Resolutions Anyone?

Good news for the New Year and all those exercise resolutions! Chronic shoulder and neck pain can be helped with exercise. This is not new information since many studies have shown that exercise helps to reduce pain and improve general well being. However, this study’s findings target specific Repetitive Strain Injury (RSI) that is becoming commonplace, affecting millions of office workers.

RSI (aka overuse syndrome) is the repetition of hand, arm and upper body movements in many ordinary tasks in the workplace. With these activities, shoulder and neck muscles can become chronically tight and painful. The trapezius is one of the muscles especially affected by RSI. Its three sections extend from the base of the skull, laterally to the shoulder blade and down the back to the lower thoracic vertebrae. The function of the trapezius involves supporting arm and shoulder movements. Chronic muscle tension in the trapezius can contribute to muscle tenderness and pain that can radiate down the arm or up into the neck and head resulting in headaches.

In the 2009 study, from the Journal of Applied Physiology, investigations showed that specific strength exercises using weights can decrease neck pain and improve muscle response to neural stimulation. Significant improvement was measured after 10 weeks of performing five simple exercises.

The exercise routine includes shoulder shrugs, one-arm rows, bent rows, reverse flyes and shoulder abduction. Three sets of each exercise were done for 8-12 repetitions using varying weights, three times a week. The movements focused primarily on the actions of the trapezius in relation to shoulder motion and to strengthening the three individual sections of the muscle.

It’s amazing that such a simple practice and small amount of time can yield such positive results. Physical movement in general is a great way to positively affect your health. But when more specific movements, that don’t take a lot of time, can make such a difference…well that’s the resolution I’m going to make.

Happy New Year!
Sherry LaBeck, ND

Business building through teamwork

Here at ZRT I get the opportunity to interview doctors, pharmacists, business manages and the like for our monthly teleconference series “Let’sTalk”. This past month I interviewed Natalie and Adam Gustafson of Pacific Compounds . They talked about how they went about starting and building their practice. I learned something from them about the value of networking within and across professions. As a clinician, I’ve always understood the importance of creating and maintaining relationships with other clinicians. It was a great reminder however, to think about networking with people outside my profession. Pharmacists aren’t the only health care professionals, who might send patients our way, there are all sorts;massage therapists, chiropractors, acupuncturists, how about the folks that help us run our clinics- the insurance billers, receptionists and office workers. That’s to name just a few.

What really impacted me was hearing the Gustafson’s perspective on networking. As a pharmacy- their business builds when the doctors (who are their clients) businesses build. To foster that relationship they do things like host continuing education meetings for doctors in the area. This brings the docs in to hear about topics like hormone replacement therapy, and which in turn gets more of these docs prescribing HRT. As the Doctors become experts in the field, their business grows and in turn so does the pharmacy’s. It’s a symbiotic relationship. Most of practice building is like that. Remembering that we as individual clinicians or pharmacists or business owners are connected to a network of others is very important. We don’t live in a bubble! Our business thrive when other businesses thrive.

Celiac, Hypothyroidism, and Adrenal dysfunction oh my!

I'm continuing my discussion on Gluten - see blog part 1 on diagnosis and symptoms. But I wanted to discuss the reason why this all ties into hormone function; in particular Cortisol and Thyroid. As many may know, Adrenal and Thyroid dysfunction and diseases are commonly linked to autoimmune diseases - Addisons, Hashimotos, & Graves for example. There is a strong association between having one autoimmune disease and having additional subsequent autoimmune diseases. Well, it does appear that we can count Celiac disease as a form of autoimmune disease. Many studies have looked at the representation of other autoimmune diseases if a patient has celiac disease; finding a higher rate than expected of thyroid, adrenal, and pancreatic dysfunction; for example - about 10-26% depending on the study and the autoimmune disease. More recent studies however, have reversed this search- looking instead for the presence of celiac disease in individuals who have thyroid or adrenal dysfunction. Not surprisingly, there has been an amazing frequency of celiac in these populations - about 3-5% for Autoimmune thyroid, 12% for Addisons, and 1/20 of patients with type 1 diabetes. So, a patient comes into the office and has multiple autoimmune diseases, think about adding a test for celiac as well and vice versa.

But what about the patient who comes in with hormonal problems, fatigue, headaches, and weight gain? Consider celiac as well. Untreated and undiagnosed celiac disease patients, which is about 90+% of celiac disease sufferers, have hormonal disruption that may not have yet been diagnosed OR as of yet, a disease. Celiac creates at number of inflammatory cytokines which may mimic multiple conditions. Cortisol levels may be high or low depending on the amount of adrenal autoimmunity, inflammatory cytokines, and overall stress of the individuals physiology due to eating gluten. As an example, individuals with profound skin itchiness due to celiacs, sleep maybe disrupted routinely due to discomfort. Plus, the changes to cortisol levels may also increase the inflammation when the adrenals are unable to produce enough cortisol to inhibit autoimmunity (TH1 and TH2 balance) and inflammation (relative adrenal insufficiency).

I routinely get asked what to do about individuals who have high levels of antibodies to their thyroid glands (TPOab and TGab) and going gluten-free is one of the tricks that you can try. I have seen that successfully lower antibody levels very quickly for some individuals. Remember however, that if you need to diagnose someone with celiac, you need to do that before they go gluten free.
The thyroid gland embryologically begins at the back of the tongue and migrates down into the neck by week 7 of fetal life. A process that to me epitomizes the magic of embryology. As a refugee of the GI tract however, thyroid tissue appears to share the same tendency to react to the same irritants as GI tissue does. Thus, we see many of the thyroid autoimmune diseases actually being GI infections; for example: H. pylori, giardia, and entamoeba histolytica.

I am constantly amazed at the many ways our body system interacts. It's truly amazing that any of us are able to be ok. But, if you haven't looked at Celiac disease as a contributor to endocrine disorders it's worth your time to consider it. Since most patients are undiagnosed, and family inheritance is high, you might cure and prevent a large amount of suffering and hormonal dysfunction.

Happy Holidays
Dr Alison McAllister

Gratitude for Setbacks: Maybe Pollyanna was Right

Loomis Dean/Time Life Pictures/Getty Images. Hayley Mills starred in the 1960 film, Pollyanna.



I am glad to be alive. It’s normal to take this for granted, but it’s wonderful to really feel it. Yes, life is complicated, life can be hard, and maybe there are no easy answers. Loss is inevitable. I’ve had a rough year. But it’s good to be alive.

The 1913 children’s book “Pollyanna” has become a cultural icon (a.k.a. cliché) because of the eponymous character’s insistence upon looking on the bright side, finding the silver lining in every cloud, always looking for something to be glad about. To call someone “a Pollyanna” nowadays is considered insulting, a reference to naïvete and being out of touch with reality: http://en.wikipedia.org/wiki/Pollyanna

I understand that pessimism is fashionable and that disaster-mongering is the key to success for the news media. I get it that pessimists are comfortable with their “never wrong and rarely disappointed” attitudes. I was raised by a pessimist, famous for saying “People are no d--- good.” He found plenty of proof for this attitude. But he did not have a happy life, or a long one. If it’s true that we can’t control what happens to us, only how we respond to it, then maybe it’s worth choosing the point of view that is associated with greater happiness and better health. Not long ago, National Public Radio Weekend Edition did a special report on “The Pollyanna Effect” (you can click to read the transcript or listen to the radio interview).

Some lucky people are just born with a sunny disposition. For the rest of us, it’s something we can learn. In fact, learned optimism is just as powerful as innate optimism. Here’s a free online self-test from Stanford University, based on the work of Martin Seligman, PhD. and here is a link to Dr. Seligman’s best-seller “Learned Optimism: Change Your Mind, Change Your Life” .

Lately I’ve been told that I’m a Pollyanna. I wish this remark would be delivered with the humble gratitude that I feel in my heart. Within the past year I’ve had pain, cancer, financial setbacks, loss of loved ones – and I know I’ve had the company of thousands of other brave souls enduring similar or worse ordeals. As a result of this series of setbacks, life has more clarity for me now than before: What I love, I really love! As for the rest, I don’t have time for it any more. The kindness and unexpected generosity of oh-so-many people and circumstances has piled up to a mountain of overwhelming gratitude. While I would not wish a series of setbacks on anyone, the bottom line is this: the payback has been tremendous. Clarity of purpose, and clarity of gratitude, are precious gifts in this life. So call me a sap. I’m a happy sap who is glad to be alive.

-Dr. Deborah McKay, Naturopathic Physician, Clinical Consultant, ZRT Laboratory