Why I'm a fan of Bulletproof Coffee...

Smell that coffee... mmmm!

I wake up around 4:50 am to the sound of my automatic Cuisinart coffee maker grinding fresh Upgraded coffee beans into the filter for a delicious fresh brew.   There is nothing better than rubbing your eyes, rolling out of bed, and padding across the cool hardwood to the kitchen as the amazing aroma of fresh brewed coffee fills the air.  Those pre-dawn hours are my absolute most productive and favorite time of day!

I thought I'd share a few of the things I've learned along the way for how to maximize the health benefits of your coffee.  I'm proud to say that I enjoy Upgraded beans because I can literally feel the difference in my mental clarity when I drink it instead of non-organic, pesticide laden, mycotoxin filled alternatives like Starbucks (oh, yes you heard me, right!).  While many of you may not be environmentally sensitive to chemicals like I am, you should really give it a try as the brain power you get from a cup of the really pure stuff will blow your mind!

Travel Tips?

And when I travel I take along Upgraded coffee cartridges, empty one into a 16oz cup, and pour boiling hot water over it for an instant "french press" brew.  After letting it steep for 2-3 minutes, I pour the brewed coffee out into a new cup careful to leave the grinds in the old one and viola!... delicious amazing, mycotoxin-free coffee anytime, anywhere.  Last time I was in an airport asking for a large glass of hot water, the man on the barstool next to me asked if I was performing a science experiment!?  Haha!  I just smiled and said, "yes".   It didn't help that I dug in my purse and pulled out my travel vial of SweetLeaf English toffee stevia drops and a few shakes from a purse-size organic cinnamon powder which I also carry with me at all times.  I've become accustomed to the funny looks I get and I really don't even care ;-)

My not-so-dirty little secret for amazing brain power at 5am!

Let me share with you my secret for 5am productivity like you've never experienced before.  After brewing a pot of this delicious black velvet, I add in a few little "brain helpers".  I was having coffee with a friend today and telling her about it so I thought I would write a blog and share with you, too.   You can get the Dave Asprey's original Bulletproof Coffee Recipe here but here is my version:

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Dr. Jill's 5am Brain-Power Brew

• Pour 1/4 to 1/2 cup full-fat organic unsweetened coconut milk into your favorite mug
• Add fresh-brewed, hot Bulletproof coffee leaving 1/4 inch from top of mug
• Add 5 drops of Sweet Leaf English Toffee or Vanilla stevia (if you like a carmel or vanilla "latte" flavor)
• Add 1 teaspoon of Upgraded Brain Octane Oil 
• Generously sprinkle organic cinnamon powder into your coffee
• Add 1 scoop of Upgraded Collagen Powder and stir!  (you won't believe what the collagen will do for you joints and skin... truly amazing!)
• If you like it frothy, you can whip it all up in a blender with heat-safe blades,  but I just drink mine as is.
• If I'm feeling a little more adventurous, I'll might add a tablespoon of toasted organic shredded coconut in, too

A few cool facts about coffee

1. Chronic coffee consumption may alter your gut microbes and is associated with lower body weight and lower percent body fat.
2. This article discusses benefits of polyphenols, especially from coffee and cocoa, on your gut microbiome.
3. The bioactive components in coffee may have synergistic effects on brain cognition.
4. In this study, coffee decreased boredom and fatigue associated with repetitive tasks.
5. Caffeine intake associated with improved working memory in middle aged males.

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Everything You Need To Know About Vitamin B12 Deficiency

Photo courtesy of www.freedigitalphotos.net

Do you suffer from any of the following symptoms?

• Weakness, tiredness, or light-headedness
• Rapid heartbeat or difficulty breathing
• Poor memory or difficulty concentrating
• Depression, anxiety, mania
• Numbness and tingling of hands or feet
• Difficulty with balance, poor coordination
• Pale skin
• Sore tongue
• Easy bruising or bleeding gums
• Upset stomach or weight loss
• Diarrhea or constipation
• Depression, irritability, paranoia, mania, hallucinations

If you answered “yes” to any of the above, it may be time to get tested for B12 deficiency.

Vitamin B12 (cobalamin) is a water-soluble vitamin that is crucial to normal neurologic function, red blood cell production, and DNA synthesis. Vitamin B12 is essential for three enzymatic processes: the conversion of homocysteine to methionine; the conversion of methylmalonic acid to succinyl coenzyme A; and the conversion of 5-methyltetrahydrofolate to tetrahydrofolate, a process necessary for DNA synthesis and red blood cell production. It cannot be manufactured by humans and must be regularly obtained from the ingestion of animal proteins or fortified food products. Gastric acid liberates vitamin B12 from animal proteins, after which it combines with intrinsic factor produced by gastric parietal cells and is absorbed in the terminal ileum.

How common is vitamin B12 deficiency?

B12 deficiency is common and reported to affect up to 25% of the U.S. population. Up to 20% of people over the age of 60 years old show marginal B12 status.  The CDC reports, one out of every 31 Americans over 50 are B12 deficient.  Sadly the current lab values of serum B12 grossly underestimate the incidence by using a cut-off range far too low. The current ranges for a common commercial laboratory, which I use are 211-946pg/ml. Many researchers propose that we raise the lower limit of normal to 550pg/ml, which is what I use for optimal levels. In my clinical practice, I have seen many patients who have significant symptoms of low intracellular B12 and they still show “within normal range” on serum lab values. Serum homocysteine and methylmalonic acid are much more sensitive markers as they may show a deficiency earlier than serum B12.

So what causes B12 deficiency?

The main causes of B12 deficiency include inadequate dietary intake and malabsorption issues. Vitamin B12 deficiency may occur if you have certain conditions, such as:

• Pernicious anemia, which makes it hard for your body to absorb vitamin B12 (characterized by a lack of intrinsic factor - individuals cannot properly absorb vitamin B12 in the gastrointestinal tract)
• Atrophic gastritis or inadequate production of stomach acid (occurs in 10-30% of older adults!)
• Helicobacter pylori infection in the stomach
• Surgery that removed part of your stomach or small intestine including bariatric surgery (Surgical procedures in the gastrointestinal tract, such as weight loss surgery often result in a loss of cells that secrete hydrochloric acid and intrinsic facto
• Alcoholism
• Autoimmune conditions, such as Grave’s disease or Lupus
• Malnutrition or eating disorders
• Long term use of medications
  • Proton Pump inhibitors
  • H2 blockers
  • Metformin
  • Certain antibiotics
• Conditions that affect the small bowel, such as:
  • Crohn’s disease
  • Celiac disease (up to 41% of patients with celiac disease will have B12 deficiency)
  • Small intestinal bacterial overgrowth (SIBO)
  • Parasite infections, such as giardia, tapeworm
  • Chronic pancreatitis

Who should be tested for B12 deficiency?

• Anyone over age 60 years old
• Anemia with elevated MCV (mean corpuscular volume)
• Neurological symptoms, such as numbness, tingling, difficulty with walking or balance issues
• Changes in mental status, confusion, or disorientation
• Early dementia or Alzheimer’s disease
• Bipolar, mania, or schizophrenia
• Gastrointestinal disorders with malabsorption, like pancreatic insufficieny
• Patients who have had gastrointestinal surgeries or gastric bypass
• Restricted diets: vegans, vegetarians, macrobiotic diets
• Autoimmune disorders
• Children with autism spectrum disorders or developmental delay
• Breast fed infants of mothers at risk
• Eating disorders
• Family history of pernicious anemia
• Chronic use of PPI medications (Nexium, Prilosec, prevacid, etc) or Metformin
• Occlusive vascular disorders (heart attack, stroke, blood clots)

Children may present differently from adults and should be tested if any of the following symptoms occur:

• Developmental delay or regression
• Apathy or irritability
• Weakness
• Tremor
• Seizures
• Lack of coordination
• Lack of appetite or failure to thrive
• Poor socialization or poor motor skills
• Speech problems or language delay
• Anemia

You can request following blood tests from your doctor to determine if you are deficient:

1. Serum B12
2. Methylmalonic acid
3. Homocysteine
4. Complete blood counts – anemia with elevated MCV may be due to B12 deficiency

So what if I do have a B12 deficiency?

B12 is nontoxic and water soluble so if you are deficient the good news is it is easy to replace! Traditionally B12 has been given in the form of intramuscular injections to ensure absorption but studies have shown that sublingual forms may be equally effective. B12 may come in the form of cyanocobalamin, methylcobalamin, hydroxycobalamin, and adenoxylcobalamin. You can discuss with your doctor which form is best for you. I typically start patients with sublingual methylcobalamin in lozengers or drops at 1000-5000mcg daily. Some patients require subcutaneous or intramuscular injections, which can be taught in the office and given by the patient at home. Depending on how severe the deficiency, I will typically prescribe 5000mcg anywhere from once per month to 2-3X per week initially. Liver stores of B12 are usually repleted with a half a dozen or so doses but full repletion may take up to 20 doses. Once a patient’s symptoms are improving, maintenance of B12 may occur with as little as one injection every 2-4 weeks. There are now forms of B12 available orally, sublingually, intranasally, transdermally and through injection.

Dietary Sources of B12

Vitamin B₁₂ can be found in large quantities in animal products, including meat, poultry, fish, seafood, eggs, and dairy products; and the consumption of these products is the most longstanding method by which human beings have taken vitamin B₁₂ into their systems.

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Reference:

1. http://ajcn.nutrition.org/content/89/2/693S.full
2. http://www.ncbi.nlm.nih.gov/pubmed/8856015
3. http://www.aafp.org/afp/2011/0615/p1425.html

6 Signs that SIBO might be the root cause of your IBS

Photo courtesy of www.freedigitalphotos.net

Studies show that over 50% of patients diagnosed with IBS actually have an underlying imbalance called SIBO, or small intestinal bacterial overgrowth. The majority of our gut bacteria should be in the colon. When the bacteria migrate backwards into the small bowel or when there is low stomach acid or poor pancreatic enzyme production, bacteria in the small bowel can overgrow and cause symptoms, such as diarrhea, gas, or bloating.

Six signs you might have SIBO

1. You notice that fiber worsens your constipation
2. You notice an improvement in IBS symptoms when taking antibiotics
3. You feel more gas and bloating when you take probiotics that contain prebiotics
4. You are celiac or gluten intolerant and do not have 100% resolution of symptoms on a gluten-free diet
5. You develop chronic symptoms of gas, bloating, constipation or diarrhea after taking pain medications, like opiates.
6. Your blood work shows chronically low iron or ferratin with no known cause

Top 6 Symptoms of SIBO

1. Abdominal bloating and distention
2. Constipation 
3. Diarrhea
4. Abdominal pain or discomfort
5.  Acid reflux or heartburn
6. Excessive gas or belching

How do I know this isn’t just leaky gut?

While SIBO usually manifests with local GI symptoms, a leaky gut will manifest with systemic complaints that affect the immune system. Keep in mind that is is not uncommon to have both SIBO and leaky gut simultaneously. And very often if you have SIBO for a long period of time, you will develop a leaky gut.

Here are some systemic signs of a leaky gut:

• Multiple food sensitivities
• Skin rashes, acne or rosacea
• Respiratory symptoms, like asthma
• Allergic symptoms or increase in seasonal allergies
• Fatigue
• Brain fog or poor concentration, especially after meals
• Any autoimmune disease
• Joint pain or arthritis
• Headaches or migraines

Remember SIBO can cause leaky gut syndrome but not everyone with SIBO has leaky gut. About half of the patients diagnosed with SIBO will also have leaky gut. Most of the time if SIBO is treated, leaky gut will heal itself!

10 conditions that may predispose you to have SIBO

1. Hypochlorhydria (low stomach acid)
2. Pancreatic insufficiency
3. Decreased motility in small intestine
4. Bowel obstruction
5. Diverticula 
6. Surgical bowel resection or bariatric surgery 
7. Food poisoning (Post infectious IBS)
8. Nerve damage that affects the GI tract
9. Drugs, like opiates 
10. Any disease that slows motility (diabetes, hypothyroid)

Other disorders that may be associated with SIBO

• Rheumatoid arthritis
• Ankylosing spondylitis
• Scleroderma
• Hashimoto’s thyroiditis
• Rosacea
• Restless leg syndrome
• Pancreatic insufficiency
• Liver disease
• Diabetes
• Crohn’s disease
• Celiac disease
• Fibromyalgia
• Kidney failure
• Liver disease
• Diverticulosis

How to Diagnose SIBO

Ask your doctor to order the Lactulose Breath Test (preferred over glucose as it will test the entire small bowel vs. just duodenum). You may also need to check a comprehensive stool analysis and urinary organic acids, which may point in the direction of other dysbiosis but are not directly assessing small bowel bacterial overgrowth

How do we treat SIBO?

1. Diet options

• Paleo diet or autoimmune paleo diet
• Low FODMAP diet
• Specific Carbohydrate Diet
• GAPS Diet
• Avoid all alcohol
• Use caution with probiotics/prebiotics
• Use caution with fermented foods as they can increase histamine
• Homemade Elemental Diet by Dr. Siebecker

2. Antibiotics

• Xifaxan

3. Dr. Jill’s favorite antimicrobial herbs

• Allimed
• Oil of oregano
• Thorne Berberine 500
• Biocidin 

Treating SIBO successfully is not always easy and may involve major dietary changes and medication or herbal treatment for an extended period of time. However, getting the balance of your gut microbes healthy will likely prove to be the most important step in regaining your health and vitality! I know it was in my case… if you haven't read My Story, read more here.

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The Thyroid Summit

Your thyroid plays a part in nearly every metabolic process and when the thyroid isn’t working you won’t feel well! If you already suffer from thyroid disfunction or suspect that this little gland may play a role in your health, you will want to hear this great info!

Don't miss out!

FREE ONLINE THYROID EDUCATION EVENT!

Dr. Jill will be interviewed among 30+ World Leading Experts during 

The Thyroid Summit - June 2-9, 2014

Click here to sign up! 

This is truly an amazing opportunity to access to great experts and free advice!

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New website and blog! Check it out!

Hello everyone!
Thank you all for following the Functional Wisdom Blog.  I work very hard on bringing you the most interesting and up to date topics in functional medicine.  I want to introduce you to my brand new website and my new blog, which has archives of all your favorite articles.

I'll continue posting both here for the short term but I encourage you to go to the new site and stay connected by signing up for my monthly newsletter so you don't miss any great content!
Wishing you many blessings for health and healing!

Sincerely,
Dr Jill

Functional Medicine: Empowering You to take control of your health...

Did you miss the Vail Living Well Experience?  Here's a few clips from Dr. Jill...

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Dr. Jill's Story

When you meet Dr. Jill, you will immediately sense her compassion and genuine desire to help people find answers and give them hope that they can feel healthy again.  What you may not know is that her own journey through life-threatening illness was a powerful force in shaping her passion for teaching people how to heal through functional medicine.  Read her story here… 

My Story

Since my childhood, I have always been passionate about seeking answers to complex problems. I believed that the human body could regain health given the right tools.  However, it wasn’t until June of 2001 that I had very personal encounter with my own mortality.  It was then I had put this belief into action...

Sudden Turn of Events … from Doctor to Patient

During my 3^rd year of training in medicine at Loyola University in Chicago, I found an unusual lump in my left breast and with my husband’s insistence; I proceeded to schedule an ultrasound and biopsy.  Although I scheduled the tests, I was not too concerned that this lump might signify something more serious.  A few days later however, my worst nightmare was confirmed with a call from the surgeon.  She said yes, despite all of the statistics against it at the age of twenty-five years old, I had invasive ductal carcinoma (i.e. breast cancer).  I was devastated!  This sudden news sent my very orderly world spinning as I began to process what the next 12 months would hold… several more surgeries, six rounds of aggressive chemotherapy followed by many weeks of radiation, ugh!  I literally went from doctor to patient overnight.  The rest of that year was a blur as I took a leave of absence from medical school to complete this harsh treatment regimen.  During this time, an important part of my plan included nutritional supplementation, daily exercise and prayers for healing.   By the summer of 2002, I had officially “beaten” the cancer but nearly destroyed my body in the process.  Completely bald, malnourished, and down to my lowest weight since fourteen, I was physically depleted but mentally and emotionally still in the game.

From Surviving to Thriving…

At this point, although I had just beaten cancer, I was determined to go further.  My desire was to go from surviving to a place of thriving… full of energy and life!  My unwavering faith in God and my passion for nutrition became instrumental in turning my health around.  The battle against an aggressive deadly breast cancer was only the beginning of my journey.  Six months after completing therapy and returning to medical school, I was once again diagnosed with a very serious medical condition.

Round Two: a Second Diagnosis…

The following year I was diagnosed with Crohn’s disease, a very painful autoimmune disease, in which the body’s own immune system attacks the gastrointestinal lining, causing nutrient depletion, cyclical fevers, fatigue, weakness and ongoing abdominal pain.  Undoubtedly connected to the toxic effect of   chemotherapy on my gut lining, I was determined to beat this new threat as well. In the beginning, my gastroenterologist told me point blank, “Diet has nothing to do with this.”  He also gave me the prognosis that I would need multiple surgeries over my lifetime and would never be completely cured. I was given powerful medications to calm the inflammation, but they did nothing for my symptoms.  I was told that I would require steroids and immune-suppressing medications to control the disease.   Refusing to believe that surgery and medications were the only options, I studied extensively on the healing power of nutritious food and dietary changes.   I began by making major changes in my own diet, eliminating gluten, dairy, and all processed foods and eating nutrient dense options instead.  I also consulted with a wise naturopath who taught me the power of appropriate nutritional supplementation in restoring health and energy and healing the inflammation in my gut.

Back to Optimal Health!

“This sickness will not lead to death... It is for the glory of God” John 11:4

Now over twelve years later, after relentless pursuit of personal healing I am currently in the best health of my life, completely free of breast cancer and healed from Crohn’s disease!   I continue to eat an organic, whole food, gluten-free Paleo-style diet, exercise regularly, and practice my faith through prayer and meditation. It is evident that God healed my body expressly for the purpose of helping others and thus, I am committed to helping people find answers and live vibrantly through functional medicine. More than ever before, I believe that the human body can regain health if given the right tools… and I am living proof!

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