"When diet and exercise aren't enough" is almost always the opening line in statin (cholesterol lowering) drug commercials. They'll finish off the sentence with "when diet and exercise aren't enough, lipitor/crestor/other brand can help lower your bad cholesterol". These commercials often start with a healthy looking man saying "I thought diet and exercise were enough" or "I wish I had listened to my doctor sooner". In both cases, the drug company wants you to identify with the person in the commercial- they want that "wow, he's just like me!" response.

I find the above statement really irritating for a number of reasons.

1. None of these people seem to remember that we need cholesterol for a multitude of bodily functions. Nearly all of your hormones are made from cholesterol, as well as bile (which you need to digest fats), the antioxidant CoQ10, and vitamin D. Cholesterol keeps your cell membranes fluid. Cholesterol isn't bad- we need it.

2. By this point, many of you realize that I see things differently than most doctors. So many things that are labeled as disease are actually symptoms of something deeper. Like so much else that I see in my clinic, I often see high cholesterol as a symptom of something bigger. Hypothyroidism? Metabolic syndrome? Hormone deficiency? Adrenal fatigue? Statin drugs don't do squat to fix those problems- they only suppress your body's cry for help.

3. Statins aren't very safe. Statin use (and low cholesterol levels) has been repeatedly linked with neurodegenerative diseases and diabetes, to name a few. It's really not shocking once you see cholesterol in this new light, though. I mean, that high cholesterol is probably a cry for help. For example, if you have consistantly high blood sugar, your body can take that sugar, make it into acetyl-coa, and turn it into cholesterol. In this case, high cholesterol is actually saving you from the inflammation of high blood glucose. If you cut off that pathway your body has no avenue to get rid of sugar and badda bing, badda boom- diabetes.

Lastly, and perhaps most importantly, the diet the American Heart Association recommends (one high in carbohydrate and low in fat and cholesterol) is the exact opposite of what you should do to bring down your cholesterol levels. The higher your blood sugar creeps from all those carbs the more your body will be forced to make more cholesterol. It should also be noted that this diet is generally pretty inflammatory. Cholesterol is not the enemy. Inflammation + Cholesterol is, however, a potential problem. Not only is the "heart healthy" diet not doing you any favors- I would bet that it's doing much more harm than good.

So when the drug companies say "when diet and exercise aren't enough", I believe what they really meant to say is:

For more reading on cholesterol:
The Great Cholesterol Con
Dr. Joseph Mercola's Article
Gary Taubes, Author of Good Calories, Bad Calories
My Older Blog Posts

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Have you been thinking of getting tested for food sensitivities? Before you run out to your MD, chiropractor or naturopath for a food sensitivity test I want to take a moment to educate you on the differences between the different types of tests that are available.


1. Food allergy tests are typically done in a doctor's office (MD, DO) or allergist's office. In my experiance, this is one of only two types of food-reaction tests "normal" doctors will run (the other being for lactose intolerance). These tests measure the antibody IgE, and detect reactions to food that are usually very fast and severe. The classic example of this type of reaction is a child with a peanut allergy- their throat closes up, they can't breathe, and someone has to administer an epi-pen to save the day.

This test does not identify food sensitivities (also known as food intolerances). However, this is the test that insurance typically will pay for.

2. Applied Kinesiology is usually practiced by chiropractors, and involves using muscle testing to determine which foods do and do not agree with your body. The appeal for such a testing method is obvious; no need for painful blood draws or messy poop tests, no expensive lab fees. However, I personally do not do this in my office.

This may be chiropractic heresy, but I do not think that muscle testing is an accurate or reliable way to identify food sensitivities.

3. Stool Testing for food sensitivities is available through labs such as Enterolabs, and measures antibodies in the patient's stool. To my knowledge, this test only looks for sensitivities to dairy and wheat. This test only measures IgA, which tends to give a LOT of false negatives in anybody who has any sort of gut inflammation (aka anybody who is seriously considering doing this type of test). My other big problem with this test is that, like most other gluten tests, it only looks for anti-gliadin IgA, which is one very small fragment of what gluten sensitive people can have a problem with.

I think that this type of stool testing is just an expensive version of the crappy (hah!) testing that most MDs do (which are covered by insurance, but borderline useless).

4. IgG Food Sensitivity Testing is done through a number of private labs (Doctor's Data, Genova, US BioTech) and is the one most commonly run at a naturopath's office. These panels test for 90+ foods and typically give you a range (either a +1, +2 type scale or red, orange, yellow, green scale) to distinguish between severe reactions, mild reactions, and harmless foods.

I have a few "beefs" with this type of test. Most importantly, these tests almost always leave the patient confused and frustrated because of their weird range/scale reading system. "Eggs are red-orange, but blue berries are orange-yellow... So I guess I have to avoid all of them?" Not only is it hard to figure out what a real positive result is from those scales, but these tests often come up with 10 or more foods to be avoided. If that wasn't enough, some labs add another layer to the mess by advising you to rotate the less severe allergens in one at a time and give you a complex food schedule to follow. I think the reason these tests have come under so much ridicule and scrutiny is because they're just too darned hard to figure out and follow.

I get really frustrated when I see how these labs break down the foods that they test. I have had patients show me these tests many, many times, and each time I want to rip my hair out. For example, such tests will show results for the following:

Yogurt
Cheddar cheese
Cottage cheese
Cow's milk
Goat's milk
Sour cream
Whey

Patients will be told that they can have yogurt and sour cream, but not cow's milk or cheddar cheese, etc when what they really have is an intolerance to all dairy. I don't know why these tests come back the way they do, but when I see these patients they generally do not feel a difference until they cut out all dairy. On the opposite side of the spectrum, the test for gluten sensitivity on these panels will come back as simply a test for Wheat. This type of test yields a tremendous amount of false negatives.

Lastly, my other issue with this type of test is really good at overwhelming you with foods to cut out, but is it worth the headache (as opposed to the alternative)? For example, you may genuinely have a slight reaction to blue berries, lemon, coconut, alfalfa sprouts, honey, sword fish, and 20 other foods... But wouldn't it make more sense to test for the big players- the foods that cause the most inflammation, and see if the rest of your issues resolve after eliminating those? I find that most people who get these tests done and have 8 or more things come back positively have deeper problems that need to be addressed. I almost always find that sensitivities to more normal foods (bananas?) are a symptom of something else, not a problem in and of themselves.

I only use this test in my office as a way to fine-tune things. I test for the big-guys first (see below), give the gut time and the nutrients it needs to heal, check for other causes of GI discomfort, and then use one of these panels as a last resort. For more on IgG testing check out this article here.

5. Cyrex Testing for both Gluten Sensitivity and "cross reactive foods" plays a huge role in my office. These tests look at three antibodies, IgA, IgG and IgM, and are the most comprehensive I have yet to find. Not only that, but their gluten sensitivity test tests for ALL of the components of wheat, barley and rye that you can have a reaction to, so there are few (if any) false negatives. The same goes for the different parts of dairy (casein, whey, and other proteins).

The good news is that it is relatively easy to get this test done, now. You can always contact Cyrex labs and find a doctor near you who is able to run the tests, or it can be run by me. I am now doing long-distance appointments via phone and skype, and am able to run the majority of the tests I offer in all states except New York.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,

Yes, you should. Thank you for tuning in.

In health,

Okay seriously- Should you be taking antioxidants, and if so which ones? How much? The easier (and funnier) way to answer this question is a simple "yes!" and "the more the merrier!" but let's take a minute to look at this objectively, shall we?

Antioxidants prevent oxidative damage (aka "free radicals" or inflammation). This is becoming increasingly important in today's world where we are exposed to a high amount of stress and inflammatory stimuli. Skeptics argue that people have lived for millennia without supplements, so they must be unnecessary. This sounds like a logical argument until you account for the incredibly different world we live in and the completely different diet our species eats now. Our ancestors ate foods that were rich in vitamins, minerals and antioxidants... meanwhile, we rejoiced as a country at the return of the Twinky.

The tricky thing about antioxidants is that it's hard to really figure out what is the ideal amount to have. You and I could have the same levels of glutathione, for example, but if I am exposed to more inflammation than you are I will have a greater need for antioxidants than you. This is why I generally don't test for antioxidants in my office, but I tend to supplement based off symptoms and apparent need. The exception to this is Omega-3 fatty acids, which I do test for in my office. One lab I run looks at the ratio of omega 6 to omega 3 in the blood, as well as the types of omega-3s present in the blood. This gives us a better idea of how much omega-3 you should be taking (quantity), as well as the type (EPA, DHA, ALA) and dietary modifications we need to make to decrease omega-6s.

Let's look at two different scenarios that can effect one's need for antioxidants.

Scenario 1
Two patients come in with the exact same medical history- the same health as a child, same diet and exercise habits, same stressors and illnesses throughout life. However, Person A has a lesser ability to cope with inflammation than Person B. This means that Person A will experience symptoms and get inflammatory diseases sooner than Person B despite having all the same stressors and inflammatory events. This may be due to genetics, epigenetics, or both.

Scenario 2
Two patients come in with the same health history- they had the same illnesses and inflammatory stimuli at the same points in their life AND they have a similar capacity to handle inflammation. However, Person A started life with less inflammatory load than Person B. This may be due to the health of the parents (or even grandparents!) prior to conception or the mother and baby's health during pregnancy and birth. In this case, Person B is likely to experience symptoms and acquire disease before Person A and it may very well be through no fault of their own!

The reality is that if you are alive today and don't live in a bubble, I'm sure you could benefit from some form of antioxidant support. The awesome thing is that there is relatively little risk that you will cause harm by taking antioxidants (as opposed to herbs, which are a little trickier). Of course, the best way to know if you've got the right dosage and type of antioxidants is to consult with a functional medicine doctor such as myself, but here are some tips for you independent types...

General rules of thumb:

1. For the most part, the dose you need to feel a benefit is related to your symptoms or disease severity. If you have diabetes, fibromyalgia, Crohn's disease or cancer and you take one fish oil pill a day it's likely not going to make a very profound change in your symptoms. For example, it is not uncommon for people with chronic diseases to need up to 10 grams* of omega-3s per day to get their levels to where they need to be. I, on the other hand, tend to do well on just 3 grams per day. You can be the judge of how much antioxidants you need.
*Be careful taking high doses of omega-3s without a physician's supervision. Omega-3s thin the blood, so patients on blood thinners such as coumadin may need to work with their doctor and lower the dose of their medication.

2. Pay close attention to the type of antioxidants you get- many fish oil supplements from drug stores sit on the shelf for a long time and are rancid (and ineffective) before you even get them home. Additionally, supplements may contain things that are not on the label (yikes!). I carefully screen any supplements I carry in my office, but if you must buy supplements elsewhere Consumerlab.com is a great resource.

3.  Finding the most effective type of antioxidant for you is a little trickier of a subject, and is best handled by a supplement-savvy doctor such as myself. However, two antioxidants that I think most people could benefit from are omega-3 fatty acids (EPA and DHA, not ALA) and glutathione.

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,