Do You Have Seasonal Affective Disorder (SAD)?

The holidays are approaching quickly but so are the long dark days of winter.  For many, this darkness creates havoc on mood and motivation as depression sets in and seasonal affective disorder takes over.  SAD is real and typically occurs when summer comes to an end and the fall season begins.  Many notice a downward spiral on cold, damp days and an improvement with the sun.

Typical symptoms include a loss of motivation, low mood, higher anxiety, sadness, feelings similar to grief, the desire to sleep a lot, and loss of joy.  When the weather changes and people feel the warmth and brightness of the sun, these symptoms often dissipate and people report better mood, higher motivation and overall feeling more happy.  It can happen at any age and affects women more than men, however men are not immune.  People commonly complain of SAD especially when someone moves from a darker more northern climate to a more southern sunny climate.  It is usually the reason people ‘snow bird’ or winter in warm environments.

Treatment is varied and involves recognizing SAD early to be prepared. 

First, remember to find the light!  There are a number of ‘happy’ lights that involve using bulbs or boxes that mimic the brightness of a bright sunny day.  The light registers through the eyes to the pineal gland in the brain in order to ward off the winter blues.  Use this light daily for maximum benefit.  Put it on the counter, the table or the desk and enjoy the benefits through the fall and winter.

Second, seek help before the depression becomes too much.  Some people need an anti-depressant medication or a natural alternatives such as 5HTP, SAMe or St. John’s Wort through the spring to help them through.  Consider counseling and find ways to motivate when it is cold, dark and raining outside and exercise or social gatherings seem like a chore.

Third, get Vitamin D testing.  Research shows that levels less than 30 ng/ml are too low and for many, proper Vitamin D levels help with SAD. 

Fourth, consider a vacation to a sunny spot.  Plan a weekend get-a-way to the warmth, plan business travel to coincide with the winter and break the monotony of the gray days.  Even a few days in the sun can restore a depressed mood if caused by the weather and can fuel someone on until the spring.

Fifth, use what light there is and be active during the day.  Sit near a window, walk outside at lunch, and exercise in a well lit area.  Take full advantage of sunny days and get outside. 

Read more on the women's health website, Empowher.

 

References:

1)      Seasonal Affective Disorder.  Web. 11 November, 2012. 

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002499/

2)      Direct health care costs of treating seasonal affective disorder: a comparison of light therapy and fluoxetine.  Web. 11 November, 2012.

http://www.ncbi.nlm.nih.gov/pubmed/23119154

New Vitamin D Guidelines - Update or Bogus?

In the October 2012 issue of the science journal PLOS ONE, researchers determined that the appropriate level of Vitamin D for the average American is above 20 ng/ml which is 10 points lower than the original cut-off of 30ng/ml.  These new lab values have been picked up and supported by the Institute of Medicine and subsequently several insurance companies however other groups, such as the Endocrine Society, maintains 30 ng/ml and above is adequate.

There is a lot of research in general about Vitamin D.  It is touted as a vitamin (actually, it's a hormone) that helps with bone strength and support, muscles, mood (think seasonal depression in the cold winter months), autoimmune conditions (most all of them) and cancer protection/prevention.  The Institute of Medicine reports that the evidence is 'too conflicting' to really support a higher Vitamin D level in the blood yet reputed groups such as The Vitamin D Council and Life Extension coupled with the Endocrine Society think otherwise.

Does it matter?

I think so.  If research can point to higher levels of Vitamin D (as in the 50-100 ng/ml) range as even *possibly* helpful for bones, mood, autoimmune and cancer without side effects (assuming one does not overdose on Vitamin D), then let's support the *possibly* and take Vitamin D.  Anecdotally, patients often report just 'feeling better' at higher levels (as in above 20 ng/ml).

Either way, talk with your health care provider and request Vitamin D testing.  Vitamin D is a fat-soluble vitamin and does require other nutrients such as magnesium, zinc and Vitamin K, to work more effectively.    The Vitamin D3 form known as cholecalciferol, is the more appropriate form to take.

References:
Holly Kramer, Chris Sempos, Guichan Cao, Amy Luke, David Shoham, Richard Cooper, Ramon Durazo-Arvizu. Mortality Rates Across 25-Hydroxyvitamin D (25[OH]D) Levels among Adults with and without Estimated Glomerular Filtration Rate <60 .="." 7="7" font="font" nbsp="nbsp" one.="one." plos="plos">

Breast Cancer Risk: Beyond Family History

October is Breast Cancer Awareness Month. It is important to recognize that there are several risks factors besides having a family member who has had breast cancer. Many people believe that they are risk-free if there is no cancer in their family or because their mom/aunt/sister has never had breast cancer. Unfortunately, this is just not true.

Risk factors are often categorized into those that one cannot change and those that are modifiable.

Starting with family history, you cannot change the genes you were born with. There are certain genes that families carry, such as the BRCA1 and BRCA2 mutation, which increases your chances.
There are other genes that can play a role too, which is why having a first degree female relative with breast cancer also increases your risk.

You cannot change your age or your gender. Incidentally, just being a woman and having breasts puts you at risk. As a matter of fact, gender is the number one risk factor – not family history. Age is also important as the older a woman gets, the more her chances increase which makes the modifiable factors that much more important to attend to.

You cannot change your exposure history – especially to the drug diethylstilbestrol (DES) that was taken by mothers in the 1940s through the 1960s to prevent miscarriage. The daughters, granddaughters and potentially even great-granddaughters born with DES exposure have an increased risk of breast cancer. Ask your mom and grandma if there is a history of DES in your direct lineage.

You cannot change the day you start your period nor can you really predict when you will go through menopause completely. Both are important risk factors. The earlier you start your period (before 12 years old) and the later you go through menopause (55 years old and later) the more cycles of hormones your breasts are exposed to, which can affect cancer.

What do you have control over when it comes to breast cancer?

You can control when and if you have children. Not having kids or having them after 30 years old will slightly increase your risk because your breasts are exposed to that many more cycles of hormones.  You can also choose to breastfeed, which has been shown in some studies to be breast-protective.

You can control your diet and exercise patterns. Alcohol and obesity have been shown to slightly increase breast cancer risk, while regular exercise and a healthy body weight have been shown to decrease the risk. Choosing fruits, vegetables, healthy oils and fiber of course are helpful for a number of reasons, not just breast cancer. Eliminating sodas, fried food, trans-fats, simple carbohydrates and sugar will also benefit your health overall.

You can control your Vitamin D3 intake (get testing first) as there is some good research that Vitamin D is protective and can lower breast cancer risk.

You can also choose what chemicals you put on your body and use in your house. While the research is guarded, it cannot hurt to use healthy body, hair, skin and make-up products for you and your family. It may be beneficial to make a conscious effort to read labels when it comes to pesticides, cleaning sprays, detergent, and odor eliminators. Also remember to be wary of plastics and do not heat up food in a plastic container as it could release phalates into your food.

It is your decision to use hormones –whether in the form of the pill, patch, ring or during menopause. Be aware of the risks involved, do your research and talk with your doctor about your options.

Do not let the risk factors you cannot change overwhelm or depress you. The modifiable factors are so important to your health overall, not just for breast cancer therefore it is important you take a positive and active approach.

Read the article here, on the women's health website, Empowher!

References
1) Breast Cancer. Web. 20 October, 2012.
 http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk

2) Breast Cancer. Web. 20 October, 2012.
 http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

3) Use of Vitamin D in Various Disorders. Web. 20 October, 2012.
 http://www.ncbi.nlm.nih.gov/pubmed/22956345

5 Ways to Boost Breast Health Naturally

October is known as Breast Cancer Awareness Month. Along with awareness, it is important to also focus on prevention.

The breast tissue is made up of fat, connective tissue, and tubes that respond to different hormones produced in the body.  Some women notice that their breasts swell before their period or that they may be more sensitive throughout the month which is often a direct result of these hormones. When someone is diagnosed with breast cancer, it may or may not be hormone receptor positive, meaning the cancer may or may not respond to hormone blocking medications.  However there are some natural ingredients that may prove beneficial overall for the tissue.

First, eat more broccoli, particularly broccoli sprouts. Research shows that a constituent in there called sulforaphane helps the liver excrete excess estrogen and may have an impact on cancer cells. It may also improve survival in breast cancer patients. Broccoli sprouts are easily mixed into salads, coleslaw, a stir fry, the morning smoothie and more. Add them into your diet daily for better health.

Second, drink more green tea or consider green tea capsules full of the active ingredient EGCG (epigallocatechin gallate). Green tea is a powerful antioxidant and in some studies, has been shown to be protective against breast cancer. Unfortunately, the jury is still out when it comes to human trials. However having a cup, two or three of green tea per day (even decaffeinated) is not going to hurt and may end up being protective. Supplements typically start at 500mg and can be bought as decaffeinated.

Third, add the spice turmeric to your foods and consider taking it as a supplement in the form of curcumin. Make sure to buy organic. Even in 2002, curcumin was recognized as a powerful anti-inflammatory, antioxidant and potential anti-cancer ingredient. The spice is not generally considered potent enough in its regular use however it is a start towards prevention. Supplements typically start at 500mg but purity is important.

Fourth, get vitamin D testing as adequate levels are important.  A potent steroid hormone, Vitamin D has been shown beneficial for both prevention and for treatment as adjunctive care. Sufficient levels start at 32 ng/mL however many in the healthcare field aim for levels between 50 and 100 ng/mL.

Fifth, eat foods rich in apigenin such as parsley, basil, artichoke and celery. This powerful bioflavonoid is showing a lot of promise to both prevent and treat breast cancer cells. Mix a handful of parsley and celery with your broccoli sprouts in a smoothie or a stir fry. Steam up an artichoke or regularly use artichoke hearts in salads. Be sure to add plenty of basil to the turmeric curry.

The best practices to hopefully avoid breast cancer are to regularly work on breast prevention. These suggestions are not magic pills nor are they guaranteed. However they are foods easily incorporated into daily life and given the research surrounding them, are worth it.

Click here to read the article on the women's health website, Empowher.

References:
1. Specific Plants Protect Against Specific, Not All, Cancers. Web. 13 October, 2012.
 http://www.medscape.com/viewarticle/769983

2. Cruciferous Veggies Boost Survival in Breast Cancer Patients. Web. 13, October, 2012.
 http://www.medscape.com/viewarticle/761792

3. Green Tea Drinking and Subsequent Risk of Breast Cancer in a Population to Based Cohort of Japanese Women. Web. 13 October, 2012.
 http://www.medscape.com/viewarticle/733795

4. Use of Nutritional Therapies During Cancer Treatment: Benefits From Dietary Supplements. Web. 13 October, 2012.
 http://www.medscape.com/viewarticle/438531_7

5. Vitamin D May Help Breast Cancer Survivors Stay on Track. Web. 13 October, 2012.
 http://www.medscape.com/viewarticle/766273

6. Vitamin D Insufficiency Linked to Aggressive Breast Tumors. Web. 13 October, 2012.
 http://www.medscape.com/viewarticle/742303

7. Apigenin induces apoptosis via extrinsic pathway, inducing p53 and inhibiting STAT3 and NFκB signaling in HER2-overexpressing breast cancer cells. Web. 13 October, 2012.
 http://www.ncbi.nlm.nih.gov/pubmed/22527937

8. Apigenin blocks induction of vascular endothelial growth factor mRNA and protein in progestin-treated human breast cancer cells.
Web. 13 October, 2012.
 http://www.ncbi.nlm.nih.gov/pubmed/20551847