture, life coaching, hypnotherapy, craniosacral therapy and massage to help you manage stress and

Primary Care

During the 20 years I worked within the conventional insurance-funded primary care system my office overflowed with patients scheduled for 10-minute appointments. Insurance company regulations and policies controlled much of the relationship between me and my patients, and it was, in my opinion, a decidedly unsatisfactory way to take care of people.

I spent many years working in that system, and I know how to navigate its complexities—but I believe there is a better way. Now I work with my patients to address their health issues from a preventive and holistic perspective; I take the time we both need to address their health concerns. And now, I work with my patients to make sure

they get the best of integrative medicine—treatment that combines both conventional and alternative therapies to treat the whole person—not just symptoms. I schedule all initial appointments for a full hour. Follow-up appointments are a minimum of thirty minutes.

Should you require hospitalization, all major hospitals now have doctors specifically trained in hospital medicine, and these physicians can keep me informed of your progress and provide care while you're in the hospital. I am also available after hours by telephone for emergencies, and can direct you to needed services.

Bio-Identical Hormones / Hormone Balancing

Hormonal Balancing: Menopause, Andropause and Other Pauses
Hormones are the essence of life, chemically regulating bodily processes—growth, aging, reproduction, and metabolism. As we age, our hormone levels fluctuate and decline. Because we are living longer—but not necessarily better—there is currently much interest in how we might enhance the body's functions as we grow older by slowing, or preventing, aspects of the aging process.

The decline in hormone production plays a major role in the decline of overall function in the human body. Depletion in testosterone in men leads to a decline in strength and endurance as well as emotional instability. Men also have a lower incidence of dementia, suggesting that testosterone also plays a role in maintaining cognitive function. For women, perimenopause and menopause bring an abrupt decline in essential hormones: estradiol, progesterone, and testosterone.  Deficiencies of these hormones as well as growth hormone, thyroid hormone, cortisol, melatonin, and DHEA all lead to a decline in optimum health, and contribute to a loss of cellular integrity that is associated with many of the unpleasant changes in aging bodies. Generalized weakness, poor balance, decreased cognition, sagging skin, and aching joints are but a few of these changes. These functional declines match the stereotypes for men and women as we age: grumpy old men and shriveled old women. Balancing and replacing hormones with the bio identical hormone equivalent for both men and women is an effective way to delay some of the unpleasant aspects of aging. In my geriatric fellowship, we were taught that aging is characterized by the body becoming “fatter, drier, shorter, slower”. These physiological changes are considered “normal aging”. However, disease is not necessarily “normal”. Many conditions—such as obesity, diabetes, cardiovascular disease, cancer, dementia, osteoporosis, physical weakness, arthritis and chronic pain—are ultimately a result of the choices we make in what we eat, how we live and our declining hormones.

Bio identical hormone therapy is not a cure-all. But in conjunction with positive changes in nutrition and lifestyle, bio identical hormone replacement therapy—the supplementation of hormones to more youthful levels with hormones bio identical to the ones your body makes—can provide a viable alternative to pharmaceutical therapies, and restore people to their former vitality.

In order to achieve balance, it is wise to look at all the main hormones: estrogen, progesterone, DHEA, testosterone, cortisol, thyroid, and pregnenelone, as the hormones work together and need each other to provide maximum benefit.  In women, studies suggest that it is important to start bio identical hormone replacement early as bio identical hormone replacement actually decreases the risk for stroke and heart attack when started prior to the onset of cardiovascular disease.
An abundance of literature exists to support the benefits of bio identical hormone replacement therapy.  Please see my blog posts discussing the various bio identical hormones that are replaced in a bio identical hormone replacement program.  “ How to Achieve Healthy Aging”, by Neal Rouzier, MD is an excellent resource.  http://marshanunleymd.wordpress.com/

Bio Identical Hormone Pellet Implantation

Bio identical hormone therapy can be administered orally, topically, by injection, and with subcutaneous implants.  All are effective but certain rules apply as to what route should be taken.  Estrogen can be given orally, topically, or via pellet implant.  Bio identical micronized progesterone is most efficacious when given orally or sublingually.  Testosterone is given topically, by injection, or via subcutaneous implant.

Hormone pellet implantation is an FDA-approved procedure for hormone replacement that has been around since the 70s. It is convenient and has comparable efficacy to pills, injections, creams, and gels. Hormone pellets are bio identical and are administered subcutaneously, and are slowly released directly into the bloodstream over a period of weeks or months. In women with cardiovascular disease, or women over 60, it is best to bypass the gastrointestinal tract as studies have shown increased risk for cardiovascular events in women who are given oral synthetic or bio identical estrogen, and all progestins (Provera or medroxyprogesterone).

Testosterone is administered as pellets to both men and women. It has been shown to have neuro-protective effects and has been helpful in patients with neurodegenerative diseases and dementias. Low testosterone levels are associated with increased risk of some diseases and conditions, like Parkinsons disease. Topical or subcutaneous testosterone does not affect the liver, does not increase blood clots or the risk of prostate cancer, and is cardio-protective.

Testosterone pellet therapy is particularly effective in perimenopausal women.  By the time a woman is 40, her testosterone is less than half what it was when she was twenty.  She may still have adequate estrogen, and testosterone, along with bio identical micronized progesterone, can be very effective in relieving the symptoms of perimenopause.  Testosterone, of course, can be given topically but the pellets offer a nice alternative for men and women who want the convenience of not having to use creams or gels. 

Testosterone pellet therapy is effective for women suffering from endometriosis, uterine fibroids, dysfunctional uterine bleeding, migraine headaches and can help with the emotional upheaval that generally occurs in women in their late 30s or 40s.  Testosterone can be combined with anastrazole (an aromatase inhibitor which blocks the formation of estrogen).  Using this combination is very effective in managing estrogen overload syndromes like uterine fibroids and endometriosis.

For both sexes, bio identical hormone testosterone pellet therapy includes relief of depression and anxiety, improved sleep, increased muscle mass and bone density, improved memory and concentration, relief from aches and pains, increased libido and performance. Side effects may include increased facial hair growth and acne in women, and testicular shrinkage in men, with no attendant effect on sexual performance. Testosterone hormone therapy can affect fertility, however, and should be used cautiously in young men wanting to preserve fertility.  Women who are still fertile must be careful not to get pregnant as testosterone can cause masculinization of a developing fetus.

Testosterone and estradiol pellet therapy in men and women is an effective alternative for bio identical hormone replacement. Insertion is a simple office procedure, requiring insertion of the pellets beneath the skin every three-to-five months.  

Removing Toxins

Why detoxify?

If you've been living on planet earth for the last 20-70 years, then you've been exposed to environmental toxins. We live in a modern age of convenience and abundance, fueled by technology and mass-production, and the by-products of these benefits are released into the air we breathe, the water we drink, and find their way, most certainly, into the food we eat.

There are basically three kinds of toxins:
• Environmental
• Lifestyle
• Internal

Environmental toxins include things like the air pollution from factories and auto exhaust, exposure to paint and household or industrial cleaning products, heavy metals, pesticides, herbicides and radiation. Lifestyle toxins are the result of the choices we make—they include anything you ingest intentionally—like

nicotine, alcohol, caffeine, recreational, refined foods and sugars, prescription and over-the-counter drugs—and also unintentionally, artificial food additives like colorings, flavorings and preservatives, or meats from animals treated with hormones, antibiotics or artificial stabilizers. Don't forget that your skin is like a giant sponge and everything you rub on it, bathe in, or wear contains potentials toxins. Internal toxins are the result of your body's processes or imbalances: metabolic, hormonal, digestive, and emotional. Internal toxins include things like: bacteria, yeast, fungi, by-products of metabolism (carbon dioxide, ammonia, hormones), undigested food, and the biological by-products of stress or unresolved trauma.
Because exposure to all three kinds of toxins is ongoing, it's important to understand that detoxification is not a one-time treatment. It is an ongoing program, a commitment, and a lifestyle choice. I generally recommend that people consider a program of detoxification twice a year.

IV Vitamins

Intravenous (IV) nutrient therapy is a wonderful adjunct to a healing regimen. As we age, our digestive system naturally and gradually becomes less efficient at absorbing necessary nutrients. In addition, a lifetime of eating a diet high in processed grains and sugar, as well as exposure to produce and meat treated with pesticides and other chemicals, may accelerate the natural decline of function associated with aging. For some, prescription medications have altered the digestive environment and interfered with absorption. These factors, in combination or isolation, can lead to an accumulation of nutrient deficiencies, and supplementing nutrients directly into the bloodstream can be an efficient way to replace nutrients and get a person feeling better quickly. IV nutrition works best when combined with a complete healing program, and a person that feels good is usually more capable of making positive lifestyle changes—like appropriate oral nutrition and exercise—that can be sustained over time.

Amazingly, we are just beginning to understand the importance of nutrition in health. We are beginning to understand how the Standard American Diet (SAD) contributes to our epidemic of chronic gastrointestinal conditions such as peptic ulcers, irritable bowel syndrome and inflammatory bowel disease.

Some conditions that respond particularly well to IV therapies are malabsorption syndromes like celiac disease, inflammatory bowel disease, Chronic Fatigue Syndrome, fibromyalgia, macular degeneration, glaucoma, and chronic headaches. Also, patients undergoing therapies for serious conditions may also benefit, such as chemotherapy and gastric bypass patients.

The "Myer's Cocktail" is a common IV preparation that consists of magnesium, calcium, B vitamins, and vitamin C. It has been found effective in alleviating symptoms for many acute conditions such as asthma, migraine, muscle spasm, upper respiratory tract infection, as well as fibromyalgia, chronic fatigue, chronic sinusitis, seasonal allergic rhinitis, cardiovascular disease and others. Though there is only a small amount of published research supporting the use of the Myers', many doctors use it with positive anecdotal reports.

IV nutritional therapies are not for everyone, but for some, and within an overall program of holistic healing and lifestyle improvement, they can be an effective tool to quickly restore nutrient deficiencies and improve overall health and vitality.