Category Archives: functional medicine

Now I have Type 2 diabetes what am I supposed to eat?

source- Canstock photos

It comes as no surprise that one of the first questions someone newly diagnosed with type 2 diabetes asks is “What am I supposed to eat?”.

Let’s face it you’ve probably heard over and over again that type 2 diabetes is a ‘disease of lifestyle’. And lifestyle commonly involves food. When it comes to the food choices we make there is a lot of emotional charge attached to that. For some, it may be the way that they have eaten since they were children and this is the only way they know how to eat. Food is a connecting force between us.

So, a common answer someone diagnosed with type 2 diabetes may receive about what to eat from their healthcare provider may sound something along the lines of ‘eat healthy portion sizes, increase fruits and vegetables, cut down on processed foods’. And all these answers are great recommendations.

You’d think it seems pretty easy right to go out there and, ‘eat healthy portions, increase your fruits and vegetables, and cut down on processed foods’. But we know that’s not really what happens.

A lot of people struggle with food choices. Perhaps that’s why we have such a growing epidemic of borderline diabetes and type 2 diabetes.

Over the course of my 20 plus years as a physician, I have encountered some really strange interpretations of what a ‘healthy diabetic diet’ means to different people. Let’s face it, the amount of information out there on the internet does not help either.

So when I address the topic of what to eat with anyone diagnosed with type 2 diabetes I start by helping them to normalize their experience. Take a deep breath. This is not a punishment for what you have done wrong. And yes, you can make a choice starting today to do things differently.

My invitation is to consider that diabetes eating is healthy eating.

I intend to give a TED talk with that title because it’s something I passionately believe. If everyone diagnosed with type 2 diabetes looked at this as a way their body was inviting them to eat healthier we wouldn’t have people walking around feeling victimized.

The great news is that by making these changes to how you eat, it is possible to halt the progression of borderline diabetes, type 2 diabetes and worsening metabolic health.

Change can be stressful. So I often start by advising you take simple small steps.

This will help bypass the gargantuan alarm signals to your primitive brain- the amygdala which ends up keeping you from making any change smack in the middle of your comfort zone.

So back to the question -where do you start?

The Mediterranean diet

The Mediterranean diet is a great starting point when it comes to making some healthy changes to what you eat. The traditional mediterranean diet attracted interest because people who were living on the Greek Island of Crete had less heart disease.

What makes up the Mediterranean diet

  • whole grains
  • fruits and vegetables
  • extra virgin olive oil
  • modest amounts of poultry, red meat and fish
  • nuts
  • legumes (beans, peas etc)
  • red wine

The Mediterranean diet has been extensively researched. Over 50 studies have shown that by eating this way there is an improvement in overall metabolic health parameters- reduced waist circumference, improvement in lipid profile, blood pressure, weight and blood sugar levels.

Functional Nutrition

Perhaps you want to go a step further and you want to develop an empowered relationship to food.

Food can be used as a powerful tool, to bring about healing. In functional medicine, we call this functional nutrition.

There are several food plans used in functional medicine, each targeting different results.

The cardiometabolic food plan is a step above the Mediterranean diet.

Features of the cardiometabolic food plan

  • low glycemic foods
  • personalized targeted calories
  • helps to balance blood sugars
  • high in fiber
  • low amount of simple sugars
  • a healthy balance of quality fats

One of the exciting aspects of the THRIVE group coaching program, will be working with clients on creating a personalized cardiometabolic food plan designed to optimize their metabolic health.

If you would like more information about joining the program, please send an email to info@doctoreno.com.

Some proven benefits of the ketogenic diet, but is it right for everyone?

canstock photos

I recall when I first started hearing the buzz around going “keto” “ketogenic” ketolife” I was very skeptical. With the roll of my eyes I dismissed it as a soon to be done fad that would blow over. But it didn’t.

After my community talks, I’d have a few people stop by and ask my thoughts on going “keto”. Again, my response would be I thought it was just another fad and would pass away. And oh by the way if you happened to be someone living with type 2 diabetes, this probably was not for you!

How wrong I was on both counts especially the latter.  

Well you know the saying “what you resist persists”?  Keto has persisted. And now it’s becoming mainstream.

The ketogenic diet was developed almost a 100 years ago- in the 1920s- by a faith healer who was trying to help children with epilepsy. There was some success with this diet intevention at the time. However, when drugs were developed for the treatment of epilepsy it fell out of favor.

How does the ketogenic diet work?

The ketogenic diet works by converting the body’s source of predominant fuel from carbohydrates to fats which are the source of ketone bodies predominantly beta hydroxybutyrate. This leads to an increase in the production of energy source -ATP.  

The ketogenic diet is now being used to treat a host of diseases and conditions. In the article below I list some of the benefits of a ketogenic diet.

Improved insulin resistance and reduced inflammation

By utilizing fats as a source of fuel versus carbohydrates there is less need for insulin. This leads to less insulin resistance. Insulin resistance is the hallmark of type 2 diabetes. There is research showing the benefits of a ketogenic diet to reverse pre-diabetes or type 2 diabetes. Insulin resistance is also associated with more inflammation because of an increase in free radical production. Inflammation is linked to a host of chronic diseases such as auto-immune diseases, arthritis, thyroid disease, bowel disorders, mental and cognitive decline (type 3 diabetes). Less insulin resistance=less inflammation, which allows the body to heal.

Improved Fat Burning leading to weight loss
By definition, being in a state of ketosis means you’re burning fat for energy. If you have excess body fat, you’ll be able to burn it at a much more efficient rate. This trend can lead to weight loss. The advantage of using fat as fuel, is that you do not have as much hunger cravings as when you are using carbohydrates as a main source of fuel.

Mood stabilizing effects
A ketogenic diet changes the energy matrix of the body. In the brain, a ketogenic diet helps to modulate mood by not only a reduction in inflammation but also changes in monoamine oxidase levels, GABA transmission, as well as mitochondrial biogenesis.

Improved Energy
Increased energy from a ketogenic lifestyle is due to a combination of factors including less inflammation, upregulation of mitochondrial biogenesis, more ATP per molecule of ketone and more stable blood sugar.

Improved Mitochondrial Biogenesis &Anti-aging
Our bodies are trained to use glucose (sugar) as a natural source of energy.  Our mitochondria are the energy powerhouse of our bodies. With aging, we tend to have less efficient mitochondria. The ketogenic diet helps to stimulate new and stronger mitochondria. Because mitochondria have such a profound impact on energy production, inflammation levels and gene expression (and therefore an overall function of the body), promoting mitochondrial health can be of great benefit when it comes to anti-aging.

How do you know you’re in ketosis?

There are a number of kits on the market which can help you to detect when you are in ketosis. Kits that measure blood levels are more accurate than urine test strips.

How do you know if keto is right for you?

Despite it’s popularity a ketogenic diet may not be safe for everyone. Despite a plethora of websites offering do it yourself keto plans and diets, I highly recommend that you invest in working closely with a qualified healthcare professional who is well versed on what to look out for if you have any of the following conditions:

  • Type 2 diabetes
  • Very high blood triglycerides
  • Severe depression
  • Older adults
  • Cancer
  • Cognitive decline such as alzheimer’s type dementia
  • Certain gene snps such as ApoE4

The next thing to consider is – how long do you need to be on a ketogenic diet?

The reality is that maintaining ketosis for prolonged periods of time can be a challenge for most.

In summary, a ketogenic diet can be a useful tool for helping to improve metabolic health. Be sure to use it under the supervision of a qualified healthcare practitioner who will be able to customize it to your unique goals as well as determine a safe duration of therapy.

To your health and wellbeing,

Scientific citations

A low carbohydrate ,ketogenic diet to treat type 2 diabetes

Veech RL. The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism.

Peer-reviewed papers from Virta health on ketogenic diet and type 2 diabetes reversal

The Women’s Metabolic Health Summit June 12-19 2019

Imagine this, you’re a woman and you’re about to hit or you’re just a little past “the big Five-O”.

Perhaps you’ve raised the kids. You’ve reached the pinnacle of your career. You may have launched that successful business. Or you’re in that sandwich generation- a caretaker for your elderly parents plus raising kids. Whatever the scenario, you’re at a reflective stage in your life and perhaps even in the process of setting new life goals.

And then BOOM! Suddenly something just doesn’t seem quite right? You start going through mood swings, just can’t seem to get control of those “hot flashes”. Hair seems to be growing (or not growing) in the most inconvenient places. And let’s not talk about the sex (what’s that I hear you say?!)

Or maybe, just maybe you go to the doctor and you’re diagnosed with a dreaded chronic illness……

This, cannot be happening to you…..

Currently there are 4 out of 10 Americans living with at least one chronic illness. Some examples of a chronic illness are type 2 diabetes, hypertension, heart disease, arthritis, thyroid disease, auto-immune diseases, arthritis, or cancer, to name but a few.

In my experience as an allopathic physician, it seems that living with a chronic illness seems to suck the very life out of their sufferers. I see it all the time and maybe you have also. People who seem to spend a great amount of time going from one doctor’s appointment to the next, taking medications, some of which cause side effects and all the while really not feeling any better.

Is that a way to live? Do you dread any of these scenarios happening to you?

For some people over 50 this is their reality. But it does not necessarily have to be yours.

My premise is that you can make a conscious choice to THRIVE in your golden years. And it has been proven over and over again. In my over 20 years as an internal medicine physician I have treated healthy and vibrant nonagenarians (people in their 90s) and even centenarians.

Even if you have been diagnosed with a chronic illness, you can still THRIVE into your golden years.

I recently had the pleasure of taking care of a 103-year-old woman who still cleaned her 8 room house every single day, and until a year ago was still gardening!

I dare to state boldly, that being diagnosed with a chronic illness should serve as an invitation to become deeply acquainted with yourself, and to let your body become your Divine Teacher ….

Even though I am trained as an allopathic physician, this healthcare model has not done such a great job of helping us manage or prevent chronic disease.

So, with that in mind, I decided I was going to mastermind with other experts in the functional health arena. I sent out an invitation and was I amazed at the response!

A lot of our experts have defied a chronic illness and have used functional and integrative ways to heal themselves.

Click here to learn more…

Imagine learning ways to access –

  • -Vital energy
  • -Abundant Health
  • -And yes! The ability to THRIVE well into your golden years

What’s more, you’d be setting an example for your family to follow. And this would become a ripple effect of good health affecting our communities, towns, countries and literally going around the planet! One small change at a time. We indeed are a global village.

Well, you can access all this information from the convenience of your home. And the great news is it is completely FREE!

Grab it Here

From June 12-19 2019, I will be hosting an upcoming interview series called The Women’s Metabolic Health Summit.

In this free series you will learn…

  • Tips for optimizing hormone balance over fifty
  • Why Menopause is not all about hormones
  • How to use spices in every day cooking to increase your metabolism and lose weight
  • The importance of sleep in boosting our metabolism
  • How essential oils can help to heal us
  • The little-known secret to improve your pelvic health and rev up your sex life
  • Making friends with the bugs in your gut
  • The relationship between your mental health and physical health
  • Simple ways relax and be more present (even if you are currently frazzled)

And so much more…

This virtual mastermind of over twenty healthcare experts from around the world will teach you how to honor and grow that ‘inner knowingness’ you possess as a woman.

Imagine as you embark on this next chapter- a life filled with purpose, joy, vitality, peace and presence.

Do you sometimes come across people who seem to effortlessly radiate those qualities? Well so can you. It’s all within your grasp. Click here to join me and make that life yours!

How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,

What Every Woman Needs to Know About Thyroid Disease

The thyroid hormone is secreted by the thyroid gland is responsible for maintaining the body’s metabolism. Every cell in the body is affected by the effects of the thyroid hormone. When there is decreased production of thyroid hormone, this is called hypothyroidism.

When there is overproduction in the thyroid hormone, this is called hyperthyroidism.

Up to one percent of the general population in the United States has clinical hypothyroidism. Ten percent of women have a condition called subclinical hypothyroidism. Hypothyroidism mainly affects women more than men.

There is also a condition where the body forms antibodies that begin to attack the body’s own organs. When this happens in the thyroid gland, this is called autoimmune thyroiditis. Up to 27 percent of women have autoimmune thyroiditis.

Reasons for loss in thyroid function

There are many reasons why thyroid function becomes disrupted. Some of these may include:

  • Stressors – whether mental, emotional or physical stress.
  • Exposure to toxins- At least 150 industrial chemicals have been shown to affect thyroid function. These include pesticides, mercury, lead, etc.
  • Food intolerances or sensitivities.
  • Infections.
  • Certain medications.
  • Autoimmune diseases such as celiac disease
  • Nutritional deficiencies such as iron, selenium, and certain B vitamins.
  • Sleep disorders

Symptoms of hypothyroidism

Some of the common symptoms of low functioning thyroid include:

  • Fatigue.
  • Weight gain or inability to lose weight
  • Constipation.
  • Dry skin.
  • Thinning of the eyebrows (especially the outer eyebrows).
  • Dry and brittle nails.
  • Hoarse voice
  • Puffiness of the face or the extremities.
  • Depression (including postpartum depression).
  • Difficulty concentrating.
  • Morning stiffness.
  • Enlarged thyroid (goiter).

How is hypothyroidism diagnosed?

Hypothyroidism is routinely diagnosed with a screening test called the thyroid stimulating hormone (TSH). However, there is a caveat when using the TSH level alone. The laboratory reference range for TSH is extensive, ranging from 0.50-4.00 mU/L. Because of this wide range, it’s challenging to assess the presence of hypothyroidism even though an individual’s TSH level may be in the normal range, despite them exhibiting symptoms of hypothyroidism.

I like to explain to my patients and clients that everyone has a set point. If their TSH was at one setpoint and then there is a significant change to that number on another blood test, even though it is still in the “normal range” that is a significant change for that person and deserves further investigation.

More specialists particularly functional health practitioners are leaning toward more detailed testing by measuring individual thyroid hormone levels.

How is hypothyroidism treated?

Using the functional medicine approach, treatment for hypothyroidism includes a two-prong approach.

Lifestyle modification:

Here we are looking for any potential factors that may have caused thyroid disorder. This is where a functional medicine practitioner is an excellent resource in helping to uncover possible triggers, nutrition evaluation, exposure to toxins, medications, etc. as laboratory testing. Your functional medicine practitioner will recommend a food plan that will help provide nutrients needed to support thyroid function. If needed you will also be placed on supplements that provide thyroid support It is also essential to focus on ways to reduce stress as well as increase exercise/movement.

Replacement of thyroid hormone

It may also be necessary to replace the thyroid hormone. This can be done with synthetic or natural sources of supplement. Your thyroid health is an essential aspect of your overall health and wellbeing.

If you are experiencing any of the symptoms I have outlined in this article, please be sure to have a conversation with your healthcare provider.

If you would like to know how functional medicine can help optimize your overall health, feel free to schedule a free 15-minute discovery session with me by sending an email to info@doctoreno.com.

Until next time, here’s to your health and wellbeing,

Dr. Eno


Could you have high blood pressure and not even know it?

Hypertension is a very common condition and is also known as high blood pressure.

Hypertension is detected by checking the blood pressure (mm hg)

There are two parts to a blood pressure measurement.

  • The top number is the systolic blood pressure which is the pressure produced in the arteries when the heart pumps blood into the circulation.
  • The bottom number is the diastolic blood pressure and is the pressure measured when the heart relaxes.

Normal blood pressure the systolic blood pressure is less than 120 mm hg and the diastolic blood pressure is less than 80 mm hg. Previously hypertension was diagnosed with a reading 140 over 90.

The American College of Cardiology and American Heart Association recently changed the guidelines for diagnosing hypertension. This means that more people may have hypertension and not even know it.

Elevated blood pressure: 120-129 over less than 80

  • Stage 1 hypertension: 130-139 over 80-89
  • Stage 2 hypertension: over 140 and over 90

Hypertension should be diagnosed not only with the readings obtained when you go to see your healthcare professional, but also with blood pressure readings taken outside the office such as at home or using a special machine called an ambulatory monitoring device which takes the blood pressure several times during the day.

There are several types of hypertension. The most common kind is primary hypertension.

Hypertension increases the risk for damage to the critical organs of the body such as the the heart, kidneys, brain and the peripheral circulation.If your blood pressure falls within the elevated blood pressure range or stage 1 hypertension, your healthcare professional will recommend lifestyle modification such as:

Making changes to your food intake

Too often when people hear or read ‘diet’ they think of restrictions in what they can eat. There is abundant scientific research that shows the benefits of certain foods to reverse or control conditions such as hypertension, heart disease or diabetes.
One example is the mediterranean diet.The mediterranean diet consists of whole unprocessed foods rich in whole grains, fruits, vegetables, nuts, legumes, oils, spices and extra virgin olive oil. There are modest amounts of poultry, fish, red meat and red wine.

Increase physical movement

Exercise not only helps with weight loss, but also the production of nitric oxide which helps to dilate the blood vessels and hence reduce the blood pressure. Exercise also increases the production of endorphins which improves the mood.

Lose weight

If you are overweight or obese, start a plan to gain healthy body weight.
For more information on the difference between overweight and obesity, click here.

Quit smoking

Reduce excess alcohol intake

If you have been informed that you have an elevated blood pressure or hypertension, it may be a time to consider working with a functional health practitioner.

 

My Journey Into Functional Medicine

 

 

 

 

 

 

The Doctor of the Future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease~ Thomas Edison

 

Earlier on in my career as an internal medicine physician, I began to feel dissatisfied with the status quo. I sensed there was something wrong in the delivery of medical care. The 15 minute double booked office appointments only added to my angst and dissatisfaction. Questions plagued me such as:

  • How come my patients kept coming back time after time with the same complaints?
  • How come I was only resorting to pills to help them feel better?
  • How come I didn’t have enough time to educate them about lifestyle modifications?
  • How come those patients diagnosed with a chronic illness like diabetes, hypertension and heart disease suddenly had these ailments become the forefront of their existence spending time going from one doctor to another, filling one prescription after the other?
  • How come as time went on I saw the light in the eyes of a lot of my patients dim; there was almost a sense of resignation. Their lives had become, one doctor visit after the other, after the other.

In 2005, I left the sizeable multispecialty group I was working for in the southwestern suburbs of Chicago and went into private practice with two other business partners. Perhaps I could create a better model of healthcare delivery.

I saw my mission as not only treating acute illness but teaching my patients living with chronic diseases about taking simple small steps toward healthier living.

 

In my time in private practice, I decided to pursue training as a professional coach. I found there was power in guiding people toward possibility, so they see the answers for themselves while holding them accountable for the results they produce. Writing about the power of coaching still lights me up and gives me goosebumps.

I wanted to promote lifestyle interventions, but could not find a model I could incorporate that entirely resonated with the kind of care I was looking to deliver to my patients. Unfortunately, the practice was not going well. There was high overhead while insurance reimbursements were low.

Finally in 2010, after paying back the business loan we had taken out to start the practice, I made a decision to leave. I have been working in hospital medicine since then. Over the last eight years, I have continued to provide health information on my blog and have published and uodated a book for patients on  how to live with type 2 diabetes. But those questions have continued to plague me.

I’ve contemplated going back into private practice, but I wanted to make sure that I created a structure that would support not only my patients but also me.

As a cancer survivor, it is my responsibility to create a space that promotes my healing; where I can thrive and continue to serve my patients.

Well, I am happy to share that I have found that structure in functional medicine. So this is the beginning of my journey into functional medicine, and I am excited to share this  with you.

  • In this video blog, I share what I understand functional medicine to be

 

 

As always I welcome your comments as well as suggestions for topics you may be interested in learning more about.
To your health and wellbeing,