Iron 301 – Treatment of Iron Deficiency or Overload

(Third in a three-part series)

by Mila McManus, MD

*** If you missed the previous articles, click here for part 1 and here for part 2.

In Functional Medicine we take an individual and multi-faceted approach to resolving iron deficiency. First, we search for the root causes of the deficiency which may include examining the diet, current female status regarding pregnancy, breast feeding, and menstrual cycle, medical history, possible lab work, and determination of whether there may be internal sources of bleeding.

Iron deficiency treatment includes some combination of supplemental or IV iron, dietary and lifestyle adjustments, and addressing gut health issues that may be affecting absorption of dietary iron. Mitigating and correcting other medical issues regarding menstrual cycles, liver or kidney function may also be included.

Supplemental iron is not ideal for everyone. Iron supplements can cause nausea, constipation, stomach aches, and/or diarrhea. Additionally, supplement quality is an important factor to consider. Supplements are NOT all created equal. An iron IV is a possible solution with much fewer side effects, and they are offered here at The Woodlands Institute for Health and Wellness. Click on: Iron Sources and Ideas for a guide to dietary tips to maximize iron absorption.

Something else to consider is that a copper or vitamin A (Retinol) deficiency may contribute to iron deficiency, and supplementing with these correctly, could be the treatment of choice!

Hemochromatosis, both primary and secondary, where there is too much iron in the blood, is normally handled by removing blood from the body through a process called phlebotomy, or bloodletting. Another possible avenue is chelation therapy using an iron binding medication so that extra iron can be carried out of the body through the bowels and urine.

[1] https://www.medicalnewstoday.com/articles/166455#causes

[1] Winters, N. & Kelley, J. (2017). The metabolic approach to cancer: Integrating deep nutrition, the Ketogenic diet, and nontoxic bio-individualized therapies. Chelsea Green.

[1] https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443

[1] https://www.medicalnewstoday.com/articles/166455#causes

[1] https://my.clevelandclinic.org/health/diseases/22824-iron-deficiency-anemia

[1] https://www.medicalnewstoday.com/articles/166455#causes

[1] mercola.com September 2022 article on iron

By Mila McManus MD|2022-09-12T15:06:59-06:00September 14th, 2022|General|

Iron Part Two – Causes of Too Little or Too Much

(Second in a three-part series)

by Mila McManus, MD

***If you missed Part One, click here.

Iron deficiency is quite common and can be caused by many factors[i]. Common causes include gastrointestinal bleeding (e.g., due to long-term use of NSAIDS or aspirin, ulcers, polyps, and colon cancer), urinary tract bleeding, blood loss from injury or surgery, heavy menstrual periods, and frequent blood donation or blood tests. Deficiency can also be caused by both inadequate supplies in the diet as well as conditions that limit the amount of iron absorbed by the body.

Almost anyone can develop an iron deficiency, though it is most common in menstruating women, pregnant and breast feeding women, and infants and children ages 6 months to 2 years who don’t get adequate dietary iron from mother’s breast milk or cow’s milk. Vegans or vegetarians can easily become iron deficient as well. Teenage growth spurts are another potential risk factor for iron deficiency.

As we mentioned in Part One of this three part series on iron, excess iron levels, though rare, are usually caused by a hereditary disease called hemochromatosis. Too much iron is absorbed by the body and stored in organs, most often the liver, heart, or pancreas, and capable of causing life-threatening conditions such as liver disease, heart problems, and diabetes. As you may recall from part one, once iron is in the blood stream, the body does not have the ability to excrete it.

There are, however, causes of excess iron that are not genetic[ii] and these are called secondary hemochromatosis. Chronic liver disease such as hepatitis C infection, or alcohol related liver disease could cause excess iron storage as could blood transfusions, taking oral iron pills, having iron infusions, or long-term kidney dialysis.

Next week we will conclude this three part series on iron by providing solutions for addressing too little or too much iron.

[i] https://my.clevelandclinic.org/health/diseases/22824-iron-deficiency-anemia

[ii] https://www.medicalnewstoday.com/articles/166455#causes

By Mila McManus MD|2022-09-06T08:26:24-06:00September 7th, 2022|General|

Iron 101 – Too Little or Too Much

(First in a three part series)

by Mila McManus, MD

Our body requires iron to make blood. About 70% of the iron in our body is located in red blood cells where it forms hemoglobin. We must have sufficient stores of it in order to make new red blood cells, and also replicate DNA for cellular repair. The intestinal tract is designed to take in needed iron supplies from the food we eat, and to block absorption when supplies are adequate. The body is not able to excrete excess iron once it is absorbed into the bloodstream[i].

Iron deficiency is quite common and can cause fatigue, anemia, shortness of breath, hair loss, and light-headedness. When these levels are low, oxygen delivery to cells and tissues is compromised. In regard to cancer, iron deficiency can increase the invasiveness and metastatic potential for growth rather than apoptosis, or death[ii].

While uncommon, some individuals have excess iron, a hereditary condition called hemochromatosis[iii]. There are, however, causes of excess iron that are not genetic[iv] and these are called secondary hemochromatosis. Detection of excess iron can be difficult, and symptoms usually develop over time. Most patients will have no symptoms. As overload progresses, symptoms include fatigue, joint pain, abdominal pain, bronze skin color, weakness, weight loss, low sex drive, and will eventually affect the liver, pancreas, thyroid, and/or heart.

It is important to have your levels checked periodically, and have abnormalities addressed when applicable. Call our office at 281-298-6742 to schedule an appointment.

Next week we will take a look at what causes these levels to be too low or too high.

And the following week, for Part 3, we’ll discuss treatment options for overload and deficiency.

[i] https://www.medicalnewstoday.com/articles/166455#causes

[ii] Winters, N. & Kelley, J. (2017). The metabolic approach to cancer: Integrating deep nutrition, the Ketogenic diet, and nontoxic bio-individualized therapies. Chelsea Green.

[iii] https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20351443

[iv] https://www.medicalnewstoday.com/articles/166455#causes

By Mila McManus MD|2022-11-01T10:08:53-06:00August 31st, 2022|General|

Vaping? – Want to Quit?

by T.R.

“I had been vaping 2 pods a day for seven years and ONDAMED helped me quit in two days. I had tried quitting cold turkey twice before and failed. I would highly recommend ONDAMED for anyone who is wanting to stop vaping. I am now 10 weeks clean and have not felt this healthy in years.”

Call our office at 281.298.6742 to see how ONDAMED can help you quit:

Smoking and/or Vaping
Alcohol
Drugs
Sugar
Other cravings or addictions

By Mila McManus MD|2022-11-01T10:16:33-06:00August 18th, 2022|General, Testimonials|

The Doctor’s Favorite Books

by Mila McManus, MD

I think these books are worthwhile reads for anyone seeking optimal health for themselves and family members.

From a Functional Medicine perspective, you will find many of the core concepts and ideas about health and wellness nestled into the following great books. I have routinely recommended these books to people over the last several years. We may not necessarily agree with absolutely every word, or suggest everything for every person, but I think these books are worthwhile reads for anyone seeking answers, treatment options, and/or optimal health for themselves and their loved ones.

The Healing Code by Alexander Lloyd, PhD., ND.
Why Isn’t My Brain Working? by Dr. Datis Kharrazian
The End of Alzheimer’s by Dale Bredesen, MD.
The Metabolic Approach to Cancer by Dr. Nasha Winters
Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride MD
Brain Maker: The Power of Gut Microbes to Heal and Protect the Brain by David Perlmutter, MD.

Enjoy!

By Mila McManus MD|2022-11-01T10:18:41-06:00August 10th, 2022|General|

Easy Avocado Hummus

by Nancy Weyrauch Mehlert, MS

Easy Avocado Hummus – This is a very simple, quick and delightful change up, especially for the bean or seed sensitive!

1 Avocado

¾ cup chickpeas (canned)

2 Tablespoons extra-virgin olive oil

1 tsp lemon zest

2 Tablespoons fresh lemon juice

½ teaspoon Himalayan or Real Salt

Blend all the ingredients in a small food processor until smooth. Enjoy with bean chips or fresh veggies.

By Mila McManus MD|2022-11-01T11:03:21-06:00July 27th, 2022|General, Recipes|

Salt Selection Matters

By Nancy Mehlert, MS

Salt is a flavor most of us really enjoy. Salt is life-giving. Every cell in your body relies on it for regulation of body fluids, bone density, blood sugar stabilization, good circulation and muscle and nerve function.

Naturally occurring salt is 40% sodium and 60% chloride. The chemical formula is NaCl. Sodium and chloride are both essential electrolytes your body requires. Sodium balance in the body is complex and impacted by magnesium, calcium, and potassium. If you change the level of one electrolyte, such as sodium, you are impacting the others. Balance is essential to your overall health. Most table salts and sodium in processed food do NOT contain the good stuff, but rather a manufactured salt which negatively impacts the delicate balance of electrolytes in the body.

Here’s the dirt on most common table salts:

Most table salt today is heated and cooked at 1200°F. At this extremely high temperature, the salt loses more than eighty important alkaline elements that occur naturally in it, including natural iodine, leaving just pure sodium chloride. Then it is chemically bleached to make it white.
Other chemicals often added in table salt including manufactured forms of fluoride, anti-caking agents and toxic amounts of potassium iodide and aluminum derivates, as well as white sugar and mono-sodium-glutamate (MSG). This is what you find in processed food and table salt.
As a result, sometimes table salt can be literally toxic to the human body.
It is found in virtually every processed and fast food in the marketplace today. Typically, bread, fast food, and frozen meals have the largest quantities.

Processed table salt wreaks havoc in the human body, especially over time. Here’s how:

Causes a rapid rise in blood pressure as the body attempts to move the toxic elements away from the heart.
Causes fluid retention and is hard on the circulatory, nervous, and lymph system.
Chronic imbalances contribute to and/or worsen diabetes, gout, and obesity.
Additives in salt can cause major kidney, thyroid, and liver problems, goiter, hypertension, heart disease, strained elimination systems, muscle cramps, edema, stroke, heart failure, PMS, and major nervous system disorders such as anxiety and depression.
It is highly addictive as the chemical additives are designed to stimulate pleasure centers of the brain, in the same way sugar does this.

So, what’s your best option? Usually, normal use of high-quality table salt along with a whole food diet will not invite issues with blood pressure, water retention, or cardiovascular disease. However, surprisingly, sea salt may not be the answer. As a result of plastics polluting the oceans, sea salt has been found to contain microplastic particles. This leaves the optimal choice to be Himalayan salt, which is mined from salt beds created long before plastic and other toxic chemicals were manufactured. Himalayan salt contains at least 80 naturally occurring trace elements which are beneficial to our health.

Be cautious when you make your purchase as there are cheap knock offs. Two brands that appear to be authentic and pure are Evolution Salt Company (harvested in the Himalayas), and Redmond’s Real Salt (sea salt harvested from a pristine ancient sea near Redmond, Utah). Most people need about 1.5 teaspoons, or 3500mg of sodium a day. Quality salt along with vegetables, fruits, nuts, seeds, will provide a balance of electrolytes and essential minerals for the day.

Resources:

Group, Edward., (2017). The Health Dangers of Table Salt. Global Healing Center. https://www.globalhealingcenter.com/natural-health/dangers-of-salt/

Mercola, Joseph., (2018). Ninety Percent of Sea Salt Contains Plastic. https://articles.mercola.com/sites/articles/archive/2018/10/31/sea-salt-plastic.aspx

Mercola, Joseph., (2022). Do You Know the Difference Between Salt and Sodium?

https://takecontrol.substack.com/p/salt-and-sodium?s=r

www.realsalt.com/Ingredients

By Mila McManus MD|2022-10-26T14:06:47-06:00July 21st, 2022|General, NANCY’S NUTRITIONAL NUGGET|

Inflammation: Fighting the Elephant in the Room

By Mila McManus, MD

Inflammation[1] lies at the root of most disease pathways, pain, and other symptoms. Reducing inflammation is mission critical to feeling better and avoiding many lifestyle diseases of our day.

The biggest contributor to inflammation is your diet![2] All foods fall on a sliding scale from wonderfully anti-inflammatory to painfully inflammatory. While the goal is to eat a balanced diet, some of which will be slightly inflammatory, most of what we eat should focus on anti-inflammatory and neutral foods.

Ranked for their extraordinarily powerful anti-inflammatory effects, nutrient density, antioxidant-richness, detoxifying ability, and gut-health promoting effects, here are the top 15 of the most anti-inflammatory foods.[3]

First – Berries – Blueberries, Strawberries, Blackberries, and Raspberries

Second – Tomatoes

Third – Mushrooms

Fourth – Broccoli

Fifth – Bell Peppers

Sixth – Sweet Potatoes

Seventh – Onions

Eighth – Apples, Cherries, Oranges

Ninth- Avocado

Tenth – Dark Leafy Greens (the best are collards and spinach, but anything dark green is great)

Eleventh – Black Beans

Twelfth – Lentils

Thirteenth – Chickpeas

Fourteenth – Gluten Free Oats, Millet, Buckwheat

Fifteenth – Macadamia Nuts, Walnuts, Pecans, Almonds, Brazil Nuts, Hemp, and Pumpkin Seeds

Seventy five to eight five percent of our diet is best chosen from the anti-inflammatory and neutral categories. While some meats, dairy, eggs, and alcohol are generally inflammatory, eaten in moderation with anti-inflammatory choices provides a well-balanced, healthy diet.

Need more help? Call our office to schedule an appointment with our nutritionist, Nancy Mehlert, MS.

[1] Inflammation displays in the body as anything that is painful, swollen, red, raw, bloody, or irritated. It applies to all aches and pains, digestive discomfort, painful joints, headaches, skin irritations and rashes, mucous membranes that are chronically producing mucus in the stool or nasal passages.

[2] On the scale, nothing is worse than deep fried combinations of wheat flour, damaged oil, and sugar. This translates directly into donuts and French fries. All fast food falls to this extreme because of the sugar, gluten, and trans-fatty acids in them. Also included in the extremely inflammatory list are candy, cookies, ice cream, and sugary beverages. And lastly, most people are unaware that bread is one of the most highly processed fake foods.

[3] Goodness Lover Pty Ltd. The Inflammation Solution: Top 29 gut Healing & Inflammation – Fighting Foods, 2022.

By Mila McManus MD|2022-07-12T07:39:47-06:00July 13th, 2022|Articles, General|

Our Love-Hate Relationship With Gluten

by Mila McManus, MD

There was a time in history when this conversation was unnecessary, and wheat (our primary source of gluten) would have been included in a healthy diet. Why all the ruckus about gluten[1] now?

The wheat we eat today is not what we ate even fifty years ago. Today, conventionally produced wheat crops undergo super-hybridization as well as chemical and radiological mutations so that it is highly resistant to pesticides. Another way to say it is to describe wheat as a man-made fake food. Wheat is also treated with noxious chemicals twice, including just before harvesting. As a result, when we eat wheat, we are consuming these poisons in every bite. Additionally, processing techniques used in the United States and Australia also increase the gluten content, especially in wheat, making it even more difficult to digest.

What happens when we eat wheat or other glutinous foods?[2] Even people who do not have a sensitivity[3] to gluten may have a temporary leaky gut and increased inflammation after consuming it.

In the gut during digestion, gluten:

First: Activates zonulin, a protein that regulates the tight junctions of the small intestine.

Second: When zonulin is released, the tight junctions open slightly, allowing larger particles of food, including gluten, to pass through the intestinal wall and into the bloodstream.

Third: The body releases anti-inflammatory cytokines to help heal the leaky gut situation. Chronic consumption of gluten makes healing extremely difficult.

Fourth: In the meantime, the immune system, specifically a number of immunoglobulins (e.g. IgG, IgA), move in to attack the larger food particles which are recognized as foe, rather than friend, since they are not broken down properly during digestion. (food sensitivities result, as does inflammation and congestion caused by them).

Specifically, the permeability of the gut barrier and an imbalance of microbiome is a primary trigger of the inflammatory process in the human body.

The truth about gluten is one of our least and most favorite messages to share with our patients. It is a love-hate topic. Hate, because glutenous foods are all around us and they are some of the most popular, well-loved foods in the world from bread and pastries to hamburger buns and pizza. Love, because we witness over, and over, and over again, the dramatic improvement in gut health and overall health, and weight when it is removed from the diet.

We love you too much to not tell you what you hate to hear. Eat well, Be well.

You can learn more about this topic by reading this article we published in 2017 about gluten:

Ghostly Gluten – You May Think You Know, But We Bet You Don’t

[1] Gluten is a protein found in specific grains including wheat and its many derivatives, rye, barley, malt, and brewer’s yeast. An excellent resource for sources is found here:

[2] Goodness Lover Pty Ltd. The Inflammation Solution: Top 29 Gut Healing & Inflammation-fighting Foods.2022.

[3] About 2 million people in the US and 1% of the global population have been diagnosed with celiac disease, the most extreme gluten sensitivity. An estimated 20% of the population has a non-celiac gluten sensitivity. We find most people feel significantly better and experience greater health by avoiding it.

By Mila McManus MD|2022-07-06T13:02:21-06:00July 7th, 2022|General|

Stop Cooking with Olive Oil

by Mila McManus, MD

When you use a good quality olive oil for cooking, it’s not doing for you nutritionally what you expected it to do. While it has been determined that olive oil is more stable with heat than originally thought, the fact remains that the longer it’s exposed to heat, and the higher the heat, it will be damaged and make the oil toxic to your body.

So, when roasting your olive oil coated vegetables in a 350°+ oven, the olive oil will be molecularly damaged. You thought it was healthy, but really it’s not. Rather, you have made an unusable anti-nutrient for your body. Your body will respond with inflammation and congestion. The same is likely true for avocado oil.

Keep in mind that the higher the heat, and the more prolonged the heating, the faster the degradation of the molecular structure. It may be alright to gently, patiently, slowly sauté something on low to medium low on the stovetop for less than 15 minutes, and successfully avoid damaging the oil. Patient and slow are not common methods for most of us in the kitchen these days. Besides, why cook in olive oil when there are so many better options that also enhance the flavor of our food?

Here are some tips: First, it’s fine to apply olive oil after cooking is complete where this makes sense. Olive oil is good when used for cold preparation in salad dressings and hummus, for example. Second, in terms of roasting vegetables, try putting the roasting pan with butter in the oven while preheating and cleaning your vegetables. Then remove it from the oven, put your vegetables in the hot melted butter and toss them until coated. This works well with any saturated fat (e.g. coconut oil, ghee, lard) and is just as fast as olive oil when you consider the wait time for the oven to preheat anyway.

There are many heat stable saturated fats with which to cook. Normally, at room temperature, these will be more solid, though that may fluctuate with the temperature in your house. Examples include pasture raised butter or ghee, duck, beef, pork fat, and coconut oil. Check out epicprovisions.com for good options. Reserve bacon fat from uncured bacon for cooking. When using the highest heats such as broiling or on the grill, consider ghee to be the most stable. One excellent brand is 4^th & Heart (fourthandheart.com) and they offer various flavors. Ghee is normally found on the olive oil aisle of the grocery store, not in the diary section. It is normally soft enough to use a silicone brush to coat a pan, or spread on vegetables or fish, for example.

Take caution when you purchase olive oil. Most olive oils are tarnished and impure, as well as counterfeit, having other added oils such as soybean, grapeseed, or canola oil. Many have been discovered to have toxic chemicals too. Here are tips for purchasing quality olive oil:

The more information provided on the label, the better.
A harvest date no more than one year old.
Know that there is no regulatory significance of terms like “first cold pressed, or “extra virgin”, so don’t let that lead you.
Look for third party certifications that promise higher standards such as “COOC Certified Extra Virgin”( California Olive Oil Council) or EVA (the Extra Virgin Alliance) and “100% Qualita Italiana”, by UNAPROL, the association of actual Italian olive growers. Interestingly, little stock is put in a USDA organic certification!
Chile, Australia, followed by the US, have better practices and stricter standards in general according to the U.S. International Trade Commission report on the quality of extra-virgin olive oil. These may be the best “go to” sources of origin when in doubt.
Newer oils are always better. Be sure to buy small quantities (a six week supply) as it is highly perishable. It should not be exposed to heat or light and is best stored in a cool, dark cabinet. Tins do the best job of blocking the light, followed by an opaque glass bottle. Oxygen is also an enemy of olive oil so once opened, the oil quality is going downhill quickly.

Reduce inflammation and increase nutrition by using oils correctly. Eat Well. Be Well.

¹ Real Food/Fake Food by Larry Olmsted, Algonquin Books of Chapel Hill, 2016.

By Mila McManus MD|2022-06-22T09:52:02-06:00June 23rd, 2022|General|