Dear Pharmacist,

I’ve been fighting low- to mid-level depression for years and at the same time trying to avoid becoming dependent on anti-depressant medication. I’ve tried St. John’s wort, and it didn’t help me. Can you recommend another alternative treatment?

Answer: Actually, yes. The herb rhodiola (Rodiolia rosea) has been safely used for centuries in Russia, Eastern Europe, and Scandinavia to help people deal with stress and bounce back from debilitating illness. Many herbs have come under the scrutiny of modern science, but researchers are definitely able to validate rhodiola’s traditional uses… and then some. Rhodiola can relieve stress, lift depression and improve attitude. NFL fans, take solace, rhodiola could help you deal with the lock-out!

Rhodiola is a plant that thrives in Siberia and withstands the harshest growing conditions on the planet, so it has to be tough. Remarkably, it can help you withstand ‘harsh’ conditions too, meaning stress! Natives in Siberia and other countries along the Arctic Circle have traditionally reached for rhodiola whenever faced with dauntingly stressful challenges, both physical or mental.

In a 2007 study published in the Nordic Journal of Psychiatry, researchers gave rhodiola extract to a group people with clinical depression -the kind that requires medical care and constant follow-up. Of the 89 study participants, only the groups which received rhodiola supplements (two different dosages) experienced “a significant anti-depressive effect” over a period of six weeks as compared to the group who were given dud pills. Physical symptoms related to depression improved, such as insomnia, emotional stability and feelings of self-esteem.

It’s just amazing that not one single study participant reported any negative side effects from taking the herb. Did you hear that? ZERO side effects! Mind you, all prescribed anti-depressants currently available come with a whole gamut of potentially devastating side effects, everything from sexual dysfunction to brain fog.

Rhodiola enhances levels of key brain chemicals such as norepinephrine, serotonin and dopamine. There is research to support it’s benefit on the heart, specifically certain cardiac arrhythmias. You can ask your cardiologist if he/she minds you trying this supplement.

Rhodiola appears to enhance performance of cosmonauts and athletes. And in a Moscow study, scientists gave rhodiola to military cadets who face mentally and physically demanding work, 24/7. The cadets receiving rhodiola performed better on a variety of tasks and experienced much less mental and physical fatigue than those who took the placebo. And get this, I found another study about students taking rhodiola before their exams! It’s a smart pill. The students all had slightly higher scores. Hmm... sounds to me like this could be a good herb to take right before a college-entry exam or a big job interview! Keep in mind, it may take a few weeks for optimal effects.

Did You Know?

Pomegranate juice helps your heart by keeping “nitric oxide” around longer, that’s a good thing.

Depression is becoming increasingly common, but often goes away with natural therapies. Although how we feel has a lot to do with psychological issues, it can also be dramatically affected by our biochemistry. The same applies to bipolar, obsessive-compulsive and other disorders that are classified as being psychological. Although doing one’s “psycho-spiritual” work is important in treating any illness, you will be amazed at how much better you can feel when you optimize your biochemistry — naturally! This article will teach you how.

By looking at American society today, one would think there is a massive epidemic of Prozac deficiency. Millions of Americans are complaining of being unhappy and depressed — yet most doctors simply throw a pill at the problem! I prefer to go after the underlying causes, while using natural therapies to support the biochemistry of happiness. When you do this, most depression can be effectively treated — without the loss of libido, weight gain, fatigue or increased risk of suicide seen with prescription antidepressants. I’m tired of being depressed and want to be happy. How should I begin?

Let’s look at both the physical and psycho-spiritual components — which is a good approach for any illness. From a psychological perspective, depression usually represents repressed anger which has been turned inward. This is why choosing to allow yourself to be angry or even to sometimes go into a rage can be healthy when you’re depressed — even if the people around you don’t like it. You can tell when the anger is healthy because it will feel good. Remember though, that you are choosing to be angry, and what you are angry about is nobody else’s fault (so don’t beat up others with your anger). When you don’t allow guilt to get in the way, notice how your depression decreases and you feel better after a good fit of anger!

There are three steps that psycho-spiritually will help you to get past depression and leave you feeling great. These are:

1. Feel all of your feelings without the need to understand or justify them. When they no longer feel good, let go of them.
2. Make life a “no-fault” system. This means No Blame, No Fault, No Guilt, No Judgment, and No Expectations on yourself or anyone else. This means changing your habits of thinking. For example, if you find yourself judging somebody, simply drop the judgment in mid-thought when you notice it. And no judging yourself for judging others!
3. Learn to keep your attention on what feels good. We sometimes are given the misconception that keeping attention on problems is more realistic. That is nonsense! Life is like a massive buffet with thousands of options. You can choose to keep your attention on those things that feel good. You’ll notice that if a problem truly requires your attention at any given time, it will feel good to focus on it. Otherwise, you’re living your life as if you have 200 TV channels to choose from, and you only choose to watch the ones you don’t like!

From a physical perspective, depression often reflects faulty biochemistry. Begin by asking yourself this simple question—“Do I have many interests?” If the answer is yes, you’re probably not depressed but rather have other physical problems causing how you feel. Common causes would include poor sleep, infections, thyroid and other hormonal deficiencies (despite normal blood tests!) and nutritional deficiencies. This is especially important to do if you have a combination of exhaustion, poor sleep, and in many cases widespread achiness. If this is so, you may well have chronic fatigue syndrome/fibromyalgia — for which effective treatment is now available — and not depression. If you do not have many interests, you probably are depressed and the treatments below will be very helpful for you. Fortunately, depression is very treatable.

What can I do to feel better while I’m going after these underlying problems?

Happiness has its own biochemistry which can be powerfully balanced and enhanced naturally. Let’s start with the basics:

• Overall nutritional support is essential, and I would recommend a good multivitamin powder (my favorite is the Energy Revitalization System).
• Begin a walking program. Research has shown that walking briskly each day is as effective as Prozac for depression.
• Get more sunshine (maybe while you are walking). Inadequate sunlight is a common cause of depression (called Seasonal Affective Disorder or SAD), which should be considered if your depression is worse in the winter.
• Use herbal support if needed to get eight hours of sleep a night as well.

These simple steps are very healthy in general, and will usually help improve how you feel considerably.

Take fish oil. Fish oil has been shown in numerous studies to be very helpful in depression and many other psychological problems. Most of your brain is actually made of DHA (docohexaenoic acid), one of the two key components of fish oil. In fact, taking fish oil during pregnancy markedly decreases the risk of post partum depression. Fish is called “brain food” for a good reason. If you have depression or other psychological problems, try eating 3+ servings of salmon, tuna or herring each week, and/or take fish oil. Be sure the oil is toxin and mercury free, and not rancid. I recommend Eskimo 3 or Nordic Naturals brands. Take one teaspoon or three (1000 mg) capsules 3 times day for six weeks and then you can lower it to once a day.

Optimize thyroid function. Natural Armour thyroid (or compounded T3), thyroid hormone (by prescription) has been shown to be very helpful in treating depression in two separate studies — even when thyroid blood tests were normal! Taking the thyroid hormone helped even when Prozac failed. Interestingly, only the forms of thyroid mentioned above (i.e. which contain T3 thyroid hormone) helped. The T4 thyroid hormone found in Synthroid (and most thyroid prescriptions used by non-holistic physicians) was NOT effective.

Be sure to treat other hormonal disorders as well. Suboptimal testosterone and estrogen levels can frequently cause depression and are easily treated by holistic physicians. Excellent ones can be found at www.FibroAndFatigue.com, where I have trained the physicians, or at www.holisticboard.com. These hormonal deficiencies often need treatment even if the tests are low normal.

Happiness 1-2-3! A natural way to enhance your mood! It is also critical that your body has what it takes to make the three key “happiness” neurotransmitters that your body needs. These are serotonin, dopamine, and norepinephrine. B vitamins and magnesium are critical for energy production, as well as for producing the hormones and neurotransmitters that contribute to your feeling good. The good news is that many neurotransmitter enhancers can be found in the “Happiness 1-2-3!” supplement. Unlike most natural antidepressants that contain one or two things that help you feel better, this product combines 12 different treatments in optimal levels — to help get you feeling great again. Many of these are each individually as effective as antidepressant medications in head-on studies.

Let’s review what’s in “Happiness 1-2-3!” beginning with the basics:

B12 and folate/folic acid seem to be especially important, and I believe the term RDA may as well stand for Ridiculous Dietary Allowances. You want at least 600 – 1800 mcg of vitamin B12 and 400 – 1200 micrograms of folic acid a day to be sure optimal levels are getting into the brain where they are needed.

Approximately one third of patients with depression have been found to be deficient in folic acid, and this by itself can cause depression as can B12 deficiency. In addition, these two nutrients together contribute strongly to the production of both serotonin (the “happiness molecule”) and a powerful depression fighting nutrient called SAMe. In fact, studies of high-dose folic acid have shown this nutrient by itself to be as effective as antidepressant medications — but much safer and without side effects.

The B vitamins riboflavin and niacin are critical for energy production.

In fact, these vitamins are key components of the “energy molecules”(like “energy dollars” — wouldn’t it be nice to have your own printing press!) NADH and FADH. Depression is a common symptom of niacin and riboflavin deficiency.

Vitamin B6 levels are generally quite low in depressed patients, and this is especially problematic in women taking birth control pills or estrogen — both of which can deplete vitamin B6 levels. Vitamin B6 is critical in the production of serotonin, dopamine and norepinephrine. Sadly, it is likely that millions of people on Prozac are simply suffering from depression caused by vitamin B6 deficiency.

Magnesium deficiency is the single most important nutritional deficiency in the United States. Where the average Chinese diet contains 650 mg of magnesium a day, because of food processing the average American diet only contains around 250 mg. This contributes to pain, fatigue, and increased risk of heart attacks, depression and numerous other problems, as magnesium is critical in over 300 different reactions in our body. In fact, numerous studies have shown that in areas with higher magnesium levels in the water, heart attack deaths decreased markedly.

Prescription antidepressantslike Prozac, Paxil and Wellbutrin work by raising levels of the neurotransmitters serotonin, dopamine and norepinephrine. Unfortunately, because these medications work by poisoning critical pathways in your body, they are rife with side effects. A much safer and more effective way to raise these neurotransmitter levels is to give your body the building blocks it needs to make them. Serotonin is made from five Hydroxytryptophan (5-HTP), and dopamine and norepinephrine are made from tyrosine. Numerous double-blind (i.e. “gold standard”) studies have shown 5-HTP to be as effective as prescription antidepressants but much better tolerated. Another placebo-controlled study has shown tyrosine to also be as effective as antidepressants without side effects. In addition, if 5-HTP is given without tyrosine, it often stops working after a few months. Giving tyrosine along with the 5-HTP results in long-lasting improvement.

I would note one caution though. If taken with serotonin-raising antidepressants and medications, 5-HTP and St. John’s Wort can raise serotonin too high. This would reflect as a high pulse and sometimes anxiety.

If you have a rapid pulse for no reason, ask your holistic practitioner to lower the dose of serotonin and epinephrine-raising medications (even if not on the herbal) and stop the herbal and see if it resolves. This side effect is much more commonly caused by combining medications than by theherbals — another good reason that your holistic practitioner opts for these natural therapies.

Most of you have heard of St. John’s Wort, and 25 double-blind studies with a total of over 1500 patients have shown it to be as effective as prescription antidepressants — without the side effects. In addition to being effective in eliminating depression, it also helped sleep, anxiety and low self-esteem.

Magnolia bark has a long history of use in traditional Chinese formulas that relieve anxiety and depression without leaving you feeling like you’ve been drugged. Magnolia extract is rich in two phytochemicals: honokiol — which exerts an anti-anxiety effect, and magnolol — which acts as an antidepressant. Magnolia has the ability to alleviate depression and stress without sedating you. Dozens of animal studies have shown it is a non- addictive, non-sedating antidepressant — even at low doses.

The good news is you can now effectively eliminate depression without the side effects of antidepressants — naturally! The “Happiness 1-2-3” product, which contains everything discussed above, is available from Health Freedom Nutrition or www.vitality101.com. Begin with three capsules three times a day (unless you are also on antidepressants, in which case I usually only give two to three capsules twice a day in my practice). Although some effect is seen within two to three weeks, the effects continue to powerfully increase over six weeks with continued use. Once your depression is under control, the dose can then be lowered, and you can ask your physician about tapering off of your antidepressants (which should not be stopped suddenly or you can go through withdrawal). With “Happiness 1-2-3” and a natural treatment approach, it’s time to say goodbye to Prozac and depression.

Important points: To help eliminate depression naturally:

1. Optimize nutrition with the “Energy Revitalization System” vitamin powder and B Complex (1/2 – 1 scoop a day as feels best).
2. Go for a 45 or more minute walk (outside so you also get sunshine) daily.
3. Optimize thyroid (using T3 thyroid hormone) and estrogen and testosterone levels using bio-identical hormones.
4. Fish oil (Eskimo 3 or Nordic Naturals) three caps or one teaspoon 3x day for six weeks then once a day, or eat salmon or tuna 3+ times per week. Fish oil is very helpful for depression.
5. Take Happiness 1-2-3! Use only two caps two to three times a day if on antidepressant medications. Otherwise, three caps 3x day for six weeks. Then you can lower the dose when the depression lifts.
6. Check a DEXA scan for osteoporosis, as osteoporosis is more common in depression. Osteoporosis is fairly easy to treat naturally though.
7. Give these treatments six weeks to begin working.

Depression now affects one in ten adults in the U.S. and is projected to be the second leading cause of disability in the world by the year 2020. Depression is also one of the leading causes of workplace healthcare expense, costing employers and employees billions of dollars in medical costs, absenteeism, and presenteeism. Attempts to find a medication to treat depression have been going on for over 50 years with surprisingly poor results. Some evidence indicates that response rates to the top medications are often as low as 17 percent and about 63 percent of patients experience side effects such as anxiety, insomnia, weight gain, sexual dysfunction and thoughts of suicide.

In 2013 there was a double-blind, placebo-controlled study comparing curcumin to Prozac and curcumin was just as effective, but without the potentially harmful side effects. Over time most prescription medications lose their effectiveness while producing ever-increasing negative side effects. Curcumin, on the other hand, has increasingly beneficial side effects including improved attentiveness, better sleep, emotions and learning. It accomplishes this through the increase of norepinephrine, serotonin and dopamine as well as the reduction of inflammation in the brain.

It should be noted that the curcumin used in the above mentioned study was a special form of curcumin called BCM-95. The form is seven times more bioavailable than any other form of curcumin.

There are some even more significant positive side effects or benefits to taking curcumin beyond its ability to improve brain function. Curcumin also suppresses the growth of inflammatory cells in our joints, thus helping to prevent and even reverse many cases of osteoarthritis. By preventing the breakdown of joint-lining cartilage curcumin has even been shown to provide significant relief for people with rheumatoid arthritis, a genetic and more difficult to treat disease.

And finally, curcumin may very well be one of the leading natural methods for the prevention and the treatment of cancer. Scientific evidence has shown the ability of curcumin to help in the following types of cancer: breast; uterine; cervical; prostate; brain; lung; throat; bladder; pancreas and gastrointestinal. Curcumin actually has been shown to intervene and disrupt cancer at virtually every stage of its development. It achieves this primarily through the suppression of inflammation, which is one of the major contributors to most forms of cancer. By preventing the proliferation, migration and thus the very survival of cancer, curcumin helps the body's natural defense mechanisms, as well as the conventional and the natural treatments that have been proven to kill cancer cells. This natural compound derived from the spice turmeric deserves serious consideration for the treatment of depression as well as the other chronic diseases mentioned here.

Depression is an increasingly common issue in the United States. The Centers for Disease Control in 2010 estimated that 11.1 percent of the American population suffers from significant depression — a whopping 35 million individuals — and this figure seems to be steadily rising. Prescribed mood modifiers are everywhere, starting as early as elementary school and continuing on into old age. How successful are these pharmacologic approaches? Not very. Optimistic estimates maintain that such interventions are reasonably successful in only one half of those treated. Less optimistic observers note that in those currently taking an SSRI (selective serotonin reuptake inhibitor) antidepressant drugs such as Prozac, despite a host of side effects, most do not attain relief. Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy; they obtain better results with, for instance, tai chi.¹ For major depressive disorder, a condition for which one would think that pharmacological treatments would win out over nonpharmacological therapy, it turns out that nonpharmacological therapy not only is just as effective, but also involves far fewer adverse events.^2,3

The causes of depression and mood disorders remain an area of controversy. Human beings are prepared to react to vastly varied environmental factors. Not surprisingly, many biological and psychological factors cut in more than one direction. Metabolic factors (inflammation, insulin resistance, and oxidative stress) are not necessarily one-direction in terms of causation, for example, with regard to emotional and physical stress and the resulting stress hormones (glucocorticoids). Sex hormones (testosterone, estrogen), likewise, both influence and are influenced by emotional and physical factors.

Is Inflammation the Central Issue?
The concept of inflammation in the last few years has been stretched to cover more and more forms of illness and dysfunction. One reason is that inflammation is actually a set of responses that occur naturally all the time, yet each of which can itself escape proper regulation. You get a sense of this from the article on inflammation available online from Wikipedia: “Inflammation is a protective response that involves immune cells, blood vessels, and molecular mediators. The purpose of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.” Inflammation thus involves both destruction and repair.

A number of researchers are looking into the issue of neuroinflammation outside of the traditional medical areas of concern, such as stroke. For instance, psychological stress has been demonstrated to increase neuroinflammation in animal models.⁴ Similarly, there is evidence to support the position that links chronic depression to chronic brain inflammation and acute depression to stress-triggered neuronal microdamage.⁵ Another line of argument is that the “metabolic syndrome and its individual components induce a proinflammatory state that damages blood vessels. This condition of chronic inflammation may damage the vasculature of the brain or be directly neurotoxic.”⁶

Countering Depression without Drugs
Inflammation and the metabolic syndrome are closely linked in physiology and biochemistry. Therefore, it should not come as a surprise that studies on obesity, diet and exercise habits often turn up implications for preventing and treating depression. For example, a large study of 15,093 people published in 2015 indicated that depression could be linked with nutrient deficits. The best results were found with two essentially Mediterranean-style diets. These diets overlapped in terms of foods such as omega-3 fatty acids, vegetables, fruits, legumes, nuts and moderate alcohol intake. Another finding was that there apparently is a threshold effect, meaning that a certain level of protective foods needed to be in the diet, but that benefits in terms of reduced risk of depression plateaued after this threshold was passed.⁷

It is difficult to find many nutrients that can be given as dietary supplements that cross the blood-brain barrier. Many of the nutrients that are of use are from berries. Pterostilbene, but not resveratrol, is a potent neuromodulator in aging and Alzheimer’s disease.⁸ “Blueberry, strawberry, blackberry, grape and plum juices or extracts have been successfully tested in cognitively impaired rodents. Published trials of the benefits of grape and blueberry juice in the treatment of small numbers of cognitively impaired persons have recently appeared.”⁹ Another potentially useful item in this regard is the Chinese herb known as blue dogbane, Apocynum venetum. This interesting item, virtually unknown outside of Asia, exerts proven anti-depressant effects, in part, via brain monoamine levels and the dopaminergic system. The latter, again, is influenced by pterostilbene, but not resveratrol.¹⁰ Of importance regarding the impact of Apocynum venetum on inflammation is its high content of the potent antioxidant / anti-inflammatory, isoquercitrin.¹¹

A complementary option to the foregoing nutrients is to reduce the impact of stress. Phosphatidylserine (PS) supports the brain’s physiological processing of stress and promotes neuronal communication by its effect on cell membrane fluidity. It is a natural phospholipid that is an essential component of cell membranes. PS promotes brain function by increasing neuronal membrane fluidity (cell-to-cell communication), resulting in improved cognition. Also, PS protects against stress by mitigating the actions of cortisol (catabolic stress hormone.) Human research routinely demonstrates these benefits and suggests the usefulness of a combination with DHA, e.g., “The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.”¹²

Finally, there is the issue of the relation between Alzheimer’s and sugar consumption. In old age, there tends to be an increasingly significant association between forms of cognitive impairment and depression. Some believe there’s a connection between sugar intake and Alzheimer’s disease. There are a number of theories as to why this might be. One argument is that increased consumption of simple carbohydrates leads to blood brain barrier degradation and subsequently to damage to the hippocampus.¹³ A related argument is that increased consumption of simple carbohydrates leads to elevations of specific advanced glycation end products (AGEs), especially the neurotoxic methyl-glyoxal derivatives (MG). High levels of AGEs also are correlated with reduced insulin sensitivity in older human adults. These factors promote chronic oxidant stress and inflammation in the brain.¹⁴

Endnotes:

1. Lavretsky H, Alstein LL, Olmstead RE, Ercoli LM, Riparetti-Brown M, Cyr NS, Irwin MR. Complementary use of tai chi chih augments escitalopram treatment of geriatric depression: a randomized controlled trial. Am J Geriatr Psychiatry. 2011 Oct;19(10):839–50.
2. Gartlehner G, Gaynes BN, Amick HR, Asher G, Morgan LC, Coker- Schwimmer E, Forneris C, Boland E, Lux LJ, Gaylord S, Bann C, Pierl CB, Lohr KN. Nonpharmacological Versus Pharmacological Treatments for Adult Patients With Major Depressive Disorder [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Dec.
3. Gartlehner G, Gaynes BN, Amick HR, Asher GN, Morgan LC, Coker- Schwimmer E, Forneris C, Boland E, Lux LJ, Gaylord S, Bann C, Pierl CB, Lohr KN. Comparative Benefits and Harms of Antidepressants, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016 Feb 9. [Epub ahead of print]
4. Barnum CJ, Pace TW, Hu F, Neigh GN, Tansey MG. Psychological stress in adolescent and adult mice increases neuroinflammation and attenuates the response to LPS challenge. J Neuroinflammation. 2012 Jan 16;9:9.
5. Wager-Smith K, Markou A. Depression: a repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition? Neurosci Biobehav Rev. 2011 Jan;35(3):742–64.
6. Cherniack EP. A berry thought-provoking idea: the potential role of plant polyphenols in the treatment of age-related cognitive disorders. Br J Nutr. 2012 Sep;108(5):794–800.
7. Sánchez-Villegas A, Henríquez-Sánchez P, Ruiz-Canela M, Lahortiga F, Molero P, Toledo E, Martínez-González MA. A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. BMC Med. 2015 Sep 17;13:197.
8. Chang J, Rimando A, Pallas M, Camins A, Porquet D, Reeves J, Shukitt- Hale B, Smith MA, Joseph JA, Casadesus G. Low-dose pterostilbene, but not resveratrol, is a potent neuromodulator in aging and Alzheimer’s disease. Neurobiol Aging. 2012 Sep;33(9):2062–71.
9. Cherniack EP. A berry thought-provoking idea: the potential role of plant polyphenols in the treatment of age-related cognitive disorders. Br J Nutr. 2012 Sep;108(5):794–800.
10. Zheng M, Fan Y, Shi D, Liu C. Antidepressant-like effect of flavonoids extracted from Apocynum venetum leaves on brain monoamine levels and dopaminergic system. J Ethnopharmacol. 2013 May 2;147(1):108–13.
11. Butterweck V, Nishibe S, Sasaki T, Uchida M. Antidepressant effects of apocynum venetum leaves in a forced swimming test. Biol Pharm Bull. 2001 Jul;24(7):848–51.
12. Vakhapova V, Cohen T, Richter Y, Herzog Y, Kam Y, Korczyn AD. Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study. Dement Geriatr Cogn Disord. 2014;38(1–2):39–45.
13. Hsu TM, Kanoski SE. Blood-brain barrier disruption: mechanistic links between Western diet consumption and dementia. Front Aging Neurosci. 2014 May 9;6:88.
14. Cai W, Uribarri J, Zhu L, Chen X, Swamy S, Zhao Z, Grosjean F, Simonaro C, Kuchel GA, Schnaider-Beeri M, Woodward M, Striker GE, Vlassara H. Oral glycotoxins are a modifiable cause of dementia and the metabolic syndrome in mice and humans. Proc Natl Acad Sci U S A. 2014 Apr 1;111(13):4940–5.

Whenever a woman is considering some form of contraception, her doctor will immediately offer her a smorgasbord of options. Of course, the Birth Control Pill made with a combination of estrogen and progestins will usually be the first recommendation. But, she could also choose an implant called Nexplanon®, a tiny, thin rod about the size of a matchstick that is surgically implanted under the skin of the upper arm, releasing progestin for up to four years. Or, perhaps, she would prefer the NuvaRing®, a small, flexible ring containing estrogen and progestin inserted into the vagina and removed after three weeks and a new ring inserted one week later.

The choices keep coming. There is always the Depo shot (AKA Depo-Provera), an injection of progestin that prevents ovulation for up to three months. For women who prefer something other than the Pill or inserted devices, there is the Xulane® Patch (which replaced the Ortho Evra birth control patch now only available in Europe and Canada). The transdermal patch sticks to the body and releases synthetic estrogen and progestin hormones directly through the skin. It works mainly by preventing the release of an egg (ovulation) during your menstrual cycle. A new patch is used each week for three weeks and a week with no patch (during your period).

A Little Secret About All Hormonal Contraceptives
The two main ingredients in hormonal contraceptives are either a combination of estrogen and progestin (a synthetic form of the natural hormone progesterone) or progestin-only contraceptives. There are well-noted "minor" side-effects experienced by many women that include breast tenderness, weight gain, skin and acne issues, hair loss, increased facial hair growth, nausea, nutrient depletion, mood swings, vaginitis, varicose veins and decreased libido.

Major mood changes including depression, anxiety, irritation, and angry outbursts are commonly experienced. A study published in JAMA Psychiatry found that women using hormonal contraception faced a 23 percent greater incidence of developing depression and greater use of antidepressants than women who did not use the drugs. Among teens using these contraceptives, that rate nearly doubled.

However, there are even more serious problems. The hormonal combinations increase the risk of blood clots, strokes, heart attacks, migraines, high blood pressure, gall bladder disease, benign liver tumors, decreased bone density, infertility and yeast overgrowth. They alter the vaginal environment making it more hospitable to sexually transmitted diseases. Birth control pills adversely affect the beneficial microbiome in the intestines, which means a women is more susceptible to yeast overgrowth, has lower immunity and more frequent infections.

Using hormonal contraceptives is playing Russian roulette with your health. These hormone combinations increase the levels of clotting factors and are responsible for a three-to four-fold increase in the incidence of blood clots. The FDA warns that the patch version poses an even greater risk because the level of estrogen absorbed from the patch is 60 percent more than the amount delivered by the pills. A blood clot can occur in a leg (deep vein thrombosis) or in the lung (pulmonary embolism) and can lead to death.

The most alarming, yet least known, problem is the fact that estrogen and progestin can cause cancer. Both the World Health Organization's cancer agency, the International Agency for Research on Cancer and the National Toxicology Program have listed estrogens and progestins as known human carcinogens. What this means is that taking any of the hormonal contraceptive choices will increase the risk of developing breast, cervical, uterine, ovarian, or liver cancers. And, the younger the age of a woman when she begins using them, the greater her lifetime risk.

Modern women are caught in a terrible dilemma. While they want to control their fertility, they don't want to have to gamble with their health.

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Françoise Farron, PhD, an outstanding biochemist, earned her degree from New Your University Medical School and went on to work at Harvard Medical School, studying control mechanisms of cell growth, as part of a larger program designed to understand the phenomenon of uncontrolled growth in cancer cells.

Francoise knew of the contraceptive formula since her own reproductive years; she used it and it worked for her. But she was not going to abandon her fascinating and successful studies at Harvard to go into the birth control business—until tragedy struck. Her friend's daughter suddenly died from a blood clot while using the NuvaRing®. At that juncture, Francoise felt a personal obligation to bring her discovery of a safe contraceptive to market, to make it available to all women who wanted to avail themselves of its unique advantages.

Smart Women's Choice, is a novel approach to effective protection from unwanted pregnancies and works in an entirely different way from hormone-based birth control methods.

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No fertilization = No pregnancy

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Women around the world who have decided to use Smart Women's Choice are delighted with its effectiveness in preventing unwanted pregnancies and a total absence of ill side effects.

Smart Women's Choice has been selling for over three years with a terrific track record. More than 1,500 women have been using SWC with no pregnancies reported so far.

Pharmacist, nutritionist and author, Ross Pelton, RPh, CCN recommends Smart Women's Choice. "I have been a long-time supporter of women's health issues. One of my concerns is the side effects caused by birth control pills. Consequently, I authored 'The Pill Problem,' which teaches women how to prevent the side effects from birth control pills. A safe form of contraception for women would be of tremendous worldwide health benefit to women (and their spouses if women are avoiding the side effects of BC pills & IUDs). I am happy to report that a safe form of contraception for women has been developed. It is named Smart Women's Choice. It works by causing the entire ejaculate to coagulate. Thus, the sperm are prevented from traveling up the fallopian tubes where fertilization takes place. The coagulate exits the vagina at the end of the intercourse and then rinse with water. It is easy and pleasant to use."

How To Use Smart Women's Choice
Using it is as simple as one, two, three!

Step 1: Squeeze approximately one inch of Smart Women's Choice birth control gel onto your middle finger.

Step 2: Insert into the vagina immediately before having sex. It helps lubricate for comfort, too. If you have sex repeatedly in short succession, you have to reapply SWC every time.

Step 3: After completion, just rinse with water to restore the vagina to its normal acidity.

Women Deserve a Safe, Non-Hormonal Alternative!
Ever since the Pill was first released in 1960, it has been fraught with serious side effects. Some of them have even been fatal. Women were forced to make the difficult decision, Use the Pill or some other hormone-based contraception and take your chances with the many uncomfortable side-effects and potentially dangerous consequences or risk an unwanted pregnancy. It has taken almost 60 years to find a truly safe natural contraceptive. Dr. Francoise Farron, a fiercely determined woman, has been passionate about her mission to save the lives of women worldwide. After years of research, she has succeeded in bringing her vision of a truly safe and effective, non-hormonal contraceptive solution, called Smart Women's Choice, into the world. As usual, it takes a woman! To learn more go to smartwomenschoice.com.

The essential GLA (gamma linolenic acid) is not just your ordinary Smart Fat. Distinctively different than thyroid-targeting coconut oil, GLA is a multitasking essential fatty acid that activates brown fat to effortlessly burn calories from heat. Our bodies need to get GLA from foods because we cannot manufacture this essential fatty acid without an outside source. GLA has proven benefits to ignite a slow metabolism and is a healer for PMS, bloating, depression, diabetic neuropathy, morning stiffness, and skin conditions like psoriasis and eczema.

As far back as the 1980s, many studies focused on GLA as a natural aid to weight reduction. They were published in prestigious medical journals such as the New England Journal of Medicine. These reports documented GLA's definite promise in the battle of the bulge.

Prostaglandin Power
GLA regulates metabolic functions all the way down to the cellular level, helping the cardiovascular, immune, and reproductive and central nervous systems through its prostaglandin pathways.

Prostaglandins are short-lived hormone-like substances that regulate metabolic processes throughout the body. They were discovered over 60 years ago in the prostate gland, hence the name "prostaglandins." Today, prostaglandins are included in a larger group of hormones known as eicosanoids. So profound is the ability of the essential fats to transform themselves into these substances that the 1982 Nobel Prize in medicine was awarded to scientists in prostaglandin research.

Prostaglandins can only be made from two essential Smart Fats, GLA, an omega-6, and EPA, an omega-3 fat. These two are the direct prostaglandin building blocks. Together they form an unbeatable combination and ideally should be consumed in a one-to-one ratio since so many overweight individuals are GLA deficient based upon essential fatty acid testing.

All That And Fat Burning, Too!
Our Smart Fat produced prostaglandins have far reaching implications. They control inflammation, blood clotting, blood pressure, tumor growth, brain function and allergies. They soothe skin, promote healing and regulate water loss. Their natural anti-inflammatory properties reduce pain, swelling and redness. They are burned off much more quickly than other fats and their biochemical structure easily permeates cell walls, making them flexible and less rigid and stiff, thereby inhibiting overeating because of more rapid satiety. Other GLA attributes include stellar skin protection to moisturize internally and diminish symptoms of eczema and psoriasis; reduction of excess inflammation and alleviation of morning stiffness; support of healthy cholesterol and relief of PMS, perimenopause, and menopausal symptoms; and alleviation of hangover and substance abuse symptoms.

The series one prostaglandins created from GLA are believed to regulate many aspects of metabolism. GLA-induced prostaglandins regulate brown fat by acting as a catalyst to either turn it on to trigger calorie burning or turn it off to trigger calorie conservation. Prostaglandins are also connected to a metabolic process referred to as ATPase. ATPase is also known as the sodium pump, a biochemical process necessary to keep the right amount of potassium inside cell walls and too much sodium out. GLA-rich substances like black currant seed oil, by means of prostaglandin activity, control the sodium pump, which in turn revs up metabolism.

When GLA is in the diet, it operates as a remarkable fat-burning agent when it triggers brown fat calorie burning and the sodium pump. Brown fat is also known as brown adipose tissue or BAT. It gets its color from the many fat-burning mitochondria it contains. It only comprises 10 percent or less of total body fat, yet it can burn one-fourth of the calories burned by all other fat tissues combined. In a similar way, GLA can stimulate the sodium pump to use up to nearly 50 percent of the body's total calories.

In 2009 a flurry of new studies about fighting fat came out that were heralded as the "newest obesity theory," claiming that brown fat was a potent regulator of metabolism and weight. The research said that brown fat was deficient in overweight people and was primarily activated by cold.

I remember shaking my head about this new obesity theory because I had written about brown fat back in 1988 in connection with GLA. Since the new research, the scientists completely overlooked the role of GLA, which stimulates brown fat activity, through its prostaglandin pathways.

And while omega-6s as a whole have gotten a bad rap, their reputation is not quite justified. The issue is that GLA's raw materials, the linoleic-acid containing safflower, sunflower, soy and corn oil, are possible, but not always probable, precursors. Possible—because under ideal conditions they should easily be converted into the powerful prostaglandins that have all the healing and metabolic benefits.

The problem is these typically refined and processed oils are further blocked from converting into the biologically potent prostaglandin, which make them biologically worthless to the human body. A number of dietary and lifestyle conditions like a lack of enzymatic cofactors such as niacin, B6, vitamin C, magnesium and zinc as well as the presence of transfats, excessive saturated fats, or alcohol in the diet, impairs the delta-6-desaturase enzyme charged with the transformation process. (The same metabolic suspects, by the way, are in play, which can impair the transformation of the omega-3 alpha-linolenic acid into EPA.)

Since food sources cannot always convert into GLA on their own, you are much better off taking GLA in supplemental form from borage, evening primrose or black currant seed oil with two exceptions: hemp seed oil (not marijuana but from the same plant) and spirulina, a blue green microalgae. Hemp seed oil contains "pre-formed" GLA with a perfect blend of omega-3s.

If you prefer to take a supplement, my recommendation is the GLA from black currant seed oil. Because of all the pre-formed GLA sources, it is the best balanced with omega-3s as part of its makeup. Perhaps most interesting of all is the hypothesis that GLA, like other fatty acids, has the potential to elevate levels of serotonin, the "feel good" brain chemical which contributes to the feeling of fullness. By elevating serotonin, you will feel calmer and satiated sooner. So not only does GLA have the ability to increase the body's metabolism and burn fat, but it may also work as an appetite suppressant as well.

Want to know how to get more GLA in your life for a metabolic kick?

1. Nibble on hemp "hearts" (seeds) and drizzle hemp seed oil. Hemp is a great tasting source of balanced omega-6 and omega-3, and also contains vitamin E. Nutty and full of flavor; the hemp seeds are great snacks and make a smoothie nice and creamy. The oil is perfect over veggies and salads. Besides spirulina, which can be taken as a supplement or sprinkled in powder form in a smoothie or green drink, hemp seeds and oil are the only direct preformed food sources of thermogenic GLA.

2. Take supplements of ready-made GLA. Found in black currant seed oil, borage or evening primrose oil for stronger GLA power, I recommend 360 to 900 mg daily.

CLA – The Tummy Fat Blaster

CLA (conjugated linoleic acid) has profound fat loss and healing benefits. CLA helps reduce body fat while retaining lean muscle mass, a ready-made innate calorie burner. It is also considered a necessary fatty acid for both cell growth and as a building block for cell membranes.

To date, there are over 500 published studies on this previously unrecognized nutrient. The first human clinical trial using CLA was conducted in 1997 in Norway. It was a 90-day double-blind clinical study that showed a stunning 20 percent decrease in body fat, with an average loss of seven pounds of fat in the group taking CLA. These results were achieved without a single change in dietary habits, establishing CLA supplementation for the first time as a simple, effortless weight loss tool.

In addition to the ability to reduce body fat, CLA has also been shown to increase lean muscle mass. In this same study, although participants lost body fat, they experienced very little change in overall body weight due to the increase in lean muscle mass. The end result was a stronger, healthier body.

CLA is also a powerful tool for anyone who finds themselves with weight gain over the holidays. In 2006 researchers studied 40 healthy but overweight subjects over a period of six months. Over the holiday season, the placebo group displayed a greater rate of weight gain; while the CLA group showed significantly reduced body fat of around 2.2 kg over the six month period.

Cellulite be gone! Did you know that biopsies of cellulite demonstrate that unlike fat in most other areas, the fat within cellulite is actually inflamed? This type of inflammation speeds up the breakdown of collagen and contributes to that puckered-up, orange peel look we all dread. Studies also show that CLA increases strong and healthy collagen and prevents fat cells from accumulating even more fat and swelling up. And, both ultrasound and visual examination has proven that CLA can markedly reduce the appearance of cellulite.

CLA occurs naturally in grass-fed dairy foods—especially cream, butter and full-fat cheese. It is also found in beef and lamb. Before the 1970s, Americans got plenty of CLA by eating these Smart Fat-filled foods. Today we are getting next to no CLA because livestock is rarely grass-fed anymore, which decreases CLA levels by about 80 percent.

To compound this deficiency, over the past 70 years many misguided Americans on low- or no-fat diets have stopped eating these dietary sources of CLA. While adding grass-fed dairy and meats back into your diet is highly recommended for a variety of health reasons, there are other ways to get more potentized CLA into your body. Science has been able to create CLA from the linoleic acid found in sunflower and safflower oils. Today CLA is available as a convenient dietary supplement.

Smart Tips: CLA
Want to increase your CLA to rev up metabolic rate?

1. Eat CLA-rich grass-fed beef and pastured butter and cream. Also be on the lookout for grass-fed, non-denatured whey.
2. Consider CLA supplements from conjugated safflower or sunflower oil. I recommend 3,000 mg daily. But, just be careful. With many of my clients, you lose weight so quickly you will go down a pants size or two in no time!

GLA vs. CLA: What's the difference you ask?
GLA (gamma linolenic acid) and CLA (conjugated linoleic acid) are both important fatty acids that will help burn fat to promote weight loss, and help control appetite to prevent weight gain.

They can be taken individually or as a duo to help break down fat.

• GLA raises your metabolism by stimulating brown fat (adipose tissue) in the body to burn calories for energy.
• CLA especially targets visceral fat (found deep within the abdominal area) and is helpful for burning belly fat while increasing lean muscle mass.

Menopause is the term used to describe the progressive cessation of menstruation in a woman over time. Menopause typically occurs after a woman’s child-bearing years, between the ages of 45 and 50. Some women, however, experience it as early as 35 and as late as 60 years old. The process of menopause can last for two to six years, during which time a woman’s hormone levels change due to the reduction in the production of estrogen and progesterone in the ovaries as they cease to produce eggs. Physiologically, menopause marks the end of a woman’s childbearing capacity and is a part of her natural aging process.

Dear Readers,

Welcome to the June 2017 issue of TotalHealth Online.

We begin with "Stocking Your Kitchen For Success," by Ann Louise Gittleman, PhD, CNS. In this first of a series of previews from her book, The NEW Fat Flush Plan—a full update of the New York Times Best Seller—she shares her preferences for cookware, knives and other handy items for a successful kitchen experience.

Dallas Clouatre's, PhD, article, "Herbs For Rest And Relaxation," lays out a convincing case for changes to our addiction to coffee. He explores a list of herbs, which will help to cut down and eventually kick the coffee habit. And your body will thank you for it.

Christine Horner, MD, in "Female And Over 40? Two Health Mistakes To Avoid—For Radiant Health, Ageless Beauty," discusses Relizen, a product introduced in the U.S. several years ago. To date, over one million women worldwide have used this supplement with great satisfaction; and it is currently the number one non-hormonal menopausal product used in France.

Elson Haas, MD, continues from last month's topic sugar, with "Sugar Health And The Glycemic Index." Haas discusses the history and politics of sugar. You can't get away from it, however, you can create an awareness of its influence. And make a difference in your loved ones lives. He Includes his basic glycemic index to start you off.

Gene Bruno, MS, MHS, RH(AHG), in "The Importance Of Minerals: For Bone & More," covers the key nutrients, calcium, magnesium, and zinc, potassium and others. For all those concerned (men and women) with bone density don't miss Bruno's article.

Gloria Gilbère, CDP, DAHom, PhD, presents "Roasted One-Dish Meals," a recipe you can adapt with your favorite veggies for this one-dish meal which is based on no nightshades!

In "A Natural Treatment for Depression-Curcumin," Charles Bens, PhD, discusses a recent study showing Curcumin as effective as Prozac and without the side effects.

Are you ready to be able to get 8–9 hours of solid sleep a night? Jacob Teitelbaum, MD, can help you with "Get Great Sleep—Naturally!" He tells us for a fact it is possible to get eight hours of solid sleep a night. And this article shows us new treatments for optimizing sleep—naturally.

Sherrill Sellman, ND, in "A Safe Personal Lubricant to Protect, Heal and Restore vaginal Health," calls attention to a product she recommends for women—who through aging, menopause or other reasons may be seeking relief for dryness and discomfort.

Shawn Messonnier, DVM includes our pets with "Ginseng Use For Pets."

Best in health,

TWIP The Wellness Imperative People

Click here to read the full June issue.

• Stocking Your Kitchen For Success
  Ann Louise Gittleman, PhD, CNS
• Herbs For Rest And Relaxation
  Dallas Clouatre, PhD
• Female And Over 40? Two Health Mistakes To Avoid For Radiant Health, Ageless Beauty
  Christine Horner, MD
• Sugar Health And The Glycemic Index
  Elson Haas, MD
• The Importance Of Minerals: For Bone & More
  Gene Bruno, MS, MHS
• Roasted One-Dish Meals
  Gloria Gilbère, CDP, DAHom, PhD
• A Natural Treatment for Depression-Curcumin
  Charles K. Bens, PhD
• Get Great Sleep—Naturally!
  Jacob Teitelbaum, MD
• A Safe Personal Lubricant To Protect, Heal And Restore Vaginal Health
  Sherrill Sellman, ND
• Ginseng Use For Pets
  Shawn Messonnier, DVM