Holistic Health News
Dr. Cathy Rosenbaum

Is Functional Medicine Another Holistic Practice?

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By Cathy Rosenbaum PharmD MBA RPh CHC CDP CFNC

The short answer is, ‘Absolutely. Yes!’  In the 1970’s Jeff Bland PhD FACN FACB CNS, former Professor of Chemistry at the University of Puget Sound in Washington state, started his work in Functional Medicine (FM).  Ten years later Dr. Bland began teaching practitioners how to implement preventive nutritional medicine in their professional practices.  FM, like many health practices, spotlights whole-food nutrition as a cornerstone of healing.

The Institute for Functional Medicine was launched in 1991, with Dr. Bland as the Co-Founder.  The organization offers a FM Certification Program for physicians and health care professionals holding at least a Masters’ degree and licensure in their fields.

In 2014, the Cleveland Clinic established The Center for Functional Medicine with the Functioning for Life™ 10-Week Program where patients can select from a disease-specific series of options to meet their individual functional health needs.  Please visit https://my.clevelandclinic.org/departments/functional-medicine for more information.

FM is a proactive, personalized care approach that incorporates three distinct paths into a patient’s health assessment/history, namely natural medicine, molecular medicine, and systems biology.  FM health practitioners are MDs, DOs, DCs, CNPs, and PharmDs, among others.  The University of Western States offers a degree in Human Nutrition and Functional Medicine (see https://www.uws.edu/human-nutrition-functional-medicine/ ).

FM practice attempts to address the underlying root cause of disease rather than symptoms and symptom management solely by asking more questions about antecedents, triggers, and mediators related to a particular concern.  FM is based on the principle that a diagnosis can be the result of more than one cause, or one cause (e.g., inflammation) may lead to multiple diagnoses over time.  The primary FM outcome goal is for a patient to modify as many lifestyle choices as necessary to address the root cause of their issues and to prevent illness as much as possible.

Typical laboratory blood tests ordered by FM practitioners to help assess patterns of imbalance may include, but are not limited to, the following biomarkers:

  • Nutrient deficiencies (e.g., blood or genetic test)
  • Immune and inflammation
  • Digestive
  • Oxidation
  • Neurotransmitters
  • Hormones
  • Toxicity (e.g., heavy metals)

The physician will assess your medical and surgical history, home/life environment, lifestyle choices, possibly your genetics, and how any/each may be influencing your symptoms.  An individual FM intervention/treatment plan will be built around your whole-person health needs.

By comparison to Integrative Health and Medicine (IHM), FM embraces much of the philosophy of IHM, while adding a biologic systems-oriented approach to proactive patient care.  Comprehensive IHM involves traditional medicine health care plus complementary, holistic, mind body spirit interventions that may include other IHM practitioners on the health team.

Your physician’s IHM care recommendations may include meditation/stress management, acupuncture, Yoga, Tai Chi, massage, dietary supplements, nutrition education, exercise, and lifestyle changes to improve your health.  For more information about IHM, visit the American Board of Integrative Medicine @ https://www.abpsus.org/aboim/ or the Andrew Weil Center for Integrative Medicine in Tucson AZ @ https://integrativemedicine.arizona.edu/ .

Check with your insurance carrier to see if FM office visits and laboratory tests are covered by your insurance carrier.  Several FM practitioners are located within the Greater Cincinnati Northern Kentucky area from which to choose.  Holistic pharmacists are becoming more involved in FM practices throughout the country.  For more information visit https://wwwifm.org/find-a-practitioner .  For more information on FM research, visit www.clinicaltrials.gov.

International Integrative Health Day January 23, 2025

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January 23, 2025 is International Integrative Health Day. Let’s celebrate! It’s a perfect time to learn more about evidence-based integrative health and wellness practices locally offered in your area including, but not limited to:

*  Acupuncture, Aromatherapy, Tai Chi Easy, Qigong, Yoga, Pilates, Massage, Art Therapy, Cincinnati Equine Therapy, Music Therapy, Laughter Therapy, Stress Management/Meditation/Mindfulness, Healing Touch, Guided Imagery, Forest Bathing, Therapeutic Hiking, Food as Medicine Nutrition Consultations, Holistic Clinical Pharmacy, Prayer Groups, Stephen Ministries ………. and the list goes on.

Enjoy your whole person health journey.  Be well!

The Microbiome & Regenerative Organic Certified Farming

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The Microbiome & Regenerative Organic Certified Farming

By Cathy Rosenbaum PharmD MBA RPh CHC CDP CFNC

The Microbiome

What is the human microbiome? It’s a complex set of genes within a group of natural microorganisms that live in and on the body. Our first exposure to these microorganisms happens in utero and during birth through the birth canal. From 2008-2012 The Human Microbiome Project identified factors affecting the human microbiome’s composition including a person’s living geography, health status, stress tolerance, diet, age, gender, and everything he/she touches. Each of these aspects influences microbiome functions.

 The gut microbiome contains a constantly changing list of over 40,000 species of microbes. This specific microbiome controls much of our immune system which mostly resides in the gut. The gut microbiome weighs about 4.5 pounds and is composed of bacteria, fungi, viruses, and protozoa and contains at least 150x more genes than the human genome. 

 When the gut microbiome is negatively impacted (e.g., we eat overprocessed foods, don’t manage our stress well, etc), paths between the gut and brain are out of sync occasionally resulting in abnormal absorption of food from the gut into our circulation, a process called leaky gut syndrome. This process may lead to inflammation and altered permeability of the blood-brain barrier and can sometimes trigger mental and neurologic changes.

 The gut-brain-microbiome axis is the bi-directional ‘second brain’ in our body. Gut microbes talk with the brain through the vagus nerve and the secretion of neurotransmitters (e.g., serotonin, dopamine). Communications between the gut and our entire nervous system may affect one’s mood as well as the body’s response to drug therapy. The gut microbiome can also manufacture short chain fatty acids to help maintain the gut barrier and may have an anti-inflammatory effect on the brain.

 Certain medications can influence the gut microbiome, altering both their wanted and unwanted effects. Much of our research is based on preclinical laboratory studies with animal models and human observational studies. More human clinical trials regarding the influence of the gut microbiome on drug pharmacokinetics (e.g., absorption, distribution, metabolism, elimination) have yet to be designed. 

 As research evolves, the sciences of pharmacomicrobiomics and nutrigenomics will offer more insight into the nutritional management of mental health conditions. In the years ahead, many professional disciplines will be needed with expertise in whole-food nutrition to maximize gut health and help treat anxiety, depression, or other mental illnesses (e.g., probiotics, prebiotics, fecal transplants, and other ‘food as medicine’ therapies).

 Regenerative Organic Certified Farming (ROC)

Concerned about reduced nutrient density in conventionally grown food sourced from big box groceries/centralized industrial farmers? You are not alone. Conglomerate farmers typically focus on replenishing three soil nutrients (e.g., phosphorus, potassium, and nitrogen). By contrast, ROC is focused on sustainable soil health. Farmers add back 18 different soil nutrients for optimal plant growth. Is it time to change our global approach to farming for better health? 

 For perspective, ROC can include, but is not limited to:

  • Minimized tilling of croplands to maintain soil moisture and reduce soil disturbance/erosion (an estimated 57 billion metric tons of topsoil have eroded in the USA Midwest over the past 160 years)
  • Crop rotation for weed and pest control and less chemicals
  • Use of cover crops like alfalfa to return more nutrients to the soil and reduce risk of erosion
  • Composting in place of synthetic fertilizers to improve soil microbes

 A great time to learn more about ROC is during the summer months while shopping at your local farmer markets. Alternatively for more information, you may contact USDA @ Farming | USDA or https://www.usda.gov/topics/organic or Regenerative Organic Alliance @ https://regenorganic.org/ .

 As consumers, we have a responsibility to purchase whole nutrient dense foods properly grown for our health and the planet’s viability for generations to come. Check out the Farm to Table Movement @ https://farmtotablemagazine.com/2024/03/07/understanding-the-farm-to-table-movement-a-comprehensive-guide/ . Finally, check out Community Supported Agriculture for year-round crop purchasing plans @ https://growingsmallfarms.ces.ncsu.edu/growingsmallfarms-csaguide/.

 References

  1. Gambaro. Gut-brain axis: Review of the role of probiotics in anxiety and depressive disorders. Brain Behav. 2020;10(10):e02803
  2. Del Toro-Barbosa. Psychobiotics: Mechanisms of action, evaluation methods and effectiveness in applications with food products. Nutrients 2020;12(12):3896.
  3. Rutsch. The gut-brain axis: How microbiota and host inflammasome influence brain physiology and pathology. Front Immunol 2020:11:604179.
  4. Chen. Antipsychotics and the microbiota. Curr Opin Psychiatry 2020;33(3):225-230.
  5. Qian. A guide to human microbiome research: study design, sample collection, and bioinformatics analysis. Chin Med J (Engl) 2020 Aug 5:133(15):1844-1855.
  6. Meyer. Association of the gut microbiota with cognitive function in midlife. JAMA Netw Open 2022:5(2):e2143941.
  7. Walsh. Drug-gut microbiota interactions: implications for neuropharmacology. Br J Pharmacol 2018;175(24):4415-4429.
  8. Malan-Muller. The gut microbiome and mental health: implications for anxiety-and trauma-related disorders. OMICS 2018;22(2):90-107.
  9. Mayer. Alive.com July 2024 pp. 61-64

Your Holistic Health Earns an IAAIS Award

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I am pleased to announce an award on June 14, 2024, given to our radio show, Your Holistic Health, broadcast for Cincinnati Association for the Blind and Visually Impaired (CABVI) participants.  Thank you, Dr. Gramillano, CABVI, and IAAIS!

“Congratulations on first place honors in the Interview/Call-In/Discussion program category for YOUR HOLISTIC HEALTH from IAAIS.org (the International Association of Audio Information Services). The winning interview is your 8-10-2023 show on Emotional Intelligence with your guest, Dr. Robert Gramillano, Certified Emotional Intelligence Coach.  The 08-10-23 episode was recorded at the Cincinnati Association for the Blind and Visually Impaired (CABVI).”

Honey – Nature’s Sweetheart

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By Dr. Cathy Rosenbaum, Holistic Clinical Pharmacist, Certified Fitness Nutrition Coach, CEO Rx Integrative Solutions

NUTRITIONAL VALUE

Honey is a carbohydrate that contains 30% glucose and 40% fructose, both of which when broken down by the body may cause spikes in blood sugar levels.  The glycemic index = 58 for pure honey (moderate glycemic index food).  For perspective, low glycemic index foods have a GI ≤ 55, moderate glycemic index foods have a GI = 56-69.

The type of flowers that bees pollinate to make the honey determine its taste, color, antioxidant, and vitamin contents.  One tablespoonful of honey contains ~64 calories.

TYPES

  • Raw honey straight from the hive (available as filtered or unfiltered forms)
  • Regular honey (pasteurized, with added sugars)
  • Pure honey (pasteurized, no added sugar/ingredients)
  • Manuka honey (from the manuka bush)
  • Forest honey (from bees fed on tree honeydew instead of flower nectar)
  • Acacia honey (from bees fed on flowers of black locust tree)
  • Organic honey (available as raw or regular forms)
  • Medical grade honey (topical therapeutic)

CONSTITUENTS

Raw honey contains water, bee pollen (26 amino acids), bee propolis (resin, oil and wax, pollen, amino acids, sugars, aromatic compounds), antioxidants (flavonoids), enzymes (diastase, invertase, glucose oxidase), minerals (calcium, copper, iron, magnesium, manganese, phosphorus, potassium zinc), and vitamins (pantothenic acid, niacin, riboflavin, vitamin C, vitamin E).

Raw honey may contain a few more antioxidants and enzymes than pasteurized honey.  Pasteurization is necessary to kill any yeast, but may reduce raw honey’s antibacterial action, wound healing benefits, antioxidant value, and anti-inflammatory effects.

It is best not to microwave raw honey or put it directly in boiling water to dissolve crystals that form over time as this may destroy some of its nutrient value.

MEDICINAL EFFECTS

UPPER RESPIRATORY INFECTIONS (URIs)

Honey may be a good natural alternative for treating upper respiratory tract infections (Abuelgasim 2020).  In this review of 14 studies mostly in children and a few adults with URIs, authors concluded raw honey used to coat the throat was superior to usual care (e.g., dextromethorphan) for improving cough severity, cough frequency, or both.

WOUND HEALING

Honey has a low pH level (acidic) that may kill harmful bacteria in wounds.  As seen in vitro studies, topical therapeutic (medical grade) honey may inhibit bacterial growth due to its high sugar content, acid pH, hydrogen peroxide production within the wound to aid in debridement, and moisture.

Subrahmanyam (1998) described a prospective randomized clinical and histological study of burn wound healing in two groups of 25 patients assigned to either topical therapeutic honey or topical silver sulfadiazine.  In the honey treated group, 84% of patients demonstrated epithelialization by day seven, and all of them demonstrated satisfactory wound healing by day twenty-one.  In the silver sulfadiazine treated group, epithelialization was present by day seven for 72% of patients and by day 21 for 84% of patients.

Regarding histological evidence of wound healing, 80% of patients treated with honey showed wound improvement by day seven compared to 52% of silver sulfadiazine treated patients by day seven.  These outcomes continued to improve for both groups up to 21 days of treatment.

Medical grade honey should only be applied with the advice and consent of a physician.  Bacterial susceptibility varies based on length of topical exposure to therapeutic honey.  It is prudent to closely monitor the use of therapeutic honey in patients with all wounds, especially diabetic ulcers due to risk of infection.  Before therapeutic honey is used on an open wound, the wound should be swabbed for bacteria culture and sensitivity to honey determined before treatment if necessary.

Not all food grade honey is sterile, and Clostridium botulinum can survive in honey, thereby causing a risk of wound botulism when applied to the wound.  Food-grade honey should not be used for wound healing.  Clinicians should consult the honey manufacturer to find out more about the product before applying honey to an open wound.

SAFETY

Using/taking honey by any route of administration is contraindicated in individuals allergic to honey or pollens contained therein, and in children less than one year of age (Abell 2020).  Individuals with diabetes mellitus should monitor oral honey consumption and its effect on their blood sugar levels.

BOTTOM LINE

Honey is an alternative to table sugar or agave syrup, artificial sugar substitutes, or Stevia for sweetening effects, nutritional value, and potential medicinal use.  Please consult with your physician for an accurate diagnosis and directions on how best to use honey for any medicinal or therapeutic purposes.

REFERENCES

Abell.  Honey for upper respiratory tract infections. Pharmacy Today November 2020.

Abuelgasim.  BMJ Evidence-Based Medicine August 18, 2020.

Almassandi.  The antibacterial activities of honey.  Saudi J Biol Sci 2021.

Boukraa L.  Honey use in burn management: potentials and limitations.  Forsch Komplementmed 2010;17:74-80.

Cooper R, Wigley P, Burton NF.  Susceptibility of multi-resistant strains of Burkholderia cepacia to honey.  Lett Appl Microbiol 2000;31:20-24.

Jull. Honey as a topical treatment for wounds. Cochrane Database Syst Review 2015.

Maric. A comprehensive study of parameters correlated with honey health benefits.  RSC Adv 2021.

Niaz.  Health benefits of manuka honey as an essential constituent for tissue regeneration. Curr Drug Metab 2017.

Olaitan PB.  Honey: a reservoir for microorganisms and an inhibitory agent for microbes.  African Health Sci 2007;7:159-165.

Pimentel. Stingless bee honey. An overview of health benefits and main market challenges. J Food Biochem 2022.

Sinha. Benefits of manuka honey in the management of infectious disease.  Recent advances and prospects.  Mini Rev Med Chem 2023.

Subrahmanyam M.  A prospective randomized clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine.  Urns 1998;24:157-161.

12 Steps in The Grief Process

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In honor of Matthew Perry’s recent passing, we dedicate this post to all who are grieving during the holiday season.

12 Steps in Grief Process Source: https://dennistoll.ca/12_Steps_in_Grief_Process_981014.html

1.RECOVERING FROM A LOVED ONE’S DEATH (OR MAJOR LIFE EVENT) TAKES MORE THAN TIME.
Yet, if we allow ourselves the time to mourn we can gradually break grief’s grip on us. Recognizing the role and value of the grieving process orients us to accepting the fact of the death or life event. Acceptance marks a major step towards recovery.

2.GRIEF IS UNIVERSAL – GRIEVERS ARE DISTINCTIVE.
Grieving follows a pattern, but each griever experiences it differently. Awareness of the basic pattern reveals common ground for mutual help and support. Recognition of uniqueness enables grievers to help themselves, guides sympathizers in what to say and do.

3.SHOCK INITIATES US INTO MOURNING.
We go numb when someone we love dies (or an unwanted life event happens). We feel stunned, in a trance. This is nature’s way of cushioning us against tragedy. The length and depth of this state varies according to our relationship, the cause of death, reason for the life event to happen, whether it was sudden or expected, etc. Shock allows us time to absorb what has happened and to begin to adjust. The guidance of caring people can sustain new grievers. As numbness wears off and acceptance grows, we regain control of the direction of our lives.

4.GRIEF CAUSES DEPRESSION.
Grievers typically, but in varying degrees, experience loneliness and depression. This pain, too, will pass. Being alone need not result in loneliness. Reaching out to others is a key way to lessen loneliness and to overcome depression.

5.GRIEF IS HAZARDOUS TO OUR HEALTH.
The mental and emotional upset of a loss by death (or by an unwanted life event) causes physical distress and vulnerability to illness. Grievers sometimes neglect healthy nourishment and exercise, overindulge in drinking, smoking or medication. We might need a doctor’s advice in regard to our symptoms, their causes and their treatment.

6.GRIEVERS NEED TO KNOW THEY’RE NORMAL.
The death of a loved one (or the occasion of an unwanted life event) makes the future very uncertain. We might panic in the face of the unknown and fear life without the one who died (or the person involved in the life event). Panic prevents concentration and defers acceptance of the finality of death or other relationship loss. It tempts us to run from life, to avoid people and to refuse to try new things. We might even think we’re going crazy. Patience with ourselves and a willingness to accept help enable us to subdue panic and outgrow its confusion.

7.GRIEVERS SUFFER GUILT FEELINGS.
Many blame themselves after a loved one’s death (or an unwanted life event) for the death/event itself or for faults in the relationship. We have all made mistakes, and sincere regret is the best response to them. However, self-reproach out of proportion to our behavior affects our mental health and impedes our recovery. Close friends or a trusted counselor can aid us in confronting and dealing with guilt feelings, whether justified or exaggerated.

8.GRIEF MAKES PEOPLE ANGRY.
People in grief naturally ask “Why?” Why him? Why me? Why now? Why like this? Most of these questions have no answers. Frustration then causes us to feel the resentment and anger. We want someone to blame: God, doctors, clergy, ourselves, even the one who died (or was involved in the unwanted life event). If we can accept the lack of answers to “Why?” we might begin to ask, instead, what can we do now to grow through what has happened. Then we have started to move beyond anger and towards hope.

9.EMOTIONAL UPHEAVAL CHARACTERIZES GRIEVERS.
A loved one’s death (or unwanted life event) disrupts emotional balance. The variety and intensity of feelings seem overwhelming. Other grievers and counselors can help us interpret and deal with these feelings. As we come to understand what we experience, we can find appropriate ways to ventilate our emotions and to channel them constructively.

10.GRIEVERS OFTEN LACK DIRECTION AND PURPOSE.
At times in the grieving process, a kind of drifting occurs. Mourners find familiar and necessary activities difficult. We prefer to daydream about what was or fantasize about what might have been. If we can foster gratitude for the past and begin to assess our potential for the future, this will prove a passing phase, not a permanent state.

11.HEALING BRINGS HOPE TO GRIEVERS.
It takes time and effort, but gradually hope dawns for bereaved people. We learn to express emotions without embarrassment or apology. We cherish memories, bittersweet though they are. We begin to feel concern for and show interest in others. We make decisions and assume responsibility for ourselves. The example of the recovered grievers helps us discover and develop our own potential.

12.SURVIVORS REAFFIRM THEMSELVES AND CHOOSE LIFE.
Eventually, grievers recognize and embrace a healing truth: Grief has changed me but has not destroyed me. I’ve discovered new things about myself. I can build on strengths developed through adversity. I’m no longer my “old self” but I’m still me, I face the future with confidence. Life is worth living because I can love and be loved.

More Resources:

Five Stages of Grief – Source: https://psychcentral.com/lib/the-5-stages-of-loss-and-grief/

https://www.griefshare.org/about Grief Share Support Groups and workbook entitled “Your Journey From Mourning to Joy”. Phone 800-395-5755, or write to Grief Share, P O Box 1739 Wake Forest, NC 27588

https://www.samhsa.gov/find-help/national-helpline SAMHSA Substance Abuse and Mental Health Services or dial 988 on your phone or go to the Emergency Room.

https://www.stress.org/holmes-rahe-stress-inventory-pdf Holmes Rahe Change Scale

Dietary Supplement Guidelines

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by Dr. Cathy Rosenbaum, Rx Integrative Solutions                                                       

Holistic Clinical Pharmacist

Certified Health Coach

Certified Fitness Nutrition Coach

SUPPLEMENT DEFINITION

A dietary supplement is a vitamin; a mineral; an herb or other botanical; an amino acid; or a concentrate, metabolite, constituent, extract, or combination of any of the above ingredients.

SUPPLEMENT QUALITY                                                                      

The FDA is not authorized to approve dietary supplements for safety and effectiveness. Most dietary supplements can be marketed without notifying the FDA (DSHEA Act 1994).  To ensure supplement potency and purity, look for proof of independent third-party analytical testing on supplement bottle labels (e.g., see the round quality seals):

  • consumerlab.com
  • NSF (National Sanitation Foundation) nsf.org
  • USP-Verified (U.S. Pharmacopoeia) usp.org
  • c-GMP (Good Manufacturing Practice – minimum required by FDA for all dietary supplements)
  • Certificate of Analysis (see store’s website, requested from the supplement’s manufacturer)

 CLINICAL RESEARCH (SUPPLEMENT INDICATION)

Look for research studies in humans with your same condition/health goal, identifying the exact product, dosing, and length of therapy BEFORE you purchase any dietary supplements

  • Visit clinicaltrials.gov (NIH sponsored website for all types of research)
  • Do not be misled by marketing hype/confusing supplement claims by famous people
  • Follow your doctor’s recommendations on the use of dietary supplements is using the latter instead of prescription medications for your health needs – discuss risk/benefits with your pharmacist (e.g., prescription statins vs red yeast rice for cholesterol lowering)

 SUPPLEMENT SAFETY/SIDE EFFECTS

  • Work with your pharmacist to manage unwanted effects and/or drug/supplement interactions
  • Write to FDA for Freedom of Information post-marking reports on supplement side effects
  • Report any unwanted supplement effects to your physician, pharmacist, or directly to the FDA via MedWatch https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program
  • Do not take both dietary supplements and prescription medications for the same indication unless directed by your physician (e.g., diabetes mellitus, high cholesterol, high blood pressure)

SUPPLEMENT LABEL

  • Carefully read all the instructions for supplement usage, supplement facts, active and inactive ingredient list, and warnings, remembering dietary supplements are regulated by FDA CSFAN as nutrition (not medication) and contain ‘nutritional labels’ (e.g., serving size, not ‘dosing’ like OTC medications)

PROPRIETARY BLEND

  • Avoid dietary supplements with ‘proprietary blends’ when manufacturers do not disclose the actual amounts of every active ingredient (amounts considered to be a trade secret)
  • Note the proprietary blends are found in multivitamins, supplements for colds/flu, weight loss, body-building protein formulations, and many more
  • GLUTEN FREE SUPPLEMENTS
  • Prescription and OTC medications are not covered under the FDA’s gluten-free labeling rule whereas dietary supplements are covered. Any foods or supplements that carry the label “gluten-free,” “no gluten,” “free of gluten,” or “without gluten” must contain less than 20 parts per million (ppm) of gluten. For more information, visit the following websites:

*            www.glutenfreedrugs.com 

*            www.dailymed.nlm.nih.gov 

*            www.celiac.com 

ROLE OF THE HOLISTIC CLINICAL PHARMACIST

  • Feel free to consult with your holistic clinical pharmacist as an equal partner on your decision-making team to determine which dietary supplements are appropriate for your individual health goals, health conditions, lifestyle choices, and your value system.