How’s Your Brain Working?

By Mila McManus, M.D.

Dementia, especially Alzheimer’s,  is on the rise. Establishing a baseline of your cognition allows for early detection of trouble to come, and also can alleviate fears of Alzheimer’s.  Many people have cognitive issues such as brain fog, forgetfulness, trouble focusing, and/or a decline in math skills.  Your issues may be related to stress, hormone imbalance, poor nutrition, vitamin deficiencies, vascular disease, food allergies or sensitivities, toxins, insulin resistance, a sleep disorder, or infection in your brain, to name a few.  Cognitive decline CAN be prevented and reversed!  Addressing root causes as early as possible will lead to the best outcomes.  

Memory loss or cognitive decline can be a symptom of other chronic diseases such as Parkinson’s, ALS, stroke, brain tumors, Multiple sclerosis, heart failure, and depression. When a person begins to experience cognitive decline, it is common to experience fear, embarrassment, and anxiety. As a result, it also creates stress and tension with close family members.  At the first signs and symptoms of cognitive decline, it’s important to quickly evaluate the sources and begin appropriate treatment. 

There is a simple and inexpensive test called The Montreal Cognitive Assessment (aka MoCA for short). This highly validated and standardized test allows you to get a baseline assessment of your memory and other aspects of cognition, such as organizing and calculating. The assessment can be repeated periodically to monitor for improvement or worsening of symptoms and disease.

We administer the test at The Woodlands Institute for Health and Wellness and it takes about 15 to 20 minutes. The initial test is $39 and repeat tests are $29.  Don’t put your head in the sand about your brain health! Call (281) 298-6742 and make your appointment today.

By |2021-06-29T07:05:54-05:00June 30th, 2021|Articles, General|

Berkeley Life Professional: Nitric Oxide Suppport

By Mila McManus, M.D.

A Nobel Prize was awarded for the discovery that Nitric Oxide (NO) plays a significant role in the cardiovascular system. NO is naturally made in your body, but as you age you produce less of it. Berkeley Life Professional helps support NO levels for a healthy cardiovascular system by supplementing your diet with dietary nitrates¹.

Berkeley Life Professional’s drug free supplement provides the same dietary nitrates found in plants, as well as key vitamins, to help support NO levels, the cardiovascular system, and overall health and vitality. This supplement is free of allergens including milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, gluten, and gelatin¹.

NO is also found in beets, garlic, leafy greens (spinach, arugula, kale, and cabbage) as well as citrus fruits (oranges, lemons, limes, and grapefruit). These are all good sources of nature-made nitrates, which are different than the harmful man-made chemical additives called sodium nitrate or sodium nitrite.

Talk with your healthcare provide to see if Berkeley Life Professional Nitric Oxide Support is right for you and purchase it here at TWIHW.



By |2021-03-22T11:14:48-05:00April 18th, 2021|Articles, General|

COVID and the flu will continue for now.

By Mila McManus, M.D.

COVID and the flu will continue to be with us for now, so I wanted to remind everyone to please support your immune system and overall health to avoid bad outcomes. I recommend a foundational daily minimum of vitamin D3, a multivitamin, and a quality probiotic. Preventing any illness means staying true to an integrative approach that is attentive to all of the key pillars of your health.  Those key pillars include:

  • A whole food diet and good hydration – maintaining balanced blood sugar is key (did you know that sugar immediately suppresses your immune system for up to several hours?)
  • Moderate exercise
  • Keep the gut healthy – easy on the alcohol, sugar, wheat, and pain relievers, while taking your probiotic and drinking bone broth
  • Get quality rest and sleep
  • Avoid toxins and support detoxification – see gut health above and step into the IR sauna too!
  • Manage stress – take time for quiet meditation, practice yoga and/or deep breathing exercises
  • Make use of appropriate supplementation – see below

For most, a healthy diet still cannot provide adequate nutrition for a strong immune system because of poor food quality, daily stressors, and the toxicity of our world.   For those with compromised immune systems, or who are living and working in higher exposure areas, or traveling, a selection from the following supplements would be wise protective additions.

All of these options, along with common sense measures such as thorough hand washing and avoiding crowds, will help to keep you healthy this year. If you are unsure about which supplements would be best for you, consult with our medical providers for a customized plan that’s right for you.

By |2021-12-10T08:42:47-06:00March 26th, 2021|Articles, General|

What is NAD+?

by Mila McManus MD

Nicotinamide Adenine Dinucleotide (NAD+) is the active form of a coenzyme that is an essential component of chemical reactions that occur in all of our cells. These reactions regulate nearly every bodily process. 

Be careful of other products marketing themselves as NAD.  NAD+, NADH and NR (Nicotinamide Riboside) are not the same. Although NAD+ plays a role in the same pathway as NADH and NR, there are certain NAD+ consuming reactions where only NAD+ can be utilized. In these reactions, NADH and NR are not effective. While NADH and NR are less expensive than NAD+, the positive effects are not nearly as potent as NAD+.

NAD+ is Involved in Two Major Functions:

FIRST: Energy Production. NAD+ helps to turn carbohydrates, fats, and proteins in the body into useable energy via the Citric Acid Cycle (Krebs Cycle). This important chemical reaction results in the production of ATP. ATP is the energy currency of life, powering nearly every biological activity such as muscle contraction, protein manufacturing, and cellular communication.

SECOND: Regulating the Body’s “Stress Response”. NAD+ partners with proteins involved in regulating and preserving health. This includes synthesis and repair of DNA, regulation of circadian rhythms (sleep-wake cycle), and stem cell production.

As we age, levels of NAD+ decrease in our bodies. Scientists believe that by the time we reach our 40’s, the supply of NAD+ is no longer able to meet the demand for important biological processes. Additionally, sickness and disease, as well as environmental and self-induced stressors can rapidly deplete our body of this vital nutrient.

Additionally, low levels of NAD+ may contribute to fatigue, depression, and anxiety. It hinders our body’s ability to overcome the grip of drug and alcohol addiction. Additionally, low levels of NAD+ may contribute to worsening disease states in vital organs such as the heart, liver, and brain. NAD+ depletion weakens our immune system, which affects our ability to fight infection or slow the progression of cancer.

Reasons to consider incorporating NAD+ into your regimen:

  • The aging process
  • Athletic performance
  • Anxiety, depression and PTSD
  • Drug and alcohol addiction
  • Parkinson’s disease
  • Alzheimer’s disease
  • Other forms of Dementia
  • Multiple sclerosis
  • Other neurodegenerative disorders
  • “Chemo Brain”
  • Low energy levels
  • Chronic Fatigue Syndrome
  • Sleep disturbances
  • Chronic pain syndromes
  • Migraine headaches
  • Autoimmune diseases
  • Autoinflammatory diseases
  • Chronic Traumatic Encephalopathy (CTE)

What is the Course of Treatment for NAD+?

Treatment strategies at TWIHW are tailored to your specific needs.

We currently offer treatments consisting of 4-8 hour IV infusions of NAD+. These treatment durations vary based on treatment protocol and allow for a larger amount of NAD+ to be delivered directly to the body’s tissues, allowing depleted stores to be replenished.

For those just looking for a quick “boost”, we also offer reduced dose IV infusions that take only 2 hours.

 What Can I Expect During the NAD+ Treatment?

A brief assessment will be conducted on the day of treatment. For intravenous NAD+, a small IV will be inserted. The infusion will run for approximately 4-8 hours (or 2 hours for the reduced dose treatment). Patients are able to pass the time in our relaxing environment by watching TV, reading, and listening to music. You will also have access to high-speed internet and can bring your laptop for personal use. Water, tea, and coffee are available upon request. Please plan accordingly for meals as needed if doing a longer infusion. Delivery can be made to the facility but we ask that you refrain from any fast food or pizza.

Call our office at 281-298-6742, or visit

When NAD+ IV isn’t possible, consider Tru Niagen as an alternative.

By |2021-03-24T07:09:21-05:00March 24th, 2021|Articles, General|

Who Needs a Ca Score?

By Mila McManus, M.D.

medical stethoscope with red paper heart on white surface
Photo by Karolina Grabowska on

Almost 50% of those who suffer from a heart attack had no known risk factors

Could this be you or someone you love? It is a rather concerning fact since it means many of us could be ticking time bombs without knowing it. Cardiovascular disease remains the number one cause of death in the United States¹, so there is a good reason for all of us to be concerned.

We know that heart attacks ARE preventable. So what can be done to ensure you are not in that 50% who don’t have known risk factors but may have heart attack risk? 

The Calcium Score, also called the Agatston Score, for many experts, has come to be the best predictor of a future heart attack. Determining the Calcium Score is done through CT Scan testing lasting less than 3 minutes and requiring no dye. The test is a measure of the amount of calcium nestled in the walls of your coronary arteries that feed your heart muscle. It reflects the total amount of atherosclerotic plaque that has built up and is an indicator of how all of your risk factors interact with each other to cause heart disease.

A study of 44,000 individuals free of known coronary heart disease underwent the non-invasive CT scan of the heart for coronary calcium scoring and were followed for a median of five years to determine if any of them died of any cause (this is “all-cause mortality”, a good marker since three-fourths of all deaths are related to atherosclerosis). Those with a Calcium Score exceeding 400, but no risk factors, had substantially higher death rates compared to individuals with three risk factors and the absence of coronary calcium. In other words, the Calcium Score was more predictive of heart attack or other cardiovascular issues causing death than the conventional risk factors for heart disease – such as high blood pressure, high cholesterol, family history, pre-diabetes and diabetes, smoking, being overweight, high triglycerides, and a sedentary lifestyle. 

Generally, all men over the age of 45, and most postmenopausal women would do well to have a heart scan to determine their Calcium Score, and especially if there are other risk factors involved. Most major medical centers do CT scans for coronary calcium and the cash cost ranges from $99-399. (In the Spring, Tx area, it’s ~$150)  It’s not covered by most insurance companies yet, and therefore is not yet considered ‘standard of care’.  For this reason, you’ll find that some doctors order this test routinely, while others don’t order it at all.  This test has been invaluable in my practice, especially since I know that cholesterol levels can be VERY misleading in regards to assessing your risk.

Ask your medical provider if a Calcium Score heart scan would be right for you.

Facebook Review from one of our patients whose decision to have a heart scan was life-changing:

“Living a healthy lifestyle; staying fit is my “modus operandi”. I’m not perfect, but I do eat right and avoid a sedentary lifestyle. I’ve been very active on the racquetball court for 35 years. Reason: Both my parents died early from Heart Disease.
A few weeks ago, my Functional Medicine MD, Mila McManus recommended I get a heart scan (due to my family history) to get a baseline calcium score. I paid the $140 for a heart scan and awaited the results.
To my surprise, my score was high. I saw my cardiologist and scheduled an Angiogram. Again, to my surprise, they found 100% blockage in one heart artery, and significant blockage in two others, I need heart bypass surgery.
I was shocked. I feel great, I have no symptoms, work hard, get plenty of exercise and did I mention: I FEEL GREAT!
But the images don’t lie. So, at 62, I’ll undergo bypass surgery next week.
I share this story for one reason only: Get yourself checked out! Even though you may have no symptoms and feel like you can take on the world, you could possibly be living with a serious heart event on your horizon, especially if you have Heart Disease in your family history.
Thank you Dr. McManus, you may have saved my life!”
By |2021-03-16T21:49:39-05:00March 17th, 2021|Articles, General|

Sacred Cow

An excellent documentary with a compelling message!

By Mila McManus, M.D.

In a well thought out documentary, Sacred Cow focuses on the great meat debate. The documentary explores the environmental and health impacts on humans, cattle, and the ecosystem when we commercially produce beef. It also explains and demonstrates the benefits of a healthy, sustainable, conscientious food system. The first part of the documentary is fairly graphic with animal handling, but it then moves into a beautiful and outstanding demonstration of the natural life cycle of all living things and their deep connectedness, guided by a noble and responsible way of resolving issues around raising and eating meat.

To learn more about the book and the movie, Go to .

By |2021-02-24T06:33:31-06:00March 3rd, 2021|Articles, General|

Food Gums: What matters is dosage.

by Nancy Mehlert MS

Food gums are plant sourced food additives used as thickening, stabilizing, and emulsifying agents. The most common gums are agar agar, arabic, locust bean, guar, acacia, gellan, xanthan, and carrageenan.   They are very common in dairy, nut milks, and non-dairy yogurt and cheese replacements, salad dressings, baked goods, and many gluten free foods. They do not provide any valuable nutrition.

Most people seem to be fine consuming gums, however if you have digestive issues, such as bloating, constipation, or diarrhea, you may want to closely examine how many foods you are consuming that have gums in them.  While a small amount in one food is generally recognized as safe and harmless, many people who count on pre-packaged and gluten free foods, as well as non-dairy dairy replacements, are actually consuming more than they realize. While all the gums are used in very small amounts, often times multiple gums will be used in one product, making the amount more than it seems.

Xanthan, carrageenan, and guar gums are polysaccharides, banned from the popular FODMOPS diet due to their impact on digestive issues. Guar gum feeds pesky bad bacteria in the gut and can cause significant bloating. Carrageenan gum is a possible source for monosodium glutamate (MSG), and has been known to cause stomach inflammation. It is currently being investigated more closely by the FDA.

To summarize, be aware of the sources of gums you are consuming, realizing that less is likely better, especially if you have a sensitive digestive system.


Dessey, Mira. The Pantry Principle; The Woodlands, Texas: Versadia Press, 2013., accessed on 1/23/21

By |2021-02-24T06:13:18-06:00February 24th, 2021|Articles, General, NANCY’S NUTRITIONAL NUGGET|

Product of the Month: Apollo

Apollo vibrations: Responding to today’s stressful world

Information provided here is from

Apollo applies low frequency, inaudible waves of vibration that are demonstrated in both the lab and the real world to change the balance of our nervous systems through our sense of touch. Apollo waves bring balance to the sympathetic and parasympathetic nervous system and improve heart rate variability (HRV), the most reliable, non-invasive biometric of stress. It can be worn on the wrist or ankle.

Apollo vibrations feel like waves coming and going.  This sensation feels natural because it is.  Apollo’s modes match a natural oscillation pattern between the heart and lungs when we breathe deeply, which consistently improves HRV.  Apollo has seven modes to support life’s activities:

  1. 1. Energy and Wake Up
  2. 2. Social and Open
  3. 3. Clear and Focused
  4. 4. Rebuild and Recover
  5. 5. Meditation and Mindfulness
  6. 6. Relax and Unwind
  7. 7. Sleep and Renew

When our bodies feel the rhythm of the Apollo vibrations, it is automatically recognized by the body as a soothing gentle touch, just like a friend giving you a hug on a bad day. 

Preliminary findings suggest that the specific vibration patterns used in the Apollo technology increase the ability to focus and remain calm during periods of stress and that these specific vibration patterns improve the body’s ability to recover and be resilient to stress, as measured by HRV. These improvements in HRV are accompanied by proportionate improvements in cognitive and physical performance under stress.  Subsequent university pilots and trials have shown that Apollo consistently improves HRV under stress within 2-3 minutes, improves athletic recovery, and supports access to meditative states. 

To learn more and/or purchase Apollo, click HERE.

By |2020-10-12T16:52:16-05:00October 13th, 2020|Articles, General|

Why Bioidentical Hormone Therapy?

By Mila McManus, M.D.

Bio-identical hormones are hormones that are near identical to the hormones our bodies produce.  This is in contrast to conventional hormone replacement therapy (a.k.a HRT) which uses synthetic hormone-like drugs, such as birth control pills and other synthetic hormones used to treat menopausal symptoms in women.  One might wonder why doctors would prescribe synthetic hormones when ‘real’ hormones are available.  The answer involves understanding patent laws.  Nobody can patent things that already occur naturally, so you can’t patent a palm tree, and drug companies can’t patent the structure of a real hormone.  Since drug companies are in the business of making money, they want to be able to protect their property with patents, so they created synthetic hormones which they could patent.  These are, unfortunately, the only hormones we learn to prescribe in medical school.

Some causes of hormone imbalance include stress, sleep deprivation, vitamin deficiencies, poor dietary habits, toxins, and side effects of various medications.  The list of symptoms of hormonal imbalance is long.  Some symptoms include fatigue, insomnia, depressed moods, decreased mental sharpness, anxiety, PMS, post-partum depression, decreased sex drive, unexplained weight gain and inability to lose weight, low  motivation, headaches, hot flashes, night sweats, and irregular menstruation.

Benefits of balancing and optimizing hormones with bio-identical hormones include improvement or resolution of the above symptoms, improvement in bone density, preservation of brain function, reduced risk for heart disease, and increased overall sense of wellbeing, to name a few.  Risks are minute compared to typical HRT with synthetic hormone-like drugs.  For instance, there is virtually no risk of blood clots with bio-identical progesterone, whereas synthetic progestins are well-known to heighten the risk.  It’s also noteworthy to say that the Women’s Health Initiative Study that revealed an increase in the incidence of breast cancer was based solely on the use of synthetic hormones.  Moreover, keep in mind that cancer is the result of a perfect storm of events, and hormones are a tiny piece of that puzzle.  Other factors that are linked to cancer that people tend to ignore are stress, sleep deprivation, poor dietary habits, vitamin and other nutrient deficiencies, and toxins.

A wonderful thing about bio-identical hormones is the ability to have them compounded into specific doses. For instance, one person may need 5mg twice daily of progesterone, while another may need 37.5mg twice daily.  We can order various doses in various forms, such as creams, pills, lozenges, injections, and pellets.  Doses are fine-tuned based on resolution of symptoms and other factors. This is not possible with most commercially-available options.

As has happened in the past, the FDA is again gearing up to issue a ban on compounded bioidentical hormone replacement therapy under the disguise of insufficient evidence of safety and effectiveness, when it is just one of the ways the FDA and the government bolster drug monopolies and undermine natural health options. Interestingly, it is the FDA-approved synthetic hormones that are known for common side effects including headaches, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, heart disease, stroke, and blood clots to the lungs. And there are numerous and severe side effects of synthetic hormones listed in the Physician’s Desk Reference.  

As a functional medicine physician, I would be very saddened to see compounded bioidentical hormones banned.  So please take 60 seconds to join the fight! Click this LINK to sign the petition.

On a final note, while not optimal or easily customized to patients’ individual needs, if bio-identical hormones are banned in the future, there will be some alternatives! There are a few bio-identical hormones that are commercially available, made possible by the drug companies patenting a delivery mechanism, for instance, such as a patch.

By |2020-10-13T06:28:33-05:00October 13th, 2020|Articles, General|

EMF Protection, Part 2

By Mila McManus, M.D.

Last month in our newsletter we wrote about the health crisis that is emerging as a result of electropollution and the magnitude of the 5G implementation around the world.  We provided an extensive list of steps to take in and around your home and workplace to protect your body from electromagnetic pollution.  If you missed it, click here to read it! While reducing exposure is the first and most important step, it is also important to take self-care measures to support your internal chemistry at the cellular level against EMF damage.

Without diving deep into biochemistry, what is important to understand is that the constant barrage of electromagnetic radiation in unusually patterned and high frequencies results in damage at the DNA level and increases oxidative stress. For the human body, this means many critical resources are depleted, preventing the immune system from being able to repair the damage and work effectively for you.  This is problematic for children who have thinner skulls and developing brains, as well as the aging, whose bodies are generally less effective with replenishment of nutrients simply by way of the aging process. Replacing these resources (e.g. vitamins, minerals, enzymes) is another critical piece to living healthfully for young and old alike.  Generally, the older (over 40) we are, the more aggressive our therapy needs to be.

Here are specific ways you can care for yourself and your family:

#1  Read last month’s article and determine to reduce the family’s exposure, especially during sleeping hours.  This gives the body time to repair and reset, away from EMF exposure.

#2  Practice time restricted eating (a.k.a intermittent fasting), limiting your consumption of food to a narrow window of time each day, ideally to a 6-8 hour window.  For example, eating meals only between 9am and 5pm, or  12pm to 6pm.  The alternating fasting period results in production of some of the essential nutrients required to support mitochondrial cleaning and repair at the DNA level. Also, having your last food at least three to four hours before going to bed protects depletion of critical enzymes for repair.

#3  Exercise in some way every day. The most effective options include high intensity exercise, aerobic, and resistance exercises.  When we exercise, the essential repair and signaling enzymes for our DNA are increased.

#4  Be sure your supplementation includes about 25 mg of niacin a day.  Niacin is a necessary precursor in the body for the production of the enzymes for DNA repair. One of the best studies suggests that inexpensive, non-time release niacin is preferred. It is often found in high quality B-Complex and Multi vitamins.  We offer both in our office.

#5  Once again, what we eat remains foundational to disease prevention, strong immunity, and protection from EMFs specifically. Fruits, vegetables, and other plant nutrients such as those found in spices, nuts, and seeds offer some of the most important nutrients for stimulating the action of the enzymes and co-enzymes that protect and correct our DNA.  Anytime we can get our nutrition from food over a supplement, we will be getting the natural, elemental vitamins and minerals needed for good health.  That is why choosing properly grown (i.e., organic, non-GMO, unrefined) minimally processed food is the most sensible first step to good health.  Some of the essential vitamins, minerals, and enzymes for DNA repair, which can be found mostly in plants, include magnesium, vitamin D, fisetin, resveratrol, epigallocatechin-3-gallate (EGCG), quercetin, isothiocyanates, terpenes, sulfur compounds, carotenoids, and fatty acids. For a specific list of some of the best sources, click here .

#6  Detoxification is an especially important step for staying healthy and providing protection from EMFs.  It involves removing as many toxicants as possible from our diets, environments, and lifestyles while always staying focused on promoting and supporting the body’s detoxification pathways.  One of the most effective ways is through the use of far or near infrared saunas.  Here is an article about detoxification and how to go about it. 

We believe it is important for everyone to begin to take intentional and consistent steps toward protecting yourself against the increasing impacts of EMFs to the human body, especially with the advent of 5G technologies. 


[1] Primary resource for this article is from

Mercola, Joseph. EMF*D -5G, Wi-Fi & Cell Phones: Hidden Harms and How to Protect Yourself. New York: Hay House, Inc. 2020



By |2020-08-07T12:17:33-05:00August 8th, 2020|Articles, General|
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