Bone Mineral Density Testing And Bone Scan Results

by Marcelle Pick, OB/GYN NP

Dual-energy x-ray absorptiometry (DEXA) technology was introduced in 1988 and has become the most popular tool for measuring bone density.

The National Osteoporosis Foundation recommends that all women over age 65, and post-menopausal women with at least one risk factor for osteoporosis, undergo a bone density test, which is usually a DEXA. Results from bone density tests are used to diagnose osteopenia and osteoporosis.

DEXA measures the bone mineral content (BMC) of the spine, hip, wrist, femur, or any other selected part of the skeleton. It does this by focusing an x-ray on a body site and measuring the proportion of light rays that pass through the tissue as opposed to being blocked by minerals in the bone. Using computer software, it then divides that number by the surface area of the bone being measured to create bone mineral density (BMD).

Bone density test results

After the bone density scan, a picture is printed out that shows where the patient’s BMD falls compared to the norm. The “norm” refers to the accepted standard peak bone mass (PMB) set by a selected reference group of young adults. There are no international standards of PMB because bone density varies so dramatically according to race and region.

Women are given a diagnosis of osteopenia if their T-score (see below) bone density deviates 1.0-2.4 points (standard deviations) below the norm (although we’ve seen patients who were put on Fosamax at just 1.3). Anywhere below 2.5 standard deviations is diagnosed as osteoporosis.

When you are measured against the younger reference group, it is called a T-score. When you are measured against the average BMD for your age, sex, weight and ethnic or racial origin, it is called a Z-score. Everyone loses bone density as they age, so someone with a normal Z-score might deviate significantly from the T-score. However, T-scores are the gold standard for traditional diagnosis. This means that eventually all women’s T-scores will deviate from the norm, and women with natural bone loss might appear to be suffering from a diagnosable disease. No wonder there’s an osteoporosis epidemic!

Limitations of bone density tests

Errors in DEXA measurement can be 8–10% depending on the machine — that’s almost one standard deviation! This means that you might have normal bone density by one machine, and osteopenia by another. It also means that measurements of change in bone density over time are only completely accurate if all your tests are done with the same machine.

Another problem with bone density tests is that the range of healthy bone is much greater than this test would lead women to believe. What’s “low” for one woman may be just fine for another, depending on the thickness of her bones, her ancestry, her peak bone mass from when she was in her 20’s, and other variables.

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Bone Density, Osteoporosis And The Risk Of Bone Fracture

by Marcelle Pick, OB/GYN NP

Bone fractures are scary, there’s no doubt. And when it is a major bone, like your pelvis, hip, or spine, a fracture can be debilitating, even life-threatening.

Many women think that osteoporosis or low bone density is a leading cause of bone fractures — one reason why the disease is so frightening. But the statistics just don’t show that osteoporosis is a major cause of fractures of the wrist, hip, or spine.

Most fractures occur as the result of falling. Wrist fractures occur most often from women bracing themselves as they fall. And not many falls are caused by osteoporosis. As response time declines with age, women are less able to throw their arms up in time and end up falling on their hips.

Statisticians will tell us that more than a third of people over the age of 65 will fall at least once. About half of them will have a fracture (i.e., 15% of the total will have a fracture). If you have established osteoporosis, the risk of a life-impeding fracture is elevated because once an osteoporotic bone is broken it is very difficult to mend.

Hip fractures

Hip fractures are particularly frightening because they have the most impact on a woman’s quality of life. After age 75, up to 30% of people with hip fractures don’t recover enough to fully engage in their usual lives. By age 90, a third of all women may experience a hip fracture.

But that doesn’t mean that hip fractures are caused by osteoporosis. Even after the age of 80, at least half of all hip fractures are the result of a fall caused by other factors — not a bone spontaneously breaking. And in most cases where bone fragility was a factor there were other co-factors.

A study published in 1995 in the New England Journal of Medicine reported that in 65-year-old women with no previous history of hip fracture, a number of other factors were more significant than bone density in predicting fractures, such as tranquilizer and sleeping pill use, poor coordination, poor vision and depth perception, past history of hyperthyroidism, being tall, low blood pressure and rapid pulse, and lack of muscle strength. The general health of the woman was also a significant factor in predicting bone fractures.

Avoiding Holiday Stress

by Marcelle Pick, OB/GYN NP

Insight into the true sources of holiday stress for women, and how to make it through the holiday season happier and healthier.

Behind the joy and beauty of the holidays is tremendous stress for women. Every year from Thanksgiving to Christmas women pour into our medical practice with physical manifestations of stress like heavy or irregular bleeding. Many feel depressed. Other women call in reporting that their menopause symptoms have roared back to life again — they have no idea why. And how many of us have friends or relatives who get sick every Christmas?

From the thousands of women whose lives I’ve shared as their health practitioner, and from my own personal experience as a daughter, wife and mother, I’ve come to understand that holiday stress arises from our own personal histories. It’s as though we are scripted, both in our actions and our reactions.

Luckily, we all have the power to rewrite our inner holiday scripts, just as we have the choice to provide our bodies with additional support during this demanding time. I’d like to explain how.

The power of the past

Outwardly it may appear that we are all exposed to the same stressful seasonal factors: overeating, overspending, drinking too much, holiday travel, staying up too late, and family dramas. But some of us sail through the holidays in good cheer and health while others just feel awful. Obviously external factors make up only part of the story.

Studies have proven without a doubt that past emotional experiences affect our health. This becomes more obvious at this time of year, when so many of us try to incorporate family tradition — or lack of one — into our own holiday. Not only are we trying to stage a major production (often all by ourselves!) but we are unwittingly following a script, whether we like it or not. I came to understand this the Christmas after my mother died. Up until then, the holidays were just an exhausting, debilitating enterprise.

When my mother was a child, she moved around a lot and never had any family Christmas tradition. Then as I grew up in Australia, I watched her drive herself wild each year, creating the perfect Christmas for all of us. She hand-made our gifts and painstakingly crafted realistic pine Christmas trees (which don’t grow in my native soil). We lived 30 minutes — by ferry — from the nearest town and still my mother managed to create a magical Christmas feast that must have taken several trips to supply. My memories of my father at this time were of the time he spent with us keeping us out of my mother’s hair.

I loved Christmas Day as a child — who wouldn’t? And Christmas to me was connected with my mother’s effort. So when I became a mother, guess what? I spent this time of year in a similar frenzy, spending every free moment recreating the legendary Christmases of my youth. I did it because I believed that was what a mother was supposed to do. By the time my family finally sat down to Christmas dinner, I felt so sick and exhausted I could barely pick up my fork. I was hesitant to admit how bad I felt because I never remembered my mother complaining.

The year after my mother died was the first year that my family and I celebrated our own version of Christmas. I chose to celebrate a few of my mother’s traditions, but we mostly forged our own. And you know what? It was fantastic!

I missed my mother, but I felt as if a 50-pound weight had been lifted from my chest. I didn’t have anything to prove anymore. Having my own Christmas did not weaken the memories of my mother or my childhood, but enhanced them. And, more importantly, my family came together on our own terms, in the present — not as a reflection of my past.

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Antidepressants and Natural Alternatives

by Marcelle Pick, OB/GYN NP

Depressed Woman Antidepressants Natural AlternativesGrace was in her 40’s when she first came to see me. She was juggling a career and a family, caring for her aging father, and helping her husband start his own business. Finances at home were tight since he’d quit his job, putting a strain on their marriage. She was feeling low and tired all the time, so she went to her doctor for help. She left the office with a prescription for an antidepressant. Four days later, she came to the clinic with her unfilled prescription in hand to ask me, “Do I really need this?”

It’s hard to believe antidepressant prescriptions have more than quadrupled in the past couple of decades, with twice as many women as men — by some estimates over 1 in 10 women in America — now taking one. Advertisements for Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Cymbalta, Effexor, and others bombard us everywhere we turn — there’s even a designer antidepressant for menopause symptoms called Pristiq, and another one for PMS symptoms called Serafem. But advertising doesn’t portray the full picture about these prescription drugs, just images of happy people relaxing in the sun. We all want that, right? So why not fill the prescription when your doctor offers it?

Woman Choosing Path Antidepressants Natural AlternativesWhile antidepressants can help some women immensely, especially those with major depression, the sad truth is that they’re just not very effective for a lot of people. And they certainly aren’t free of side effects. Like many women I see, Grace was reluctant to take a prescription drug, and wanted to know if she had any alternatives. I always tell my patients that there are many ways to navigate these difficult periods in life, and numerous options that can help improve mood and outlook naturally. It may take some time to figure out which path is right for you, but I promise, you can feel better. And the fact is, antidepressants will still be there, should you decide you need them.

Let’s take a closer look at antidepressants and some natural alternatives.

How depressed are you?

Depression involves a range of normal negative emotions. But “clinical depression” differs significantly from minor situational depression or mood disorders, even though the symptoms can be similar or the same. The difference is that in mild depression, symptoms ebb and flow, and eventually do lift, while in major depression they tend to spiral downward toward a more entrenched mental health crisis. Most forms of depression are characterized by:

  • Overwhelming feelings of grief, anxiety, guilt, or despair
  • A sense of numbness or hollowness
  • A loss of interest or pleasure in activities that were once enjoyed, including sex
  • Dullness, decreased energy, difficulty concentrating or making decisions
  • Disrupted sleep patterns
  • Overeating, weight gain, loss of appetite, or weight loss

Compassionate Gesture Woman Antidepressants Natural AlternativesIf you’ve noticed symptoms consistently for over a month, we urge you to see a medical professional, preferably a trained psychiatrist, psychologist, or social worker. Suicidal thoughts or attempts and obsessing about death are serious warning signs that need to be addressed immediately.

 The depressing truth about antidepressants

Most healthcare practitioners have an average of seven minutes to spend with each patient. As you can understand, seven minutes isn’t nearly enough time to talk about a person’s emotional state. We can’t blame conventional doctors for how over-reliant on antidepressants our society has become — our medical system is broken, and antidepressants are a Band-Aid attempt to alleviate miserable symptoms. But in the end, any emotional concerns, including depression, anxiety or mood changes deserve more attention than seven minutes, and I encourage you to give yourself that attention.

There’s good reason to take some time with this decision. For one, antidepressants can cause several surprising side effects, such as restlessness, anxiety, sexual dysfunction, increased sweating, and more (refer to the following list). What’s more, there’s been ongoing debate for years about whether they are even effective for people with mild to moderate depression. A 2010 meta-analysis revealed minimal or nonexistent benefits as compared to placebo for mildly to moderately depressed people, although people suffering from severe depression showed more substantial benefit.

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Anatomy Of The Skin

by Marcelle Pick, OB/GYN NP

The skin is an amazing, versatile organ that is truly holistic. It covers your entire body and stretches from deep within to the outside. Once you understand how comprehensive your skin is, you will see that it only makes sense to start caring for your skin where it starts: deep below the surface.

The skin is both the largest organ in the body and the most visible. It is the body’s primary defense against the elements, its greatest sensory organ, and a unique communicator between the emotions and the body. It regulates temperature and stores water, fat, and vitamin D. Our skin also serves as a gatekeeper, allowing certain molecules to enter our bodies while keeping others at bay — at the same time it allows certain molecules to leave our bodies while keeping the rest inside.

The skin layers

There are many intricacies to both the anatomy and physiology of the skin, but we will discuss only the most fundamental of these here. Basically your skin is comprised of three main strata, though the surface may have anywhere from 50–100 individual cell layers. These are as follows:

The hypodermis is the deepest section of the skin. It is composed of subcutaneous fat tissue that serves two functions: insulation and padding; and the storage of nutrients and energy. The amount of tissue in this layer varies from person to person but tends to thin with age. It is metabolically active, like other fat tissue, and responds to hormonal and metabolic fluctuations.

The dermis is the middle section of skin, and this is where most of the action takes place. A beauty product needs to penetrate through the surface to this layer to do any good — and most don’t. Generally, the molecules in a product must be very small to permeate into the dermis.

The dermis is a dual-layered section comprised of a network of glands, follicles, smooth muscle, corpuscles, and fibers, the latter being principally collagen (fibers that provide structure) and elastin (a flexible protein that encourages elasticity). This network gives shape and structure to the skin, and contains blood and lymph vessels as well as nerves, fibroblasts and mast cells. All of these components are surrounded by a viscous fluid made up of moisture-binding molecules. These molecules allow the mesh-like network of the skin to retain water.

The circulatory vessels bring nourishment to the dermis, while the lymph flushes waste. Blood vessels help regulate temperature by dilating or constricting, which is why the skin reddens when you flush. Fibroblasts produce the protein that becomes elastin and collagen, and mast cells are important to the skin’s immune response. When provoked, mast cells trigger the inflammatory response we discuss in our articles about holistic skin care.

Inflammation – Allergies and Sensitivities

by Marcelle Pick, OB/GYN NP

Allergies and sensitivities have increased radically in our lifetime — acute, chronic and subclinical allergies are all up — so much so that by some estimates over 60 million Americans now suffer from allergies, and millions more from sensitivities.

But conventional medicine doesn’t try to explain why. Instead, conventional diagnostics treat each allergy as an isolated issue. Women with chronic allergies are often put on drugs for years, and their conditions rarely improve. And the tens of millions with subclinical allergies and sensitivities are regularly misdiagnosed — even given antidepressants! — or dismissed by their doctors because their symptoms seem mysterious and unconnected.

The reality is that allergies and sensitivities almost never occur in isolation. They are usually accompanied by other health conditions and symptoms, typically appear as part of a broad pattern, and can be readily diagnosed by a skilled practitioner.

This is a very gratifying area of practice for Women to Women because our patients see such dramatic, lasting improvement in their allergies and sensitivities — without drugs! — through an integrative approach to diagnosis and treatment.

So let’s talk about how symptoms of allergies and sensitivities arise, their links to other health conditions, and how to find natural relief. I think you’ll be surprised, and perhaps inspired by how easy it is.

Before we begin: what is an allergy, anyway?

Seen in its simplest form, an allergy is an over-reaction of the immune system, the body’s natural defense system. In short, the body responds as though it’s under attack, releasing antibodies and triggering inflammation, even though the stimulus of the attack (the allergen) is normally harmless.

We view allergic responses in three categories:

  • First is the acute allergic reaction, which may occur rarely or in response to a single allergen (such as peanuts) and can be quite dangerous. (One of my patients broke out in hives after a routine leg wax — it never happened before or thereafter, but was how she discovered she was pregnant!).
  • The second category is chronic allergies, in which women regularly (perhaps in a seasonal cycle) or always show symptoms, sometimes in response to a specific allergen (e.g., dust mites or ragweed), or as the result of an overload of allergens (e.g., women with chemical sensitivities).
  • In the third category, subclinical cases, women may suffer transient, seemingly disconnected symptoms that can be difficult to recognize as an allergic response.

The allergic response engages the body’s inflammatory cascade, and that’s one reason it has such serious health effects. Allergic reactions are recognized as one of the most important causes of illness and disease in America.

Allergies and sensitivities are at the root of many health problems, including respiratory ailments, skin conditions, mood disorders, and gastrointestinal symptoms. And the negative health effects resulting from the mechanism of inflammation can be profound. For more on this, see our other articles on inflammation. In short, neither a chronic nor an acute allergic response is something you should ignore.

Type I allergies and anaphylactic shock

If a certain substance in your diet or environment consistently triggers an acute, measurable immune response, you have what is known as a type I, or immediate-response allergy. Type I allergic responses are what most people (and doctors) refer to when they talk about allergies. Elevated levels of antibodies called IgE’s in the bloodstream trigger a histamine reaction: itchy watery eyes, runny nose, hives, itchy rash, swelling, scratchy throat, wheezing and coughing. Hay fever and some food allergies are type I allergies. The conventional treatment protocol is to manage these symptoms with avoidance, steroids, or anti-allergy medications like Claritin and Allegra.

Another kind of type I reaction is anaphylaxis, which is a rapid, or sometimes delayed system-wide reaction to an allergen. People allergic to bee stings, medication, and common food allergens sometimes have this type of allergic response, with severity ranging from mild to life-threatening. An anaphylactic reaction can start with a tingling sensation, itching, or metallic taste in the mouth. Hives, flushing, wheezing, swelling of the mouth and throat, difficulty breathing, vomiting, diarrhea, cramping, a drop in blood pressure, and loss of consciousness are all characteristic of anaphylaxis or anaphylactic shock. If you experience any of the above symptoms, get help immediately — go to the emergency room or call 911. Anaphylaxis is a case where conventional medicine is your best option and can save your life.

Type I allergy symptoms usually recede with treatment or removal of the allergen. However, after an anaphylactic episode it is possible to have something called a biphasic reaction, in which symptoms recur two to three hours after the initial attack, which is why most ER doctors will keep you at the hospital for observation.

The problem with conventional medicine and allergy diagnosis

Conventional doctors may test the level of IgE antibodies in the blood during a type I allergic response. If you walk into your doctor’s office with hives, he or she will take the situation seriously and give you either a skin (intradermal) test or a blood test for IgE. Skin testing (scratch test, puncture test, or prick test) involves introducing a very small amount of a common allergen to the skin’s surface or just beneath, and waiting to observe and record any degree of reaction. Skin testing is convenient and results are quickly available, but, like blood testing, its accuracy is somewhat limited.

Once an allergy is clearly identified, most doctors tell people to avoid the allergen or take antihistamine medication for their symptoms. If the allergen can’t be avoided, a specialist may start an immunological protocol known as “desensitization” therapy: progressively higher amounts of the allergen(s) are injected into the bloodstream until the first sign of allergic reaction. The hope is that the body will learn to mitigate its inflammatory response to the allergen with slow but steady exposure.

The trouble with the conventional approach is that it only measures the IgE antibody response. This limits the diagnostics to screening for full-blown allergies, and misses many allergies and most sensitivities. It also treats everyone as if their biochemistry were the same, often offers no real long-term solutions, and skips over the most relevant question — what’s going on inside your body to cause the allergic response in the first place?

I have no problem with this paradigm when it comes to severe, life-threatening allergies (if I were allergic to peanuts, for example, I would never go anywhere without an EpiPen). But it ignores the less serious, but more widespread kinds of allergic response that affect the majority of sufferers — the chronic and the subclinical allergies and sensitivities.

Chronic allergies and the drug culture

The rise in diagnosed cases of chronic allergies has been accompanied by a rapid increase in sales of anti-allergy medications. Allegra, Claritin, Flonase, and a host of others now account for billions of dollars in annual sales.

For many women, these drugs are prescribed at the first sign of an allergy or sensitivity, and women come to depend solely on their pills, drops, or sprays for symptom management. They’re rarely if ever told that there are natural alternatives.

Importantly, women with chronic allergies are usually treated as though the allergen causing the allergic response were an isolated problem. By that I mean that a woman will typically be told that she has dust or airborne allergies, or perhaps a more specific allergic reaction (such as to animal dander), and that she should avoid the allergen and take the medication to control her symptoms. It is very unusual to find a conventional doctor who will explain that the allergen that appears to trigger symptoms is just the tip of the iceberg.

Hidden allergies and environmental sensitivities

If you begin to take note of how certain foods, substances, and environments affect you on a day-to-day basis, chances are you’ll notice a pattern — and increasingly so as you age. Some women find that keeping a diary is a useful first step in “connecting the dots” between their allergens and their symptoms.

Conventional medicine dictates that unless we react to something with stereotypical allergy symptoms, we’re not allergic. When it comes to the inflammatory response underway in your body, this is patently untrue — whether the allergic response is an “allergy” or a “sensitivity” is a matter of degree. If your body is alerting you to a problem in the form of symptoms, you probably have some kind of sensitivity — even if your standard allergy tests keep coming back “normal”.

Hidden allergies and sensitivities are real. Over time these allergic responses compromise your immune system, give inflammation the upper hand, and slowly erode your well-being. Sometimes classified as type IV or delayed-response allergies, these lurking health bombs are often (but not always) food- or additive-related. They are most often associated with different types of antibodies called IgG and IgM, and work on a subtle level, targeting specific organs or body functions. They can cause a ripple effect, with confusing symptoms occurring as much as 72 hours or more after exposure to the allergen. This delayed response is one reason they are more difficult to test for and identify.

Symptoms of sensitivities will sometimes follow a set course, sometimes be cyclical or cumulative, and at other times vary in presentation from person to person — what gives me a skin rash may give you a headache. Even time of onset varies among individuals. This variability has a confounding effect on two fronts: it leads sufferers to tune out the very symptoms they need to heed; and it leads most doctors to dismiss patients with transient symptoms that are hard to diagnose when they can’t detect a pattern.

If you don’t tune in and take measures to alleviate your body’s allergic response, it will eventually up the ante until you have full-blown chronic inflammation. Some may go on to develop multiple chemical sensitivities. The farther you travel down this path, the higher the climb back to wellness. So the first step is to understand what’s going on with your body right now. How big a load of allergens is your body dealing with? And how much support are you giving it?

Common allergens and the toxic load

Every substance on earth that can be eaten, inhaled, or touched is a potential allergen. Whether or not it negatively affects you depends on your individual genetic profile and how well your system is running.

Much is made of the genetic factors in allergies, but often your emotional inheritance, lifestyle, diet, and physical environment are more important, in part because they define the “body burden” your system must detoxify and process on a daily basis.

How allergic you are at any one time relates to how well you process this “body burden”. One reason we often see women come in with adult-onset food allergies is that the older we get, the greater this burden becomes and the less able our bodies are to deal with it.

Even if you eat well and live a healthy lifestyle, you may be inadvertently exposed to numerous chemicals and potential allergens. There are over 3000 chemicals added to our food supply, and more than 70,000 chemicals used for other purposes in North America.

That fresh scent you get from fabric softener or Febreze is all-chemical — when you sniff it, those particles go up your nose and into your lungs. There are dozens of heavy metals, lead among them, and chlorine in our water. Phthalates and VOC’s (volatile organic compounds) are dangerous substances used abundantly in construction and household products, fragrances, and plastics. 

Over the course of many years, all this chemical exposure has a cumulative effect. If you add the other factors so prevalent in the modern woman’s life — poor diet, emotional stress, and hormonal imbalance — it’s a marvel our bodies can cope at all. No wonder the majority of my patients come in with chronic low-grade inflammation! 

Because everyone is different, the range of potential allergens is huge. More than 11 million Americans have a diagnosed food allergy, but countless more have food sensitivities — often to a certain amino acid or food additive. For brevity’s sake, I’ve included the most common categories of allergens and the top contenders in each category in the chart below. But I encourage you to investigate possible allergens further if these don’t apply to you.

  • Food and ingestants:  Dairy, wheat (and other gluten-containing grains), corn, soy, shellfish, eggs, nightshades, nuts, chocolate, caffeine, yeast, medications, sulfites, salicylates, MSG and other glutamates, xanthan and other gums, artificial food coloring and preservatives (BHA and BHT), sorbic and benzoic acid, pesticides.
  • Inhalants:  Mold, pollen, dust, dust mites, animal hair and dander, synthetic fiber off-gases, down, feathers, artificial chemicals, VOC’s, scented candles and cleaning products, perfumes.
  • Contact substances:  Latex, plastics, cleaning solvents, insect bites, chemicals in air, water, cosmetics, sunscreens, shampoos, and other personal care products.

To start lightening your load, the first most effective place to look is your diet. Everything you eat can be supportive or burdensome, depending on your unique profile. Many of my patients have seen marked improvement when they pay closer attention to their nutrition — even those with type I allergies. The idea is to better equip your body to process its toxic load by providing it with the right nutrients, and to minimize the toxic load by eliminating dietary allergens. That way, when a particularly sensitive substance gets introduced to your system, your body can handle it without causing allergic symptoms.

Before you start whittling away at all of the known allergens, let’s take a look at two food items that cause the majority of issues at my practice: sugar and wheat. Then we’ll give you some suggestions on how to start managing your allergenic burden.

Sugar and allergies: the secret saboteur

Sugar is not recognized by traditional doctors as an allergen — after all, goes the party line, our body breaks down all of our food into glucose, or blood sugar — so how can anyone be allergic to sugar?

Although sugar may not register on a standard allergy test, too much sugar (or carbohydrates with a high glycemic value) does invoke an inflammatory response similar to what the immune system mounts to an allergen. How? Well, too much sugar (or even worse, high-fructose corn syrup) places major demands on our digestive system, interfering with absorption of crucial vitamins and minerals. Too much sugar suppresses the immune system, wreaks havoc on the metabolism, and depletes valuable neurotransmitters. The energy rush and insulin spike that you get from sugar creates an imbalanced body chemistry that leads to weight gain, insulin resistance, and loss of appetite control. Confusion, forgetfulness, ADHD, and depression are symptoms that can occur as much as 48 hours after eating excess sugar. Muscle cramping, PMS, joint pain, and fatigue are more common symptoms of a sugar sensitivity that can go undiagnosed for years.

I would say that the bulk of the patients I see have issues that relate to excessive sugar consumption — it’s hard to avoid sugar in our culture. Those who try to avoid it often do so by consuming products sweetened with artificial substances like Splenda, which only adds to your toxic burden. Removing sugar from your diet — without replacing it with chemical sweeteners — can be a very powerful natural remedy for women with allergies.

Wheat, gluten sensitivities, and allergies

It’s estimated that over 90 million Americans have certain genetic variants that make them sensitive to gluten. Remember, hunting and gathering were around for two million years before the dawn of agriculture. And people who descend from cultures dependent on corn, potatoes, rice or other grains often do not possess the genetic snippet (SNP) required to process grains in the wheat tribe. Many of us don’t know we are gluten-sensitive because gluten can cause symptoms that don’t involve the gastrointestinal (GI) tract, like infertility and decreased cognitive function.

Gluten is actually an umbrella term for a family of proteins found within the seeds or grains of wheat, rye, barley, spelt, kamut, and triticale. Gluten sensitivity differs from celiac disease (a genetically inherited condition in which the lining of the small intestine suffers damage if gluten is eaten), but together they make up a large percentage of people who don’t do well with cereal products.

In such cases, the immune system responds to gluten as if it was an intruder in the body, not a food. If you are gluten-sensitive and continue to eat the recommended daily allowance of cereals and grains in the form of wheat and wheat relatives, your body will simmer on a low burn. This will eventually wear down the immune system and disrupt your metabolism, setting the stage for systemic inflammation, weight gain, chronic disease and a snowball effect of other sensitivities.

The irony in this is that our notion of “comfort food” often means a combination of wheat and sugar! Think about what donuts, sticky buns, and cake are made of. But why do we crave the very foods that make us sick?

The allergy–addiction connection

Often people feel better for a short time after they eat the foods to which they are sensitive or allergic. It’s possible that their bodies have grown used to this dysfunctional body chemistry and suffer withdrawal symptoms when deprived. Nature likes homeostasis.

Poor digestion can lead to build-up of a kind of digestive sludge (called ama in Ayurvedic medicine) that interferes with all of your body’s functions. The mental fog and sluggishness that result have an anesthetizing effect: it literally wipes you out and distracts you from your present (now you know what’s behind comfort food). This kind of “food coma” can itself be addictive, like alcohol. And if the sludge isn’t eventually cleared, most people reach a tipping point and have to deal with allergic symptoms.

I also want to mention the emotional connection to food addiction and sensitivities. This is not a proven area of medical theory, but I have seen it over and over in my patients. Perhaps as a child you were prone to spilling your milk. Each time it happened you were yelled at or spanked and your body reacted in kind. Guess what happens when you get older? A glass of milk may put your system in revolt.

In contrast, perhaps the only time you ever felt cared for by your mother was when she set down cookies and milk for you after school. Your feelings of safety and comfort are deeply imbedded in that ritual. We know that emotional pathways can be hard-wired, like grooves in a record, so that these rituals express an unresolved experience — if we can just understand their origin. But that doesn’t mean they’re good for you. Please see our article on emotions and health for more on this topic.

So how do you know what’s happening inside you? Let’s talk about our approach.

Women to Women’s approach to allergies

At our practice, we try to understand all the factors in your life that contribute to your “body burden” and your ability to process it: your diet, your emotional history, your lifestyle habits, your physical environment, and your digestion. This comprehensive approach help us see not just the tip of the iceberg but what’s hidden beneath the waterline as well.

We may begin with allergy testing. As described above, there is the conventional scratch test for IgE antibody response. The radioallergosorbent test, or RAST, is a blood panel that measures IgE directly. While these tests are good at detecting acute allergies involving IgE antibodies, they are not when it comes to allergens that trigger IgG, IgM, IgA or IgC antibodies such as food sensitivities and other non-acute allergic reactions. Certain enzyme-linked immunosorbent assays, or ELISA tests, are better at detecting these sensitivities, as they measure both IgE and IgG antibodies.

But in addition to the above tests, we sometimes use a family of blood tests known as ALCAT, which directly measure the allergic response of white blood cells to various panels of allergens. We’ve found ALCAT tests to be excellent indicators of the broad range of antibodies involved in sensitivities that produce delayed allergic responses.

While we pay close attention to the ALCAT test results, we are just as interested in how a patient feels. To really get at the root problem, you have to look at the entire health picture, not just one aspect. Food issues can be a major factor in that picture, but we may need to treat the adrenals or hormonal imbalance as well. Every woman is different, and we customize our approach to her individual needs.

That said, we can say with confidence that almost everyone feels much better when they take steps to decrease their overall body burden — even if they have severe allergies. When my son was younger, we moved into a new house. Within days, he was wheezing and had ulcerations on his eyes. His pediatrician, a practitioner of functional medicine, told me he had asthma. We took up all the carpeting in our new house and replaced it with wood floors. Guess what? His symptoms went away. Now, if he’s careful with his diet and avoids chemical off-gassing, he rarely has an asthma attack or needs to use an inhaler.

Natural allergy relief

Diet. You may be groaning inwardly at the thought of pulling up your carpets. Don’t worry! The first step toward allergy relief is easy — just look at your diet. For a week, keep track of what you eat and how you feel after eating it.

Many of my patients dread being put on a low-allergen diet. If you do too, try this easy elimination diet:  Avoid a particular food entirely for two weeks, then eat a lot of it in one day and look for a reaction. At first many women feel worse when they go off a certain food (especially if they’re allergic or addicted), but if you stick with it for a few days you may be surprised how good you feel. If you are unsure what to cut out, try eating only vegetables and fruit for a few days and gauge how you feel, then reintroduce dairy, wheat, sugar, and other food types one at a time. Many Eastern cultures practice fasting or eating lightly for a few days each month to ward off potential food sensitivities. Alternatively, you may want to try a more progressive, thorough approach with a two-week Quick Cleanse.

Sensitivities can indicate an underlying digestive issue or imbalance. When people are sensitive to certain foods, it’s usually because their GI tracts can’t fully digest the proteins in their food. The undigested proteins pass into the bloodstream and trigger an immune reaction — otherwise known as “leaky gut” syndrome.

A rich multivitamin/mineral complex with adequate essential fatty acids is the cornerstone of our treatment for food sensitivities — this is often enough to correct imbalances and soothe diet-related inflammation. In some cases targeted therapeutic use of supplements is required, as determined on a case-by-case basis.

Digestive enzymes and probiotics can alleviate intestinal inflammation and help restore intestinal function. Overuse of antibiotics, hypersensitivities, and other imbalances will undermine a healthy digestive tract. Replacing valuable enzymes and beneficial bacteria improves the body’s ability to fully break down and down absorb your food. Recent science also supports the value of probiotic supplements that contain “prebiotics” — in effect, food for our good bacteria — for reducing the allergic response. For more information, see our article on probiotics for more information.

Women to Women offers these high-quality, pharmaceutical grade supplements to enhance your health.

Additionally, a gentle detox program can rejuvenate your GI system and soothe inflammation. If you don’t see results, you may need more guidance on how to cleanse your system of inflammatory molecules and restore optimal detox function. Please refer to our articles about detoxification for specific suggestions.

Environmental sensitivities. Another effective way to decrease your overall body load is to clean house. Invest in a good vacuum cleaner with a HEPA filter. Go through your cabinets and throw out cleansers, creams, soaps, and cosmetics with irritating synthetic chemicals. Buy green building materials, furnishings, cleaners, and laundry detergents. Encase your bedding and choose all-natural fabrics and bed linens. Some natural products, like soy and aloe, can be allergenic — and don’t overlook houseplants.

Chemical sensitivities. If you are becoming more and more sensitive to noxious fumes, air fresheners, perfumes, chemical odors, and other synthetic off-gassing, it’s usually a good sign that your system is on overload. Headaches, dry mouth, sore throat, dizziness, nausea, coughing, and rashes are common symptoms of chemical sensitivity. NAET (Nambudripad’s Allergy Elimination Techniques) are an effective, noninvasive way to eliminate many sensitivities and allergies. Using a combination of therapies, including nutrition, acupuncture/acupressure, allopathy, chiropraction, and kinesiology, practitioners have successfully desensitized patients so that they can tolerate the offending substances without symptoms.

Emotional burdens. These are often the trickiest to clear. Talk therapy and energy work may help you connect an allergic response with any emotional underpinnings it may have. At the very least, you can determine the areas in your life that add the most emotional stress and limit them, just as you would an offending food. The important thing to remember is that our bodies don’t function in a vacuum. If there’s a symptom, there is usually some sort of emotional root — and vice versa. Please take the time to read our important article, “How Emotional Experience Determines Your Health.”

The key is balance

We talk a lot about balance at Women to Women, and it is especially appropriate when it comes to allergies and sensitivities. The key is to know your body well enough that you’re able to read its signals and respond with support.

If you suffer now from allergies or sensitivities, I want to encourage you to follow the natural anti-inflammatory approach outlined above. So many women have come back to see me completely transformed and revitalized, with renewed energy and stamina, a clear head, healthy digestion, and beautiful skin. You can too!

 

“Am I Losing My Mind?” What You Can Do About Fuzzy Thinking

by Marcelle Pick, OB/GYN NP

Where are my glasses? It’s on the tip of my tongue! Did I turn off the iron? Am I losing my mind?

How often do thoughts and questions like these race through your mind? All of us experience forgetful, fuzzy moments, particularly during periods of high stress, and increasingly so as we grow older. I see many women at my practice who are alarmed at lapses of attention or memory, and they are frequently embarrassed to admit how bad it can get — particularly when the results compromise safety.

Many of these women are caring for aging parents with Alzheimer’s disease or other forms of dementia, and they fear that the fuzziness they’re experiencing is just the tip of some terrible iceberg for them as well. Others have children with an ADHD diagnosis and wonder if they may have it, too. Most of them are concerned that their mental lapses will only get worse. I hear versions of If I’m this forgetful now, what’s it going to be like in ten years? all the time. In my experience, women (and men!) fear the mental symptoms of aging as much or more than the physiological changes.

But for the large majority of women under 70, there’s simply no reason to. Episodes of difficulty with word retrieval, an inability to focus, or feeling overwhelmed by a rush of thoughts and ideas are common signals that your body is overburdened and not getting the support it needs — and this includes how well you are coping with stress. Fuzzy thinking is one of several symptoms that may develop during perimenopause and menopause due to changing hormones, but problems with memory and attention can also be related to other physiological imbalances that respond well to simple changes in nutrition and lifestyle. So don’t let fear or shame of your wandering mind keep you from taking stock of what’s really going on — and then doing something about it.

Let’s discuss how.

When is fuzzy thinking serious?

Less often than you might think. Current medical thinking brackets lapses in cognitive function within two extremes. On the minor side, you have a temporary state of mental deterioration that is a direct result of a traceable behavioral pattern or situation — sleep deprivation, low blood sugar, illness, falling in love, childbirth, poor eating habits, and acute stress are a few examples. In this scenario, clarity returns when the “crisis” is over. On the more severe side, you have mental lapses that do not get better with time and self-care and that may indicate onset of an underlying serious mental or physical condition, including but not limited to clinical depression, bipolar disorders, schizophrenia, ADHD (also known as ADD), dementia, Alzheimer’s disease, post-traumatic stress disorder, or brain trauma or disease. Obviously the more serious neuropsychiatric conditions are topics of scientific research and get more press, so we hear more about this end of the spectrum.

As a result it’s easy to veer into catastrophic thinking when it comes to your own cognitive symptoms — but let me reassure you that developing a spontaneous degenerative mental condition at mid-life is usually the exception, not the norm. And in the case of ADHD, there’s technically no such thing as adult onset ADHD (although it’s possible that your symptoms were overlooked during childhood). Of course, if you have a family or personal history of a clinical disorder, or recently have experienced significant trauma, it makes sense to call your health care practitioner and discuss your concerns. If your friends and loved ones are worried for you and mentioning their suspicions, it can’t hurt to listen and get more information. There are many tests available that can put everyone’s minds at ease.

What is far more likely is that you fall on the minor side of the scale. And while your symptoms may be causing you a great deal of anxiety, it is more beneficial to think of them as signals asking you to pay more attention to your whole health picture. Rather than drown those calls out with drugs or shame, take them as a sign to sit up and take notice. At our practice, we assess fuzzy thinking in the context of many other biochemical and emotional issues — a great deal goes into maintaining an agile mind! — beginning with the simplest possible explanation first.

Stress and over-scheduling — the brain foggers

Women are fantastic multitaskers. We are hardwired to spin many plates in the air at once — and make dinner while we’re at it. And while this is a most admirable trait and quite possibly a good reason our species continues to thrive, it can come at a cost — particularly in today’s fast-paced, information-dense and stress-saturated culture.

If you think of your brain as a filing cabinet and information as folders downloaded, filtered and filed by your short and long-term memory systems, we are living in a time when the cabinet is just plain stuffed — and the older you are the more jammed your filing cabinet becomes, especially if you have not been taking care of yourself. This doesn’t mean you can’t learn new things (in fact, learning new skills is a proven way to stretch your file cabinet capacity). It just means that it’s easier for the newer files to slip through your short-term memory filter and get discarded than it is to pack them into storage.

Distraction and overscheduling are also key players. If you are constantly thinking of ten things at once, rushing hither, tither and yon and barely remembering to breathe, your brain may choose to take a holiday whether you want it to or not. Spacing out and shutting down are very real coping mechanisms for chronic stress.

Chronic unremitting fatigue and mental lethargy can also be the result of overburdening your adrenal glands. Our adrenal glands evolved to function in short but limited bursts, switching the central nervous system (including our brains) into full-alert mode to pump out cortisol in response to sudden threats, then returning to resting phase. In this situation (and when you are insulin-resistant, which I discuss below), the brain calls upon cortisol for instant energy rather than the slower, but more sustaining glucose. When a woman’s adrenal glands are overtaxed with no prolonged periods of quiescence, there are huge implications for your brain function. Prolonged exposure to cortisol actually damages brain neurons and reduces your ability to think clearly and efficiently.

Reducing overt stress, both emotional and environmental, and learning positive coping mechanisms are terrific therapy for the brain, and your lifestyle and daily schedule may be the first place to start when thinking about what may be causing your mental fog.

Better sleep on it

Another lifestyle factor within your control is how much sleep you get, and the quality of that sleep. While we do not yet understand all the reasons why both too little sleep and too much sleep can be detrimental to our health, it is sleep deprivation — ranging from minimal to dramatic — that is the more pervasive problem in our culture. We all know that when we are running on empty we just don’t think well.

If your “to-do” list is keeping you up late at night, or if you are drinking excessively in order to relax, your REM sleep may be deficient, and a valuable part of information processing occurs during REM sleep. Go too long without it and you will feel the disembodied mental effects directly — as anyone who has pulled one too many all-nighters can attest.

You may think you’re functioning “normally” for days at a time on limited sleep each night, but several cognitive–behavioral functions slip, including declarative memory (your ability to recall specific facts and experiences) and memory consolidation (your ability to crystallize recent events into long-term memory), just for starters. Then too, studies show that getting less than six hours a night can very quickly reduce reaction time, judgment, and coordination, so with less and less sleep not only can you not think straight, you are also compromising your safety.

We do not metabolize glucose well without adequate restful sleep either. In recent analysis of over 70,000 women enrolled in the Nurses Health Study, researchers found both too little sleep and oversleeping were associated with an increased risk for diabetes. In other studies, poor memory function, including spatial memory (the ability to remember locations and the “lay of the land”) were found to be more common in individuals with diabetes and individuals otherwise compromised by low blood glucose.

When sleep deficits are short-term, we can generally recover well and quickly return to normal functioning once better sleep patterns are restored. But many women face each day with an ongoing sleep deficit that is cumulative over weeks, and even years. So catching up on your zzzz’s is one of the easiest and quickest ways to improve fuzzy thinking. Read our articles about insomnia in women for more practical ways to reduce the effects of this health-robbing problem. The next place to look is your diet.

Nutrition, inflammation, and exercise

Optimal nutrition plays a tremendous role in brain function, as anyone who has sat through a long meeting without eating breakfast knows. The B-complex vitamins, especially B1, B2, B6 and folate (folic acid, or B9), which are commonly associated with energy and stress, are also critical to our capacity to reason, verbalize, and remember. Not only are the B vitamins important, but research also suggests that antioxidants and essential fatty acids (EFA’s) likewise support optimal brain function, in part perhaps by reducing inflammation and plaque production along nerve endings. Studies indicate people with ADHD have lower-than-normal blood levels of omega–3 fatty acids, and numerous studies correlate behavioral and cognitive improvement with supplemental omega–3s, omega–6s, and vitamin E. Fish truly is brain food, especially if you eat the right kind and it’s free of mercury.

Omega-3 fatty acids have also been shown to reduce inflammation markers, such as C–reactive protein (CRP), in the blood. Inflammation is an immune process carried out by the body to protect itself from foreign substances. Sometimes, however, our bodies produce an inflammatory response when there aren’t any foreign substances to fight. Inflammation in the brain has been linked to neurological disorders, such as Alzheimer’s and ADHD, and may play a role in how well the brain functions. So eating your omega–3 fatty acids may be a way to protect that important function.

Exercise is also a key player in cognition. Just as less plaque on our arteries makes way for easier blood flow, exercise naturally opens your arteries to increase blood flow as well. Like all living tissue in our bodies, the brain needs oxygen (via blood) to do its job and regular exercise makes for better circulation all around. Fittingly, some common symptoms of heart disease are memory loss, aphasia (a loss for words) and fuzzy thinking, thanks to inefficient blood circulation.

Again, these conditions are at the far end of the scale, but it only makes sense to prevent inflammation as much as possible before it gets the upper hand.

Food sensitivities and mental clarity

Inflammation can also be caused by undiagnosed food sensitivities, allergies, exposure to environmental pollutants, excessive caffeine, alcohol and sugar intake, and pervasive GI issues. In regards to cognitive dysfunction, I see a lot of women who drastically improve once they remove wheat and gluten from their diet. Sensitivity to yeast (candida) can also manifest as fuzzy thinking, which can improve when you avoid yeast’s favorite food: sugar! The metabolic by-products of yeast can actually be neurotoxic.

Each one of us is an individual with a unique reaction to different substances, so you may have some sleuthing to do — but don’t disregard the possibility of mental fuzziness as the telltale sign of something awry in your diet. The cleaner you can make your diet and your environment, the easier it is to identify any possible connections — and the clearer your thinking will become. Try a gentle detox to see what comes to light. Most of my patients report a rapid increase in energy and mental alertness within days of initiating a detox diet if food sensitivities are an issue. Who knows — you may even recover that photographic memory!

And while implementing a change in your nutrition, you should also consider a reduction in carbohydrate consumption. Let me explain why this is important for your memory and attention.

Insulin resistance — an overlooked cause of depression and fuzzy thinking

Your cognitive function relies on a steady supply of oxygen and glucose. When levels dip, you yawn or begin to crave food. If your circulation and metabolism are hopping along, and your hormones are balanced, your brain gets what it needs without much fanfare. However, insulin resistance — a precursor to diabetes, metabolic syndrome, and cardiovascular disease — can make this whole process far more complicated by causing inflammation and affecting brain function.

Let’s digress for just a moment, to help you understand how insulin can dramatically affect your mental functions. Insulin and glucagon are the major hormones that facilitate your body’s ability to regulate blood sugar (called glucose). If each of your cells had a door, insulin would be comparable to a key that unlocks the door and enables the cell to access glucose. If the cell does not require any energy (in the form of glucose), insulin stores that energy for future use in fat cells. Glucagon is the hormone responsible for releasing glucose from storage if needed.

A diet high in simple carbohydrates (the kind found in the ubiquitous “white foods” – bread, pasta, cereal, refined sugars) and overly processed foods cause levels of insulin in the body to remain extremely high. Sooner or later, if insulin levels aren’t normalized, your cells become resistant to insulin’s effects and their doors stay closed and locked. What happens to all that glucose in circulation? It’s transported straight to fat cells — usually around the belly — even if your other cells are actually starving! And because your cells can’t function properly without glucose, insulin resistance can lead to other serious health problems as well.

The brain isn’t exempt. Insulin resistance prevents brain cells from accessing glucose as well. What fills the void? In some cases, possibly cortisol. Our brains are not geared to run on cortisol for long periods of time; it’s only meant to be an emergency substitute. In any event, if this situation isn’t rectified it can have far-reaching implications, including neurotransmitter imbalance, cognitive malfunction, and possibly a steady decrease in thyroid function, too. All of these conditions may present initially with a lack of mental clarity.

Some women discover that they’ve become insulin resistant when they enter perimenopause and menopause. Before that time, estrogens appear to have a protective effect; when levels decline the protective effect is diminished, but you gain the opportunity to understand what’s really been going on in your body. This is one of the many gifts of menopause.

If you are dealing with insulin resistance, reducing your simple carbohydrate load may significantly improve your mental clarity — not to mention your mood. And once you’ve stabilized your insulin and cortisol levels, addressing other components of hormonal balance becomes more straightforward. Your body can’t balance its “minor” hormones (estrogen, progesterone and testosterone among them) until your insulin metabolism is on an even keel.

Estrogen and brain circuitry

Estrogen and progesterone balance is also crucial for proper brain functioning and healthy neurotransmitter levels. Any woman who has experienced sugar cravings, bouts of fatigue or extreme mood swings as part of PMS, knows instinctively that estrogen and progesterone influence how you feel and think.

The effects of hormones on cognitive processes are being scrutinized more closely by the medical research community as recent studies show correlations between estrogen levels and the incidence of Alzheimer’s disease. Estradiol in particular appears to have a potent neuroprotective, antioxidant effect, preventing our neurons from oxidative damage and early death. Studies are showing that estrogen in general profoundly impacts mental agility by helping the brain strengthen and expand the nerve endings — dendrites — that complete the final, crucial steps in cognitive functions. Estrogens help connect the little wires in our brains to make processes like memory, reasoning, and mood run smoothly.

So, it makes perfect sense that as estrogen levels shift during perimenopause and menopause, memory and attention may wax and wane. Supporting your body’s hormonal transition with gentle endocrine support is one way to reboot your natural hormonal rhythm and help regulate estrogen levels. Changing your diet, supplementing with nutrients, and decreasing stress, inflammation and toxic exposure will also clear out the mental cobwebs.

And speaking of clearing out, this brings me to one frequently overlooked topic that should be addressed in relation to mental clarity.

Heavy metals and fuzzy thinking

Heavy metal toxicity is an extremely controversial subject and although it has been implicated for many years in neurological disorders, adequate research remains to be done to fully define the connections with cognitive impairment. At poisonous levels, a loss in cognitive performance has been documented for at least seven different heavy metals (cadmium, chromium, cobalt, lead, mercury, nickel, and silver). Although aluminum is not categorically a heavy metal, work has been done that links exposure with cognitive disorders, including reduced verbal and visual memory, visuo-spatial problem-solving, concentration, “concept formation” and attention, as well as with increased risk of Alzheimer’s and other forms of dementia. But in an overall sense, little has been done to quantify the cumulative effects of daily exposure in humans to low levels of heavy metals — the kind of exposure we all experience every day.

Mercury, arsenic, lead, and cadmium are the most common heavy metals with which we come into daily contact. Studies of songbirds, aquatic life and groundwater show that these metals are everywhere. We inhale, eat, absorb and breathe them — and the younger we are the more dangerous they can be. Toddlers are particularly vulnerable to lead poisoning, and the effects can be irreversible. To my thinking, if we have proven that high levels of heavy metals affect brain development and functioning, doesn’t it stand to reason that long-term exposure to low levels would have a detrimental effect?

This month a landmark study of 4700 children will be published in Environmental Health Perspectives that documents a causal relationship between childhood exposure to environmental pollutants with a diagnosis of ADHD. In this particular study, prenatal exposure to cigarette smoke resulted in a child being 2.5 times more likely to have ADHD, and childhood exposure to lead elevated the risk four-fold. What’s more, scientists recorded this increased risk when blood levels of lead were far below the Center for Disease Control’s definition of acceptable blood levels. I encourage you to read this report for yourself or peruse an interview with the lead researcher and another national expert on lead poisoning at Living on Earth.

To put it bluntly, heavy metal toxicity doesn’t go away just because we’ve grown up. After 20–plus years of treating women in my practice, I believe that heavy metal toxicity is a real issue for many more people than we’d like to believe — and it may be an issue for you.

Ironically, there is one metal that causes fuzzy thinking when you have too little of it in your system: iron. Anemia, or iron deficiency, is a common concern in women. From time to time anemia is the result of a blood disorder, but we see it most frequently in postpartum women and in those who experience heavy periods. Fortunately, this is a condition that is easily treatable with a few dietary changes and temporary iron supplementation, but it is a situation that deserves medical attention.

Putting the pieces together: the Women to Women approach

For the sun to burn off your mental fog, you will need to tune in to the signals your body is sending. Consider the possibility that your lifestyle and habits are getting in the way, but if you don’t feel these are your main issues, talk to your health practitioner about getting some tests. We recommend the following tests:

  • Iron levels
  • Fasting insulin, glucose tolerance test, & 2–hour postprandial glucose and insulin
  • Homocysteine and CRP
  • Thyroid function
  • Adrenal function
  • Hormone panel
  • ALCAT or other allergy testing
  • Urinalysis
  • Other alternative tests we use include the organic acid profiles by Metametrix

Once your tests have ruled out any major underlying medical issues, you can put your mind at ease and begin to take steps toward improving your core foundation of health. Once you’ve made a few positive changes, I would not be surprised if you find your mental agility returning in spades. Don’t let fear of ADHD, dementia, or old age keep you from addressing mental difficulties.

For the vast majority of women, a combination approach that restores inner physiological vitality will help keep you sharp as a tack well into your older years. And if you are on medication for a more serious condition, these suggestions can only enhance your prognosis:

Eat often and well. Focus on eating three well-balanced meals and two snacks per day that include protein, richly colored vegetables and fruits, whole grains, fiber and healthy fats. Drink plenty of water and take a balanced multivitamin to fill in any nutritional gaps. I also suggest supplementing with omega–3 fatty acids, either through diet or capsules. Check to be sure your brand is lead– and mercury–free, and also make sure that any multivitamin you take has a rich complement of B’s and antioxidants like C and E.

Cleanse your system. Diagnosing hidden food sensitivities and cutting them out can do wonders in terms of mental clarity. If you suffer from headaches or joint pain along with your fuzzy thinking, you may very well be sensitive to gluten. Limit alcohol, sleeping pills, and prescription pain medications. Try a gentle detox for a couple of weeks. By ridding your body of environmental aggravators, allergens, and toxins, you can give your immune system a rest and roll back the brain fog bank.

Cultivate your relaxation and sleep habits. In fact, try to spend about a third of your life doing this! There simply is no effective substitute for the restorative effects meditation and sleep can have on your neurobiology; they are fundamental to reversing the downward spiral of fatigue and stress.

Exercise daily. Moving your body will help focus your mind. When you exercise, your heartbeat quickens and you breathe more deeply — which gets more oxygen to your brain and sharpens your thoughts. If you find yourself dull and tired, try taking a brisk walk around the block. If you feel refreshed when you move, you are suffering from lethargy, not fatigue, and may find that increasing your physical activity is fuel for your brain. Exercise also helps decrease cortisol levels.

Restore hormonal balance. Avoid simple carbohydrates, refined sugar, and processed foods to help keep insulin levels in line. Consider gentle endocrine support to kickstart your natural hormonal balance and to promote a healthy ratio of estrogen, progesterone and testosterone. This will also help keep your neurotransmitters happy.

Reduce stress through time management. Try sitting down and making a comprehensive to-do list. Decide which tasks fall into the “have-to” pile and which fall into the “want-to” pile. Don’t underestimate the value of the “too-hard basket”either: it may be that some of your life rescue missions are overwhelming you! Then take out your calendar and space the have-to items evenly across the days of a week. At the top of each month, divide the want-to items across the next six months. Be realistic. Most people can accomplish only one or two extra errands or goals per week on top of their regular activities. If there is something that can give, let it go — as long as it isn’t sleep or exercise!

Stretch your brain. Crossword and Sudoku puzzles, games of logic, and learning new skills (like a foreign language or an instrument) are great brain workouts. Our ability to generate new brain cells after age 30 might be minimal, but creative thinking exercises can help build efficiency and agility to those we already have, and hopeful new studies indicate that even damaged nerve cells may be able to recover under certain conditions. Try simple memory exercises like recalling all your elementary school teachers’ names. Don’t let your computer do your thinking! As you work on boosting your nutrition and increasing your physical exercise endurance, don’t forget to challenge your brain power! Download games, puzzles and brain teasers from Audible.com onto an iPod and do both at the same time! Your brain power is like your muscle power; you have to use it or lose it.

Thinking comes from doing

With the complicated, often overlapping symptoms that fall under the umbrella of “fuzzy thinking,” the average woman may leap to the conclusion that she is developing a variety of serious diagnoses. And often with age comes a gnawing fear that something is really “wrong” with our brains that will surely get worse.

But before you take that headlong downer, take time to assess your total health picture and face the reality of your diet and lifestyle. Are there things you can do now to give yourself more support? I’m fairly confident the answer is yes.

Brain chemistry is not a fixed state and will react for better or worse to the way we treat ourselves and our bodies. And this includes all women of all ages, whether you have a clinical condition or not. So put your mind over matter and take action — and lose those muddled moments for good.